Examination of Witnesses (Questions 100
- 119)
WEDNESDAY 24 FEBRUARY 1999
PROFESSOR T H PENNINGTON
100. Not necessarily applying heat?
(Professor Pennington) No.
101. And do you have any views about increasing
the number of problems which are notifiable, diseases which are
notifiable? The Minister did indicate that they had in mind to
do this. Do you think that would be a fruitful, early extension
that the Food Standards Agency could pursue?
(Professor Pennington) Yes. I have been keen for
a long time, but I am speaking as a microbiologist, remember,
that data that is generated by microbiological laboratories should
be in a sense notifiable. At the moment the data that is collected
is essentially sent on to those who collate the data in a voluntary
way. There are problems with the notification system as it exists
at the moment done by clinicians because very often that data
is based on clinical diagnosis rather than laboratory diagnosis
and I would regard that as softer data. I think if we had the
statutory reporting of laboratory-recorded data, I think we could
be more certain that the statistics that we work from are good
statistics.
102. So it is what is meant by notification
as well as extra notification in the sense of more problems?
(Professor Pennington) Yes.
103. You mentioned that you think that this
Agency can work if you get the right people running it. Would
you like to elaborate on how you think that could be brought about?
Particularly I have in mind clause 2 which outlines the sorts
of people who should be composing the Agency, the not less than
ten and not more than 14 members. Were you thinking partly of
them or only of the chief executive and so on?
(Professor Pennington) I was thinking of both.
I think there are two issues here. One is clearly I would think
the Agency would have a much greater chance of success if it was
vigorous and proactive and aggressive from time to time in following
up problems. That is not to say that existing authorities have
not done that, but clearly the Food Standards Agency will have
to do that if it is going to be successful. On the other hand,
it will be staffed largely by existing civil servants and so on
and there has been talk of the need for a culture change and so
on in some of those. I do not want to get into that in any great
detail, but clearly it will be a slightly different kind of body
and the openness, I think, will contrast perhaps with some of
the traditional ways of working, for example, and make it more
difficult in some ways too.
104. Do you welcome the notions of openness
which were very strongly emphasised to us this morning by Ministers?
Do you welcome that? Do you think it would be helpful? Do you
think that there might be clashes around the issue of commercial
confidentiality? How do you think that should be solved?
(Professor Pennington) Well, I welcome the openness.
I do not think it will work without being as open as is reasonably
possible. Commercial confidentiality is always an issue and my
familiarity with it is, for example, when the laboratory data
is generated, that really should go at least into the semi-public
domain so that the experts know what is wrong with a situation,
but the firm may not want that to happen, so I think one has to
strike a bargain there as to what sort of data one wants to be
in the public domain in terms of, say, the level of infection
and the damage that might do to a commercial concern. I do not
think there is a hard-and-fast way of handling that. I think there
is a way of negotiating through that problem to get the sort of
data that one needs for public health purposes.
105. Do you think that the provisions in
the draft Bill are sufficient to achieve the degree of openness
that is needed?
(Professor Pennington) As far as I can tell, yes,
I think they are.
Mr Curry
106. Can I just ask a supplementary on the
right people. Do you believe that the right people would be, as
it were, twelve men or women, good men and true, in other words,
people who have got common sense, a bit of experience, know their
way around the world, but are not necessarily experts, or would
you think that the commissioners, or whatever they are eventually
called, ought to be people who represent parts of industry? In
other words, should they be people who are sensible, sane people
who can command the expertise or should they themselves have that
individually at their command?
(Professor Pennington) I do not think that they
should be representing a particular interest. Clearly to get credibility,
they will have to have expertise, but they do not necessarily
have to be experts, if you see what I mean. They certainly will
have to be people with bags of common sense.
107. Common sense is what comes first, is
it?
(Professor Pennington) Yes, I think so, and the
ability for the majority of them to get to the heart of the scientific
problem without necessarily knowing the details of the science.
Mr Moonie
108. Professor Pennington, one of the things
that struck us today was the multiplicity of organisations involved
in this field, and the FSA will produce some rationalisation.
Do you think there is scope for further rationalisation of management
structures now that we have another organisation? In other words,
should its managerial remit, if you like, be extended?
(Professor Pennington) I am reasonably happy with
the level that has been proposed in fact in terms of, for example,
its relationship to enforcers. I think that is about the right
sort of balance where it is essentially monitoring what goes on
and raising standards, but not actually doing a lot of enforcement
itself. I am happy about that and the way that the mechanism has
been proposed, for example.
109. Do you think then as presently constituted
that the Food Standards Agency might have prevented a large outbreak
such as that in Lanarkshire?
