Select Committee on Food Standards Minutes of Evidence


Examination of Witnesses (Questions 800 - 819)

MONDAY 15 MARCH 1999

PROFESSOR BRIAN DUERDEN, PROFESSOR RICHARD GILBERT, MR KEITH BAKER, MR BOB STEVENSON, DR ALAN MARYON-DAVIS and DR DICK MAYON-WHITE

  800.  So does the FSA have any role in that as you see it, given it will need proper data, will it not?
  (Dr Mayon-White)  I believe it will because this will be part of this co-ordinating role, because there are different players, different laboratories, who would be providing data or potentially providing data, and certainly one would see the Food Standards Agency having an important co-ordinating function not least of course because it reaches all parts of the UK.

Dr Stoate

  801.  Just to pick up the point Mr Paterson was asking, Mr Paterson pointed out, and I agree with him, that the vast majority of food poisoning cases are in fact caused in the home—I have been a GP for a long time and that is certainly my understanding—and the outbreaks we have talked about are relatively rare, although from a public health point of view they might be important (and they certainly grab the media headlines) in terms of overall numbers they are actually a small proportion. Can I come back to the question which was asked earlier and ask the Faculty of Public Health Medicine what can a Food Standards Agency do to try and reduce the much larger numerical burden of food poisoning in the home?
  (Dr Mayon-White)  I would say that the term "food poisoning caused in the home" is confusing an issue. I think the majority of cases certainly occur from domestically-prepared food but part of the cause of these cases lies in the fact that the person who has bought the food (e.g. chicken) which is already contaminated with food poisoning bacteria or other micro-organisms. Part of the work of the Food Standards Agency is going to be, surely, in public education and this should be covering not just food hygiene but nutritional elements as well. I would see the Food Standards Agency being able to help prepare, across the whole country, high quality advice for the public on the safe preparation of food, but at the same time reassuring the public that other parts of the food chain that lead up to the domestic kitchen are also having the same pressure put on them to improve food hygiene.

  802.  You say that surely the Food Standards Agency will be taking these into account, but that is exactly what this Committee is here to look at. Do you think that the Bill as currently drafted will give the Food Standards Agency not only the right powers but also the right steer to do exactly that?
  (Dr Mayon-White)  I think that lies partly in the make up of its advisory committees and the Faculty would very much hope that the public health practitioner professional voice is clearly within the advisory committees.

  803.  That brings me on to the subject of nutrition which is something that is very dear to my heart. What do you think the FSA's role will be in improving public health nutrition?
  (Dr Maryon-Davis)  I think one of the key roles is to ensure that people have an informed choice when it comes to choosing particular foods and also some public education about what constitutes a balanced diet. I think the wording of the draft Bill does encompass that, but I am particularly concerned about consultation over the objectives and practice. I am not sure that the wording of the Bill is quite clear about whether or not we, the public, will be consulted upon when it comes to how the Agency draws up its objectives and its practice and I would like further clarity on that so that we have an opportunity to influence that.

  804.  I entirely agree with that. How do you think that the Food Standards Agency will be able to maintain the balance between the food safety function and the nutritional function?
  (Dr Maryon-Davis)  In various clauses where it says "and other food related matters" I would like to see it specifically mention food standards and nutrition as I think it is most important that that happens because I think there is a real danger that the nutritional aspects of the Agency's work could be very easily marginalised by the major concern of food safety.

  805.  So the nutritional aspect is extremely important and is currently underplayed, is that what you are saying?
  (Dr Maryon-Davis)  I think it is very much underplayed in the draft Bill as it stands. It gives it scant mention. I think it needs beefing up.

Audrey Wise

  806.  When this has been put to Ministers and other witnesses an element in their answers has been that health is influenced by other factors besides diet and usually they mention exercise. Therefore, the argument is it would be too difficult to isolate the dietary aspects of health and it might give a false impression. I notice that in Sweden there is an expert group on diet, physical exercise and health and that expert group reports both to the food side and to the health administration at large so that there is a bringing together and then a twin reporting function. Does that strike you as being a useful device?
  (Dr Maryon-Davis)  I think it may well be. As currently envisaged the main committee advising on diet and health would be a joint effort between the Agency and the Department of Health. I can see the reasons for that. I can see that the Department of Health has to have that wider policy perspective, but at the same time the Agency is in a unique position to provide major input as far as the diet is concerned. One of things it has as a unique selling feature is its independence and its transparency and those are terribly important things when it comes to dietary messages about health.

