Volume 9: Wales, Scotland and Northern Ireland
Part 1: Wales
6. Comment

6.1 In Wales the Chief Medical Officer, Dr Hine, had an advisory public health team which included two public health epidemiologists linked with the Welsh Unit of the PHLS's Communicable Diseases Surveillance Centre, and an environmental health adviser with extensive knowledge of meat hygiene. The medical officer member, Dr Jacobs, also had firsthand knowledge of slaughterhouses. The issues identified by this combination of talents when they addressed BSE were not peculiar to Wales. They raised wider scientific and medical questions that bore on the general handling of the disease.

6.2 This Welsh intervention brought a cool response from London both initially and over the next two years. It was seen as trespassing on a policy area where the Welsh Office did not have automatic authority and where, generally speaking, it was expected to follow the Whitehall line. The reaction was that those raising the questions were ill-informed and not to be taken seriously. Mr Bradley saw their points as 'likely to result from ignorance'. Dr Pickles reprimanded Dr Jacobs for challenging more senior and experienced colleagues with 'frequent access to the real experts in the field'.

6.3 Because of shared statutory provisions, all the BSE measures were introduced simultaneously in Wales and England, so there were none of the 'tailoring' difficulties that had to be handled in Scotland and Northern Ireland. Likewise, enforcement was carried out under parallel arrangements. It would in principle have been possible for Welsh Ministers to argue for a different line on the policy to be followed on BSE - as they did in proposing 100 per cent rather than 50 per cent compensation for farmers and, later, in opposing the creation of the Meat Hygiene Service. However, we do not think there was any reason why there should have been a different application of BSE measures in Wales.

6.4 Nevertheless, Wales was also a partner, notionally at least, in preparing advice for Ministers and taking follow-up action. We have therefore asked ourselves two questions:

• Was the response of the Welsh Office, and in particular of the Welsh CMO Dr Hine and her team, to the emergence of BSE appropriate and timely?
• Did they adequately pursue their concerns thereafter?

6.5 As volumes 5 and 6 on animal and human health between 1989 and 1996 indicate, some of the points raised by the Welsh Office were highly pertinent, especially given their bearing on the enforcement strategy for the SBO ban.

6.6 On the first question, the Welsh Office Agriculture Department was initially in the lead and working closely with MAFF. Dr Hine understandably did not involve herself until alerted by the shared concern of Dr Jacobs and Mr Alexander following the diagnosis of a transmissible spongiform encephalopathy (TSE) in the Bristol cat. On being advised of the proposed statement of Sir Donald Acheson, CMO for England, in May 1990, about the safety of eating beef, she immediately convened a meeting to agree a line. This avoided endorsing what she saw as the excessively reassuring statement by Sir Donald. She and her colleagues then took prompt action to pursue the immediate concerns raised and discussed at her meeting. We commend this as an appropriate and timely initial response.

6.7 On the second question, no time was lost in following up those concerns. They were highly pertinent. They included the risks from feeding non-ruminants with MBM which contained bovine material; the ethics of continued exports of animal feedstuffs that had been banned in the UK; and the contamination risks in slaughterhouses to carcasses and to workers from brain material. Mr Alexander is to be commended for his prompt identification of these risks and Dr Jacobs for immediately drawing the attention of the HSE to the need for guidance for workers on this last point and, together with Mr Huws of WOAD, for challenging the treatment of head-splitting in the proposed MAFF guidelines for the industry regarding cutting procedures. ¹ When SEAC considered these guidelines in June 1990, they were unaware of the Welsh Office views, but followed the same line of thinking in advising that in future head meat had to be recovered before the brain was removed.

6.8 During the summer of 1990 the Welsh Office continued to press its other concerns, to the irritation of MAFF and DH, as we have noted above. However, we consider that it was right to do so. The issues being raised were relevant. If the Welsh Office lacked the information it wanted and needed, both then and later, that was because the communication arrangements were inadequate. Dr Hine's team had a combination of knowledge and experience to offer that might have helped both MAFF and DH in securing effective action.