(Professor Pennington) If it had been running
for a while, yes. With the E.coli test, would it help to
solve that problem? I think if it was working as it is hoped that
it will work, it might well have prevented that particular outbreak,
yes.
110. Could I switch tack slightly and looking
at zoonoses, there has been a marked switch in the pattern of
cases last year of Salmonella and Campylobacter.
Do you think there is room here again for extending the role of
the Agency or would you like to see it in terms of further research
in this area?
(Professor Pennington) Yes, I think the practical
issue here is that we do not understand what is going on with
Campylobacter. Essentially it is out of control and it
has gone up 15 or 16 per cent in the last year, whereas at least
we are within sight of getting a real grip on Salmonella,
and the E.coli cases did fall very substantially in Scotland
last year, so in a sense the last two of those are a present to
the FSA in that if those statistics can be rolled on, they can
take the credit for that and that would be a good start. Campylobacter
is entirely a different problem and clearly there is a need, I
think, to spend more on research to find out what the actual problem
is, where this organism is coming from and I would think that
is all well within the remit of the FSA as laid out for it to
commission research on that particular problem. It may turn out
that a good bit of the Campylobacter that we are suffering
from is not actually food-borne, that there may be other sources
of it, but I do not think that is a problem that the FSA should
get hung up on.
Dr Stoate
111. I would like just to go back to something
you said earlier about notification and you were saying that you
thought that notification ought to be associated with microbiological
diagnosis through a lab, but surely that is not the way things
work in this country and, speaking as someone who has been a GP
for a long time, food poisoning is almost never diagnosed microbiologically,
but GPs diagnose food poisoning several times a week, if not more
frequently, and if you sent it all off to the lab, surely that
would be very difficult.
(Professor Pennington) No, I would not be saying
that every sample of diarrhoea should have a laboratory test performed
on it. At the end of the day one has to have an element of judgment
in what is required for the management of the patient and one
has to use one's resources in an appropriate manner and doing
a vast number of laboratory tests just to get the data is not
a very profitable way of spending money. On the other hand, there
is a study about to be reported, I understand, the IID study for
England and Wales, which will give us a multiplier factor where
we can take the laboratory data that we have at the moment—we
know it is a gross underestimate of what is actually happening
out there—and this study, we will be able to use it for
a few years yet to say, "Yes, for every sample that the laboratory
picks up of, say, Campylobacter, there will be another
ten human cases that go unreported or undiagnosed by laboratory
tests", so I am quite relaxed about the fact that the laboratory
data itself will be incomplete and it will just be a sample of
what is happening out there. It annoys me when I know that people
are doing laboratory tests and getting positive results and nobody
is finding out about it. That data is not being publicly recorded
and I think that is a waste of public resource.
112. Can I just change tack slightly. I
want to talk about the boundary issues of Governments. What I
want to know is the liaisons between the different functions of
MAFF— pesticides, veterinary medicines, etc.—do you
think those will be strengthened by the new structure or not?
(Professor Pennington) I think they could be,
if there again there was the right dynamic and the right bodies
that were liaising between each other. I was concerned about the
veterinary medicine side, for example, but that was pretty well
left—obviously with additional mechanisms—to MAFF
to sort that out. I have a particular bee in my bonnet about antibiotic
resistance which I see as a major health problem and one that
we really need to get a very, very firm control on. I am not pointing
the finger at any particular group of practitioners—whether
they are vets or medics or the patients pressing for the antibiotics—but
there is an overuse of antibiotics in my view which is leading
to this particular problem being made much worse. I saw the FSA
as being a very powerful mechanism for getting a grip on the use
of antibiotics, say for example in growth promotion where there
is a greater weight of antibiotic being used for that than for
the treatment of disease and I think that is a scandal myself.
There are alternatives and one would not be proposing that everything
should be stopped immediately. That is an issue I think which
typifies the boundary problems that we have. It does come into
food issues at the end of the day but it is also relevant to the
prime interest of Ministry of Agriculture, the use of veterinary
products. Myself, I would have been happier if the FSA had a stronger
role than the one that has been proposed.
113. What you are saying reassures me to
some extent but also leaves me feeling quite uneasy and that is
because what we continually come back to is with luck, if the
right practices are in place, if it works as it is supposed to
work then, yes, we will achieve what we are hoping it will achieve.
That is precisely what this Committee is constituted to look at.
(Professor Pennington) Yes.
114. We keep leaving that door open, the
"if, if, if". Okay if the right people are in there,
what if they are not? Are the structures right in the Bill because
that is what we must concern ourselves with? Will the powers be
there, will the enforcement powers be there, will the monitoring
powers be there to ensure it happens? I do not want in five years'
time to see another major food scare simply because it did not
quite work as we wanted it to work. That will not do.
