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Spain's anger at new BSE risk status
POLICY AND PEOPLE
E coli outbreak deaths spark judicial inquiry in Canada he Ontario provincial government has reluctantly convened a judicial inquiry into the worst public sanitation scandal in Canadian history. The government was forced to act in the wake of an enormous public outcry over an Escherichia coli outbreak that may have killed nine people and made more than 700 people ill in Walkerton in southwestern Ontario. The federal government has been under siege for devolving environmental responsibilities to regional muncipalities as part of the government’s red-tape-reducing exercise and pledge to cut environmental regulations by 50%. Premier Mike Harris announced on May 31 that an inquiry will be held into events surrounding the contamination of Walkerton’s water supply. The town’s utilities commission was informed on May 17 that E coli O157:H7—a known bacterial contaminant from human and animal intestines—had infiltrated the water supply. But provincial deregulations
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Within 2 days, five people were made in 1996, including discontinuadead. Since then, four more people tion of the Drinking Water have been identified as having died Surveillance Program, meant that the from drinking the E coli contaminated private sector laboratory that did the water. Provincial test was not police say they are obliged to notify considering crimithe environmental Rights were not nal charges ministry or the granted to include this against city offilocal medical image in electronic cials. officer. Since these When signs of media. Please refer to deaths it has been illness began surthe printed journal. learnt that a facing in the local private-sector labpopulation, the oratory, which utilities commishad been testing sioner, Stan Walkerton’s Koebel, insisted Failure of communication led to deaths water, had this three times to the year twice notified the Environment regional medical officer, Murray ministry of the contaminated water McQuigge, that the water was fine. supply. The ministry was also tipped However McQuigge was not conoff by an anonymous caller on May 20 vinced and on May 21 ordered people that the water was contaminated but to boil their water. His suspicions were did again not notify McQuigge. confirmed on May 23 when his own laboratory tests showed that the water supply was definately contaminated. Wayne Kondro
UK doctor’s failures prompt NHS introspection
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he UK’s national health service was put under close scrutiny last week in the wake of a scathing report into the conduct of NHS management, arising from the actions of a disgraced gynaecologist at the South Kent Hospitals NHS Trust (see commentary p 2010). Rodney Ledward maimed hundreds of women through poor surgical and clinical procedures during 16 years at the William Harvey hospital, Kent. Ledward was dismissed from the South Kent Hospitals NHS Trust in 1996 and struck off the medical register by the General Medical Council in 1998. In March, 1999, the Health Secretary set up an inquiry headed by Jean Ritchie QC to investigate why Ledward’s behaviour was not identified and acted upon earlier, and to review the wider implications for NHS management at the Trust and nationally. The inquiry team reported that alongside poor surgical standards, Ledward also pressurised NHS patients to become private patients, and asked patients to bring cash with them when admitted for surgery. The inquiry concluded that “failure in senior management, a culture where consultants were seen as gods, and where there were powerful inhibitions against telling
2058
tales” were among factors that prevented him being caught earlier. The inquiry recommended that senior NHS managers must be of the highest calibre, and that doctors must be given time to participate in clinical governance, which should apply equally to the private sector. They urged that a climate of openess is vital to foster good care for patients and that NHS Trusts should provide support for people who have the courage to whistleblow on underperforming or misbehaving colleagues. The inquiry noted that many consultant colleagues did not speak out about Ledward because “they felt inhibited from voicing their concerns”. The chief executive of the General Medical Council, Finlay Scott, warned that this case highlighted the importance of having effective local mechansims for detecting and acting on poor performance. The chairman of the British Medical Association, Ian Bogle, stated the NHS culture had changed for the better and that doctors are now much more prepared to report on incompetent colleagues. But, “in this case doctors did speak on a number of occassions but managers failed to act”. Haroon Ashraf
Spain’s anger at new BSE risk status he Spanish Ministry of Agriculture reacted furiously on June 1 against a report by the European Commission’s (EC) Scientific Steering Committee (SSC) on May 25, which stated that Spain is at risk of a bovine spongiform encephalopathy (BSE) outbreak in its cattle. Spain’s minister of agriculture, Miguel Arias-Cañete, denied the presence of any BSE cases in the country so far and accused the SSC of being “irresponsible” for releasing a report “which is provisional until June 19”. The ministry announced that it would go to the EC to force the SSC to amend its evaluation of Spain’s BSE status. Spain’s general director of farming, Quintiliano Pérez-Bonilla, will go to Brussels “to demonstrate with scientific data that the SSC is wrong”. The SSC published a risk study that placed 25 European countries into four BSE outbreak-risk groups. Spain was placed in the third-level risk group of countries where “BSE is not yet confirmed but where the combination of stability and challenge makes it likely that BSE could indeed be already present”.
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Xavier Bosch
THE LANCET • Vol 355 • June 10, 2000
For personal use only. Not to be reproduced without permission of The Lancet.
