John is an independent consultant. His training is in public health microbiology. And he's been involved with the Pool and Water Treatment Advisory Group and also the Health Protection Agency, the public health program in England. He has over 30 years of experience really in detection, survival and control of pathogenic microorganisms in the environment, particularly water and air. And he's been involved in so many outbreaks of, primarily legionnaires disease. So he has a lot of experience in that regard. He's also been involved in this issue of control and control of legionella growth in water systems. And he's been involved in iso-methods. So he has a lot of experience both in outbreaks, monitoring and development of these methods. And he's advised the UK Health and Safety Executive in the Health Department and has been involved in WHO. So we've got experience here in cooling towers, industry, methods. So John, I'm going to let you take it over and thank you very much for joining us. We really appreciate it. Thank you for that introduction, Joan. Can you all hear me okay? Yes, nice and clear. And yes, so I'm going to briefly talk about the legislation approach to controlling legionnaires disease in England rather than the UK. Although the legislation in the UK is all very much the same. Since devolution, there are some slight differences between the various countries, Scotland, Wales and England and Northern Ireland in their laws. And so I'm going to be speaking specifically about the laws as they are currently in relation to England. Having said that, the overall approach in the UK to controlling legionella is very much I think the same as it is elsewhere. That is a preventative strategy with control based on our current knowledge of the ecology, not just of legionella itself, but also the supporting microflora and that combined with good management practice. And this is enshrined as you'll see in UK law. Now, when I first started working on legionella around about 1980, there were two pages of legionella specific guidance which were produced by the Department of Health in response to a couple of hospital outbreaks in Oxford and Kingston specifically. But as you can just summarize on this slide, there's been a massive increase in the amount of guidance available since then. In the next decade, up until about 1990, we went up to about 25 pages or thereabouts, in the next decade, we saw up to nearly 250 pages, over 250 pages, in fact, which is more or less where we are today. So briefly, if we look at the evolution of legionella specific guidance in England since 1974, now that predates the first recognition of legionella disease, but it's significant because that was when we had a new act, the Health and Safety at Work Act, which replaced the old Factories Act. And it covers all hazards, chemical, biological, physical and radiological. And as we'll see later on, virtually everything to do with legionella disease or the laws associated with the regulations come under that act. So the first guidance note was, as I said, produced by the Department of Health in 1980. But as with many other countries, we had our wake-up call in Britain as a result of the very large outbreak of legionella disease at Stafford General Hospital in 1985, which was very exciting for those of us doing the investigation, led to a public inquiry, and that's quite an experience, giving evidence to a public inquiry. And the initial response was an extra notice from the Department of Health, our HN86, giving extra engineering guidance related to cooling towers and evaporative condensers because of our observations in relation to that outbreak. That was followed by the first outbreak, the first report of the public inquiry, and then following that, the Health and Safety Executive produced its first guidance note, EH48. Now, in the next few years, there was concern that people were not interpreting the existing laws and regulations appropriately in relation to the control of legionella. And so in 1991, the Health and Safety Commission, which was then the governing body over the HSE, but it's now all incorporated into the HSE, they produced the approved code of practice on the prevention of legionella. So that's the first specific legionella document with any real legal status. As you can see over the next few years, we got new guidance and new additions of the code of practice. And then in 2000, there was a big change in that the code of practice, which interprets, tells you how to comply with the law and the guidance, the technical guidance, we're all combined in this one big document which was still referred to as L8, and now has, as you'll see, recently been changed again. And then in 2006, we had the HSE and HPA publication on the management of spa pools, that's spa pools or hot tubs, and it's commonly known as jacuzzi's to many of us. So in the UK, as in many other countries, there's layers of legislation and guidance, there's an act of parliament, which is the law must be followed, and then there are regulations which interpret some of those clauses in the act of parliament, and they also have legal status must be obeyed. Under that, you have sometimes have approved codes of practice, which tell you how managerially to comply with the law, and then below that is pure technical guidance, and we'll see how this affects, or rather how, what applied, which regulations and acts of parliament apply to Legionnaires disease. So as I said, the health and safety work act was written in 1974, obviously predates Legionnaire and doesn't specifically mention Legionnaire, but it's duties extend to risks from Legionnaire, and in particular, the sections that people are most likely to get prosecuted under are section two, which requires employees and non-employers, I self-employed people to ensure health and safety of employees, and section three, which requires them to ensure health and safety of non-employees so far as reasonably practicable. And then section six also requires substances and articles supplied for use at work to be safe, which is also interpreted in regulation, we'll see in a moment. The term reasonable practicality or practical practicability involves taking proportions proportionate to the risk. Now, this have term or similar terms occurring much UK legislation and has caused us some problems in recent years. The European community took the UK to task in the European court saying that this was a let-out from the health and safety legislation, which the Europeans had then published a directive on the healthy safety, which very much follows our health and safety at work act, in fact, but they thought that that clause meant that people wouldn't necessarily apply appropriate precautions. I'm glad to say that the UK actually won their case in the European court, and the law has remained the same, and terminology has remained the same. So the degree of risk in a particular job or workplace needs to be balanced against the time, trouble, et cetera, taking measures to avoid that risk. This is not a let-out clause, but if there's the risk is insignificant and the cost is disproportionately large, then you don't need to take steps. But in the case of Legionnaires disease, for example, the risks from cooling towers are significant and they can be deadly. And therefore the courts take the position that costly preventative measures are justified. So now briefly look at the regulations. Most of the regulations again, don't specifically mention Legionnaires disease or Legionella. But the control of substances health hazardous to health regulations covers all chemicals, radiologicals and biological substances. So Legionella and other infectious organisms come under this general regulation. And the next couple of regulations you'll see have certain things in common, right? There's a requirement to protect your employees and non-employees. We've already seen that in the Health and Safety Work Act, but a risk assessment is required. Where a risk is identified, if possible, that should be replaced by substituting something which has no risk. For example, you could replace a cooling tower, a wet cooling tower with a dry system. But if that's not possible or not practical, then exposure must be controlled in some way by using control measures and there must be appropriate systems of maintenance and examination of the equipment and the test equipment and control measures, such as automatic dosing equipment and so on. Adequate provision of information, instruction and training for employees and health surveillance may also be incorporated where appropriate. There's management of health and safety at work regulations again that don't specifically mention Legionella, but they're quite important from the point of view of management. And again, you'll see the second bullet point mentions risk assessment assessment and the risk assessment must be written. And it's, well, where there's five or more employees and the advice generally is that even if you have fewer than five employees, it's still worthwhile having a written record. There should be effective planning, organization control, monitoring and review, particularly review and there should be good communication and so on. You can, if you don't have the appropriate competent help within your organization or knowledge, employ external competent help. That doesn't mean that you, the duty holder is divested of all of their responsibilities. They still need to be able to ensure that the people they employ are competent and doing their job properly. So they need some level of education themselves to do that. And there should be cooperation where there's more than one duty holder. Legionnaires disease, maybe if it's contracted in the workplace, such as somebody working on corning towers or hot and cold water systems and sparkles, maybe reportable as under the reporting of injuries, disease and dangerous occurrences regulations as a workplace accident. But Legionnaires disease is also a reportable course, at least since 2010 under the health protection notification regulations to the appropriate health authorities. Now we come to the first and only set of regulations that specifically mentions Legionella and that is the notification of corning towers and evaporative condensers regulations which were introduced in 1992 in response to pressure from environmental health departments and local government departments and public health individuals like myself involved in outbreak investigations. We often spent a lot of time looking for corning towers and thought that if a register existed, it would save an enormous amount of time right at the beginning of an outbreak investigation when it's very critical to examine the potential sources as rapidly as possible. Excuse me. So the local authority holds the register and they need to be informed when the towers are going to be constructed, when they're put in operation and also when they're taken out of operation. Now in our experience, particularly in the last decade or so, compliance with this regulation is really quite good. Way over 90% of towers are usually registered when we do an investigation. The biggest failure in compliance is usually with people failing to report when towers are being taken out of service which can be an inconvenience. But generally it has certainly assisted us in outbreak investigations. So then underneath the regulations we have code of practice. We have a specific one for Legionella, as we see it learned, and technical guidance of which we have quite a quantity. So the current situation now in 2018 is that we have an approved code of practice which as I said before has special legal status and associated with that are four technical guidance documents, HSG 274 parts one, two, and three relating to the control of Legionella