HC Deb 30 April 1953 vol 514 cc2489-500

Motion made, and Question proposed, "That this House do now adjourn."— [Mr. Drewe.]

11.1 p.m.

Mr. Barnett Janner (Leicester, North-West)

The problem with which I am dealing, if not as old as the hills, is certainly one which attracted the attention of no less eminent a law giver than Moses himself more than 3,000 years ago. It has prevailed throughout the centuries. The consumption of unclean food has produced serious consequences.

In a very interesting and useful booklet, published for the St. John Ambulance Association, on "Clean Handling of Food," my hon Friend the Member for Batley and Morley (Dr. Broughton) states that in the 17th Century in London alone, which had then a very much smaller population than now, more than 2,000 people died each year from disease which is now known to have been caused by unclean food and unclean drink.

The necessity for encouraging cleanliness in the handling of food by industry and the general public is just as topical today as it has been in the past. The amount of death and disease arising from the use of unclean food is, of course, far below that which prevailed hundreds of years ago, but it is certainly not inconsiderable, especially as it could and should be practically eliminated altogether. I trust and believe that the Minister will be able to give us encouraging information tonight indicating what further steps are to be taken to speed up and intensify action and to educate our people with a view to reducing the evil of the handling and use of unclean food.

In recent years there has been an increasing incidence in the cases of food poisoning. In 1951 there were 5,797 cases definitely found to be attributable to food poisoning. In 1952 there were 6,021 and in the first quarter of 1953, 1,035. These are, of course, official figures proved to be due to food poisoning. I understand that all medical practitioners agree that the number of cases is much larger than this. Indeed, it has been estimated by some that there are as many as 5,000 deaths a year today from food poisoning.

I have made inquiries about the City of Leicester, of which my own constituency forms a part. During 1951 and 1952 in that city 20 outbreaks of food poisoning were notified to the health department. Meat products acted as a vehicle of infection in 12—pressed meat in four, cold pork in one, and other meat products such as gravy, shepherd's pie, and pork pie, were the cause in seven. In addition, they were possibly responsible in another one. There was a considerable outbreak of dysentery there from July, 1950, to July, 1951, when there were 2,120 notified cases, of which 1,412 were found positive. There were small outbreaks in the winter of 1951–2 and again this winter.

I am informed by the Assistant M.O.H. of Leicester that some forms of dysentery are a disease caused by unclean food and they have increased considerably in recent years. In its prevention the important thing is hand-washing by everyone, and particularly by food handlers after visiting the toilet. The health department of local authorities has a very important part to play in the prevention of food poisoning, such as sanitary inspectors inspecting carcases in slaughterhouses, taking samples of food, and enforcing health authorities' clean food bye-laws, etc. In addition, local authorities help in the education of food handlers by running courses, sanitary inspectors' visits, etc.

In Leicester we also have a food hygiene officer who is trained in domestic science. She visits food premises with a view to improving their standards of hygiene and methods. We have also a mythical doctor, "Doctor Fosse," who helps by being used on cards bearing health education slogans. These cards are also displayed in buses, being changed nearly every fortnight. In 1951, Leicester held a clean food exhibition for a fortnight, showing clean and dirty shop windows. The exhibits depicted were, first, how food can be infected; secondly, food and drink infections; thirdly, how people can help to avoid infection; fourthly, the production of clean milk: fifthly, clean and dirty kitchens.

I can only touch upon a few points to show the gravity of the problem in the short time at my disposal. The steps taken in Leicester go some way to deal with the position, but in the opinion of those responsible for these matters in Leicester, and in my opinon, they are far from meeting the need. I am sure the Minister will agree with that. Much poisoning is due to food remaining uncovered. It is a revolting sight in warm weather to pass a heap of dung or filth on the roadside covered with flies, and a little further on to find a shop with food uncovered in its windows and on its counters, the food itself being covered with swarms of flies. Obviously that food ought not to be used, particularly if it is not to be cooked.

