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Saturday, 9 July 2011

Public expectations and inspections - when they are not met

The Peel Health Unit settled out of court on its failure to deliver on the public's expectation on inspecting a personal services establishment (tattoo parlour) http://www.mississauga.com/news/news/article/999812 .   The cost potentially $800K.  The acknolwedgement in this settlement is that there is an expectation by the public that a miminum level of health protection is being provided, and when it is not, there is an obligation to compensate. 

For public health managers it is a dilemmia.   There are not sufficient funds available to perform the level of inspection which is considered health protective.  Food establishments should be inspected 1-3 times a year depending on the sorts of food they serve.  Ask your local health unit what their compliance with this expectation is. I have seen as low as 50%, and I've seen high risk establishments go uninspected for years.  Now, as a manager when the information becomes available there is a duty to remediate it and things are better - but try to find the performance of public health entities anyway on this expectation.

Other areas that the public expect are healthy and depend on the work of enviornmental health officers include ensuring the water is safe at the tap, restaurant food won't make you really sick, when you swim in pools or at beaches that you aren't going to contract an illness, that housing is safe, our children aren't exposed to nasty things in schools like radon, that the disposal of human waste doesn't lead to sickness, or in the hospital setting where sterilization processes ensure germs don't spread from one person to the next on whom those instruments are used.   Or at least we have come to expect that these things are safe.   History has shown repeatedly that when routine inspections are whittled to lesser infrequency - disasterous situations occur.  These aren't the situations where one or two people become ill, but as in the Mississauga tattoo parlour, some 3000 persons were potentially exposed are recommended to be tested.

There are three solutions. First lets begin by ensuring that inspection rates are transparent and compared across regions, second is to ensure programs are adeqately funded to perform the duties. The third choice is to lower public expectations and depend on the old adage of buyer beware.  In the absence of this, politiicans and public health managers play a game of chance with people's lives.   Most of the time there won't be a problem, and when a problem occurs perhaps we will apologize and compensate somewhat for the damages. 

Tainted blood scandal, Walkerton, Listeriosis outbreak, "Hamburger" disease outbreaks in large fast food chains, E. Coli in sprouts from Germany, and many more that I could list.   My sympathies to any who personally, or through a family member or friend, were impacted by similar situations. We have been good at learning from these situations, but implementation of the solutions has almost inevitably fallen far short as the memories faded and burried.

Look around and ask the question what do you depend upon that your health and safety have been protected by an inspection process - and what would it mean if you know that the job was undertaken in a "half" hearted fashion.

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