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"Systemic failures" in public health led to an outbreak of listeria, the expert says


According to a former health manager, "systematic failures" in public health have resulted in the deaths of nearly 20 people, five of which were linked to a listeria outbreak.

Professor John Ashton, an independent public health consultant, described 17 deaths related to isolated outbreaks of listeria and streptococci earlier this year as "serious failures" in the public health system.

The former Northwest Regional Director of Public Health from 1993 to 2006 said that since the transfer of responsibility for public health to the municipality in 2013, public health institutions were "separated" and budgets and salaries were cut "dramatically".

Writing in The Royal Society of Medicine on Friday, he warned that nearly a decade of austerity and "huge cuts" in municipal budgets have led to environmental health departments no longer able to "withstand human health threats." ".

He added: "Now is the time to digest these recent public health system failures that were introduced only six years ago as part of (former health secretary) Andrew Lansley's structural changes to the NHS and public health.

“There is a scheme in which the clinical perspective in the local government has disappeared and the links between the local authorities and the NHS have become increasingly dysfunctional.

“This is reflected in the decline in performance in areas including sexual health, immunization and vaccination, and screening programs.

"To increase the anguish, 10-year austerity measures and major cuts in local government budgets have led to the destruction of environmental health departments, which, despite their efforts, are no longer able to keep up with human health threats."

Between the time of writing and the publication of the report, the number of deaths associated with the Listeria outbreak has risen from five to six and the number of streptococci from 12 to 13.

Prof Ashton compared two major incidents that caused 41 deaths in the mid-1980s due to outbreaks of salmonella and legionella.

He said these outbreaks followed a "radical change" in the local government that "unraveled" the existing public health system.

At the request of 1988, he considered the lack of effective control of the local environment and communicable diseases at the center of both events.

Prof Ashton warned that the lesson of history was not to start another organizational "nonsense".

He added: "So in 2019, just six years after the card pack was discarded and public health was reorganized into a NHS-style downhill reorganization, we have a systemic problem that has led to the death of 17-year-old citizens who deserved better.

"The lesson of history is that we should not resort to repeated organizational stupidity, but rather find ways to strengthen what we have now and support its development as something fit for purpose."

Public Health England (PHE) announced earlier this month that a sixth person has died after eating a sandwich and salad packed in connection with a listeria outbreak.

The most recent death was one of nine previously confirmed cases, and the PHE said there were no new cases related to the outbreak.

The patient, whose age and gender were not specified, obtained listeriosis from Good Food Chain Products while in West Sussex hospitals at the NHS Foundation Trust, the PHE said.

The Food Standards Agency has previously confirmed that the source of the outbreak was not the Good Food Chain, which was closed in June.

The NHS Mid Essex Clinical Commission Group reported last month that 13 people had died in an invasive outbreak of Group A streptococci.

Health superiors had previously reported 12 deaths due to a rare bacterial infection, but after the PHE reviewed how the cases were defined, an additional case was added to the total.

Nick Phin, deputy director of the National Infection Service, PHE, said: “PHE quickly identified the size and source of the recent Listeria outbreak using a whole genome sequence that undoubtedly saved lives. The public health system works around the clock to protect the country from infectious diseases and other health threats. "

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