§ Mr. Ronnie Fearn (Southport)(by private notice) asked the Secretary of State for Health if he will make a statement on the recent outbreak of botulism in Lancashire.
§ The Secretary of State for Health (Mr. Kenneth Clarke)I regret to report to the House that there has been a serious outbreak of an extremely rare form of food poisoning in the area of Manchester, Blackpool and Preston and also in Clwyd in Wales. I am sure that the whole House will wish to join me in extending my sympathy to those suffering from this particularly unpleasant form of food poisoning. Currently, we are aware of 14 cases clinically diagnosed as botulism, 12 in Lancashire and two in Wales.
Inquiries at Youngs Fruits Ltd. of Folkestone, Kent, where the implicated hazelnut puree was manufactured, have shown that the company supplied eight other small dairies, in addition to Acorn Foods, and Forshaw, Littletown Farm Dairy named yesterday, with puree for use in the production of hazelnut yoghurt. The local public health authorities for the areas where these additional dairies are located have all been contacted. Environmental health officers are visiting these dairies and arranging for immediate withdrawal of hazelnut yoghurts manufactured by them. I should stress that no cases have been associated definitely with hazelnut yoghurt from those eight dairies. In addition, the possible association between one case and the consumption of hazelnut yoghurt produced by Forshaw, Littletown Farm Dairy which was referred to in statements yesterday is unclear at present.
The eight other dairies which received hazelnut products from the Folkstone farm are:
- Lord Crathorne's Dairy, Cleveland;
- Stockmeadow Farm Dairy, Staffordshire;
- Ann Forshaws Farmhouse Yoghurt, Preston;
- Madresfield Dairy, Worcestershire;
- Bodfari Foods Ltd, Chester;
- Yieldingtree Packers, west midlands;
- Grange Farm, Buckinghamshire; and
- Battledean Farm, Gloucestershire.
Inquiries are still not complete, however, and my Department maintains its advice that, for the time being, the public should not eat any brand of hazelnut yoghurt.
§ Mr. FearnCan the Minister state exactly when the chief medical officer was informed of the outbreak? Can he also inform us when he first let the public know? He mentioned that the outbreak is confined to Lancashire and Wales, whereas information seems to be coming through now that one of the yoghurts was purchased in Gosport. Can he also state why the Bristol research centre on food safety is due to be closed and why five out of the seven horticultural stations are due for closure? Does he agree that the figure of food poisoning cases for this year is 60 per cent. up on last year and that his Department and the Ministry of Agriculture, Fisheries and Food are possibly to blame for this? Surely they are putting the botch in botulism.
§ Mr. ClarkeOn wider issues than this, it is a pity that every time we have a disastrous and possibly tragic announcement people instantly leap to attribute blame, 704 although if blame is established it must be faced by those responsible. No blame has yet been attached to anybody and I believe that that is a sensible position to maintain.
The hon. Gentleman asked when action was first taken. We were first informed of the diagnosis on Friday evening of last week. My congratulations go to the neurologists in Manchester and to the communicable diseases surveillance centre for their prompt action in identifying and diagnosing this very rare condition. It takes some time to discover exactly what the cause of this most unusual neurological condition is and they were particularly good in spotting the correct diagnosis as quickly as they did.
Once we knew, of course, we began to take very prompt action over the weekend. A local warning was issued to the public by the authorities in Lancashire on Sunday 11 June on the advice of my Department. On Monday 12 June my Department issued further statements warning the public not to eat hazelnut yoghurt. Meanwhile, over the weekend, the two dairies mentioned specifically in the statement were contacted by the local public health authorities and all hazelnut yoghurt produced by those companies was withdrawn from sale. Since then the other eight dairies supplied with hazelnut products by Youngs Fruits Ltd. have been contacted and all their hazelnut yoghurts are being withdrawn from sale.
My Department has been communicating rapidly and instantly first with the environmental health officers in the case of the farms affected and then with those who serve the areas where people are distributing the products of those farms. We are today issuing general information to environmental health officers because they will require specific scientific advice to add to what we have already said.
As all hon. Members will know, very quickly over the weekend we began to issue the most prudent warning possible to the general public, who needed to be alerted first. That advice was that nobody should purchase any brand of hazelnut yoghurt until the position had become more clear.