in cooling systems on the first, hot and cold water systems part two, control of Legionella bacteria in other systems, sprinkler systems and so on. And in 2017, the HSE guidance HSG 282 the control of Legionella bacteria and other infectious agents. This is the first one that specifically mentions other infectious agents in spa pool systems. So let's have a little look at these Legionella specific documents in more detail. So the code of practice provides advice to the managers on complying with the Health and Safety at Work Act and the cost regulations and the regulations under that act. You can use alternative methods to those set out in the code of practice and also in the technical guidance in order to comply with the law. But if you do so, you must be able to show that they are effective. Code of practice has a special legal status. If you don't follow it, you must show that the law has been complied with in some other way and in reality, most people do comply with it. It applies to all plant and systems containing water that's likely to exceed 20 degrees Celsius where there is a means of creating and transmitting water droplets or generating an aerosol, which is likely to be inhaled and thereby causing reasonable foreseeable risk of exposure to Legionella bacteria. So it includes cooling towers, evaporative condensers, hot and cold water services, humidifiers, air washers, tunnel washers in industry, spa pools, agricultural misting systems, and so on. It emphasizes systems that are normally closed and operation therefore not considered to be a risk, can still present a risk when opened for maintenance. And it applies to all types of premises, shops, offices, factories, hospitals, industrial plant, agricultural establishments, entertainment facilities, et cetera. The only real exclusion are privately owned and occupied residences. If you own your own house, then you don't have to comply with the law. But if it's a rented property, the landlord has to comply with the law. And Allate specifies a series of steps that are necessary to control the risk. There has to be somebody appointed who's managerially responsible. There has to be a risk assessment process to identify and assess the source of the risk. And this needs to be written as we've seen if there's more than five employees. If you can't eliminate the risk by substitution, then there has to be a written scheme for preventing and controlling the risk. And that has to include up-to-date schematic diagrams to enable people to rapidly identify key parts of systems. There needs to be consultation with the employees to find the risks and control measures. And most important of all, there needs to be a good management system with good lines of communication and monitoring of all the appropriate precautions. Everything needs to be recorded and the records of the monitoring tests, whatever they might be, measuring temperature, high-side concentrations, pH and so on, must be kept for at least five years. The written risk assessment when it's replaced by a new written risk assessment also has to be kept for at least two years. And everything should be auditable and you should be able to follow an audit trail by documents being appropriately signed. So a risk assessment should be a living document. It used to be that we said it had to be reviewed and revised every two years. That specification has now gone. Although in practice, if you look at the reasons for reviewing the risk assessment, on large buildings and large industrial premises and so on, it's very likely that a risk assessment will have to be reviewed at least that frequently. So situations when the risk assessment might need reviewing include changes to the water system or how it's used, change of the building use, changes in the building itself, new information that comes to light on the control measures that you use from research or new control measures that might become available. All new information on the risk, if it's shown that a previously perceived risk is no longer a risk or vice versa. If the monitoring checks carried out show that control measures are no longer working, appropriately, if there's changes to key personnel, in particular the responsible person or the management above that or any key individuals in the management of the control measures. And of course, if there's a case of legionary disease or other legionary locus associated with the system. In addition to the risk assessments, the management communication procedures also need to be regularly reviewed to ensure that they are kept up-to-date. There's a requirement that there should be an up-to-date schematic plan identifying key components in the system. Furthermore, training and the importance of training and confidence and ongoing training are emphasized and the new LA has extended the information on the responsibilities of designers, manufacturers, importers, suppliers and the installers so that systems need to be designed so that they are constructed in a way that will hopefully inhibit the growth of legionary and they need to be provided with appropriate up-to-date information and instructions that need to be updated when appropriate as well. And the suppliers of products and services such as water treatment specialists need to ensure that their measures are designed and implemented so that they are effective and safe and they can show that they're effective and they need to provide adequate information to the user and those respects as well. Finally, there's a requirement that you should have a written scheme of action in the event of an outbreak, how you're going to go about testing your cooling towers or your water system and so on. Now in healthcare establishments there's a slightly different set of regulations and acts of parliament. The ones that we've already spoken about are still applied, the Health and Sative Work Act and all the HSE documents. But in addition to that, in 2008 the Care Quality Commission was created by the Health and Social Care Act and this body is responsible for managing all healthcare buildings in the NHS, not buildings, so all healthcare organizations like hospitals, GP surgeries, nursing homes and so on. And underneath that Health and Social Care Act there are some sets of regulations again. And finally, and specifically there's the Health and Social Care Act 2008 Code of Practice on the Prevention and Control of Infections and Related Guidance which is particularly important again in relation to Legionnaire's disease and other potential waterborne pathogens within hospital environments. And then there's also some very again detailed health technical guidance called Health Technical Memoranda and the 0401 is entitled Self-Safe Water in Healthcare Premises in three parts covering the design, installation and commissioning, operation and management which includes details of testing for Legionnaire and other microorganisms and also part C which is specific for pseudomonasal regionosa in augmented care units. So the Health and Social Care Act Code of Practice on Prevention of Infections applies to all registered providers of healthcare. So as I say, hospitals, GP surgeries, nursing homes and so on. And it includes managing water safety, including Legionnaire but also other waterborne pathogens. There's a set of criteria against which the Care Quality Commission judge people and those who wish to be registered need to ensure they follow those same criteria. So by following the Code of Practice, registered providers will be able to show they meet the requirements of the regulations and they must continue to do so. Now the Health Technical Memoranda, the latest version, 2016, it's a development on the previous guidance, it's moving users towards the holistic management of water systems, i.e. the water safety plan approach and water safety groups. Water safety plan approach has originally, the terminology originally applied by WHO. It provides comprehensive advice and guidance to all those involved in healthcare and management, design engineers and so on. And in addition, it's got some information now on climate change and the need for adaption and mitigation of measures in response to climate change. It doesn't just apply to Legionnaire, it also applies to Uruginoza instead of trophomaniacid multifilia, multifilicobacteria and others. It's in line with L8, an HSG274 guidance, that's the HSE document, it's also in line with the healthcare prevention and infection code of practice and appropriate regulations. It gives a lot more information now on the formation of writing water safety plans and the formation of water safety group who will manage the water safety plans and manage water safety in healthcare environments. It's emphasized the importance of competency and the training of not just the people responsible for overall management, but also plumbers and installers themselves. Something that's been in the water industry for a long time but hasn't always been the case in hospitals. Emphasizing safe hygiene practices associated with the use of water, equipment that uses water and detailed sampling for testing. So all of these guidance documents essentially follow the same control principles which I'm sure you're all familiar with. If possible, eliminate the source of the risk that I said before, substituting a dry cooling system for a wet cooling system for example, would be one possibility. Avoiding the water temperatures that might support growth of Legionella, specifically particularly 20 to 45 degrees Celsius. And where there is a risk inhibiting growth either physically by temperature management for example, or chemically by the use of biocides and so on. Sessons need to be designed and operated so you can keep them clean, prevent dirt getting into the system, keep them closed as much as possible and they need to be flushed and disinfected after construction, immediately before occupation that is, and also before and after modification or repair. And systems should be designed and constructed so that they're easy to clean and disinfect so there must be ease of access to the appropriate bits and pieces, easy to remove equipment to service it and to dismantle it as appropriate. As with all systems that use potable water, the materials that are used in construction of Legionella prone systems should wherever possible be tested so that we know that they don't support significant microbial growth. Keeping the water's moving, keep it flowing, control aerosolization as much as possible and limit dispersal, so for example on cooling towers, you would have drift eliminators. So they keeping the system clean and removed dirt and biofilm regularly, again, particularly in cooling towers, preferably combining physical or chemical removal with chemical disinfection. And the new HSG274 part one, which relates to cooling towers and evaporative condensers gives excellent sets of pictures of cooling tower pack to try and explain what a clean cooling tower pack should look like. And similarly for the hot and cold water systems, there are pictures of the inside of tanks, again, indicating how clean a tank should appear for the purposes of the Legionella guidance. In healthcare environments, particularly you need to identify high risk areas. That is not so much areas of the water system, but the population that's exposed to that water system. And obviously it has to be continuous maintenance and monitoring to ensure the safe operation of the system continues, as we said before, with training of star. Now, both the HSE document relating to hot and cold water systems, that's HSG274 part two, and the Department of Health, Health Technical Memorander, advise the water safety plan approach, first described by WHO, I guess, in healthcare premises. And such as, the way I described in the