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8.48 pm
Mr. Graham Brady (Altrincham and Sale, West): I am here this evening because I am appalled by the arrogance of those who believe that they have a right to require me, my family and my constituents to consume fluoride in water. I oppose that proposal, as did the hon. Member for Cunninghame, South (Mr. Donohoe), as a matter of absolute principle, because, however we play with semantics, this is a matter of compulsory medication. We can say that it is not medication but a supplement, but, however we play with the words, this measure is an attempt to affect the health of the population by requiring us to ingest a substance that may or may not be of our choosing.
It is important to look at the matter in context. My hon. Friend the Member for Bournemouth, West (Mr. Butterfill) spoke about the authoritarianism of the present Government. Let us look at some of the other things that have happened in recent years. There has been a debate about whether parents should be required to use the combined measles, mumps and rubella vaccination rather than separate vaccines. At least in
that case it was argued that it was necessary and important to create herd immunity, because there was a danger to others.The hon. Member for Ceredigion (Mr. Thomas) spoke about the vitamin supplements directive. The argument on that appears to have moved on one stage: it seems to be that, even where people choose to take vitamins or supplements, the Government or agencies of the Government should be in a position to prevent them from so doing. This evening, we move from the sublime to the ridiculous because, having prevented people from taking supplements that they want to take, the Government are putting before us legislation that could require my constituents to take a supplement that they do not wish to take. All pretence has been dropped: the state knows better than my constituents.
Is it the role of the state, or the role of parents and families to look after the dental health of children? That issue was raised earlier in the House by the Secretary of State for Education and Skills when he unveiled the new proposals for protecting children. He spoke about the importance of improving support for parents and about the balance between the role of the state and the role of the family. Now we have to ask whether the Government are seeking to support parents, or to take the responsibility for children's dental health out of parents' hands and to put it into the hands of the state?
That is wrong not just because it is being done against people's wishes and because there are worries about the health implications—we could debate the science of fluoride for some time—but because, by the simple act of taking that responsibility away from people, yet another step is being taken towards creating a less responsible society, where parents feel that they can take less responsibility for the health and welfare of their children, where we all become more dependent on others and on the state.
Adding fluoride to water is potentially harmful. Even the British Dental Association accepts that fluorosis is a fact and that it is created by the addition of fluoride to water. Many other claims of adverse health effects are made. We have a fundamental right to the purest water that it is possible to supply. Few things could be more fundamental but, that said, there are even more basic rights and freedoms at stake here: the freedom to refuse medication; the freedom of us all to make our own decisions about our health and that of our families; the right of parents to make decisions for their children; and, crucially, the responsibility to make the right decisions.
The House is here first and foremost to protect the freedoms of our constituents, not to inflict things on them. I hope that, tonight and in further considerations of the Bill, the House will vote accordingly.
8.54 pm
Mr. Terry Lewis (Worsley): We have reached the stage in the Second Reading debate where we are involved in repetition, repetition and repetition. I am afraid that I will have to contribute to that repetition.
I welcome much in the Bill. However, my support for it is at risk due to the insertion of clause 61, which has been well debated this evening. It reintroduces the concept of mass medication to the people.
I refer obviously to the proposal to facilitate, largely against the wishes of the public, the corruption of the water supply with fluorosilicates. I shall return to that matter, because I want now to move to a positive note—the Minister will be glad to hear.
The new regulatory framework is not without merit. Short of bringing the water industry back into full public ownership, which is my preferred option, it none the less puts a positive gloss on the Bill. I am especially pleased that Ofwat is to be lined up for the chop, to be replaced by an independent consumer council. I am also attracted to the prospect of increasing the powers of the drinking water inspectorate to institute proceedings and impose penalties for the supply of unfit water or failure to supply information.
I am less than enamoured of the idea of introducing, in clause 59 and schedule 4, the concept of competition in the water industry. However, I will not press that matter, as I would not get very far. Instead, I shall return to my principal objection to the Bill, which is the easing of the way to mass medication of the people.
I object to the principle of adding fluorosilicates to the public water supply, and I object in particular to the way in which Ministers sneaked what is after all a public health measure into a non-health Bill. I hope that, even at this late stage, the measure will be withdrawn so that it can be considered in the framework of public health legislation in due course. My support for the Bill tonight depends on that.
Stephen Hesford: I have listened with care as that argument has been repeated a few times today. Is it not a spurious one, because the power to fluoridate is already contained in the Water (Fluoridation) Act 1985, and the Water Industry Act 1991, which are water Acts? It may be a public health measure, but this is the right place to discuss it.
Mr. Lewis: The 1991 Act has flaws, as water companies cannot be forced to fluoridate, even if the local health authorities want that to happen—so it is my hon. Friend's argument that is spurious, not mine.
The matter should be debated under a public health Bill and taken out of this essentially good Bill that has nothing to do with public health.
Tom Levitt: Does my hon. Friend accept that the compulsory wearing of seat belts is a public health measure, and that was not in a health Bill either?
Mr. Lewis: It was in a transport Bill, which is the right place for it. That really was a spurious argument.