The point about the Bristol research centre to which the hon. Gentleman referred can be answered in more detail by my right hon. Friends with responsibility for that, but I am informed that that research centre is not concerned with any work on food safety relevant to this outbreak. I see no connection between the horticultural centres and botulism in hazelnut yoghurt.
My right hon. Friend the Minister of Agriculture, Fisheries and Food and I have made it clear that we are concerned about the increase in food poisoning generally and we have made repeated statements about the action that we are taking. I am glad to say, however, that our figures on this very rare type of food poisoning are exceptionally good. There were only nine outbreaks in this country in the period from 1922 to 1988. I compare that with 210 outbreaks in the United States of America between 1971 and 1985 and 115 outbreaks in France between 1978 and 1984. So, fortunately, we do not have a particularly serious history of botulism. Indeed, the last case in Britain was in 1987; and I am glad to say that we have not had a death from botulism since 1978, when there were four cases from which two deaths resulted.
This case is obviously serious. We are now establishing as rapidly as possible all the facts that can be established about the origin of botulism and we shall act in every possible way if any reason for further action is indicated as a result of our inquiries.
§ Dame Jill Knight (Birmingham, Edgbaston)Are the experts yet able to say whether the trouble comes from a process in firms dealing with hazelnuts in this way, or whether there is a danger from the processing of hazelnuts generally?
§ Mr. ClarkeSo far, we have good reason to believe that only the hazelnut products from the one firm at Folkestone are implicated in the outbreak. Obviously, botulism is widely prevalent in the environment and precautions have to be taken against it in the case of all sorts of food, although outbreaks are more often associated with meat and fish products. As far as I am aware, there is no evidence to suggest any trouble with hazelnut products in general and at this stage we do not know precisely what has caused the outbreak associated with hazelnut products from one firm in Folkestone.
§ Mrs. Audrey Wise (Preston)The Secretary of State has been congratulating himself on speedy communication, but is he aware that the director of environmental health in Preston has, at each stage in the matter, received his information first from the press, not from the Department of Health? Would the right hon. and learned Gentleman like to comment on that? Would he also care to ensure that the environmental health officers are the first to receive full information, and that, at all times, they have the resources necessary to do their work, as they are the first line of defence and the public depends on them?
§ Mr. ClarkeI do not know whether some people communicate with the press before they communicate with my Department, but all I will say is that as soon as my Department has received evidence it has communicated directly with the environmental health officers in the areas concerned. The hon. Lady will appreciate that we are talking about the weekend, and, for understandable reasons, it was not possible to raise all the directors of environmental health instantly. First, we went directly to those directors of environmental health in the areas where the farms concerned distributed the product, and, when we found where the product was being distributed to, we contacted the directors of environmental health there. Meanwhile, we have been giving public warnings to those who might purchase hazelnut yoghurt that they should not purchase or consume it.
§ Mr. Michael Jack (Fylde)May I congratulate, through my right hon. and learned Friend the Secretary of State, those in Blackpool, Wyre and Fylde district health authority on the way in which they have handled the matter and the nursing care that the victims have received at the Victoria hospital in Blackpool? When does my right hon. and learned Friend expect that further public statements on the matter will be possible, and what advice will he give on post-production quality control for future monitoring of this type of problem.
§ Mr. ClarkeIt is too soon to have a full picture of the outbreak, but, as far as I can see at the moment, everybody acted extremely promptly once the diagnosis was confirmed. I stress that this is a difficult diagnosis to make because the average doctor, including the average consultant, has never encountered a case in his career. We acted promptly once the situation became clear, as did those responsible in the Health Service, and they are caring 706 for the unfortunate victims in every possible way. At the moment, most of them are stable and the prognosis seems reasonably good.
On monitoring, the first step is to have a proper scientific investigation of exactly what went wrong so that we can discover what caused the growth of the organism in this particular product, and, in the light of that, to see what further steps have to be taken—for example, whether it will be necessary to strengthen the law.