  807.  Professor Duerden, you mentioned one of the factors being problems about poor temperature control. It reminded me of how the Health Select Committee some years ago, when looking at listeria and listeriosis, recommended that domestic refrigerators should be required to have integral thermometers to make it easy for householders to keep the temperature under check, but to our surprise that was fiercely resisted by the then Government. Do you and your colleagues from public health think that is a sensible suggestion or not?
  (Professor Duerden)  Certainly the maintenance of appropriate cool conditions in refrigerators is absolutely essential to the safe holding of food and whether you build the thermometer into the fridge or not, a control on the temperature and a monitoring of the temperature would be regarded as important. Professor Gilbert was particularly involved with those activities.
  (Professor Gilbert)  One wishes that the refrigerators had it built in in the first place. The alternative is the little ones that you stick inside and these are very good and they are very inexpensive. I have to say in fairness that standards of temperature control in this country are probably better than they have been for many years. This has been mentioned time and time again and you did mention the subject of listeria and the good news there, of course, is that the listeria figures now are very low indeed and as low as they have ever been in this country. We have always had a problem in relation to temperature control, but I think at the moment that is not my major concern. My major concern is that really a very high percentage of raw meat, poultry and this sort of product which you can buy is actually contaminated when we bring it into the kitchen and that is where I believe we need a co-ordinated response all the way across the food chain with our veterinary colleagues. If I could see the Food Standards Agency doing one thing it would be setting targets for the industry and everybody else to meet.

  808.  Quite. I was not at all meaning to imply, nor did the then Health Committee, that having integral thermometers would be the key. Clearly, reducing contamination in the first place is the key. It seems sensible to make it as easy as possible for people.
  (Professor Gilbert)  I agree. Food poisoning is a preventable disease not being prevented and there is one major thing which I do not think necessarily comes out in the documents and it is the very important lead the FSA can take on the educational front. We have got the great and the good telling us what to do. I think it really does need to be co-ordinated. As I said, it is a preventable illness and I believe that this is a major area that the FSA can take a very significant lead on.
  (Mr Baker)  Can I support the co-ordinated approach because I think that temperature control is equally as important before it gets into the home. There is a need to maintain the control mechanism all the way from the slaughter house because if you do not then you do have a potential problem. It goes back even further than that because if you can actually start the process with healthy animals on the farm then you have got a greater potential for safe food and that is where I think we see our major product.

  809.  Of course. The Health Committee, I hasten to say, regarded it as a "minor useful thing" and therefore was very surprised to have it resisted, so it became more major than we expected. Mr Baker, I noticed that you said that personalities were the most important thing in communication and if you got the personalities right then you would get good communication and obviously one can see in human terms that is likely. Do you not think that that is a little bit hit and miss or random? Do you think that one of the functions of the Food Standards Agency should be to ensure that there are systems in place which reduce reliance on having just good personalities who can communicate? I would feel very uneasy if we had to rely entirely on personalities. I would like systems. Is that something the FSA should be taking into account?
  (Mr Baker)  I agree totally with you that there must be procedures in place and systems in place to ensure that you have got adequate communication as far as it is feasible to do so, but I am afraid personalities still come into it. So you do set down a framework for communication and I think that that is extremely important. Do not get me wrong, I think that communication has worked extremely well because of personalities or in spite of personalities in the past and I think that we have got a measure of control over quite a few of the problems.

  810.  Some people are describing this partly as a need for a change in the culture and a generalised shift in attitudes and methods. Do you think that it is fair to say that there is a need for that and that the Food Standards Agency should have a different culture itself and encourage an improved culture or changed culture in the other institutions involved?
  (Mr Baker)  Yes, I think that would be a considerable benefit. My colleague indicated that there will probably be a change in culture at the farm level because instead of looking for disease we will be trying to promote health and I think that that is a very important message that the FSA could get across.
  (Mr Stevenson)  As a veterinarian working on farms every day, I can see that that change of culture really is happening and it is on the back of BSE, unfortunately, but the time is ripe to develop that and with the structure of the FSA I think that people are looking for assistance, they are looking for information and they are ripe for entering into the communications backwards and forwards. They have realised that there is a need for very strong verification and the enforcement of procedures right down onto the farm and I am seeing every day now that there is a clear understanding of the need for really strong verification of procedures and auditing of procedures.

Dr Brand

  811.  Professor Gilbert stressed the role of education for the Food Standards Agency. Do you believe that the definitive advice should come from the same authority on food safety as well as nutrition? Should it be the Agency itself that promulgates that advice or should we see something within the Bill that links it to the Health Education Authority?
  (Professor Gilbert)  I would like to see the Agency taking the lead because I do believe that at the back of all this is to try and prevent food poisoning and there are messages which go out which are sufficiently convincing. The media is only used sometimes to spread bad news. If it is backed up by health education authorities then that is fine, but it seems to me that if you are talking about food safety then you have to talk about prevention because that is what we are trying to do, is it not? Therefore, I do think this is a very significant role. It is getting the message over to the general public but it is also teaching teachers and teaching trainers which I think is also very important.
  (Dr Maryon-Davis)  There are distinctions with the HEA. The HEA's particular skills are in terms of getting the messages across, it is using the various media that are available, but I think those messages themselves need to be formulated and that is where the Food Standards Agency's role is mainly formulating those messages and then working with others to get the messages across and it will be horses for courses, who does what best. One point about the relationship with the Department of Health. We are told that there will be concordats with the various departments. I do not think it is sufficiently clearly worded in the Bill, but I think we should have an opportunity to comment on the proposed concordats as well because it is through those concordats that the work is carved up between the various agencies.

