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Water Fluoridation
5. Mr. Simon Thomas (Ceredigion): What recent representations he has received regarding the extension of fluoridation in the public water supply. [122421]
7. Andy Burnham (Leigh): If he will make a statement on water fluoridation. [122424]
The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson): We have received representations from the water industry requesting that the legislation on fluoridation be amended to make strategic health authorities solely responsible for deciding, where their populations are in favour, that a new fluoridation scheme should be introduced. We will table a relevant amendment to the Water Bill tomorrow, for debate on 9 July before Third Reading of the Bill in another place.
Mr. Thomas : I am grateful to the Minister for that reply. I welcome the new team in the Department of Health to their remaining duties in Wales and Scotland.
Fluoridation is one such matter. In my constituency, 69 per cent. of people do not have access to an NHS dentist. The incidence of lip and mouth cancer is among the highest in western Europe, and we have an above-average incidence of decay in children's teeth. My constituents tell me that they do not want fluoride in the water as a matter of compulsion; they want to be able to opt to take fluoride as a supplement. Will the Minister give them the guarantee that the NHS will deal with the dentistry that needs to be performed, but that fluoridation will be a matter of personal choice for the consumer?
Miss Johnson: We are enabling local communities to decide what they want to do on this matter. I appreciate the hon. Gentleman's points about dental services, but those are a matter for the National Assembly for Wales and I cannot comment on them. I hope that hon. Members accept that we are looking to give local communities the decision-making power. I am sure that the hon. Gentleman, who believes strongly in devolution, accepts that that is the right way to go on these matters.
Andy Burnham : Has not Parliament spoken in favour of water fluoridation but mistakenly left the final decision in the hands of plcs, not the people? I thank my hon. Friend—and her predecessor, my hon. Friend the Member for Salford (Ms Blears)—for ignoring the bluster of the flat earth society and agreeing to table an amendment that will help us to improve children's health. Will she give a firm assurance that, regardless of what happens down the Corridor, this House will get a chance to vote on the issue and clear it up once and for all?
Miss Johnson: I am grateful for my hon. Friend's support for the proposal. I emphasise that no fluoridation scheme will take place unless there has been wide-ranging consultation in which both the proponents and opponents of fluoridation have been encouraged to participate and in which the majority of the population have indicated that they are in favour. Ultimately, this matter should be decided locally, but we recognise the difficulties that water companies have faced and are proposing to table the amendment in accordance with suggestions put to us on many fronts over recent months.
Dr. Andrew Murrison (Westbury): Countries as diverse as Finland, Cuba, Canada and Germany are now abandoning water fluoridation, but are not finding
that tooth decay has increased or decreased. Why should we consider bucking that trend in this country by introducing this illiberal measure?
Miss Johnson: I have said that the amendment is enabling and will not necessarily lead to any more fluoridation schemes, which will depend on what people decide locally. There is a strong correlation between fluoridation and reducing tooth decay; that is an important fact. Large chunks of England down the east side—roughly from Hartlepool to Essex—have fluoridation occurring naturally at the sort of levels that might be put into matter, and 5 million other consumers already receive fluoridated water in Birmingham and other areas.
Dr. Brian Iddon (Bolton, South-East): A very long time ago, the people of Bolton voted in a referendum against fluoridation, but it was a very long time ago. Bolton metropolitan council also voted against fluoridation, but that was some time ago as well. Will my hon. Friend give consistent guidance to all councils and people across the country so that everyone can have a say in this emotive matter, the guidance is upheld and up-to-date consultations are carried out if and when Parliament decides on the issue?
Miss Johnson: The detailed guidance will be a matter for regulations. At the moment, we are only at the stage of tabling an amendment to the Bill in another place. Local people will decide how they engage with the options covered by the regulations, which will be a matter for them.
Mr. Charles Hendry (Wealden): Does the Under-Secretary understand the concern of many that there is already too much interference in what we eat and drink? Fluoridation is one concern, but there is concern also about far too many colourings and additives and the effect that they have on children's behaviour, about the reduction of basic vitamins and minerals in food, and about GM food. I accept that there is a positive dental benefit from fluoridation, but should not the Government concentrate on the real cause of the problems: the amount of sugar consumed by children?
Miss Johnson: As the hon. Gentleman knows full well, we are doing that as well.
Mr. Simon Burns (West Chelmsford): How?
Miss Johnson: We are doing things to improve diet and decrease the intake of sugar and salt. I reiterate to the hon. Member for Wealden (Mr. Hendry) that 5 million people already receive fluoridated water at one part per million, the proposed level of any scheme, and large chunks of the population receive it naturally through the water supply. The idea that it is purely an artificial additive is clearly wrong.
Digital Hearing Aids
6. Ms Joan Walley (Stoke-on-Trent, North): What the take-up of NHS digital hearing aids is. [122422]
The Minister of State, Department of Health (Ms Rosie Winterton): By the end of May 2003, 98,540 digital hearing aids had been fitted to 62,865 people as part of the modernising hearing aid services project. We have recently announced that an additional £94 million will be made available over this and the next financial year to support national roll-out of a modernised hearing aid service providing digital hearing aids.
Ms Walley : I welcome my hon. Friend to her new post and wish her well in it. I also welcome what the Government are doing on digital hearing aids, but I must tell her that it is not happening quickly enough in North Staffordshire. Does she agree that there is an unsung hero in North Staffordshire—my constituent, Mr. Longstaff—who will not be satisfied until everyone who needs a digital hearing aid can get one? He does not want people to have to wait until 2005. Could the Minister contact the Treasury and ask whether it could free up the £10 million or so in balances that existed under the old health authority? If we could free up that money and get it moving over to the new primary care trusts more quickly, we could roll out the digital hearing aid programme that much more quickly for constituents in North Staffordshire.