guidelines of safe drinking water. Both hospitals and healthcare premises should have a water safety group, rather individual, which has collective responsibility for managing the risk in the water systems. That group will generally include representatives of the Infection and Prevention Control staff, nursing care, engineers, one or more engineers who are familiar with the water systems and the cooling systems and so on. A health and safety representative, member of the executive management team, probably a specialist water advisor, and possibly representatives from specialist users like hydrotherapy or decontamination, dialysis, et cetera. So that's all I want to talk about, the regulations and as they are existing currently, and I want to move on to microbiological monitoring, which is one of the questions we're asked to address. In the UK, in the HSE documents, cooling towers are recommended to be tested quarterly for Legionella and the target is they should have less than 100 CFU per litre. That's effectively the detection limit for most laboratories when using culture. And also a TVC or head of traffic, aerobic count is 48 degrees, sorry, 30 degrees Celsius for 48 hours incubation, and that's commonly done by a DIP slide, although as a microbiologist, I don't particularly like DIP slides. And there are the targets, there should be less than 10,000 per mil. Hot and cold water systems at Legionella is not required, but it is recommended if there's any doubt about the efficacy of your control region. So if you know there's a failure in your temperature or biopsychontrol, then initially you'll be testing weekly and gradually over time, that frequency of testing will be reduced as you gain confidence that the system is under control. Similarly, where biocides are used as the primary control, and not water temperatures, and water temperatures likely to support growth. So if you deliberately keep your hot water system, that's 40 to 45 degrees Celsius, for example, which will be the highest risk for generating Legionella, then you would certainly initially test monthly, and you might over time gradually reduce that frequency of testing. In hospitals, particularly, where there are populations at a high risk of infection, then monitoring may well be justified, and obviously again, if there are cases of Legionellosis associated with the premises, then testing will be undertaken. This is a table taken from HSG 274 Part 2 in relation to hot and cold water systems, and you can see it just gives you some advice about what action should be taken. I personally don't really like this. I don't think it's specific enough, and what does the majority of samples mean? What does the majority of samples mean? Does it tell you how many samples to take, or what proportion we're talking about there? And there's, we try to get that change in the revision of the latest revision, but it's still being left in that sort of vague manner. If you get relatively high numbers, then immediately there should be some action taken, and that also applies to the TVC and cooling towers. If you've got over a million per mil, then some action is supposed to be taken straight away. In healthcare establishments, again in areas where patients who have increased risks, some point is commonly undertaken. I think strictly speaking, it's possibly not required by the law, but in practice is generally undertaken, and the Quality Commission will take a pretty dim view of establishments that don't do some legionella testing, and certainly pseudo-malice erosioners are testing in the appropriate parts of the building. And Part B of the Health Technica Mirandum, includes very comprehensive guidance on the interpretation of legionella sampling results, and including when using pre and post-fushed samples, it's a very complicated set of figures, which I did think about putting up, but I think you wouldn't be able to read them anyway, but these documents are all freely available for over the internet if anybody wants to look at them. The guidance for spa pools, it's slightly easier to illustrate on the slide, pH and chlorine measurements should be made at least twice a day in hot tubs, which are used for business. That's for example, if you rent chalets out, holiday chalets and each one has a hot tub, then they should be tested at least daily, and depending on the risk assessment, the degree of usage that might be increased to three or more times a day. In commercial spa pools of large leisure complexes, these are pools with overflow, deck-level overflow and balanced tanks, then they should be tested like swimming pools on opening and then every two hours throughout the day. The microbiological testing, jet colony count, E. coli and pseudomonas legionella on a monthly basis, and quarterly legionella in the same way as cooling towers. So, enforcement. Who are the enforcing agencies? Well, the Health and Safety Work Act and the Associated Guidance of Regulations are enforced by two bodies in England, well, in the whole of the UK. That is the Health and Safety Executive Inspectors, and they will enforce in manufacturing establishments generally, heavy industries, hospitals, and unfortunately, you know, reflection on the shortage of funds these days. Generally, there's no preventative inspections undertaken, or very few preventative inspections undertaken these days. It's a complete contrast to when I was a young microbiologist some 30 years ago, the Health and Safety Inspectors regularly went round factories amongst other things, looking at legionella precautions. And the other group is the local government of environmental health officers, and they are responsible for enforcing the Health and Safety Work Act in offices, hotels, retail establishments, leisure facilities and so on. If there are local government-owned premises, then the HSE would be the enforcing body for those. And now, following the 2008 Act and the Creation of the Care Quality Commission, they also have powers of both inspection and prosecution, not so much under the Health and Safety Work Act, but under the appropriate healthcare acts. And they do, unlike local government and health and safety inspectors, they do carry out regular inspections as part of the registration process. And now, in UKlay common law is based on precedence, and there's one very well-known case which is very significant to the interpretation of the Health and Safety Work Act in relation to legionella disease in particular in England and Wales, sorry, in UK. There was an appeal, there was an outbreak of legionella disease in about 1991, as I recollect now, in London, in Kensington, and the Science Museum was prosecuted. And they were found guilty. They didn't cause the outbreak. There was no evidence that they had caused the outbreak, but they didn't have adequate precautions in place on their cooling systems, which were clearly at risk of being contaminated with legionella and managed in a way that would allow legionella to grow in them. They appealed because they said legionella hadn't been found and there was no link to the outbreak, and the appeal was dismissed. And the judgment said it was sufficient for the prosecution to prove that the public were exposed to the possibility of danger, that the risks that harmful bacteria might emerge outside of the appellation, and had exposed the public to a possibility of danger. And the jury were entitled to conclude, as they had done, that they hadn't taken all practical steps to minimize the risk. So how effective is this legislation and guidance? Well, unfortunately, it's very difficult to measure the effectiveness against the background of improving ascertainment of cases. In the UK, just as in much of the rest of the world, we've seen an increase in the number of cases in the last decade or two, particularly since the introduction of urine and antigen tests. So some of this is probably due to under-acertainment privacy, and then there may well be some real increase in the instance of cases. In the early 80s, when I first started working on legionnaires, the Department of Health was funding a very large investigation of the instance of legionella in hospitals and other buildings and cruise liners, for that matter. We got a lot of interesting information, so much of which has never been published. And in my latter years in the Health Protection Agency, we have tried to get funding to repeat that work, to establish whether there'd be any significant change in colonisation of buildings, or the numbers of legionella that were detected. We are never successful in persuading people to give us the money to do that. It was a very expensive survey initially, and wouldn't have been much different, I guess, now, to be quite expensive to undertake. And with the improvement in laboratory techniques, it might have been difficult to interpret some of the results. But my personal feeling is that the proportion of buildings that have legionella in them has probably not changed dramatically, but the actual numbers that are detected will be appreciably lower, and also the frequency of the detection around the building. There's certainly, it's not possible to see any effect on the numbers of cases over the years. No water system, however, that has been shown to be the cause of an outbreak of legionella disease has failed. Sorry, can I start the wrong way around? No water system that's managed and operated following the managerial and technical guidance in LA-8 and the HHG274 and 282 and the HGMS has ever been implicated or shown to be a source of legionella disease. If that's saying anything, I'm not sure. But certainly in every outbreak investigation where we've identified a possible source of legionella disease or definitely identified it, then there've been significant failings in compliance with the law and the guidance. There was concern that the fines in health and safety cases were not reflecting the severity of the offences. And as a consequence, in February 2016, there were new sentencing guidelines produced. And the principal focus of that was to ensure that fines are sufficiently substantial to have a real economic impact, which will bring home to both management and shareholders the need to comply with health and safety legislation. And the fines are based on the company turnover and they may be as much as 10 to 40% of the annual turnover. Potentially huge, international companies, the international turnover would be considered. And we have seen quite a dramatic rise in the last few years and it will continue because this will only apply to cases since 1st of February 2016. So a lot of the cases coming to court now predate that by a long way. But for example, there was this store in, sold a hot tub and infected a number of people. Hot tub was on display, sorry. And the store there was fined a million pounds and there've been several other instances of cases the last year or two where fines have been in the millions. So whether this will have a greater effect on the, or greater effect on the application of the health and safety law remains to be seen. So thank you for listening to me. I hope you've gained some benefit from my discussion. And I'm free now to take any questions. Thank you very much. Yeah, we'll have that committee go ahead and ask you some questions. Start with Chuck Hopp. Yeah, so I've now heard in your presentation that I've heard in the previous several you used the phrase risk assessment. And I wonder if there's any specific guidance as to what that constitutes. What the risk assessment? What is a risk assessment or what constitutes a risk? What constitutes a risk assessment? Well, there's a, it's explained in the HGM document, sorry, in the HSG documents. And there's a standard for risk assessment as BS 8580 which also outlines the process and where, how