6.9 A complicating factor in subsequently pursuing all the concerns that Dr Hine's team had identified was the existence of separate networks through which the Welsh Office normally communicated both formally and informally with Whitehall. Dr Hine, as Chief Medical Officer, met regularly with her counterparts in England, Scotland and Northern Ireland. Most health business was, however, done through links between WOHD and DH officials. WOAD had its own separate links with MAFF and its veterinary advisers. The Under Secretary concerned, Mr John Davies, was initially not happy over what he saw as Dr Hine trespassing on his Department's (WOAD's) remit by raising her concerns through the health network. That was subsequently resolved as having been a professional exchange, and thereafter he and Dr Hine combined their efforts to get their concerns taken on board, in particular by SEAC.

6.10 The issues that concerned Dr Hine were, however, never elevated to the Permanent Secretary or Ministers at the Welsh Office. This we found a little surprising. Dr Hine told us in oral evidence, when asked about her reaction to Dr Pickles's exasperated letter of 9 August, that she and her staff at the time had a responsibility to the people of Wales to raise their concerns about the disease with DH. We note that the Secretary of State, Mr Peter Walker, had not only participated in the Cabinet discussion of the Southwood Report but had subsequently pressed for better compensation for farmers. However, by the time Dr Hine's team began to raise their concerns, Mr Walker had been succeeded by Mr David Hunt. Even so, it would seem not unreasonable for Mr Hunt's chief medical adviser to have told him of her misgivings and the difficulty she had in getting a Whitehall reaction to these.

6.11 Mr Lloyd, Deputy Secretary in the Welsh Office, told us that he considered it desirable that Dr Hine's points and misgivings on scientific aspects should be put to DH. ² However, he did not consider it necessary to inform Ministers at this stage as discussions between professional staffs took place all the time on a wide variety of subjects, and the time to report them to Ministers would only be when 'anything of significance emerged'. ³ Dr Hine told us she did not do so for fear of placing the Secretary of State in the embarrassing position of raising unsubstantiated concerns, and 'at best he would have been given the same reassurances that we had received and at worst been rebuffed in similar fashion'. ⁴

6.12 We think this underrates the robustness of Ministers and the importance of the topic to them. For example, Lord Walker, who was Welsh Secretary of State immediately before this period, told us that if the CMO had come to him with arguments that were being disregarded in London and he had had sympathy with them, he would have raised the point with his Health opposite number and the Prime Minister if need be. ⁵ One might expect that his successor, Mr Hunt, whose period of tenure overlapped with Dr Hine's, would have done the same.

6.13 Dr Hine did seek to press her concerns through other channels, however, both in relation to Dr Salmon's criticisms of the quality of epidemiological analysis and, in particular, with a view to opening up a better line of communication from SEAC. The history of these efforts is set out in Chapter 5. She told us she raised these concerns at her regular meetings with other CMOs, in particular her desire to gain better access to SEAC thinking. Unfortunately her efforts appear to have been treated simply as a narrow point about membership of Dr Tyrrell's Committee. We admired her tactic, when faced with a stone wall, of inviting Dr Tyrrell to Wales to discuss Welsh issues. The correspondence that ensued attempted to press the points raised at that meeting, in particular about epidemiology and slaughterhouse practices, though Welsh Office staff were disappointed by what they saw as the failure of SEAC to take these further.

6.14 We were not surprised that after 1992, when policy-making on BSE appeared to have gone quiet and the enforcement inadequacies had not yet come home to roost, Dr Hine turned her mind to other matters. She had done her best when key policies were being put in place to ensure that they gave proper weight to the uncertainties of the science and the realities of slaughterhouse conditions. We think the Welsh Office was well served by the combined talents of its team of medical staff and the advice they gave during the initial stages of the epidemic. We do not suggest that all the points they raised were well-founded but nevertheless it was unfortunate that their voices were not more clearly heard in Whitehall at the time.

Welsh Office Ministers

Welsh Office Agriculture Department

Welsh Office Health Professionals

Welsh Office Health Administrators