The zealots for fluoridation might better employ their energies arguing for more direct health care, based on ways of improving the nation's oral health. There can hardly be a single Member of Parliament who is satisfied with NHS dental provision in his or her constituency. More and more dentists are declining to do NHS work, and it is almost impossible in some areas to gain access to NHS dentistry. For the many people who cannot afford private dentistry, fluoridation is like offering a drowning man swimming lessons. Should we not tackle that issue first?
It is argued that record numbers of young children suffer from tooth decay and that it is they who will benefit most from fluoridation. The question for me is, how much fluoridated water is needed to prevent tooth decay? I do not know. It could be very little.
My second recommendation to the mass medication lobby is that we should educate parents to stop feeding their kids on sugary soft drinks and other tooth-rotting convenience goodies. Manufacturers of such items should be prevailed on by Government to reduce the amount of tooth-rot that they encourage youngsters to digest.
I am passionate about this argument. My own teeth, although not very pretty, are a full set and are about 64 years old. I attribute that to the fact that my childhood spanned the war years, when soft drinks and sweets were not part of people's diet—a factor referred to by my hon. Friend the Member for Bolton, North-East (Mr. Crausby). I also recall that annual dental checks were carried out in schools by visiting dentists. All this with a war on. And now, the best that the fourth largest economy in the world can come up with is to mass medicate everybody cheaply, with the unproven benefit of reaching a minority.
Finally, I turn to the public consultation promised in the Bill. I must ask Ministers to be open and transparent about their intentions; it will not be good enough to leave this matter to the strategic health authorities. Any meaningful test of public opinion must be carried out through the medium of local referendums. I hope and anticipate that when the Minister winds up, he will give grounds for comfort on this issue.
9.1 pm
Mr. Steve Webb (Northavon): When I saw that the Government had added clause 61 to the Bill, I approached the issue with an open mind. I was born and brought up in Birmingham, where water is fluoridated. I experienced no adverse reaction, nor did I know of anyone who did. On the other hand, I instinctively feel anxious about adding something to the water supply, given that those who do not want it have no choice in the matter. So I found myself torn, and approached the issue with an open mind.
I decided to consult my own constituents, in the spirit of clause 61, to discover how they felt about the issue. I sent e-mails to some 1,200 constituents, and sent text messages to dozens of others. I then pointed out in the local press that I was seeking letters from those who were either for or against fluoridation. My e-mails provided links to websites presenting the case for fluoridation—such as the Department's own website and that of the British Dental Association—and to websites presenting the case against, such as that of the National Pure Water Association.
I invited my constituents to make up their own minds on the basis of the evidence before them, but I had little idea what the outcome would be. In fact, they were split down the middle almost exactly. The argument of those who were in favour of fluoridation was based predominantly on two reasons. First, they said that it was a question of democracy, and that the majority should have what they want. That is obviously a very important principle, but it is clear that restrictions are needed on the principle of the rule of the majority. For
me, one such restriction is that the majority should be constrained from imposing something on the minority if, for example, there is another way of delivering what they want, or if the minority are thereby being denied a choice that they might reasonably expect. I accept that local democracy is important, but it should not be unconstrained.The second reason given by those of my constituents who were in favour was either that they came from a fluoridated area and had good teeth, or that they had given fluoride tablets to their children, who also had good teeth. Such anecdotal evidence, which is all that many people have to go on, suggests that fluoridation is beneficial, but the strongest arguments came from those who were opposed to fluoridation. Indeed, they gave me reasons for their opposition. Lack of choice, which has been mentioned throughout this debate, was central: people who want fluoride can have it now, but those who do not cannot opt out.
As an academic and a social scientist, I thought it important that I look at the scientific evidence. The Government themselves asked York university to review the evidence. I was struck by how the university's conclusions were then spun by everybody who examined them, such that Professor Sheldon—he has already been quoted during today's debate—felt moved to say that he was astonished at the poor quality and quantity of the research, and that there was "legitimate scientific controversy". I fully accept that some of the protagonists in this debate use rather lurid and extreme language and adopt an approach that is not very analytical. But if an eminent professor who has looked into the issue says that there is "legitimate scientific controversy", surely that is not a sufficient basis for adding something to the water supply; rather, it is a very weak basis.
Hon. Members will have been sent copies of the British Dental Association's rather gruesome league table of the number of dental cavities in the teeth of children in their constituencies. Naturally, I looked up the figures for my own constituency and for West Bromwich, East—the constituency in which I was brought up—which has fluoridation. In West Bromwich, East, the average five-year-old has 0.94 decayed, missing or filled teeth; in my own constituency, which is not fluoridated, the figure is 0.9. The fact that the figure for cavities in my constituency, where water is not fluoridated, is lower than that for the midlands, where water is fluoridated, does not mean that I am going to infer that fluoridation does not work. But equally, I object to the argument—made by Members in the media and elsewhere—that because more cavities occur in Manchester, for example, than in Birmingham, fluoridation therefore works.
Those figures prove that a whole variety of explanatory factors—access to dental care, dietary habits, what appears in water naturally, and a raft of other issues—are relevant. If scientists are acknowledging "legitimate scientific controversy" about the issue, how can it be right to impose it on people? Even if a majority in a local community are in favour, a significant minority will not want fluoridation, and they do not have the option of opting out.
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