Health Committee looks at Legionnaires outbreak

Last week the Parliament’s Health Committee met to discuss the Legionnaires outbreak in Edinburgh.

I attended the meeting so that I could question representatives from the Health and Safety Executive (HSE), NHS Lothian and the City of Edinburgh Council about their handling of the outbreak.

If you are interested in the full discussion you can watch it online here or read it in the Official Report. Colleagues raised concerns about the frequency of the inspection regime at the potential source sites, the numbers of qualified inspectors and the responsibility of companies to ensure that they and any subcontracted companies upheld standards.

There was a lengthy discussion about the process of identifying people with legionnaires and ensuring they got access to the right medical support.

My focus was on the distribution of information to the public and the fact that many people have reported to me that they are still to receive a leaflet from NHS Lothian.   I raised the fact that many people in the area, particularly older members of the community or people on low incomes, were less likely to have access to broadband and therefore would not see e-alerts.  

On the distribution of information, I am still hearing from people who have not received information leaflets through the post regarding the outbreak.  This sort of direct contact is vital to raising public awareness.   We cannot assume that every household has access to the internet or buys a local paper to get information.   I made the point that the area is largely tenemental and that particular care was needed to ensure that literature was delivered through residents’ doors, not just dropped at the bottom of stairwells.

In addition to the failure to comprehensively cover the outbreak area, interesting points were also raised about targeting the message to different communities taking account of, for example, different languages – it is important that lessons are learned in this regard.

I was concerned at the time both about promoting wider public health messages to those who hadn’t shown signs of legionnaires as well as those who needed urgent medical attention.   From discussions with people locally clarity on drinking water and when it was safe to be outside were issues that people wanted more information on.   I also raised the issue of support for families who had direct experience of legionnaires and were struggling to get through the outbreak.

The other issue I focused on was the question of whether there would be an enquiry, what format may take, whether local people’s views would be sought and listened to and when it might happen.   People who have lost loved ones or seen relatives seriously ill need answers about how the outbreak started.

Other issues raised at the meeting were cuts to both the Council and the HSE in relation to staff who have responsibility for monitoring and upholding safety standards.  Neither the council nor the HSE believed that their budget cuts had compromised safety.   

Then there is the issue of the possibility of cuts in the proactive inspection regime.   Recent reports have revealed that some suspected sites have not been inspected for between two and four years.  The HSE view is that they have their priorities and that it is the job of company owners and managers to ensure that safety is upheld.

The NHS Lothian’s board interim report from the Incident Management Team formed to deal with the crisis was published last week.   Although investigations into the source of the outbreak are continuing, the interim report includes the team’s risk assessment that exposure is not on-going.

The report identifies that NHS Lothian have dealt well with the increased demand placed on their services.  In particular highlights the importance of past lessons, pointing to the experience of the H1N1 outbreak in helping to manage the outbreak.

The response from NHS staff to the considerable demands of the outbreak has been exceptional providing treatment and reassurance.  However, I am mindful of comments from Professor Hugh Pennington, an eminent bacteriologist, that the outbreak should never have happened and of calls from the Chief Executive of the Royal Environmental Health Institute of Scotland for a public inquiry into the outbreak.

The evidence session in Parliament was useful to highlight the issues where lessons can be learned but I believe that a full public inquiry would be a useful exercise to ensure that this process is conducted transparently and am requesting that the Scottish Government considers this option.

I followed up the issue at the final First Minister’s Questions of this session.   I am keen that lessons are learned swiftly and we get full understanding of what further health and safety measures can be put in place.   In particular there is the issue of changes that can be made in relation to cooling towers.   I will be researching this issue over the summer.