you go about the process is what you consider. So you consider, as I said before, if the system uses water, what's the temperature of the water or what temperature is it likely to get to? Is there stagnation of the water anywhere? Is the water likely to be aerosolized? So on the hot water system, obviously in the cold water system, there's potential for aerosolization at the outlets, showers, taps and so on. What measures are in place to control the risks existing measures? Whether they're adequate, you'd look at mostly, most of these time these days we're looking at a risk assessment or a system which has already been risk assessed in the past and has already got control measures in place. So in a hotel or a hospital, for example, you'd look at whether the sampling points for measuring temperature and maybe biocide measurements and possibly Legionella or other microbiological sampling were in the appropriate place, whether represented of the highest risk in that system. If not, then they should be recommendations to change them. So it says, I'm not sure that answers your question, but I'd say there's certainly, there's documents several pages long explaining the risk assessment process. No, no. With the water safety plan in a hospital, now you'd look at where the source of water is, whether it's, so if there's a private water supply as well as the public water supply that might imply, have implications, whether there's intermediate storage tanks and so on. So, John, is it the HTML401 document that has the, okay, thank you. And the HSG documents as well. There's a table in the back of the HSG document which lists the things you should be looking at in a risk review or a risk assessment. And I say there's a question. Okay, that's the 274, HSG 274. Yes, yeah. Okay, got it. Steve, Mark. So, just a question about the levels that you've given. We've heard from a couple of different groups about risk levels in terms of detection of Legionella where it's greater than 100 seems to be the threshold for detection as one. But the other is, I think it was greater than 1,000, I think is what it was. Do you have a sense with that data or is that sort of a decision that sort of, from others, is it, where does that, where does the cut-offs come from that you guys didn't use? Well, I should emphasize, I think I didn't say that, testing for Legionella is not essential of hot and cold water systems. The essential things are monitoring temperature or biocide levels where they're applied. And in cooling towers, it will be monitoring your biocide levels, TVC's are monitored as well. General operation of the system, the operation of the biocide dosing. So the microbiological monitoring is only as the final sort of validation. Now the levels, yes, there's a lot of debate about the levels. And in hot and cold water systems, when we've examined those in following outbreaks, we've quite often only seen relatively low numbers. And the important thing is often not so much the actual numbers, but the frequency with which you get isolation. So you're in a hospital and you might find that one area, a couple of wards, have a high frequency of positives. And these will be counts of hundreds or maybe thousands, but rarely above a thousand or 10,000 in hot and cold water systems. So a thousand was considered to be an alarm bell. That's, you wouldn't really want to consistently have those sort of levels in systems because you know that the numbers can actually go up very abruptly overnight to from thousands to tens of thousands or hundreds of thousands. Personally, the highest numbers I've ever seen in a hot and cold water system are in toilet systems in tropical countries, where we've seen hundreds of thousands of lesionella muroffler, the litre. In contrast, in cooling towers, then in, if you look at the data from outbreak investigations on those few occasions when we've actually got to a cooling tower while it's definitely still been infecting people, then the counts have always been above 10 to the five, usually almost with one exception actually, they're always above a million per litre. And so again, the time to go from 10 to the four per litre to a million per litre can be relatively short in nature. So we set a maximum level that would require media action that are relatively low, what might be considered by some to be a relatively low level. In the European guidelines, we did, when we first wrote the European guidelines, which are very much based on the UK guidelines, we did actually relax the action level for cooling towers. In the current guidelines, they've been brought in line with the UK. I'm not sure that really answers your question, but I think it's based on experience, there's not lots of published data, but I'd say a few outbreak investigations. Okay, so we're running a little bit short on time, so we'll take a few more questions, and then we'll wrap it up. Ruth, then we'll go to Michelle, then we'll go to Nick. Okay, thank you, Tom. This is about two questions. Why do you have any codes or laws that address the public water response? The public water supply, I mean, there are drinking water regulations, they do not specify testing for Legionella currently. There are also regulations on the design and construction of hot and cold water systems. They are designed very much to prevent microbial growth and to prevent microbial contamination of systems. So they would in part cover Legionella, but they don't specify Legionella, although they do take Legionella into consideration when you're talking about hot water temperatures. But the current, the European drinking water directive is currently up for revision, and there is a suggestion that Legionella should be included in that. Although we are leaving Europe, well, I'm told we are, we will continue the European drinking water directive as far as I understand. So I guess we'd introduce Legionella testing if that was agreed. I'm not sure personally in a cool climate, whether there's a lot of value in testing main supplies for Legionella. Very, very rarely find them by culture, you can by PCR. But as you get into warmer climates, or certainly if the water temperature increases, then that may well be worth investigating. Again, I've investigated outbreaks in the West Indies where the incoming town supply had thousands of Legionella per litre in it. And my second question is, is there any evidence that use of urine and other testing has increased in the past 10 years? Any evidence that the use of urinary action testing, did you say? Yeah, the clinical, yeah, the clinical use. Yes, I mean, it's been widely used in the UK now for some time, yeah. And in fact, we always, the reference laboratory for decades has had a urinary action in tests which they use as a confirmation. But now, of course, there's bedside tests available which are used widely used. Thank you. Michelle? Yeah, and I have a detailed question for you, John. You covered such wide regulations and all topics. One of the things that I think the UK is very progressive about is the addressing the issue of TMVs or mixing valves and dead ends. I think you have probably the most detailed technical guidance on whether or not to install them. And if you do and they become contaminated, this remembering in your HTMO 401, I think it's the second or third one of that serial one, yeah. Page 59, it shows the importance if it's a TMV and the device is contaminated, what you have to do. And so would you comment in general on where you are in the UK in installing these devices for scalp prevention? Is it still a question of risk balancing or is it like you want to get away from it if you can or are you installing them for scalp protection all over the place still? Right, so there was a big move to install TMVs. There was a big, both in the States and in the UK and probably elsewhere in Europe as well. Of course, there was a big campaign to anti-scolding campaign at one time. And I think this caused too large a swing to the installation of TMVs. And of course, once you install a TMV, you've got no control from that point down on the no temperature control anyway, to enable you to prevent Legionella growing in that. And we did see an increase in the incidence of Legionella in hospitals because of that. The 10 trend now is moving away from installing TMVs wherever possible, but still installing them where there is a risk of, a severe risk of people being installed, so, sorry, being scolded. So in intensive care units, for example, the patients are not going to be washing their hands. There's not really any logical reason for having TMVs there. There will be limited number of showers in those premises as well. So where there's total body immersion, yes, you should have some protection. But where possible, we would discourage fail-safe TMVs. Thank you, John. Nick? Just to follow up on this, would it be possible? Michelle, we're running out of time, so I think we'll have to follow up via email. Okay, thank you. Yeah, yeah, thank you. And Nick? John, in relation to action levels, I was wondering if you had an update from your 2011 publication on the value of QPTR versus culture, and in that paper, as you know, you focused on unofficially contaminated waters. Have you moved on to evaluating that in real scenarios, and what's the uptake for QPTR? Well, we did publish a paper where we looked at naturally contaminated systems. But there's, oh, the HSE has certainly had a group looking at rapid methods. They haven't produced a report yet. That's working in conjunction with Public Health England and the Water Management Society. There hasn't been a big uptake of PCR, to be fair, because of the problems of interpretation. I think people are afraid of using PCR because they know they get lots of positives, and then they don't know how to interpret them. I think we could write guidance which would enable people to interpret them properly. If you've got a system which is under control and you're not getting culture positives, but you're still getting significant PCR positives, then you've got a system which has got Legionella feeding into it from somewhere, and you can trace that source by using PCR, but that's not widely applied at the moment, and there's no real written guidance that's been accepted at the moment in the UK. Having said that, there are more specific PCRs looking for C1 specifically, and also looking for those strains which have a particular pathogenicity market we're interested in, and they have been used in outbreak investigation with success, but not currently being used for routine monitoring. Thank you. Okay, thank you so much. We're going to follow up probably with some emails on some of the reports that you mentioned, and papers, I think we'd be particularly interested in your, if you have documented data on the increase in Legionella cases after the TMV installations in hospitals, before and after. Cases, I think. We have a very low incidence of hospital-acquired cases in the UK. We're less than the European average, significantly less. So it's different, that certainly you've got no statistics on the basis of cases because there aren't sufficient cases to get any significant data. What I was talking about. So you meant occurrence then? When you said that, you meant occurrence in environmental samples? I meant occurrence in environmental samples. That's great. Okay, that would be of interest to us as well. So we'll follow up. We have some other questions in some of these reports, and you threw a lot of information at us, so we're going to look through your emails and get back, or your PowerPoint and get back to you. We really appreciate your time. There's, I've put the web links into the lot of the documents in there so you can get the significant documents. I saw that. Thank you very much. We appreciate it.


