Sarah Boyack: Lessons to be learned from the legionnaires’ outbreak

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The announcement from NHS Lothian that the legionnaires’ outbreak has officially ended will come as a huge relief to communities across Edinburgh. Over the last couple of months, the outbreak has caused untold distress to families across the city.

In the end, just over 100 cases were either confirmed or suspected and, sadly, three lives were lost. Some patients may also have to live with long-term debilitating after-effects.

The response from NHS staff to the considerable demands of the outbreak has been exceptional, providing treatment and reassurance, particularly given the backlog of waiting times cases that NHS Lothian is currently dealing with.

However, now the outbreak has been stemmed, our focus must shift to reviewing the response by all agencies, identifying areas of improvement and ensuring that steps are taken to minimise risks in future. For that to happen, I support the call made by Tom Bell, chief executive of the Royal Environmental Health Institute of Scotland, for a full public inquiry.

One of the key issues that needs to be addressed is how the outbreak was allowed to happen.

Eminent bacteriologist Professor Hugh Pennington has stated that this was no act of God and comes down to a failure of maintenance. Mr Bell believes it is clear that there has been “some kind of negligence”.

The Health and Safety Executive confirmed in correspondence with me its position that responsibility for the control of risks lies with those who create them. They see inspections from the HSE as being simply to check up on the management systems that are in place.

However, as reports in the Evening News revealed, firms suspected in the outbreak had not been inspected for between two and four years. Such an infrequent approach seems unlikely in itself to engender good practice and when the fact that unannounced inspections have been cut by a third in the last year is factored in, I am concerned that this is could have contributed to a slip in standards.

An inquiry would allow for the inspection regime to be considered. This would help to identify whether this made a substantial contribution to the outbreak and what steps could be taken to address the current shortcomings.

There’s also the issue of communications with the public. The main concern raised with me by constituents concerned the distribution of information. Initial reporting of the outbreak was bound to cause considerable concern. That made early, clear information about the disease, how it is spread, sensible precautions and when to seek help, absolutely vital to provide much-needed reassurance.

However, in the weeks following the announcement of the outbreak I continued to hear from concerned residents who had not received leaflets spelling this out. Moreover, the failure to provide the information in a range of languages and formats meant not everyone was fully informed.

Much up-to-date information was made available through the internet, from the Scottish Government and NHS Lothian. However, many households don’t have access to a computer. On an issue as important as this, there is simply no substitute for direct contact addressed to every household.

I also believe the experience of residents could provide valuable insight. I would therefore welcome moves to consult with the public as part of an inquiry.

Interestingly, the importance of learning lessons from the outbreak can be demonstrated in the handling of the outbreak itself. It is worth noting that the coordination of the NHS response was in large part based on the lessons of past experiences, particularly the swine flu pandemic of 2009.

While the calls for a public inquiry continue, I am pleased to see initiatives springing up around local communities to move beyond the outbreak.

The Getting on in Gorgie Dalry Campaign is bringing together residents, community groups, businesses and politicians to share ideas about how to promote the positive aspects of the area and repair the damage done.

I warmly welcome this initiative. There is a strong community spirit in Gorgie and Dalry. The outbreak has been difficult for the area and it is great to see that people want to come together to talk about how we can move forward constructively.

n Sarah Boyack is a Labour MSP
for Lothian

TIMELINE

Thursday, May 28: The first case of legionnaires’ is identified.

Monday, June 4: The Evening News reports that three men are being treated in intensive care, and another in a high-dependency unit, with four other suspected cases.

Tuesday, June 5: Construction worker Robert Air, 56, dies at the ERI, the first victim of the outbreak.

Friday, June 15: A second man dies, as ten people remain in intensive care.

Wednesday, June 20: Holyrood’s health committee announced it is to investigate the handling of the legionnaires’ disease outbreak which has claimed two lives in the Capital.

Wednesday, July 4: A third man dies as a result of the outbreak, while another is taken back to hospital more than a month after he first became ill.

Monday, July 16: The Scottish Government says the number of confirmed and suspected cases has reached 101.

Thursday, July 19: Health bosses declare that the outbreak is over – but that some undiagnosed cases may still be detected.