Introduction

At the meeting of the LegCo Bills Committee on the Provision of Municipal Services (Reorganization) Bill on 27 July 1999, Members asked the Administration to provide a paper elaborating the following:

1. the procedures for the proposed Food and Environmental Hygiene Department (FEHD) to co-ordinate with the Department of Health (DH) and Agriculture and Fisheries Department (AFD) in the surveillance, investigation, assessment and control of outbreak of food-borne diseases, using the examples of the avian flu crisis, suspected food contamination caused by dioxin and presence of ciguatera toxin in coral reef fish;

2. the authorities for each step of action described in (a);

3. the comparison of the existing and proposed procedures and workflow for dealing with food and environmental hygiene matters;

4. the existing and proposed arrangements for secondment of health officers from Department of Health, the line of command and their sphere of responsibilities; and

5. the authorities for identification, assessment, control and prevention of communicable diseases, including those involving bathing beaches, livestock and seafood.

2. This paper sets out the current division of responsibilities between the relevant government agencies in dealing with food safety and environmental hygiene matters and the Administration's initial thinking on the proposed division of responsibilities under the new structure to be set up by 1 January 2000.

Current Division of Responsibilities

3. The major bodies involved in food safety and environmental hygiene are the two Provisional Municipal Councils (PMCs), the Urban Services Department (USD) and Regional Services Department (RSD), the Health and Welfare Bureau (HWB), the Department of Health (DH), the Economic Services Bureau (ESB), the Agriculture and Fisheries Department (AFD), the Planning, Environment and Lands Bureau (PELB), and the Environmental Protection Department (EPD). Their functions are summarised below, and illustrated in a diagram at Appendix I. Other bodies also involved include the Government Laboratory which analyses food products for regulatory compliance and the Hospital Authority which is responsible for treatment of communicable and foodborne diseases.

Provisional Municipal Councils and Municipal Services Departments

4 The PMCs are statutory bodies which enjoy a high degree of autonomy in setting policies and utilising resources in the provision of services and facilities within their regions. They are financially autonomous and have powers to make by-laws applicable to their regions under the Public Health and Municipal Services Ordinance (Cap. 132). USD and RSD are the executive arms of the PMCs. The PMCs are responsible for a host of functions relating to food safety and hygiene, including the setting of certain food standards (such as milk and frozen confections), licensing and inspection of food premises (such as food factories, restaurants, fresh provision shops), management and hygiene of markets, meat inspection in abattoirs, licensing of private slaughterhouses, etc. They are also the major bodies responsible for environmental hygiene, including street cleansing, pest control, waste collection, and control of disposal of the dead.

Department of Health

5. The DH is the Government's health adviser and the agency for executing health care policies and statutory functions. The Hygiene Division of DH is funded by the PMCs. The Division is responsible for the control of food safety of imported and locally produced food. It runs a regular food surveillance programme, taking food samples for laboratory testing at the import, wholesale and retail levels. The Division also provides advice to the two PMCs on pest control and health education. Moreover, the PMCs have delegated certain food safety-related functions in Cap. 132 and its Bylaws to staff of the Hygiene Division, such as powers for approval of sources of manufacture of imported milk and frozen confections.

Agriculture and Fisheries Department

6. The AFD is responsible for control measures on live animals and poultry at farms, import and wholesale market levels, and related matters such as control of pesticides, monitoring of red tides and tracing of ciguatera toxin contaminated fish. It is also responsible for licensing dairies and the prevention and control of diseases transmissible from animals to man such as rabies.

Environmental Protection Department

7. The EPD is responsible for waste disposal and reduction, and the prevention and control of air, noise and water pollution.

Policy Bureaux

8. DH reports to the Health and Welfare Bureau while also being accountable to the PMCs in food safety and hygiene matters. AFD reports to the Economic Services Bureau (except for country parks and conservation, which are the policy responsibility of PELB) and EPD reports to the Planning, Environment and Lands Bureau.

Hygiene Services Committee and Interdepartmental Co-ordination

9. To facilitate liaison and co-ordination between the PMCs and other relevant government departments, an administrative co-ordinating body called "Hygiene Services Committee" has been set up. The Committee is chaired by the Director of Health and consists of members drawn from the two PMCs, the two Municipal Services Departments, and other relevant bodies such as HWB and AFD. They meet at periodic intervals during normal times, and more frequently during a "food crisis" or epidemic outbreaks. In case of incidents such as a massive outbreak of foodborne disease, ad hoc interdepartmental committees may be convened to co-ordinate the activities of Government departments concerned.

Current Management of Food and Environmental Hygiene Hazards

10. Depending on the nature and source of food and environmental hygiene hazards, DH, USD, RSD, AFD and sometimes EPD are involved in the surveillance, investigation, assessment and control of outbreak of diseases. At the policy level, HWB, ESB, PELB and the two PMCs are also involved. A flowchart on the current management of food hazards in general is at Appendix II. The broad division of responsibilities between the operational departments is summarized below.

Surveillance

11. DH, USD, RSD, AFD, EPD each has its own surveillance programmes concerning different aspects of food and environmental hygiene. They are:

1. DH: disease surveillance and monitoring, food surveillance programme (including surveillance of imported fresh produce such as vegetables and milk, local food products and food complaints);

2. USD and RSD: regular inspections of food premises, handling of food complaints, meat inspection in abattoirs, monitoring the hygiene conditions of public markets, and controlling street hawkers, etc.;

3. AFD: surveillance of hygiene of local livestock and poultry farms, surveillance of livestock and poultry at import points, holding lairages and on farms, instituting a reporting and registration system for coral fish harvesting zones; and

4. EPD: monitoring water quality of beaches, including E-coli density.

   There are established procedures among the relevant departments for reporting suspected cases of food or environmental hygiene hazards found during the surveillance.