Thank you. Thank you, Yosef, and thank you all for being here. It's been my misfortune starting off, my misfortune to not being here for the rest of the day today, and that's quite a disappointment to me because I've had the pleasure of being here yesterday and also for one evening earlier on in the week, and I got to see what a fantastic gathering this is and what a fantastic opportunity it is to share ideas, so I would have liked to have been here because education is one of the areas that we're particularly interested in, environment being the other, and today unfortunately a bit of a clash arose where we partnered with a big company and big companies run to their own timetable in one of our projects. The Fonterra and the dairy industry announced today that they're putting $5 million into one of our projects, Zip, which I know a number of you people here today were involved or have heard about from Lou and Lou and Al over the last few days, and so that's fantastic step forward for Zip, and given that it's really the first month of Zip's existence, it's a great start for the business or for the opportunity, but I'm going to talk about education and our interest in education. First of all, I know for some of you who were here yesterday, I talked a little bit about Next Foundation, but for those of you who weren't, I'll run quickly just through who we are, and because we've been around for less than a year, Next Foundation was launched in March last year with a fantastic gift of $100 million to the country from a couple of fantastic New Zealanders called Neil and Annette Plowman. Very low profile New Zealanders, their wealth came from a company called New Zealand Towel Services that I think many of you will have had some experience with if you've used the white towels with the blue stripes on the side in public places at any time over the last 90 years or so, and Neil and Annette had been involved in a number of philanthropic projects already over the last decade really, most notably for those of you from Auckland Way, the restoration of Rotorua Island, and now the restoration of Abel Tasman National Park, and they have really decided to formalise the way they went about their philanthropy in forming Next Foundation last year, really with an objective of creating a legacy of environmental and educational excellence for the benefit of future generations of New Zealanders. So it's $100 million to give away over the next five to ten years and to give it away to a small number of large-scale projects in a way that can make a difference in the areas that those projects are operating in. So and really those projects that we're looking for have got three characteristics really at a high level. We want them to be able to be transformational in the area that they're operating in. We want them to be inspirational so that people who are in that space really look at them and say these are projects that we think should continue and we want to support in whatever way we can. And part of getting to that place in our view is that they need to be run in a business-like way even though they're not commercial projects. We're supporting charitable organisations, not for-profit organisations, and we're not looking for financial returns. We're looking for in the educational returns and in the case of the environmental projects, we're looking for ecological returns. Just how do we operate? I guess I've come from outside the philanthropic industry. The last 20 years for me have been involved in private company investment really and one of the sort of observations or one of the things that's become clear to me is that our way of philanthropy is a little different from many players not all in the space in New Zealand but not in the US. Our model for next is really the US philanthropic foundation model and really we are doing that in New Zealand in a way which will work in New Zealand, we believe, and we are all New Zealanders although our Chairman is based in the States. He lives in New York and has been there for about 15 years, Chrysler Dell, and Chrysler's exposure to the US philanthropic scene has been a big factor in shaping next and the way we go about things. But we think about the projects that we're joining with as having, we bring funding to them obviously and if they don't need funding then we're not there but we also bring partnerships and that's really about networks and introductions and so on. That's something, I think it's probably fair to say that if I take today's example with ZIP I think relationships with Fonterra that really were held by next were really a significant factor in actually getting that discussion started and getting it credible and so it's a good example of how those networks can help the projects that we invest with and if we do things in the way that we believe that we can and we believe that we should then we'll build credibility for those projects. I don't think that we've necessarily got it yet because we haven't really done much yet but if we continue to do things and build a credible way of evaluating, of investing and of partnering with our projects then we'll hopefully build some credibility which will bring credibility to those projects that we invest with and I think in an educational, particularly in the educational sphere, one of the things we can give projects is some surety of longevity of support. The electoral term is a major factor I think in educational initiatives and there's not a shortage in our view of good educational initiatives in New Zealand and probably the opposite but getting past the three-year mark or that mark or the next three-year mark when it comes is often a hurdle or an abyss or whatever you and if we're looking to support projects for the terms of five years or more so that I think with those initiatives that we support we can hopefully make a difference to them through doing that. We certainly see ourselves as much more than just a funder. We'll build over time in those areas we are interested in, become a source of research and information. We can be a convener and bring parties together and again I think today's a great example of that. It was really interesting for me sitting and listening to Tayo Spearing, the chief executive of Fonterra and then the chief executive of one of the four other companies that joined with them, Westland Milk Products standing up there and both saying that this was a fantastic opportunity for them to work together which is something that they both acknowledged that in many cases they hadn't done in the past and so I think that we have the good fortune to be able to help create an environment where that sort of thing can happen and I'm not overstating it. I said help create, we're not doing it but we can bring those parties to the table and maybe help start them acting in a way that they wouldn't necessarily be doing naturally and that's a great gift that I think philanthropic groups have got and something that I think hopefully we'll do more and more of so it's a lot more than just handing out money. We're about transformation means change and so we see ourselves very much as a catalyst for change in those areas that we choose to. I've talked about us partnering and partnering with projects and with others and you know New Zealanders are unnaturally outward looking. I think that's one of the benefits of living in one little corner of the world and you know having to get on a plane for three hours to get anywhere and even when you get there you only get to the West Island anyway so it's a long way out so I think we look out. So partnering with global philanthropists is something that I hope that we will do over time and the US is obviously one of the key areas that we look for that. We've chosen that sort of model here and partnering with groups and being a New Zealand partner for those groups is something that we're really keen to do. Not many of them have got the foresight and the get up and go that you people that mantained and you people have got to actually be here in the way that you be here and I think this is, I value the opportunity to meet and make the relationships that we've got here. You guys have partnered with New Zealand in a way that's just incredibly powerful but we'll look to make those connections with others who aren't here yet and help build that. So that's next. What about education? Well we're new at education so I'm not going to give you any blinding insights into education and I'm sure you've had those over the last five or six hours really but I can talk to you about our short experience with it. We ran a once a year process in terms of applications. We did that in the middle of last year. I thought in education we might get about 40 applications. We got 140. They were incredibly spread in terms of the areas that they were in. This is this pie chart that sort of gives you a feel for that. I wouldn't read too much into the splits that we've chosen. That was something that we did at the time and it was just a way really at the time of helping to bring some order to what we'd got. You'll see that the biggest section is environmental education and I think we'll start talking. I've said to you that our two areas of interest are the environment and education but I think from now on or certainly after my board meeting next week I'm hoping that I'll start talking about us having three areas of interest and those will be environment education and environmental education. I think that's an area that we haven't got engaged in yet but we definitely want to get engaged in. There's a number of people that are here this week who have got significant experience and capability in that area of environmental education and that's another one of those connections or one of the other values out of this week for me and for us. The other comment I'd make about that pie chart is how diverse it is and for those of you who are from the education industry none of that will be a surprise because you know how diverse it is. One of the things I'll talk in a minute about the two projects that we did choose in education out of 140 or so but one of the things that we will also do and are starting to do now is narrow down what are the areas of real interest to us. You know $50 million for education is a lot of money but it's not changed the world type of money unless you're very targeted about where you're going to go and how you're going to go about doing it and if we're looking to commit to maybe you know I say half a dozen projects I hope with partners it'll be more. Again today's a great example we've talked about bringing partners in. The dairy industry comes in and pitches in $5 million that's not that's additional in fact to the money that is in there already but there's other situations where we'll be able to put less in and others will put more in and we should be able to do more projects. I'll talk about the two that we supported but just briefly how did we choose really? How did we go through our process? You know five characteristics really and for those of you who are here yesterday I touched on those yesterday but transformational really transformational change and change that would would not otherwise occur so we're not looking to be a substitute funder for anybody and if there are other funders then that's not who would do things then that's not the place for us. That puts us in places where there is either higher risk or different time frames or different ways of doing things from traditional means and that means that not everything we back will succeed and we're upfront about that and you know the people who are from Silicon Valley or been involved in early stage ventures themselves will be well familiar with that. You don't expect that they're all going to succeed but that's a place that will be. Understanding what the problem is and being able to be clear and have clarity around it is a fundamental part of the early part of the evaluation process for us and if Africans haven't really got a clear picture of that themselves then that tells you something. You know the project management I've put there project management with leadership but I probably should have put those the other way around. It's really leadership you know if you've got leadership then the project management will come and one of the things I'm sort of proud of but not surprised by is that if you look at the leaders of the four projects that we support they're all outstanding leaders in our in our view and you know not necessarily high profile. Al Bramley today this is up who some of you have seen did an outstanding job standing up there beside Tayo Spearing who's you know probably one of the bigger CEOs in a New Zealand context. Al's probably one of the newer ones were in week two of Zip in his first CEO role and he stood up there and did a brilliant job of talking of talking about Zip and that you know that sort of you