(Professor Pennington) Yes.
115. I want to ensure that the regulations
and the powers and the enforcement and the monitoring are such
that it is very much less likely to happen again, if at all. I
really want to see that because otherwise we will not get the
public confidence that we need on food safety because after all
it is about public confidence, it is about assuring the public
and reassuring them that the food they eat is safe, sound and
secure. I do not want to keep hearing "if, if, if".
What can we do to ensure the structures are right so that it is
much more watertight than that?
(Professor Pennington) My view is that I think
Phillip James had it right in his Green Paper on the veterinary
products side. From my perspective, from the antibiotic perspective,
I felt that was a very good move because the FSA, as a new body
coming in with this openness and so on, would be in a better position
to sort this problem out than all the bodies up to now which have
not sorted it out particularly well, I will have to be frank about
that. We have a major problem with antibiotic resistance, a lot
of people have spent a lot of time doing things about it which
do not seem to have very much effect. It is embarrassing to me
as a medic that many of my colleagues dish these out like smarties.
That is an exaggeration, but there is a major problem there and
I think we need stronger structures to sort that problem out.
Dr Moonie
116. Can I rephrase that question slightly.
What do you see as the main weaknesses in the present structure
as proposed?
(Professor Pennington) If I can come back to these
boundary issues, this is one that I have just been discussing.
I mentioned zoonoses where I would like to see the FSA having
a role right back to the cow's gut as it were in terms of sorting
out zoonoses. Even if zoonoses are an animal health problem as
well as a human health problem most of the animals that we worry
about from the zoonotic point of view are animals that people
will eat. Even if it is an animal health problem indirectly it
is a human health problem. That is an issue which I feel quite
strongly about. Again, as a microbiologist I have been able to
work on veterinary problems and human problems being an academic
without worrying about boundaries, and I can see the importance
of having that kind of approach where you do not make a boundary
just because it is MAFF or FSA, try and move the boundary so it
disappears altogether in terms of zoonoses.
Mrs Organ
117. You said at the beginning with a bit
of luck if we do not have a food scare in the early months then
we are well away and in answer to Lewis's question you felt that
in relation to the E.coli breakout in Scotland, if we had
had the FSA set up it would have helped solve the problem. Can
I just ask if you think that maybe there should be a benchmarking
for the number of food scares we get in the next five years or
are we actually trying to achieve the impossible, we are trying
to measure the success of the FSA against something that is totally
impossible because we are trying to produce food in a dirty world?
(Professor Pennington) There is something in what
you say but I think, say for Salmonella, we should be aiming
to do what, for example, the Scandinavians have done and get Salmonella
levels in animals down to very, very low figures indeed, virtually
zero for all practical purposes, and reduce the human infections
with Salmonella very substantially. There is no rocket
science needed there, it is clear what has to be done. It will
take time and it is being done in this country, the figures are
coming down and I think everybody involved can be quite pleased
that things are going well. Contrast that with Campylobacter
where the problem is there but, however, you can rest assured
that you will not get food scare issues with Campylobacter
because it hardly ever causes outbreaks. It does not cause the
kind of media frenzy type of situation just by the nature of the
way it infects people. On E.coli I think the figures may
have come down in terms of the number of human cases very substantially
but I do not think that means at all that there is not going to
be an outbreak. I think it is right that the FSA should set itself
quite hard targets on things that it knows it can achieve by existing
methods. I think for Salmonella it would be very, very
wrong if it did not set itself targets that it would beat in terms
of reducing the number of cases.
118. If we had a massive epidemic of diarrhoea
in the nation because they have all been eating kebabs would they
say that the FSA had failed?
(Professor Pennington) Yes.
119. I can understand on E.coli and
Salmonella but just general food poisoning, somebody who
takes a couple of days off work, and the whole structure, or do
you think we are not doing it in the Bill?
(Professor Pennington) I think the opportunity
is there in the Bill. The FSA is going to have to say what it
is going to do. It has got the opportunity to set itself more
precise targets and I would hope that it would do that for things
where in a sense the science is there. It is a question of driving
that forward on the basis of rational methods which you know are
going to work, and if you cannot get those implemented then you
have failed. As you are saying, there will be times when nature
takes over and a new bug comes in from the side which one cannot
predict and one has a problem. I think perhaps one dramatic way
of saying that is would the FSA have stopped BSE, for example?
I do not think the FSA, if it had been in existence and working
well, would necessarily have stopped BSE arising in the first
place. It might have meant that it would have been handled differently
later but I think BSE would have arisen as in a sense an accident
of nature and I do not think we can ever prevent new organisms
evolving out there because they are evolving out there and new
organisms or organisms are being imported into the country from
other places.
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