§ Mr. Jack Ashley (Stoke-on-Trent, South)Is the Secretary of State aware that the increase in convenience foods means an increase in the risks involved, which requires an increase in monitoring by more environmental health officers? What is the right hon. and learned Gentleman doing to increase the number of environmental health officers?
§ Mr. ClarkeThe Government readily acknowledge that there is an increase in the incidence of food poisoning in this country, which is a matter of serious concern. It is quite possible that it is connected with the growth of convenience foods. For that reason, we set up the expert committee under the chairmanship of Sir Mark Richmond, vice-chancellor of Manchester university, to advise us generally on the microbiological safety of food, and we are taking every other step as well. However, the latest incident appears to involve a canned food, and canning is traditionally a pretty safe process that is not normally expected to give rise to the risk of botulism—certainly not in the case of a non-acidic food such as hazelnut puree. Nevertheless, every outbreak increases the sum of human knowledge, and we shall find out exactly what happened to allow that particular consignment of hazelnut puree to become infected.
§ Mrs. Maureen Hicks (Wolverhampton, North-East)The general public will be reassured by my right hon. and learned Friend's comments today, by his prompt action, and by his recognition of the seriousness of the matter. Does he agree that the sooner there is informed research into why food poisoning is increasing and how risks may be reduced, the better for all of us?
§ Mr. ClarkeThe overall expenditure on research connected with food poisoning is being maintained. If anything, it is increasing. It is always necessary to find useful avenues of research and I am sure that whenever we find them they will be given proper priority by those of my right hon. Friends responsible for the relevant research budgets. Beyond that, all I can say is that our record on botulism is very much better than that of most other countries, but obviously we shall make every effort to ensure that we sustain that good record.
§ Mr. Martyn Jones (Clwyd, South-West)The Secretary of State's advisers no doubt told him that clostridium botulinum is a spore-bearing organism and therefore is very likely to be found in canned food and is a danger when canning, especially meats. That is why the record in France is worse than in this country, because of the large amount of sausages and preserved meats, rather than heat-treated meats, that the French consume. The case in Wales that the Secretary of State described probably occurred in my constituency or in its vicinity, and I should like his assurance that he has liaised with the Secretary of State for Wales.
707 I should like an assurance also that environmental health officers, who are struggling to keep at bay a tide of food poisoning outbreaks in this country, will have the resources and the ability to stem that tide in future. The current case is relevant because it involves small outlets that were supplied with a large amount of infected food product. Only environmental health officers can possibly help to prevent a recurrence in future.
§ Mr. ClarkeI hear what the hon. Gentleman, who I believe has professional expertise in the field, says. I am advised that the very much higher incidence of botulism in other countries is associated particularly with the home preservation of meat, poultry, game, fish, vegetables, and some kinds of raw fish. I do not believe that canning usually gives rise to that particular danger to any marked degree. We will find out what went wrong with the canning process at Youngs Fruits Ltd.—if anything did go wrong—and then we shall all be better informed.
Environmental health officers have a vital task, and my Department communicates with them promptly and effectively as soon as it has the scientific basis for giving the advice that EHOs require. The question of resources devoted to environmental health officers is primarily a matter for local government, but obviously resources need to be applied consistent with the risk that the public appears to face.
§ Mr. Geoffrey Dickens (Littleborough and Saddleworth)My right hon. and learned Friend knows that there are two cases in my constituency, and, on its behalf and on behalf of the north-west, I thank him and his Department for the speed with which they acted over the weekend, which is always a difficult time. Radio and television bombarded us with many warnings, which were most helpful and surely saved many people from being poisoned.
Does my right hon. and learned Friend agree that people have been poisoned since time immemorial and that poisoning will continue for as long as diseases find clever ways of beating us and our cures? Nevertheless, we thank the doctors and other medics for acting so quickly. Can my right hon. and learned Friend assure the parents of children and the adults who have been affected that they have a very reasonable chance of a full recovery, and that there is every reason to believe that the disease—which is a killer disease—will be contained?
