Brexit: in the shadow of Louis Pasteur

By Richard North - February 12, 2021

There’s maybe a book to write about this, about how the (then) EEC screwed up public health in the UK, although I doubt anyone would read it. But there is nevertheless a story there, one which helps explain part of the mess in which we find ourselves, and points the way to how Brexit should be handled in the future.

The story, however, does not start with the UK joining the EEC in 1973. It has multiple threads, one of which is the emergence of organised public health in Great Britain, led by the great reformer Edwin Chadwick whose work led to the Public Health Act 1848. This was the first instance of the British government taking responsibility for the health of its citizens.

From this came a locally based system of public health control, in the form of health boards, which laid the foundations of local government in England, as we know it today.

The key officials who made this new system of government work were the Medical Officer of Health, who headed their departments, assisted by then “inspectors of nuisances”, who became sanitary inspectors, then public health inspectors and, finally, the environmental health officers, posts which are still part of our current system of local government.

In parallel, we saw the great revolution in infectious disease control, largely (but not entirely) due to the experiments of French Chemist Louis Pasteur which led to the evolution of the “germ theory” – postulating what was at the time considered the outrageous idea that tiny organisms (known as micro-organisms, of “germs”) were responsible for the spread of disease.

Such blasphemy was initially rejected by the French medical establishment and, for a series of reasons – not lest a search for a cure for rabies – this led Pasteur to work closely with the veterinary profession in France.

When he came to England, though, Pasteur’s ideas were embraced by the English medical profession, already used to such ideas through the activities of John Snow (he of Broad Street pump fame). They were taken up enthusiastically by pioneering surgeon, Joseph Lister, who demonstrated in practice the virtues of disinfection and aseptic techniques in the prevention of infection during surgery.

Alongside the strictly medical applications of germ theory, we also say the development of “sanitary systems” for what later became better known as food hygiene, and latterly food safety, centred initially on slaughterhouses which had always, since biblical times, been regarded as potent sources of disease.

Such developments largely took place simultaneously on the continent and in the UK but, because of the way public health systems were emerging, and the way Pasteur’s theories had been treated, food control developed in entirely different ways.

In the UK, we saw a medically-based local government system, led by Medical Officers of Health and supported by their public health inspectors, taking charge of this increasingly important discipline. But, by contrast, the general trend was the emergence of centralised systems, led by veterinarians, focussed mainly on meat hygiene and inspection, developing entirely separately from mainstream infection control.

With the two very different systems more or less established by the time Monnet had set the Six on their path to Rome, with the creation of the EEC in 1957, it was inevitable that, when the Community started looking seriously at the harmonisation of meat hygiene, it would build on the existing continental practice of veterinary-based systems, led by what became “official veterinarians”.

This, in more ways than one, left the UK out on a limb, with its own separate and distinct system, further developments of which had led to a more-or-less fully integrated system of public health, where Health Departments were responsible for the control of epidemic infectious diseases, only one part of which was food borne disease and food poisoning prevention, investigation and control.

As the EEC built up its Common Market acquis, first with Directive 64/433/EEC on trade in fresh meat, and then with Directive 71/118/EEC on fresh poultry meat, and developed its systems, local government in the UK was undergoing major reform, with the Local Government Act 1972, taking effect in 1974.

With this came the most fundamental change to the public health system since 1848, with the abolition of what had been the statutory post of Medical Officer of Health, and its replacement with a weak system of “Community Physicians”, detached from their former departments.

In another major change, these became Environmental Health Departments, headed by their own directors, who were qualified EHOs. The “ugly duckling” sanitary inspector had emerged from the shadow of the medics, and were now in charge of their own destinies, covering a far wider range of duties than the former public health departments, reflected in the new name.

This change was thought vital at the time (and since), on the basis that it would be difficult to attract the high quality, degree-educated staff necessary to perform the wide range of complex tasks covered by environmental health, if the best they could aspire to was to be “assistants” to another profession, without ever being able to head their own departments.

This was entirely logical and sensible. The new profession had to offer its practitioners a career path that would not only attract recruits but keep them in the profession.

It was about that time also that food safety was emerging as a specialism within environmental health, facilitated by local government reorganisation which massively reduced the number of districts, and increased their sizes, making the employment of specialists a viable proposition.

A year before reorganisation, of course, the UK had joined the EEC and the profession had to confront the new food safety legislation. The big difference for EHOs was that tasks historically reserved for them, under the control of medical officers, were now allocated to “official veterinarians”, which the UK chose to define as official veterinary surgeons (OVSs), holding the qualification of the RCVS.

For EHOs, with their new-found professional independence, this was a disaster. In fact, looking at the text of Directive 71/118/EEC, it was more than a disaster. It was an outright insult. There, in black and white, it stated:

Whereas in order to ensure satisfactory health inspection, taking into account the particular conditions under which it is carried out, certain tasks must be entrusted to qualified assistants acting under the responsibility and supervision of the official veterinarian.

In key areas of food safety, our newly emergent profession was relegated to the status of “qualified assistants”, handmaidens to the vets, the majority of whom, in the UK, had no background in food safety and very little involvement or experience.

Looking at the broader picture, the prospects were dire. For most environmental health departments, there was not enough work to justify the employment of a full-time vet, and they were useless for other functions, such as clean air monitoring, housing, noise pollution and the myriad of other duties we had to deal with.

There was talk, therefore, of splitting off the meat hygiene function, to create a new, centralised meat hygiene services, on the continental model, fragmenting the previously unified food control system. In the fullness of time, that is exactly what happened, seriously damaging the original systems which had emerged from Chadwick’s efforts and the early pioneers.

In an attempt to prevent this, the profession campaigned hard. I and a few other EHOs set up a campaigning organisation called the Food Law Action Group (FLAG). Collectively, we had some limited success. We got the matter raised not only in Parliament but also in Brussels.

In 1981, the Commission then reported on the issue, in COM(81) 504 final. In a patronising and humiliating rejection of our case, it confirmed the supremacy of the official veterinarian system, and kicked us out of the slaughterhouses.

It relegated us to the supervision of “poultrymeat cutting plants and storage premises separated from abattoirs in relation to meat product establishments”, even while acknowledging that, in the United Kingdom, “neither the medical nor veterinary profession is made responsible for food hygiene and inspection”.

One of the first victims of the EEC’s “one-size-fits-all” philosophy, our profession was expendable, sacrificed on the altar of European political integration. And, as we listened to the prattling of Europhiles about the need to keep the peace in Europe, we had cause to ruminate on how essential it was for vets, with their coloured crayons, to supervise slaughterhouses, an essential element in the plan to prevent Germany invading France, or vice versa.

Unsurprisingly, many EHOs became lifelong eurosceptics, as did I, not having moved from that original position of resenting EEC interference in what was, in fact, part of our cultural heritage.

On the more rational side, the break-up of the previously unified and integrated public health system was a grave mistake, for which we are paying in this current Covid epidemic, with the test and trace debacle. The EEC and now the EU was not directly responsible for that, but their damaging interventions did not help.

History cannot be undone, but Brexit does give us the chance – however forlorn – to remedy historical wrongs. It also gives us a chance to drag food safety control out of the 19th Century and the shadow of Louis Pasteur, where it resides with the EU.

It needs to be brought into the 21st Century with the development of food safety as a separate discipline, its practitioners no longer handmaidens to the veterinary profession.