Source · Select Committees · Public Accounts Committee
Recommendation 8
8
Accepted
Require Defra to set public health goals for wastewater and conduct more research
Conclusion
Mismanagement of wastewater and sewage is a serious public health concern and heightens the threat of AMR. Storm overflows involve sewage getting into waterways such as rivers. They increase the prevalence and diversity of resistant pathogens in the environment and are a serious public health concern. In 2016, 862 storm overflow sites were monitored for spills, and they averaged 15 spill events in the year each. By 2023, the number of storm overflow sites monitored had increased to around 14,000, and they averaged 33 spill events each in the year. However, information on AMR in the environment and how it is affected by the UK’s management of wastewater is limited. An independent evaluation of the 2019–24 NAP by the Policy Innovation and Research Unit criticised the relative lack of action taken to address the issue of wastewater in relation to AMR. DHSC stressed to us the importance of clean water and good sanitation as a public health issue, and the relevance of measuring the performance of water companies in public health rather than just environmental terms. VMD noted the importance to AMR of planned investment in wastewater treatment and told us that by the summer of 2025 Defra should have received recommendations from the Independent Water Commission on how to tackle systemic issues in the water sector. The Committee may be revisiting this in future as part of their inquiry into ‘Water Sector Regulation’. 6 recommendation To manage the public health risks from wastewater, Defra should: • treat the management of wastewater as a public health concern and set out public health goals relating to water; • monitor the impact of increased investment by water companies; and • conduct more research to better inform its decisions on the regulation of wastewater.
Government Response Summary
Defra commits to providing a full response via a White Paper in Autumn 2025, outlining its approach to embedding public health across the water system and addressing public health goals. It highlights ongoing research on AMR in sewage sludge, with phase 4 reporting in 2027, and will commission further research on human health and wastewater by Summer 2026.
Government Response
Accepted
HM Government
Accepted
The department agrees with the Committee’s recommendation. on 21 July 2025. It recommends making public health a statutory objective for water companies and highlights their role in tackling antimicrobial resistance through better wastewater management. It also recommends that the UK and Welsh governments should tighten regulatory oversight of sludge activity by moving the treatment, storage and use of sludge into the Environmental Permitting Regulations. The department will provide a full response via a White Paper in Autumn 2025, setting out its approach to embedding public health across the water system, ensuring public health is addressed substantively and systemically. The department has been working with water companies under their Chemical Investigations Programme (CIP), to improve the evidence base on the behaviour and fate of contaminants during treatment processes. Research from phase 3 of CIP investigated antimicrobial resistance (AMR) and sewage sludge and evidence suggested that anaerobic digestion – the prevalent sewage sludge treatment method – demonstrated some level of effectiveness in reducing AMR in sludge. Building upon these findings, phase 4 aims to delve deeper into the relationship between AMR and sludge and will report in 2027. Defra is also in discussions with DHSC and stakeholders to understand the evidence gaps on human health and wastewater. The department will commission further research to address these gaps by Summer 2026 and will continue to test and improve the evidence base.