know if you talk about leadership capability and so on then Al's got it he hasn't got the profile. Some of the other projects Dayman Salmond is the leader of one she's probably known to to many of you and for on the educational side Francis Valentine maybe known to some some of you are people who've got probably more of a profile but but a strong leadership capability and potential. Why the impact we want to support projects that we think can ultimately have a national impact even restoration of Abel Tasman National Park is obviously clearly a local thing but but that's having an impact on the on our partner in that which is dock and and so we can see that that project even though it's clearly not got national geographical aspirations can have national can have national impact and the and the the last capability is around sustainability. There's no point in us going and supporting a project for five years doing wonderful things or other things with it and then if the end of the five years when our we we decide that our funding stops that it all falls in a hole or goes backwards. So having a plan for sustainability is an integral part of us of us being involved. In Abel Tasman National Park one of the ways we went about that was we talked to the government about the fact that we were keen we were happy to come in and fund making Abel Tasman National Park predator free. It's a 30 year project but a lot of ground can be made in the first 10 years but we said that we were happy to do that provided the government was prepared to commit that any ecological gains that were made during that time would be at least at a minimum maintained and the government agreed to that and have signed an accord with us called the tomorrow accord by which they undertake that that what I what I've just described to maintain the ecological gains and and we have the ability and and it is written in a way that any philanthropic group with a suitable project can join to to bring their projects in under the tomorrow accord so it's not just a it's not just a next agreement. So that's that's how we got to sustainability in that example so there's lots of different ways of doing it but it's it's a fundamental part of the of the picture for us so the projects look I'm going to talk there's I've got a short video on on these two projects which which I'll show so the mind lab how many of you know of the mind lab just out of interest to me okay maybe maybe a fifth of you say and so the mind lab is a is a technology laboratory in Auckland set up by a lady called Francis Valentine she really set it up because she recognised that kids were not getting you know young people were not in her view getting exposure to to technology in a way that was that was good that was quick enough and fast enough very quickly she she set it up with holiday with holiday programs and so on very quickly school started bringing classes in very quickly the day filled up with school classes coming through the mind lab and then she and and she noticed that when classes came classes would come along with maybe 30 children and there'd be 10 teachers and and and not because that took 10 teachers for the class but because that the teacher told the other teachers in the school and and brought them along because they they were hungry for that knowledge so Francis who's a who's a woman of action brought Unitech in and set up a postgraduate diploma for teachers 40 week program that started last year or the first course was run last year teachers do it while they're teaching 10 hours a week the first 16 weeks they do six hours six hours a week in the mind lab as a cohort of 40 they're sharing all their work online obviously and working and then the second 16 weeks of the course are are done online and you know we we took a look at the program thought it was thought it was fantastic and really Francis just wants to get it out around the country as quickly as possible so we're we're providing scholarships for teachers to help get it out the the program cost $2,750 a teacher we're providing $801,000 scholarships and and the mind lab and Unitech have come in with $1,000 scholarships so 800 teachers this year will get to do the course for $750 fact in Gisborne off to the side but you know sort of how these things can build on each other in Gisborne they've said it's so fantastic Eastland Community Trust have come in with a program and they're they're paying the other 750 so teachers in Gisborne will be doing it for free the year 2020 is 1300 days away you know we can't keep talking about 21st century literacy and incapability as though it's coming you know we're right from the thick of it the mind lab was an interdisciplinary lab it looks at the needs of today's world we need to raise our digital competency and change in the role of careers and jobs we need to start with young children and so the mind lab was developed fundamentally so we can enable children to get excited about the possibility of technology but once we realised that it's all very well to teach kids and to have schools come through and get educated the teachers are just important and with that probably more so we're developing the next generation of teachers and what they are is teachers who have been in the workforce in the teacher profession for many years in many cases sometimes 30 40 years but actually are wonderful teachers who are trying to continue to be engaged with their students for the support from the next foundation what we've done is establish the next generation teacher scholarships 800 teachers around New Zealand next year undertake postgraduate studies in digital and collaborative learning in their region or region post them where they'll be able to learn all about new ways of actually teaching changing the way the education is delivered in this country as a nation contributing to a global market we don't have time for catch up right now we need to be leapfrogging our teachers forward and we need to take them from where they are right now which potentially is a fairly old traditional analog model of delivery and we need to go rock it fire them forward to make them feel really confident working with young people today digital literacy for teachers was something that struck us as as as an issue that and and something that we could that we could help make a difference in and and and was important um the other educational project that we supported is springboard trust out of interest how many of you have heard a springboard trust yeah rebecca because you've talked to me so yeah same not many and it's it's it's interesting it's that's what i sort of what i expected so um springboard trust about leadership professional development for primary school principals really focused on low-decile schools and um it's uh it's it's a it's a program that started about five years ago has worked only with schools in south Auckland to date about 90 principals have done the program and um is expanding with the back of our support into northland uh and um and then next year will be Waikato um and um and is and is really building up its backbone the backbone organisation to be able to expand further um in a rev who i've got a have got a video who's the chief executive of commonwealth bank which is about a 50 000 employee business uh in run out of australia um is is the champion for this he was a mckinsey partner when he started up in new zealand a passionate new zealand a passionate about education and and um and gives you know his time and energy to driving this program in a way that we think is fantastic and has and has brought in a really great range of um of of educationalists and business people together and part of the thing that attracted us to us other than just the importance of leadership in terms of um uh driving education outcomes uh was um uh was the fact that it's a partnership between business that business and education that is for education um but but the educate the principles are not the only beneficiaries of this so are the business people business people who partner they buddy they run a program but they buddy principles up with business people uh for the year for 12 months asb have been there from the beginning and i've now made that partnering that buddy program part of their leadership program within asb because of the value that they see that their people have been getting out of the buddying with the principles um and for those of you who don't uh haven't got the sort of exposure the principles it's one of the hardest jobs in the world really and it's a it's a it's a really challenging job so i think it's not only been an eye opener for a lot of these business people but it's been an education for them too i had a great time at school as i say grew up in the public system i remember inspirational teachers right from what used to be called the primers tried my best in class maybe wasn't always the best student loved the sports loved the drama classes the music classes and just felt that there were a whole lot of people there to try and help me do the best i possibly could in whatever area i choose to to try and do well simply put springboard trust works with principles to help make their schools better uh so our view is that with schools like in business like in the arts like in sports if you want to help an organisation or a team get better you start with the leader we are definitely focused more on the low-design schools who tend to need a bit more of the support because they don't have the same resource delightfully what we found a lot of these schools are run by great principles with great staff who really are in a good position to provide good education to kids and we bring people from different businesses to work alongside the principles we call them capacity partners maybe somebody from McKinsey ASB Russell McVeigh Spark Fonterra we've had people from all sorts of different businesses and they work very closely with the principles talking to them about the schools getting out of schools they help the principles a lot the partnership between the principles these capacity partners works very well for the principles we found that what we also found is what a difference that makes the life of the capacity partners they are inspired what the principles are doing they love going to the schools they love seeing the impact the schools are having on the kids they repeatedly tell us well actually i think i'm getting more out of it than i'm putting in and that's when you know you're onto something good what we're hoping to achieve over the next five or ten years again starts with the kids we want to help impact the education outcomes with the schools we've worked to date we've touched schools comprising in total over 32,000 children we're hoping to more than double that number without that we need from next foundation and others the good news is even if schools get to an even higher level you then want them to get to a higher level still so the model of helping principles helping the people who make the most difference bringing businesses together with schools and all focusing on better outcome for kids that never goes away and what all of us currently working at springboard hope is that when we all leave we've left an organisation which is sustainable and which five years will be doing an even better job than it was doing and we were out and we're pretty confident we're on that path okay so i'll uh i'll finish up there they've got uh the um one of the things i love about those videos is the um that the music it comes is is from our secondary school students in New Zealand there's a competition run here in Elijah you know you're here there's a competition run in New Zealand by a guy and by a guy called Mike Chan which is for which is for songwriting songwriters for secondary school children and they and it's widely supported they choose 40 each year and the four songs that we've chosen have all come from those kids and um they are um i love them and uh you know they're very cool and one of the nice things that will come out of this will profile those kids and their songs on our website and do some stuff with them over over the year to come and uh that's sort of one of the that's that's one of the little nice kickers for us okay so um yosaf i'll go to i know on time but if you want to go to questions and answers that's fine by me so oh hi um it's really exciting that you're investing in education in this country um i i used to be a secondary school teacher and i've involved with been involved with some of the professional development around um upscaling teachers around language code ict that sort of thing um i guess i found the experience pretty disheartening um and the the experience that i had was that the the acceleration of learning and the students was outstripping anything that the teachers could hope to keep up with and i found that the approach was uh teaching the teachers