Volume 9: Wales, Scotland and Northern Ireland
Part 3: Northern Ireland
14. Departmental responsibilities
Department of Health and Social Services (DHSS)
Medical professionals
Medicines and Food Control branch
The Health Promotion and Disease Control branch
The Health and Social Services Boards

14.26 The DHSS was headed by a Parliamentary Under-Secretary, a post held at different times by, among others, Mr Richard Needham and Baroness Denton.

14.27 The responsibilities of the DHSS with respect to BSE/CJD fell into two broad categories:

1. to engage in preventive action to protect public health; and
2. to provide healthcare to persons suffering from illness.

14.28 The groups in the DHSS relevant to the BSE story were the Health and Social Policy Group, and the Medical and Allied Group. Within the former, the Medicines and Food Control branch undertook the public health responsibilities of the DHSS. The medical professionals within the Medical and Allied Group consisted of the Chief Medical Officer (CMO) and his/her staff, who provided advice to administrative branches and directly to the Secretary of State.

14.29 There was no organisation in Northern Ireland equivalent to the Communicable Disease (Scotland) Unit (see paragraphs 9.24-9.25) or the Welsh Unit of the Communicable Disease Surveillance Centre (see paragraphs 4.21-4.22). The analogous function was carried out by a medical division in the DHSS, supported by the Regional Communicable Diseases Liaison Group, which is described more fully below (paragraphs 14.37-14.40). As mentioned in paragraphs 9.28-9.29, the CJD Surveillance Unit in Edinburgh had a remit that covered the whole of the United Kingdom.

14.30 There was also no Public Health Laboratory Service in Northern Ireland. Samples taken from humans were analysed at the nearest hospital or referred to the Central Public Health Laboratory of the PHLS at Colindale in England or the Belfast City Hospital if further study was required. The latter institution also had the capacity to examine food samples.

14.31 The DHSS did not have its own in-house expertise or any research or investigative capacity in food science and technology, and thus it was departmental policy to look to MAFF and DH for national guidance and advice in relation to food safety matters generally.

Medical professionals

14.32 As in the other parts of the United Kingdom, the Chief Medical Officer (CMO) was head of the medical professionals. Dr John McKenna held this post between December 1986 and June 1994, when he was succeeded by Dr Clifford Hall and later Dr Henrietta Campbell. He described his public health duties as follows:

to monitor the state of health of the public of Northern Ireland;

to advise the Minister on matters relating to the public health and on medical matters relating to the Health and Personal Social Services (with a right of direct access to the Minister);

to advise the DHSS and all other Northern Ireland Government Departments on matters relating to the Northern Ireland public health;

to advise the Northern Ireland public on matters relating to their health, being the chief Government spokesperson on these issues;

to bring resolved medical advice to the DHSS;

to provide direct medical services for Northern Ireland Government Departments;

to provide medical professional leadership in the implementation of Government policies by initiating and driving through necessary changes;

to monitor and review the provision of medical services, ensuring their appropriateness, effectiveness and quality; and

to represent the DHSS and the Northern Ireland medical profession on national committees. ¹

14.33 The CMO reported to the DHSS Permanent Secretary but in addition had direct access to the Secretary of State. He or she was assisted by a Senior Medical Officer (SMO) and Deputy Medical Officers. For the whole of the period covered by this Report there was an SMO in the DHSS with specialist communicable disease expertise. ² According to Dr McKenna, this meant having enough expertise to deal with the range of zoonoses that arose in the population of just 1.6 million, and in particular in the farming community. ³ The Department had access to whatever training was available in the UK to deal with zoonoses, but did not have its own zoonosis specialist. ⁴ The SMO also had access to the full network of microbiological expertise in Northern Ireland, both in the DHSS itself and in DANI. Dr McKenna emphasised how the close-knit nature of the Northern Ireland Departments facilitated internal communication. ⁵ DANI and DHSS staff, for example, were housed in the same building.

Medicines and Food Control branch

14.34 The Medicines and Food Control branch was responsible, among other things, for preparing Regulations under the successive Food Acts covering food additives, labelling, composition, hygiene, etc. ⁶ The name of this branch was later changed to the Health Protection branch. Mr George Hamill, head of this branch between 1988 and 1993, described its involvement in the BSE story as follows:

Neither I nor my administrative colleagues in Medicine and Food Control branch had any expertise in BSE or CJD and we were certainly not in any position to propose alternative courses of action in relation to BSE or CJD. Our sole function in relation to BSE was to implement policy by producing legislation for NI to maintain parity with Whitehall Departments. ⁷

The Health Promotion and Disease Control branch

14.35 This was headed by Mr P Green and then Mr E Rooney and provided administrative support to the CMO and his/her staff.

The Health and Social Services Boards

14.36 At the level of the four Health and Social Services Boards, control of communicable disease was coordinated by an Area Team led by a Consultant in Communicable Disease Control. The Team also included a nurse, an Environmental Health Officer and a Divisional Veterinary Officer where necessary, and could call on the Regional Communicable Diseases Liaison Group (see below) for assistance at any time. ⁸