Kitchen confidential

THE GARGANTUAN job of inspecting establishments that prepare, sell, or serve food in Massachusetts falls to hundreds of local health authorities, and the state Department of Public Health in turn oversees the local authorities' work. But a recent studyby state Auditor Joe DeNucci found thatunderstaffing, insufficient training, and a poor flow of information have impeded the inspection process. Eleven of the 13 authorities audited by DeNucci's office weren't inspecting food establishments frequently enough to comply with federal and state standards. And the consequences for consumers can be nasty.

The report describes an unnamed eatery that was inspected only twice by the local authority during a period when it should have been inspected five times. Closer scrutiny was in order; DPH had received several complaints about foodborne illnesses possibly traceable to the restaurant. One complaint came from a physician whose family was in the seafood business. Two of his colleagues at different tables got "violently sick" a day after being served "dry, rubbery" oysters. Despite the complaints, inspectors cited the restaurant for a single serious violation.

Massachusetts food sellers, by and large, aren't hotbeds of tainted shellfish or other blemished goods. They must designate trained in-house safety managers to enforce good practices. But when health threats do arise, the inadequate inspection system makes it less likely that they will be identified and fixed.

Better computer systems should improve communication between state and local health officials. But a more basic flaw in the inspection system is harder to fix. Most of the state's 351 cities and towns handle health inspections for their own food retailers. But a town with a small population, and only a handful of food establishments, has no reason to hire a full-time inspector.

As DeNucci's report points out, health agencies serving areas with more than 100,000 residents can more easily afford to hire specialized food inspectors. Smaller towns ought to clump together to share those costs -- and perhaps to provide other public health services as well. A group of 14 Central Massachusetts towns is doing this already.

Yet further consolidation won't occur unless the state promotes it, using money as a carrot. John Auerbach, who led the Boston Public Health Commission before taking over last week as head of the state department, says regional health initiatives have been useful in combating smoking and HIV in the past. But state financial incentives to encourage such initiatives have come only sporadically. Auerbach says other states have used post-Sept. 11 homeland security grants to encourage communities to collaborate on public health, and his department ought to pursue the same strategy here.