how to deliver and it was the the word delivery used a couple of times in one of those talks um i feel like my my preferred approach would be give teachers the skills they need to just really support the students and get out of the way i think we've heard that theme as well do you have any sense of of whether that's possible with these programs um and i'm also interested do you i'm not sure if you mentioned whether you've got someone who's got experience in the education system on your team sort of advising you on these things yeah thanks okay well to take the second question first thanks um yeah i've got a um uh first of all uh an advisory panel uh that works so um the two of the educationists that are on it that you might know uh Margaret Bendall who who was um who was a former principal of Epsom Girls Grammar actually but has been involved and and is involved with uh things like cognition and Teach First uh and and uh and others now and a guy called John Taylor who was um who was also a former principal uh and then talked to a lot of principals and talked to a lot of uh and and talked to a lot of other people one one point i'd you know one point i'll make and and uh it's not defensive at all but in in any sense this is not the end of what next is going to do in education it's just the beginning and um and they're the two that we chose this year um the question around you know all of this gets every educational project and our view gets back to what what's it doing for learning outcomes in the classroom that's the that's really that in some ways the only measure and um so our response to try to get to that is that each so each project that we support we are also supporting um what what we consider to be um rigorous uh you know evaluative framework to go alongside to find out whether that's the case so in the so in both both of those two cases we have we have also funded that research that is commencing and that is so that is going on and in the case of springboard trying to draw the connection between improved strategic direction amongst principals and learning outcomes in the classroom is is a very hard thing to do but these guys are going to have a go at it they've they've they've um so NZER have been contracted to do that to to essentially shape up that framework um and do that so we think that that I guess my my main response to your question is that we can't guarantee any of those things but we're going to make sure that there's good evaluative framework alongside each of the projects so that we can actually find out find that out over time um and uh and and it's the same and same in mind really so so for two questions you mentioned the other day that education is quite a broad area and you're narrowing down on a few sections of it would you be able to say what they are yeah I put them on the slide Josh there so as it turned out so this is not um as it turned out because it was the one it was the one slide I had to go so this is our current thinking don't take this out and and quote us uh if you can because um I haven't put this in front of my board yet so um uh but but this shows you where my thinking is going um and and let me say not my thinking too this is something that uh you know the educational advisers have been uh have been in as well so really those four areas um you know putting environmental education as an area in itself but you know early childhood education but really also the naught to two parents as first educators is an area where there's not necessarily a lot of institutional uh uh work where there hasn't been but but where there's where there's an increasing welter of research showing that to use sorry a commercial term but where you get the best bang for your buck and um and that's uh in terms of change so I think that's an area that will certainly end up uh end up uh looking looking to get involved in um I heard it might have been you Josh but just when I walked in somebody talking about collaboration as a factor and that's something that uh that we're really interested in there's a project called an XL Rotorua which uh some of you may or may not or not which is about the city of Rotorua really trying to take responsibility for the education outcomes across all of the schools in Rotorua 46 schools primary intermediate and secondary and they're going at that in a way which is which is not at odds with but is a different line to tomorrow schools and really looking for ways for schools to collaborate on various things um and uh and and learn from each other so that's that's one of the areas mentoring and mentoring and buddy systems there's a lot of anecdotal evidence and not a lot of hard research to support that that they're a great area and future focus really technology and education it's going to change things I'm sure you've been talking about it all day so it's a place that we want to look one more question hi um one of one of the big barriers that I find a lot of school leavers have to getting their first jobs is finding some um work experience um or some kind of volunteer project that's you know a really structured mission focused project that they were part of that means something to employers and the work experience often doesn't even have to be relevant to the type of career pathway that they want it's just a a way of being able to show that they could be part of a team part of a project be reliable so on I'm interested in whether um a next foundation could be a connector between some of your organisations that are doing big um environmental projects and people are organisations that are interested in setting up mass work experience or volunteer project schemes um and if it's on that scale it can be recognised you know as a young person I was on that such and such scheme to do you know the possum trapping mission to clear up able Tasman is anything like that in the pipeline yeah well it's got a bit further along the pipeline with your question because uh because it came it came up in a discussion this week uh really and uh somebody made a made a similar sort of suggestion around there was an opportunity there around and around predator predator management you know trap that you know um labour for manual labour for the traps is a major uh is a major constraint to to acceleration so so that suggestion was made you've you've given another another angle on it and it's something that we will go back and have a have a look at because we're interested we're really interested in the predator management space and we're really interested in the in that in that education space um the other thing sort of relate it the other thing I'll tell you to go and have a look at a website I just I just remit I said told Matt yesterday I was going to email it to you and I remembered just when I walked in here Matt so is a is an organisation called pride and joy that a couple of kiwis set up about 18 months ago um that is that is about providing vocational training for the young unemployed uh they will only take on the young unemployed in their business um and they want to form a these these two guys who are um who are who are young by my standards not by many of yours but they're in their 40s probably um two really capable guys one uh ex Nike managing marketing manager in the States one ran NZ ski basically the South Island ski fields they both want to develop a global brand in New Zealand and they latched on to out of New Zealand and they've latched on to providing vocational training for the young unemployed through this pride and joy which is about ice cream vending actually and um so go and have a look at pride and joy that's a um that's one uh you know New Zealand companies sort of take on it as well and your suggestions a great one thank you Bill I'd like to congratulate you for the great work you did today with Fonterra and the dairy industry coming in and for doing all the work you do through next and very excited to co-create with you uh in the education space as well as the environmental space but thanks very much for taking your time and sharing this with us really appreciate the insets and the work next is doing thank you


Next question is from Kyros Captures, are alkaline and pH water another processed item on the market or are they worth the money? Here's a great example of taking, you know, maybe some applications of alkaline water and saying there may be some benefit and then just, you know, doing it across the board. Bastardizing it. Which is, yeah. So, okay, so alkaline. $5 bottle of water, no. Right. Normal water's pH levels like 8 or 8.5 or something like that and something that's alkaline is over that and oftentimes the way that they improve its alkaline, you know, the alkaline quality of water is by adding certain buffering minerals to the water. So now, you know, water is a little bit more alkaline, meaning it will counteract some acidity in the body. What are the potential applications? Well, I guess if you have acid reflux issues, maybe it might help a little bit. In which case, I'd say eat a Tums or a Rolades, which is way more alkaline, it'll solve that issue a little bit better. Yeah, or just eat, you know, like non-inflammatory foods. Yeah. Now, is it going to change the alkaline of the measurements of your body? Probably not.  That's how I thought they dispelled this, right? Yeah. I thought they did, because that's how the true way to test this works is to drink this stuff and then like take a piss test, right? Isn't that how they would measure and like see if it's actually changing it? Yeah. Your body is very, very good at maintaining a certain pH level, because if it goes a little bit outside of that, even if it goes too alkaline or too acidic, it's not good. Bad. It can become quite dangerous.  Isn't it too? There's people that I know, in my case, specifically, like I'm not producing acid when I should be producing acid. And so that's really the biggest problem that I've been facing. And so it'll show up, you know, at night or inopportune times where I'm needing to digest food. And it's training that to, you know, my body to really get that response while I'm eating the food. Yeah. And I mean, here's the other side of it, right? If you drink water that is devoid of minerals and that's all you drink, you could cause electrolyte balance. Like distilled? Yeah, distilled would be the worst, right? If you just drink distilled water, you could cause problems, right? Because you're flushing out or causing imbalances with electrolytes. So just regular mineralized spring water, tap water, believe it or not, is fine. pH water, you're spending more money for something that does nothing for it. What if you're not producing enough acid and you throw more alkaline, you can actually make the problem? Yeah, I guess that's what I was getting at. Yeah, you could make the problem even worse. This is what marketers do. They'll take something that everybody knows they need more of, like water, and they'll say, how can we inexpensive, you know, in a very inexpensive way make it seem more valuable to buy our water? So they'll say, our water's pH balance is high. What'd they do? They added a little bit of, you know, magnesium to it or something like that. Is it interesting to you guys? Doug, do you have any idea? You're old. You probably should have a better idea of this. Do you remember when water was invented?  So there wasn't even a... Before then, it was just hydrogen and oxygen. Bottle water wasn't even a thing. Like you couldn't buy, you didn't go buy bottled water anywhere. Like that wasn't a thing. That was like, if you did, you were like storing for like... You were like rich. Only rich people bought. Not even that. It was like, because you're going camping or somewhere and you couldn't be able to get to water, maybe you bought the... But other than that, nobody bought water bottles, right, Doug? It was like, you just drink. Just drink it out of the tap, right? And so this has to be like a multi-billion dollar industry now that didn't even exist like 20 years ago. Oh, at the time, I can remember when it first came on the market and I go, why would I pay for water? This is ridiculous, right? We're going to start bottling up air. Bro, space balls. Remember in space balls? Yes, I know. You're going to buy a can of air? Yeah. Oh, I did buy a can of air. I think that's brilliant. That's totally like the next move. I think you guys are on to something. Yeah, I know what, you know, it's funny too is that bottled water is one of the largest contributors to waste because of all the plastic bottles. So people are like, this is good, you know, tell them, whatever, you've got all these plastic bottles that we're dumping into. You know, those islands of plastic.  Just regular water is fine. Tap water is usually fine. If you feel like you need to clean it further, buy yourself a purifier.  If you're real gangster, you'll drink out of the garden hose. Yeah.