Ms Winterton: I thank my hon. Friend for her kind comments and welcome, and I understand the point that her constituent makes. The programme that we have set in train on digital hearing aids has been widely welcomed. I understand that the North Stoke primary care trust is commissioning this work on behalf of the other four PCTs in the area, working with the local service provider—the University hospital of North Staffordshire—and the project team. Funding is being examined and they are trying to establish how best to provide those services as quickly as possible. In fact, we look to PCTs to provide only about 25 per cent. of the funding; in a typical area, that will amount to about £6,000 per PCT. In view of the increase in PCT funding, we believe that they should try to match the 75 per cent. provided centrally to help introduce the service.
Mr. Henry Bellingham (North-West Norfolk): I too congratulate the hon. Lady on her appointment and I am sure that she will add sparkle to the Front-Bench team and do very well. She will be aware that digital hearing aids can help people to stay in work and revolutionise people's lives. Is she aware of the disappointment in west Norfolk that the Queen Elizabeth hospital was not part of either the first or the second pilot scheme? Can she give us any idea of when my constituents will be able to get these worthwhile and important aids?
Ms Winterton: I thank the hon. Gentleman for his kind comments. Digital hearing aids will be in place by March 2005. It has been done in waves, with different trusts signing up to the programme at different times, but it obviously takes time because various things have to take place. The proper equipment must be installed and audiologists must be trained. We need to ensure that, once the service goes out, it is able to deal with people's individual needs. I hope that the hon. Gentleman's constituents will accept that we are moving as quickly as we can. No one would be happier than we
if it could be done more quickly, but real practical problems must be addressed. Nevertheless, the service should be rolled out nationally by April 2005.
John Cryer (Hornchurch): I welcome my hon. Friend to her new position and I also welcome the fact that, as a result of the Government's investment in the health service on an unprecedented scale, this technology has been made available. However, is she aware of age-based discrimination in certain areas where older people who have old-style analogue hearing aids are not receiving the new digital aids? Will she make it clear that the Government will not tolerate that sort of discrimination in any NHS trust, and that the service should be freely available at the point of use so that older people can have access to digital aids?
Ms Winterton: I thank my hon. Friend for his comments. I completely agree that there should be no discrimination. The approach taken has been that people who require new hearing aids or are obtaining them for the first time have been prioritised for digital hearing aids. Provision is then worked through so that people who have had hearing aids longest get the new ones, and that may be people who have had them four years, then three years, then two. We are renewing the oldest analogue hearing aids by replacing them with digital hearing aids. That may be why my hon. Friend's constituent believes there is discrimination, but that is not the case. We are simply working through the system to deal first with those who have had hearing aids longest before we move on to others.
Mr. Archie Norman (Tunbridge Wells): I add my welcome to the Minister, but while she has a fresh pair of eyes, will she look again at the facts behind her brief? Her words will sound hollow to people like my constituent Tony Warner, who is 83 and who had to wait 23 months to have a digital hearing aid fitted because of the lack of audiological technicians in the area. Does she realise that it is no good making digital hearing aids available if there is no one available to fit them? The hearing aids must be fitted by technically qualified people, but the number of audiological technicians qualifying last year was half the number in the previous year. The gap between supply and demand is widening, and the waiting lists will lengthen, not shorten.
Ms Winterton: I thank the hon. Gentleman for his welcome. I understand his constituent's frustration at any delay. As I have said, we are moving as quickly as we can to institute proper training and to put equipment in different areas. The hon. Gentleman has certainly drawn attention to a real problem in the training of audiologists. We have instituted new training programmes in recognition of the fact that there is a difficulty, and we are working with other sectors to see whether more can be done to train people. There is a difficulty, but we are working hard to redress it. I hope that that will give some comfort to the hon. Gentleman's constituent.
Mr. Peter Pike (Burnley): Does my hon. Friend accept that many people who are partially deaf, as I am, have stopped using the analogue hearing aids issued by
the national health service because they pick up too much noise that we do not want to hear, meaning that we cannot hear what we do want to hear? We want the new generation of digital hearing aids to be introduced as soon as possible because they make a great difference to what people hear.
Ms Winterton: Yes, I am well aware of the differences between analogue and digital, although it might be quite handy in this place to hear some things and not others. My hon. Friend has hit the nail on the head. It is absolutely true that the new digital hearing aids allow much greater personalised tuning to serve the problem of the person concerned. Through computerisation, people are better able to adjust the hearing aids to deal with particular problems. My hon. Friend is right to say that we need to have systems in place as soon as possible, and I assure him that that is what we are working to do.
Derek Conway (Old Bexley and Sidcup): I too welcome the Minister to her post. She has had a remarkable first outing. By the way, the jacket that I am wearing is not a hospital jacket, so she need not worry too much about that.
May I press the Minister on the timing of the roll-out programme? Will Queen Mary's hospital in Sidcup, which has its service provided by Lewisham, be dealt with at an early stage of that programme? The hospital feels that it is getting postcode treatment and facilities at the moment, and I hope that it will be dealt with early rather than at the tail end in 2005.
Ms Winterton: I thank the hon. Gentleman for his kind comments; I assure him that he has no need to apologise for his white coat.
I understand that there will be concerns about the roll-out in different areas, but as I said, we have worked closely with primary care trusts in different areas to ensure that the programme can be properly met by 2005. We are encouraging other areas to come forward; we shall then work closely with them to ensure that they have the proper training and equipment so that, once the service is up and running, they can deal with people quickly and ensure that they have the benefits of digital hearing aids.
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