The fear in the Department of Health over swine flu is palpable.
Its leadership is worried that primary care trusts have become complacent. The modest numbers infected so far and the mildness of the symptoms have provided false assurance that we have been spared a major and deadly outbreak.
The propaganda from ministers and experts has exacerbated the problem. The soothing refrain is that Britain is better prepared than any other country in the world.
Britain has amassed huge stockpiles of antiviral drugs, and PCTs have been drafting plans to co-ordinate action with hospitals, councils, strategic health authorities and businesses.
But the DH fears many of these plans will fall apart in the face of a renewed and more virulent onslaught in the autumn. Last week, behind closed doors at a hastily arranged meeting hours before the World Health Organisation declared a pandemic, flu czar Ian Dalton ordered PCTs to test their plans to destruction.
Some PCTs will get it right, others will be lucky. Those who get it wrong and are unlucky will be exposed to the full force of public anger. The exemplary performance of the best PCTs will be used as a stick with which to beat the worst.
Local managers should be in no doubt about what they will endure if they fail. After five years of preparation, millions of pounds of investment, months of warning over swine flu and endless declarations that the country is ready, the public and local and national media will lynch you.
The political climate has rarely been more hostile to public servants, and NHS managers are always seen as a legitimate target. If you are deemed to be responsible for avoidable deaths they will dissect your pay packet, dissect your organisation and dissect you.
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