Surely it ought to be possible for sufficient inspectors to be available to see that all food is kept covered in shops. American visitors frequently comment on the way food in this country is allowed to be kept uncovered and exposed to flies and dirt. This, as the Minister is aware, is not permitted in many parts of the United States. I appreciate that I cannot deal with questions involving legislation, but I think that under the administrative possibilities which prevail under the Acts in force in this country, much could be done. In America and other countries, people have been trained to reject any food which is not produced and prepared in a clean way. The same prevails, I understand, in Sweden and other Scandinavian countries.

I would point out in passing, that there is additional importance about the supply of clean food at present because of the large numbers of visitors coming to this country for the Coronation. They will no doubt be influenced by what they find here in that and other directions, when considering future visits to Britain. Outstanding in the matter of unclean food is uncleanliness of the hands of those manufacturing or preparing it. During the war, when there was shortage of paper and linen I am afraid that people were discouraged from washing their hands. It may be that this is the reason why today a large number of people go to the toilet and do not wash their hands afterwards. This applies to all sections of the community.

A lady friend who was aware that I was raising this question this evening has informed me that she was in the ladies' room of the stalls of a large London theatre for some 10 minutes and not one of the women who emerged from the toilet washed her hands. Facilities should be given for people to keep their hands clean. All food factories, restaurants, and other places used for the production and supply of food ought to be circularised with regard to this problem. They ought to see that there is solid or liquid soap available, and some form of towel in all their toilets, and they ought to do everything in their power to ensure that their employees use them.

Encouragement in this direction could also be given by the Government asking local authorities to have some form of towelling in their public toilets. This is infrequently found. Another cause of germ-ridden food is cracked crockery. There is no shortage of plastic or earthenware crockery for replacement, and restaurants should be told not to serve food in cracked crockery. I am told that in one neighbourhood in London customers are asked to bring back bags, and the retailer then puts unwrapped food into these dirty bags, which may have been returned by an entirely different customer. Some customers bring back a whole pile of bags, and who knows whether or not they come from a clean or dirty home.

All foods which are not to be cooked again, such as cakes, biscuits, cheeses, unwrapped butter, bread, cooked meats and fish should all be either wrapped in cellophane or covered with muslin or kept in a proper container. Apart from the cleanliness, I think that any expense involved to the retailer would bring big dividends because the majority of people prefer to shop in a clean shop than in a dirty one.

When will the manual of guidance to the catering industry be published? Of course, I think it will be a very useful thing, but nevertheless not everyone is going to read a manual of that description, and other steps must be taken in order to bring to the attention of those working in catering establishments the importance of this problem. There should be large posters in all the toilets and rest rooms used in these establishments, and there should be continuous propaganda to the whole of the public. People should be encouraged to refuse to accept their food on dirty plates in restaurants.

There are 236,000 catering establishments, excluding public houses, but including schools and factory canteens and the catering departments of hospitals. It is estimated they serve 103 million meals a week. Weekly consumption of light meals and snacks is some 171 million, while the number of of hot beverages we drink outside our homes is 311 million. This makes a grand total of 585 million every week. There are, however only 5,000 sanitary inspectors in Great Britain, and they cannot be everywhere to see what is being served. We must therefore supplement their efforts.

There is no doubt that the public themselves are to a considerable extent to blame, for if we refused to eat dirty food it would in the course of time be served in a clean form. A great deal of infection comes from dirty heads. Catering establishments should insist that all those preparing food should have their heads covered. Some information has come to me from one of the catering firms in the country which has taken every precaution it possibly can to provide clean food, and I think it has been very successful. The six things they stress most relate to persons, foodstuffs, service hygiene, equipment, premises and vermin control.

They emphasise that in actual dealing with the customer such things as always using tongs and never dipping into things with the fingers are important. They provide that walls and everything else must be streamlined so that there are no dust traps. Everything is to be away from the walls and off the floor so that no dirt can accumulate behind such things as refrigerators, and no dirt can accumulate underneath. Often things are put on little steps so that they can be thoroughly cleaned. As far as vermin control is concerned they make sure that premises are free from mice, rats, cockroaches, and the like.

In this establishment—it is Marks and Spencers, in which incidentally, I have no interest—I am told that everyone taken on as an employee in the production and sale of food has to have a medical examination. This is followed up by a series of examinations by the doctor. They are examined for superficial skin diseases, and things like heavy colds and boils. If any of these develop while they are working on foods they are immediately taken off. They stress most the developing of a positive attitude to hygiene by films and talks and making the staff realise where the infection comes from.

