We totally agree that there is a need for long-term solutions

Department of Health

"This winter will be a real struggle due to depleted resources - but we will work furiously to provide the best care we can."

Last year's flu outbreak last year led to many patients suffering potentially life-threatening lung complications such as bronchitis.

A shortage of trained respiratory consultants and nurses was the key reason behind the struggle, said Professor Geddes.

Extra consultants

A similar outbreak this time around could push the NHS "over the precipice" and leave seriously ill patients facing inadequate standards of care.

At least 600 extra respiratory consultants are needed by the year 2010, according to the British Thoracic Society, along with another 1,500 trained respiratory nurses.

The society said that too few doctors were even now undergoing training to become respiratory consultants, and that at this rate the NHS would be a third short of the required numbers by 2005.

So far, there have been few flu cases

A spokesman for the Department of Health insisted that an unprecedented level of planning had taken place in the NHS to prepare for this winter.

He said: "We totally agree that there is a need for long-term solutions, and that is why the NHS Plan clearly set out the weaknesses in the current system and what we think needs to be done to bring about long-term reform.

"This includes expansion in doctor numbers in all specialties and we look forward to talking to the British Thoracic Society about this."

Extra money

He said that extra cash dedicated to winter preparations, alongside the new agreement to use spare capacity in private hospitals, would help reduce the pressure on the NHS.

Lung specialists deal with a variety of conditions and say they are under pressure because of the rising number of patients with serious lung problems admitted to hospital as an emergency.

The good news so far this year is that, compared to last year, there is relatively little flu about.

Experts now expect the bulk of the flu cases to start emerging during January.