E coli outbreak deaths spark judicial inquiry in Canada he Ontario provincial government has reluctantly convened a judicial inquiry into the worst public sanitation scandal in Canadian history. The government was forced to act in the wake of an enormous public outcry over an Escherichia coli outbreak that may have killed nine people and made more than 700 people ill in Walkerton in southwestern Ontario. The federal government has been under siege for devolving environmental responsibilities to regional muncipalities as part of the government’s red-tape-reducing exercise and pledge to cut environmental regulations by 50%. Premier Mike Harris announced on May 31 that an inquiry will be held into events surrounding the contamination of Walkerton’s water supply. The town’s utilities commission was informed on May 17 that E coli O157:H7—a known bacterial contaminant from human and animal intestines—had infiltrated the water supply. But provincial deregulations
T
Within 2 days, five people were made in 1996, including discontinuadead. Since then, four more people tion of the Drinking Water have been identified as having died Surveillance Program, meant that the from drinking the E coli contaminated private sector laboratory that did the water. Provincial test was not police say they are obliged to notify considering crimithe environmental Rights were not nal charges ministry or the granted to include this against city offilocal medical image in electronic cials. officer. Since these When signs of media. Please refer to deaths it has been illness began surthe printed journal. learnt that a facing in the local private-sector labpopulation, the oratory, which utilities commishad been testing sioner, Stan Walkerton’s Koebel, insisted Failure of communication led to deaths water, had this three times to the year twice notified the Environment regional medical officer, Murray ministry of the contaminated water McQuigge, that the water was fine. supply. The ministry was also tipped However McQuigge was not conoff by an anonymous caller on May 20 vinced and on May 21 ordered people that the water was contaminated but to boil their water. His suspicions were did again not notify McQuigge. confirmed on May 23 when his own laboratory tests showed that the water supply was definately contaminated. Wayne Kondro
UK doctor’s failures prompt NHS introspection
T
he UK’s national health service was put under close scrutiny last week in the wake of a scathing report into the conduct of NHS management, arising from the actions of a disgraced gynaecologist at the South Kent Hospitals NHS Trust (see commentary p 2010). Rodney Ledward maimed hundreds of women through poor surgical and clinical procedures during 16 years at the William Harvey hospital, Kent. Ledward was dismissed from the South Kent Hospitals NHS Trust in 1996 and struck off the medical register by the General Medical Council in 1998. In March, 1999, the Health Secretary set up an inquiry headed by Jean Ritchie QC to investigate why Ledward’s behaviour was not identified and acted upon earlier, and to review the wider implications for NHS management at the Trust and nationally. The inquiry team reported that alongside poor surgical standards, Ledward also pressurised NHS patients to become private patients, and asked patients to bring cash with them when admitted for surgery. The inquiry concluded that “failure in senior management, a culture where consultants were seen as gods, and where there were powerful inhibitions against telling
2058
tales” were among factors that prevented him being caught earlier. The inquiry recommended that senior NHS managers must be of the highest calibre, and that doctors must be given time to participate in clinical governance, which should apply equally to the private sector. They urged that a climate of openess is vital to foster good care for patients and that NHS Trusts should provide support for people who have the courage to whistleblow on underperforming or misbehaving colleagues. The inquiry noted that many consultant colleagues did not speak out about Ledward because “they felt inhibited from voicing their concerns”. The chief executive of the General Medical Council, Finlay Scott, warned that this case highlighted the importance of having effective local mechansims for detecting and acting on poor performance. The chairman of the British Medical Association, Ian Bogle, stated the NHS culture had changed for the better and that doctors are now much more prepared to report on incompetent colleagues. But, “in this case doctors did speak on a number of occassions but managers failed to act”. Haroon Ashraf
Spain’s anger at new BSE risk status he Spanish Ministry of Agriculture reacted furiously on June 1 against a report by the European Commission’s (EC) Scientific Steering Committee (SSC) on May 25, which stated that Spain is at risk of a bovine spongiform encephalopathy (BSE) outbreak in its cattle. Spain’s minister of agriculture, Miguel Arias-Cañete, denied the presence of any BSE cases in the country so far and accused the SSC of being “irresponsible” for releasing a report “which is provisional until June 19”. The ministry announced that it would go to the EC to force the SSC to amend its evaluation of Spain’s BSE status. Spain’s general director of farming, Quintiliano Pérez-Bonilla, will go to Brussels “to demonstrate with scientific data that the SSC is wrong”. The SSC published a risk study that placed 25 European countries into four BSE outbreak-risk groups. Spain was placed in the third-level risk group of countries where “BSE is not yet confirmed but where the combination of stability and challenge makes it likely that BSE could indeed be already present”.
T
Xavier Bosch
THE LANCET • Vol 355 • June 10, 2000
For personal use only. Not to be reproduced without permission of The Lancet.