Chairman

  812.  I understand that at least one of your organisations is in favour in principle of statutory notification. I do not want to go into any of the problems of it. Could you each in turn tell the Committee if you are in favour of the principle of statutory notifications of food poisoning?
  (Professor Duerden)  Yes. For many years the PHLS have been in favour of a statutory responsibility on the laboratories to notify positive isolations of food poisoning organisms as well as other communicable diseases. Notification is just one aspect of communicable disease. There currently is a statutory obligation on medical practitioners to notify when they make a diagnosis of food poisoning. It is the laboratory side that is not obligatory, although obviously we do get a lot of notifications.
  (Dr Mayon-White)  We support very strongly notification of laboratory information.
  (Mr Baker)  In terms of veterinary laboratories, there is already a requirement to notify isolations of salmonella and brucella. We hope we do not get any brucella cases these days because we think we have got rid of it. I think we would be in favour, but we are talking from the veterinary side and not from the public health side.

Chairman:  Thank you.

Mrs Organ

  813.  I wonder if we could talk a little bit about surveillance. What surveillance, if any, should the FSA be carrying out independently of that that is done by existing bodies?
  (Professor Duerden)  We would look to the Agency to help and support in improving the surveillance programmes that there are in place and really surveillance from our perspective comes in in two ways: one is the surveillance of infection in people, in other words it goes back to the notification we have just talked about to ensure that we know what the pattern of disease is; and then there is the surveillance of contamination in food by regular monitoring of foodstuffs in surveillance programmes here. Both of these are in place. Both of them happen. Again the co-ordination and the national picture could be enhanced with links to surveillance in the veterinary field as well.

  814.  I wonder if you could enlarge on that because at the moment do we not have a problem in that there are all sorts of bodies coming in doing a bit of regulation and a bit of surveillance here and there and it is possible that you could have a series of visits from different authorities over a few days? How would you like to see that improved with co-ordination?
  (Dr Mayon-White)  I would be strongly opposed to the Food Standards Agency having surveillance which was independent of the other systems. In many cases there would be the risk of duplication even to the point of interference and there would be a lack of accountability for what was done. There may be surveys or parts of surveillance which the Food Standards Agency wishes to do itself, but those should be discussed with the other agencies that have inspection and surveillance activities. It is a co-ordinated function. I feel very strongly about this business of a food producer being inspected by different people at different times. That almost always loses the impact of that inspection because, in fact, the producer is saying these guys do not know what they are doing.
  (Mr Baker)  We would support that. I think that the Food Standards Agency ought to be able to co-ordinate the approach to surveillance, but from a veterinary point of view, we would like to see a continuing surveillance programme because the epidemiology of a lot of the organisms that cause food poisoning in man is not necessarily well known at the farm level and so one needs to know more about what is happening at farm level if one is going to help produce healthy animals and therefore directly improve human health. We would like to see more co-ordinated surveillance there.

  815.  Does the PHLS anticipate that it can have a concordat with the FSA to produce timely provision of information?
  (Professor Duerden)  I would certainly hope so, yes. We would expect to be required by the Agency to produce the figures on national surveillance of both infections and the food contamination side of surveillance.

  816.  Do you think that this concordat should cover advice about surveillance and interpretation of that?
  (Professor Duerden)  Yes, most certainly. There is expertise available in the disease processes and in the food microbiology side within the Service and with our associated colleagues outside the Service, but we have particular expertise there that we would hope the Agency would want to take advantage of and would not wish to duplicate but would wish to use.

  817.  How can this concordat be put together for the maximum benefit of public protection?
  (Professor Duerden)  I would expect that standards would be set by the Food Standards Agency nationally for the way investigations are done, for the level of surveillance and targets for contamination reduction and disease reduction. We would then be expected to provide the evidence of what was happening to monitor these targets and to conduct some of the investigations with our colleagues in the other agencies on behalf of the Agency.

  818.  And you would want those targets published and reviewed so it was very open?
  (Professor Duerden)  I would think it would have to be. That is what the public would expect and we would expect nothing less.

Mr Jones

  819.  I would like to examine your respective relationships with the Food Standards Agency. How do you see your members netting in with what the Food Standards Agency is supposed to be doing?
  (Dr Mayon-White)  At the moment, if I had a food-borne outbreak of a problem that I was dealing with I would talk with people in the PHLS and so on just as they would talk with people in the Department of Health and say, "Look, I think there is a problem which is a national problem or it is bigger than just my patch, I think there is potential for preventative action." What I would now see as being different with the Food Standards Agency is instead of going to an organisation that has got several other important topics on the agenda, I know I would be going to the Agency and this is their topic, they want to hear from me and they want to work with me on this particular problem. I think that would be very exciting and potentially very strong. Equally I can get back from them advice and information on what they are planning, what they are doing, what are the proper standards that I could expect with this on food. I think having the Food Standards Agency, to be for the public health doctor the one agency that brings it all together, will be very good.


 
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