Any unpleasant habits must be eradicated. Whenever they leave the room, for any reason whatsoever, whether to go to the toilet or to talk to someone else in another room, on their return they must thoroughly scrub and wash their hands. Basins, hot water, nail brushes and soap are provided and each person has his or her own towel. That system is inculcated into the staff. They also insist that heads shall be covered to prevent stray hairs getting into the food, and they deal with the question of the clothes of those employed. They have to be clean.

The food is chemically analysed. I could give other instances of what varied precautions are taken in this establishment and others of that kind, but the result is that they provide clean food. I hope that the Minister will take such steps as are possible to bring this extremely important subject to the notice of all concerned in these trades and that we shall, by his efforts and the efforts of those who are guided by him—not only in his own Department but throughout the community as a whole—put down this scourge. I do not want to use extravagant terms, but it is a scourge which can be eliminated.

11.16 p.m.

Mr. Charles Doughty (Surrey, East)

I support what the hon. Member for Leicester, North-West (Mr. Janner) has said. I go further and say that the conditions under which food is prepared in this country are a scandal and a disgrace. I do not refer to private homes where, on the whole, the work is extremely well done, but to restaurants and public eating places. Those who go there and see what appears to be a comfortable and well-prepared place where they can eat would be disgusted if they went into those places where the food is prepared.

What is the remedy for that? It is better education and better hygienic facilities. This is the responsibility of those in charge of these establishments. They should take a pride in their establishments and ensure that those who prepare the food should be clean and should wear clean overalls etc. over their outdoor clothes. More important than that, they should provide clean cooking apparatus, ovens, pans, etc., and there should be frequent inspection.

It would be helpful if, under the Factory Acts, we could produce regulations so that Government inspectors could visit these places unexpectedly at curious times, such as 11 o'clock at night or closing time, when people are about to go home and after dinner or before dinner has been prepared. They should be able to warn those concerned, "If these sort of conditions occur again whereby you are poisoning the people for whom you are preparing food you will be heavily fined". Then we should have an improvement in the conditions under which food is served to people, and fewer people would have those pains in the stomach which are caused by food poisoning.

11.18 p.m.

The Parliamentary Secretary to the Ministry of Food (Dr. Charles Hill)

We are grateful to the hon. Member for Leicester, North-West (Mr. Janner) for raising this most important problem. Indeed, it is not inappropriate that a representative of Leicester should raise it, for that city, under the guidance and leadership of Dr. MacDonald, the Medical Officer of Health, plays a big part in health propaganda devoted to the elimination of food poisoning. Dr. MacDonald succeeded me as Chairman of the Central Council for Health Education some years ago.

The hon. Member dealt with this subject, I am glad to say—and indeed the rules of order require it—primarily from the angle of personal hygiene. In replying to him I will concentrate upon that aspect, although much could be said under other headings. I dissent from nothing that he said. He stressed the importance of personal hygiene in this matter. I would add that the basis of health education, the basis of the personal approach to this problem, needs to be the understanding of certain very simple facts. It is not a difficult matter to explain. What is difficult is to change personal conduct in the desired way.

Nowadays this problem of food poisoning is primarily one of germ infection, and the old fears of metallic contamination and the like have largely disappeared. Secondly, it is as well to appreciate that this is primarily a problem of meat dishes, made-up dishes which are cooked and thereafter left exposed, allowed to cool slowly, and as the hon. Member reminded us, often left exposed to flies. It is primarily a circumscribed problem of meat and milk products—mainly meat products—that are not eaten as soon as they are cooked, if indeed they are cooked.

I add that point because sometimes in our zeal to expound this problem we are apt to give the impression that there is a widespread danger of food poisoning. I know there are other considerations— aesthetic and so on—that play a part, but I am concentrating on the narrow field of food poisoning. It is as well for the public to realise that it is not the food that smells that is necessarily dangerous. The greater danger lies in those foods that are not obviously contaminated. Indeed, there are some foods with a rich aroma—I need not identify them—which are both healthy and attractive.