§ Mr. ClarkeI was in the constituency of my hon. Friend the Member for Littleborough and Saddleworth (Mr. Dickens) yesterday. I was meant to be campaigning in connection with the European elections, but I found myself addressing television and radio reporters and reinforcing our warnings to the public about the consumption of hazelnut yoghurt. The media in the north-west gave wide coverage to my warnings and those of the Government's chief medical officer. Everyone acted promptly, and I again congratulate the medical staff who diagnosed the problem and those who gave the treatment. Fortunately, although it is a dangerous disease, its treatment has advanced considerably in recent years. The news on the present patients is as reassuring as can be hoped for.
§ Mr. John D. Taylor (Strangford)To reassure the public, can the Minister say for certain that the source of the problem is hazelnut puree and not any of the milk products involved? Do any of the firms which he has named manufacture any other flavours of yoghurt, and, if so, are they still available on the market?
§ Mr. ClarkeWe have strong reason to believe that the hazelnut puree is responsible for the outbreak. That particular canned hazelnut puree is used only in yoghurts. In fact, yoghurt is mentioned in the title under which it is sold. Therefore, at the moment there is no reason to believe that any other type of yoghurt or dairy product is implicated in the outbreak. Obviously, in all cases of food poisoning we encounter great difficulties when trying to trace the exact source and cause. All we can do is to carry on giving the public the full extent of our knowledge as it unfolds.
§ Mr. Robin Cook (Livingston)May I press the Secretary of State to answer the question put by my hon. Friend the Member for Clwyd, South-West (Mr. Jones): what action has been taken by the Welsh Office in response to the cases in Clwyd? Has it provided advice to the public?
The Secretary of State will acknowledge that the figures which he quoted to the House confirm that this is the most serious outbreak of botulism for decades. Given the alarming increase in food poisoning, when will the House see the regulations on food hygiene, which have been lying in the Department in draft form for two years this month?
I wish to take up the Secretary of State's reference to the Bristol food research laboratory which he maintained was not carrying out research into food poisoning. Will he acknowledge that that was partly because last year the Government cut the grant for research into salmonella food poisoning? When will the Government start to reverse their irresponsible cuts on research into food safety?
In response to the concerns expressed about environmental health officers, will the Secretary of State acknowledge that there are currently 430 unfilled vacancies for environmental health officers? Will the Government reverse the cuts in training places which have partly contributed to the national shortage?
The Secretary of State said that it was far too early to attribute blame. Will he at least acknowledge that this is one time when he cannot blame the consumer? Shoppers need not another leaflet from his Department giving them advice, but action to ensure food safety. When will they receive it?
§ Mr. ClarkeI realise that the hon. Gentleman has a duty to oppose. However, when discussing serious issues of this kind, he should not scratch about to find faintly associated causes of complaint, which is what he is doing. The new responsible official Opposition might join in the public warning. I would hope that any Labour Government would, like this Government, speed up efforts to find out what has caused the outbreak.
We are in close touch with the Welsh Office. The Government's chief medical officer is responsible to the Government, and our advice was addressed to the entire population of the United Kingdom. The advice is that, until further notice, people should not eat any brand of hazelnut yoghurt, and that advice is sustained.
The hon. Gentleman knows perfectly well that the food hygiene regulations which he mentioned have nothing to 709 do with this outbreak of botulism. He also knows that, as a result of the consultation, we are seeking to resolve the conflicting scientific and other advice which we have received and will produce the regulations as soon as possible. I have already talked about Bristol, where the research station is not engaged in food safety research—
§ Dr. David Clark (South Shields)That simply is not true.
§ Mr. ClarkeThat must be taken up with the responsible Ministers. My right hon. Friend the Minister of Agriculture, Fisheries and Food will have to deal with that—[Interruption.]
I remain reasonably confident—I look to my right hon. Friend for advice—that it is doing no research of any kind—relevant to botulism.
I have already dealt with the question of the number of environmental health officers. The resources devoted to them are a matter for local government. We all appreciate that there is an increasing problem of food poisoning in this country, and local authorities, like everyone else, must address their priorities in that connection.
The hon. Gentleman began by saying that this was the worst outbreak of the decade. That sounds sensational until we recognise that there have been no deaths from botulism in that time, and that the country has a singularly good record on botulism in general. The hon. Gentleman should make sure that the points that he makes on this particularly difficult issue are well founded.
§ Mr. SpeakerOrder. I shall take points of order after the statement by the Home Secretary.