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Mr. Adrian Bailey (West Bromwich, West): Did the survey provide any assessment of the number of children who have died under general anaesthetic as a result of tooth decay? I can tell the House that, on the basis of

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figures released for 1998, three children died. We would all agree that that is a serious and devastating health argument.

Mr. Thomas: That is so irrelevant to this debate—[Interruption.] I shall tell the hon. Gentleman why. It is because modern medical practice is not to give general anaesthetic to children undergoing dental examination and treatment. The hon. Gentleman should know that. It is precisely because of those unfortunate deaths that it is not now general practice to give general anaesthetics to children in dental surgeries on the high street. The hon. Gentleman knows that and he should not adduce that evidence to support his position.

Andy Burnham rose—

Mr. Bailey rose—

Mr. Thomas: I am not giving way for the moment, because I want to continue with my speech.

As emphasised in the York review, only high-quality studies can fill the gaps in knowledge about those and other aspects of fluoridation. The question that we must ask is whether the Government have, since the York review, commissioned those high-quality studies. No, they have not. They have not even received the report that they said they would commission from the chief medical officer and the chief dental officer. That report is not yet published; not yet given to Members; not yet available to the public. The one thing that the Government said they would do in response to the York review has not been done. Yet we are being told to rush this Bill through as a great opportunity to improve the dental health of children and our population. It is not. It is too fast and based on too little evidence.

Richard Burden (Birmingham, Northfield): The hon. Gentleman is describing the York review and I understand that he wants all the facts out. Will he also confirm—he has not said it in his speech so far—that the York review found no evidence to substantiate allegations by anti-fluoride campaigners to the effect that there was a link between fluoridation and bone cancers, thyroid cancers, Down's syndrome and hip fractures?

Mr. Thomas: I am grateful to the hon. Gentleman, who makes a reasonable point. We have all received material from all sides of the argument—particularly perhaps the side to which he refers—about fluoridation. I agree that some of it comes across as rather hysterical, shall we say. However, I would not like the hon. Gentleman to believe that the points made on that side of the argument are completely without validation in the York review, which said that there could be possible negative outcomes such as IQ and congenital defects. They acknowledged that that could not be proved, but argued in favour of further high-quality research. That

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was the York review's recommendation—we do not know enough about the effects, so may we have further high-quality research, please?

The Government's response, which had unfortunate consequences, was to ask the Medical Research Council to advise on any further priorities for research into water fluoridation. The MRC concluded that research on a number of other possible negative health outcomes—including the IQ and congenital defects mentioned in the York review, to which the hon. Member for Birmingham, Northfield also referred—was of a "low priority".

Thus the York review asked for higher-quality research as a priority, but in response to the Government the Medical Research Council declared that such research was a low priority. I cannot step into that argument. I acknowledge that I do not have the scientific ability to do so, but I do know one thing: if I am to support legislation, I want to be able to examine relevant studies and reviews. I want to be convinced that what we put into our water supply will not have adverse effects.

As I said earlier, much of the publicity and propaganda on the issue verges on the hysterical. Although it remains the case that there is no evidence to prove the negative, as legislators we surely remain in difficulties. We need to be absolutely certain about what we are putting into our public water supply before we make any progress in that respect.

I now want to move on to consider in more detail the Government's view of these matters.

Gareth Thomas (Clwyd, West): I am inclined to support the hon. Gentleman's viewpoint. For the sake of clarity, however, is he saying that if the medical evidence were stronger, the human rights arguments would effectively be overruled?

Mr. Thomas: The hon. Gentleman makes a good point. From my perspective, I am opposed to compulsory medication. It may be good for me to have a little aspirin for my heart, particularly in debates such as this, but I do not want to be forced to take it. I want to be able to choose whether to take any medication. A little later in my speech, I shall deal with the question of whether fluoridation counts as water treatment or medication, which is at the heart of the hon. Gentleman's question. We must think clearly on these matters. If it is clear that we are trying to achieve a medical result, I would say that civil liberties is an absolute issue. If it is clear that it is a different matter of water treatment, then a rather different argument applies. I hope to persuade hon. Members this evening that what is at stake here is a medical matter and that we should not proceed down those lines.

Stephen Hesford: Having examined the hon. Gentleman's amendment, the logic of his argument seems to be that we should not fluoridate water because there is no proof either that it works or that it is not harmful. However, I have seen no amendments on the amendment paper that require water companies to

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withdraw fluoridation from the 5 million people who receive fluoridated water and have done so for about 40 years.

Mr. Thomas: The hon. Gentleman is absolutely right that no amendment is designed to achieve that, but new clause 1 would do precisely what he says. I am afraid that the hon. Gentleman misleads the House in going down that road. New clause 1 withdraws fluoridation from those who receive it. I hope that those who believe in civil liberties will support it, as well as those who have a more practical or pragmatic view. It is for hon. Members to decide.

Mr. Alan Williams (Swansea, West) : Is there not an alternative, which goes closer to meeting a point of principle: to refuse to allow clause 58 to stand part of the Bill?

Mr. Thomas: That is amendment No. 1. I would say to the right hon. Gentleman that that at least keeps the status quo, but it will continue to allow fluoridation to be decided by water companies, which is the real problem. We all agree that water companies should not decide that sort of thing, and I want to argue that we should not decide it either.

The Government have usefully copied to members of the Committee their own arguments based on a briefing from the chief dental officer of why we should fluoridate. I understand that we have a free vote tonight, but also that the Government are clearly behind fluoridation as a method of dealing with the problems of NHS dentistry, to which I shall return in a few moments. The review examined alternatives to water fluoridation. Let us accept for a moment that fluoride benefits teeth. I can accept that at a personal level because I use a fluoride toothpaste, but it is my own choice to use it. In a letter to Committee members, the Government said:

That strikes me as a defeatist attitude from the Government. Just today, the Government addressed the issue of obesity in young children. At other times, they have talked about too much salt in our diet and, in an apparently constant stream of initiatives from No. 10, have stressed the need to change our diet. I do not disagree with that. Let us have exhortations from the Government about changing our dietary habits, how we look after our health, not smoking and not drinking too much. But let us not then use the same argument to impose compulsory fluoridation, because—it is claimed—people are too thick to learn how to look after their teeth. That is a ridiculous argument.

The situation is even more ridiculous, because the letter continues:

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Are the Government honestly suggesting that we should all drink fluoridated water and throw out our toothbrushes and toothpaste to save £9.50 a year? That would not improve oral health, gum disease or rates of mouth cancer. It would not help us to address the increasing problems of the NHS dental service, with one third of children in Wales not having an NHS dentist. Some 69 per cent. of the population in my county do not have an NHS dentist—

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