Select Committee on Health Appendices to the Minutes of Evidence


Memorandum by Professor Michael Lennon (PH 79)

Subject: Water fluoridation—implications of University of York systematic review

  The final report of the University of York NHS Centre for Reviews and Dissemination systematic review of water fluoridation was published on 6 October 2000. The review confirms that fluoridation is both effective and safe. (See attached Department of Health News Release.) [85]

  In its 1999 public health White Paper the Government committed itself, subject to the outcome of the York review, to "introducing a legal obligation on water companies to fluoridate where there is strong local support for doing so."

  Since the 1985 Fluoridation Act was passed over 50 health authorities have persistently attempted to implement their fluoridation proposals—to no avail. They have conducted extensive publicity and consultations—many going well beyond the requirement of the Act—and have demonstrated substantial public and local authority support. Despite this, every health authority has had its request for fluoridation refused by its water supplier.

  In a 1998 House of Commons debate the then Minister for Public Health, Tessa Jowell, described the current Act as "a mess". The Minister said that Government "cannot allow decisions on the principle of introducing a fluoridation scheme to be taken by a body that is accountable to its shareholders rather than its local population" (Hansard 6 May 1998).

  Furthermore, a 1999 Judicial Review of Northumbrian Water's decision to refuse a request for fluoridation from eight health authorities found in favour of the Water Company. This judgement confirmed the water industry's belief that, as the law stands, and irrespective of their customers wishes, water companies are entitled to refuse health authorities' request for fluoridation and are not required to give reasons.

  A targeted programme is needed to reduce dental health inequalities. The Government's dental strategy Modernising NHS Dentistry sets ambitious targets for improving the dental health of young children. It highlights the striking improvement in the dental health of children living in Sandwell in the West Midlands since fluoridation began there in 1986, and compares it with the poor dental health in Bolton, an area in the North West with a similar population mix but without fluoridated water. To reduce such inequalities fluoridation in the UK should be extended to reach 25-35 per cent of the population—targeted to those areas where tooth decay rates are unacceptably high. These areas include the North of England, parts of the West Midlands, Inner London, the West of Scotland, parts of Wales and Northern Ireland.

  Public health practitioners, clinicians, health authorities and the water industry itself are calling on government to modernise legislation so that they can proceed with fluoridation in those areas with worst dental health and where it can be shown that local opinion is in favour.

85   Not printed. Back

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