Investigation

12. In case of suspected incidents of food or environmental hygiene hazards, DH, USD, RSD, AFD and EPD may be involved in the investigation depending on the nature of the incident. Their respective roles are as follows:

1. DH investigates patients/food poisoning victims and other exposed persons, and participates in joint investigation on possible sources of infection if necessary. It will also seek advice and information from international or overseas health authorities (e.g. World Health Organization) if necessary;

2. USD and RSD investigate and trace source of contamination on the food chain, in particular food premises and market stalls, and participate in joint investigation with DH when necessary;

3. AFD investigates cases involving animal diseases (e.g. H5 influenza in birds) and veterinary drug residues (e.g. clenbuterol) etc., and traces the source and outlets of ciguatera contaminated reef fish; and

4. EPD investigates cases concerning sudden deterioration of beach water quality.

13. In case of a massive outbreak of communicable/foodborne disease, an interdepartmental co-ordinating committee will be convened to co-ordinate efforts by the relevant departments to tackle the problem, including taking concerted action to investigate the disease. An example is the Interdepartmental Co-ordinating Committee on H5N1 to co-ordinate control measures across departments.

Assessment

14. DH normally takes the lead in assessing the impact of food or environmental hygiene hazard on public health while AFD is responsible for assessment of impact on veterinary public health and the farming and fishery industries. Interdepartmental co-ordination and co-operation is often required in case of a massive outbreak of disease. The PMCs are informed or consulted on the assessment as appropriate.

Control and Prevention

15. Concerted action by the relevant departments is often needed to control and prevent the spread of the disease. Decisions are often made by an interdepartmental co-ordinating committee or after interdepartmental consultation. Each department is then responsible for control and preventive measures within their respective portfolio. Examples of the control and preventive measures undertaken by the departments are as follows:

1. DH may step up sampling of affected food items, initiate suspension of sale of suspected food items and their withdrawal from sale, or order an area or premises to be isolated to prevent the spread of infectious disease under the Prevention of the Spread of Infectious Diseases Regulations (Cap.141 sub. leg.), etc. DH will maintain close contact with the international or overseas health authorities where appropriate;

2. USD and RSD may assist DH in sampling and inspection of food, step up inspection of food premises and cleansing of public markets, or close the affected beaches temporarily;

3. AFD may step up the surveillance of the live poultry/livestock concerned, contact with the main supplier on appropriate preventive work, or trace back to the likely origin and trace forward to the retail outlets; and

4. EPD may step up the monitoring of water quality of the affected beaches or ensure the proper disposal of contaminated food items or dead poultry, etc.

16. The departments concerned will be involved in risk communication with the public and the affected trade. Certain control and preventive measures may require the review and amendments of policies and legislation. The relevant policy bureaux and the PMCs will be involved in the process.

Problems Encountered

17. Under the current structure, three policy bureaux, two PMCs and five departments are involved in the management of food and environmental hygiene hazards. The fragmentation of responsibilities has led to a lack of central point of direction for the overall co-ordination and direction on food safety and environmental hygiene matters. This undermines our ability to deal with large scale food safety or environmental hygiene emergencies, which by nature require quick central decision and large scale mobilisation of resources among different departments/bodies within very limited time.

Proposed New Structure

18. Under the proposed new structure, the Food and Environmental Hygiene Department (FEHD) will be responsible for all major aspects of food safety and environmental hygiene. In addition to Health Inspectors, it will have professional staff drawn from DH and AFD. Health and veterinary officers, whose major responsibilities include the provision of professional advice and/or execution of functions in relation to food safety will be formally seconded from DH and AFD and be accountable to the Director of Food and Environmental Hygiene. The new department will adopt a multi-pronged approach to manage food safety and environmental hygiene.

19. Moreover, the proposed new Environment and Food Bureau to whom FEHD, AFD and EPD are accountable will play an overall co-ordinating role to and provide policy direction on food safety and environmental hygiene matters. It will facilitate the pooling of resources for formulating and implementing territory-wide policies and action plan and strengthening the food control systems. It will also enhance the food surveillance and research programmes, with greater emphasis on prevention of food and environmental hygiene hazards.

Future Management of Food and Environmental Hygiene Hazards

20. After the reorganization, the line of command relating to management of food and environmental hygiene hazards will become more streamlined. It will mainly be focused on the proposed Environment and Food Bureau. The proposed FEHD will play an enhanced role in the surveillance, investigation, assessment, control and prevention of food and environmental hygiene hazards.

21. Nevertheless, depending on the nature and extent of the incident, it is difficult for FEHD to undertake full responsibilities. Following the reorganization, DH will continue to be responsible for overall control and prevention of communicable diseases in human being and act as Special Administration Region's representative in global networking for disease control. AFD will remain the authority for control of communicable diseases in animals and birds. The departments will co-operate closely under the overall co-ordination of the new Bureau.

22. For example, in case of incidents of food poisoning, notifications will continue to be received from hospitals or clinics by DH. It will then focus on clinical investigation of the patients and other exposed persons and liaise with international or overseas health authorities where appropriate. FEHD will trace the sources of infection or contamination in connection with the food chain and environmental hygiene and take appropriate control and preventive measures. AFD will be involved in exceptional circumstances where drastic measures are required to control communicable diseases in animals or birds such as declaration of places infected by such diseases under the Public Health (Animals and Birds) Ordinance (Cap.139).

23. A flow chart on the future management of food hazards in general is at Appendix III.

Constitutional Affairs Bureau
4 September 1999