APPENDIX 38
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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