Volume 1: Findings and Conclusions
Executive Summary of the Report of the Inquiry
7. Measures to address the risks posed by BSE to humans
Slaughter and compensation
Food risks

Slaughter and compensation

• Compulsory slaughter and destruction of all animals showing signs of BSE was a crucial measure to protect human health and, incidentally, animal health. It prevented the use, for any purposes, of sick animals, which could otherwise have been sent to the slaughterhouse for human consumption.
• A compulsory slaughter and compensation scheme was introduced in August 1988, following the commendable interim advice of the Southwood Working Party. Had there been prompt and adequate collaboration between MAFF and DH, this measure could and should have been introduced months earlier.
• Levels of compensation to farmers were adjusted on two occasions, but at no time did they lead to any significant failure to comply with the duty to notify the SVS of animals showing signs of BSE.

Food risks

• The Southwood Working Party considered that all reasonably practicable precautions should be taken to reduce the risks that would exist should BSE prove to be transmissible to humans. However, they did not make this plain in their Report and did not recommend that the possible risks from eating animals incubating BSE but not yet showing signs of the disease ('subclinical cases') called for any precautions, other than a recommendation that manufacturers should not include ruminant offal and thymus in baby food. This was a shortcoming in their Report.
• Because of a failure to subject the Southwood Report to an adequate review, MAFF and DH failed to identify this shortcoming. Concern about the food risks posed by subclinical cases was, however, expressed by some scientists, by the media and by the public. With the agreement of DH, MAFF reacted by announcing in June 1989 that those categories of offal of cattle most likely to be infectious (SBO) were to be banned from use in human food. The introduction of this vital precautionary measure was commendable. However, this ban was presented to the public in terms that underplayed its importance as a public health measure.
• Careful consideration was given by MAFF and DH in 1989 to the terms of the human SBO ban, with one important exception. During the consultation process, concerns were raised about the practicality of ensuring the removal of all of the spinal cord during abattoir processes, and about the practice of mechanical recovery of scraps left attached to the vertebral column for use in human food ('mechanically recovered meat' or MRM). However, MAFF officials discounted these concerns without subjecting them to rigorous consideration - in particular no advice was sought as to the minimum quantity of spinal cord that might transmit the disease in food.
• MAFF gave detailed consideration to spinal cord and MRM in 1990. A lengthy paper was submitted to SEAC, the Government's new expert advisory committee on TSEs. Unhappily, as a result of a breakdown of communications, MAFF officials understood that the members of SEAC were not concerned about the inclusion in human food of an occasional scrap of spinal cord, so that no action was called for. In fact the advice of some, at least, of the members of SEAC was premised on the false assumption that spinal cord could readily be removed from the carcass in its entirety, and would be so removed.
• This was one of a number of occasions that has given rise to lessons for the future about the proper use of expert committees by the Government.
• Not until 1995 was action taken in relation to MRM. Following the takeover by the Meat Hygiene Service of the enforcement of Regulations in slaughterhouses, occasional instances were discovered of failure to remove all spinal cord from the carcass. Strenuous and successful steps were taken to improve standards of compliance with the Regulations in slaughterhouses. Eventually, in December 1995, on SEAC's advice the extraction of MRM from the spinal column of cattle was banned.
• Up to 1995, MRM was a potential pathway to the infection of humans with BSE, not merely because of the risk of inclusion of the occasional portion of spinal cord, but because the material recovered by the MRM process included dorsal root ganglia. These were peripheral nervous tissues which were not thought to be infectious at the time, but which have since been demonstrated to be infectious in the late stages of incubation.