Therefore, the problem is primarily one of putting over certain simple scientific facts, followed by certain pieces of simple advice. The hon. Gentleman mentioned them all. It is wrong for a person in the home or in a food establishment to handle food when suffering from a heavy infection. It is wrong for a person suffering from diarrhoea to handle food. It is wrong for a person suffering from a superficial infection of the skin, however apparently trivial, to handle food, because there is the chance that that infection may be conveyed to the food. Most important of all, it is absolutely essential, as a simple and automatic precaution, for persons to wash their hands before handling food.

I am glad that the hon. Gentleman laid stress on the desirability of washing one's hands after using the w.c. Nowadays we speak quite frankly about that sort of thing, though I remember that during the war, when the Central Council for Health Education sought to have published at the Government's expense advertisements based on that piece of advice, "Always wash your hands after using the w.c.," a number of national newspapers thought that there was a lack of delicacy about that advice which prevented them publishing the advertisement. Indeed, the representative of one great newspaper told me that he was confident that his readers always washed their hands.

Be that as it may, it is as well to stress the importance of eating food as soon as it has been cooked, or putting it in a place of safety—for instance, in a refrigerator—immediately it has been cooked. It is the food that is left around which presents the greater danger.

Now for the ways and means of conveying this advice to the public. Health education can be imparted through such bodies as the Central Council for Health Education which, as the hon. Member knows, is the agency of local authorities in this matter. The initiative rests with the individual local authorities, but the facilities of the Central Council for Health Education are available to them, as they have been made available to the hon. Member's own city. Admirable work is done by such bodies as the St. John's Ambulance Association and the Red Cross, and mention has been made of the admirable little publication of the hon. Member for Batley and Morley (Dr. Broughton) which shows what can be done in a simple and understandable way. There is the work that is being done by a number of firms and trade associations. The Ice Cream Alliance is one body which comes to my mind, as do firms like the one which the hon. Member quoted.

I know that the hon. Gentleman will not misunderstand me when I say that we must get this matter in perspective. These are preventable conditions. We have in the Chief Medical Officer's Report the cases notified. Let me say at once that we all recognise there are many more cases of food poisoning than those that find their way to the medical officer of health through the process of notification. I make no apology for repeating, for it is important, that the danger lies with a particular restricted kind of food, the kind of food that germs like, food that has been cooked and left around, particularly meat and dairy products. There are many foods which, however contaminated they may be before they are cooked, when well and truly cooked become safe if eaten hot—for example, meat that is roasted. This problem is a small but important one.

The hon. Member asked me about the Ministry's own publication "Clean catering." That will be published in about two months time, but it is, as he indicated, for the caterer and the catering manager. It is a manual for the people in executive positions in the catering industry, and so meets only one small part of the problem.

There is another kind of propaganda which is of great importance. I refer to the food guilds that have been formed in a number of areas. I think I am right in saying that the initiative began in Guildford, with Dr. Belam, the Medical Officer of Health, 10 or more years ago. Their purpose is to call together in friendly but regular meetings those who are engaged in the handling of food as part of their daily lives. For the most part it is enough simply but plainly to present the facts to these people and to put to them certain simple rules of the kind which the hon. Gentleman and I have mentioned tonight, to convince them of the dangers, which are really out of all proportion to the trivial errors of conduct which may lead to them.

Today, eating in the mass is much more common than it was. I imagine that that is really responsible for the increased number of cases of food poisoning. That, of course, means that a careless food handler can infect a dish and so infect 200 or 300 persons through one simple error of conduct. We cannot deal with this question, on the basis of the Factory Acts, as an offence. It is a matter for health administration, and it is a matter for persuasion rather than one of regulation. There, in this field of personal conduct, must lie the solution to the problem.

We know that present legislation could be improved. We know that it is out of date, but it would be improper to say more. Let me conclude by saying that I think the hon. Gentleman has done a public service in selecting this subject tonight, in ventilating it so well and in giving me an opportunity to underline some of the important points that he has made.

Question put, and agreed to.

Adjourned accordingly at Twenty-nine Minutes past Eleven o'Clock.