They say nothing is more inspiring than a challenge and our creative agencies today have literally proved that right With the wonderful campaigns that they have dished out We have with us in our beating all odds segment today once such creative advertising leader Shrija Chatterjee MD Hi, Shrija MD of publicist worldwide Shrija tell us how has his lockdown affected the creative ideation that purposes Well, it's actually opened our eyes that we could ideate potentially on on on a screen like this earlier ideation was all about sitting around a Sofa or you know going out for a smoke break and discussing ideas Now it's a form of formal process and initially there there was some sort of Tension amongst our creative people But I must say it's a It's happening very well very efficiently actually Are you saying that your team is surprising you because you know there was like you mentioned there was a belief that unless you're bouncing off ideas With each other sitting in the same room. You can't really deliver Is that happening in a in a way that surprised you right now? Absolutely and nowadays what's happening is what has happened is the regular phone call has stopped It's all video call. So anything that you require you're just you know calling the person up on Microsoft Teams which is the the platform that we're using quite well and Everything is therefore just immediately discussed and closed and it's it's happening very seamlessly I must say I am surprised. I expected Some sort of pushback or some sort of you know getting over a you know because of this condition This is the reason why this was not delivered. That's not happening. They're all delivering it very very well But tell me even having said that what kind of problems are you currently troubleshooting? Well actually troubleshooting is about delivering so we cannot shoot shoot a film So it is about looking trying to find a solution within the You know allowable means which is either looking at stock photography looking at animation looking at you know a the kind of films So that's the only real constraint that we are in other and I guess creative was better with Constraints, so they are also finding creative ways of finding the solution Other than that, I don't think there is any any real issue the the only potential Think is that there are some employees from an employee perspective There are some employees who are living alone And and you know living in this time hooked up in your house can be quite harrowing if we're living alone So that's the meaning we're just taking care that you know, we are taking care of those employees There are conversations happening with them regularly. We're also instituting in our organization a mental health number So if anybody has you know any issues with mental health because you know these things can affect different people in different ways You know, there is a number that they can call and they can you know sort of get some sort of counseling You know, but unlike the other agencies, we're not releasing a lot of these work from home ads Coming from progress is worldwide yet We had a lot of farmer clients a lot of farmer work has come out We had some B2B clients a lot of work of those have come out videos video campaigns Print video. Yes. It's a combination a lot of work has already come out. We are not going out there and bring PR of that There's a and now the teams are, you know workshopping and working with the clients regularly to Plan when it opens up what happened in the short-term what will have potentially happened in the long-term and looking at different scenario buildings and Plans for that. So they're like up to here with work. So much so that nowadays, you know, this Nobody's keeping track of lunchtime and breaks and there was a whole conversation we had on that and we said that okay Let's just you know, make sure that people get that up in our 45 minutes will eat at least because it's just But you know the lockdown and literally thrown up a different kind of challenge at the brands mostly So as an agency, have you adapted? Are you also giving them different kinds of solutions? Which is not exactly an ad. What kind of other things are you coming up as an agency? Actually depends on what what the brand is what the cycle it is in and its developmental phase There are there are different solutions that are happening for example a brand like ZT Which is you know a GC and it is connected with the consumer every day The consumer needs those characters every day and now suddenly the consumer is not connected with those characters Because obviously they are unable to shoot. How do we keep those characters alive in the minds of the consumers? Because the consumers love those characters the viewers of those shows love those characters So we are giving them interesting ideas and mainly digital because that's the medium where you know You can best connect at this time and people are also now a lot more digitally active than they were earlier even the older generation So there are those kind of ideas that we're looking at. So how do you keep the brand alive in the in the mind of the consumer without super hard selling because this is not the time for super hard selling But yet in a software way yet in a kind of brand love way to stay alive in the mind Well another interesting things that some of the ad professionals have told me is you know during the lockdown They've seen a very different kind of different side to the clients. They are much more understanding So would you say that the clients that you have right now are less of dictators than what they were a month ago?  I mean they clearly Everybody understands that everybody has pressures at home So they do understand it's work from home and work for home and therefore there needs to be that balance There are SMS is coming or rather what's up coming thing can we connect it so and so time versus picking up the phone So yeah clients also Need to do their share at home. So they also want that so-called me time to complete that so they are get they are They were good But tell me what are the unique problems that you are hearing from clients anything specific that is Would be nice to you know talk about here. We each category is going through its own share In fact, we had a very interesting Table that we did so our B2B business does a lot of not just B2B but a lot of talent communication So organizations connect with their consumers with their employees and therefore they need to communicate to them So we do coms on that so we had an HR round table where we called in the HR heads of a few of our clients And it was a very interesting You know talk like this like you and I are having so just imagine There are some eight night clients and there's a somebody moderating it And it was a very interesting conversation on how the HR people are coping with the employee issues Also with how they are personally, you know Developing themselves in a way because different people are going through different learning curves So those kind of things were very interesting. So I found that we're doing more of these round tables now Across categories. So we have a farmer one plan for tomorrow So these are ways we have been connected with the consumer consumer our consumer being the clients Understanding what they're going through and then we're workshopping with each and every client to figure out What should we be doing the immediate what should we be doing in the midterm and then also laying some stones for the long term Though how long is the long term? We don't know because that really depends on how this all pans out But then we have pictures happening right now. Are they on hold very much?  We have one on Saturday coming up See now what's happened is because we're all working for more Saturdays are also okay to have meetings Because it doesn't matter. So we have another picture on Saturday. So pictures are very very much But would you say you know clients apart from you know slashing ad spends are they also looking at cutting agency costs right now? Yes, some some clients aren't some clients are asking us for help for partnership during these tough times some clients aren't and Wherever we can help we are helping And they also understand that we have a business to run So if they are not being you know Unfair we also understand that they have a business to run So it's a each client is a different Conversation, but there are some clients where we've offered to help out where we know that those categories are going to be far more Long-term affected than then some of them That's in such a testing in such testing times and agency becomes that much more important for the client Of course, it definitely becomes far more important because what's gonna happen is you need to do communication now Which is more as I said, you need to get the pitch right and it could be hard self, but then when things come back But it's gonna be shouting. So how do you shout best because once the market opens up everybody's gonna say So how do you shout best and that's when they need the partnership of the agency they need the partnership of the agency to develop different scenarios and Create plans for each scenario and depending on what scenario pangal because as I said Then we deploy one of those plans. So definitely they need they need the partnership That some of the businesses are under pressure and whenever we can help you Another thing is you mentioned, you know, it's uncertain and you know, once the lockdown gets I mean, it's called off How will the client react? So do you think the client will become more cautious because a lot of sectors production has been halted And they'll just resume.  They will spend not that much, but they will by the time they get their supply chain and The entire Um Up the stuff into the into the outlets done Distribution They will probably take their existing assets and they will redeploy those existing assets by making them, you know A little bit you are here and there Which is what our task should be and then we will start preparing and I think the big bang Around the opposite number, you know time is when we're fully things will then all Be back to normal to some extent and the clients will spend on on new communication And I was just reading after an early release of your first quarter earnings I mean your CEO chairman Arthur He spoke about a cost-cutting plan where every country could decide how to go about it So as far as India is concerned, are you looking at layoffs or major salary cuts for your income? No, now we are we are not looking at a mass layoff or any salary cut that we are going to write really not As much as we can Currently we are definitely we we're looking at of course, you know, this is the instrument cycle So we put a point to that for some time till we get As to how it's all going to pan out We're also, you know, making sure that we don't take any party help and do a lot of in-house Because we have a lot of things in our power one solution. We have content We have digital we have PR. We've got everything so Mandate is you cannot go out to any other party walk with them because the more you water But you're eating to somebody else's job So everything needs to be in house And a few replacements that we have you know replacing them for now It's all on hold so that we are once we get an act our act together Have a better visibility as to how things are happening then things So that's our kind of cost-cutting Okay, and last question. What are your learnings from the lockdown? Oh My learning for the learning number one Actually haven't stepped out of house from 19th of March. I haven't stepped out. I haven't even gone on for a walk I'm exercising indoors. So I had the fact that I can be indoors for some 33 odd days By to me is one personal Learning I didn't know I was capable of that I think From a professional perspective It's amazing how humans can you know Take over any challenge and fight that and that's something that has been demonstrated I mean, we know we keep saying Mumbai is resilient and Mumbai is that but that's really the human human Side to everything all human beings are resilient They'll find a way to break out of any issues and find a solution The fact that the teams are working so well in such a planned manner There are jobless meetings every morning. There's a review of the jobs every evening Creative people are you know doing this so well of course planning and Already and the fact that is something that you know has been in a hot sauce to everybody They have understood the situation. They're doing way more than what they should And they also know the situation that everybody isn't now and therefore they're delivering a lot more than they should And that's something that is absolutely Like you mentioned, we're all working from homes, but we are more connected than ever Virtually, so let's let's take this time to maybe recharge and come back with a bang When the minute the lockdown is actually lifted, maybe so thank you so much for speaking to Ashija Lovely speaking to you. Bye. Bye. See you. Take care