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Mr. Deputy Speaker: That was not a point of order for the Chair, but a personal correction. I hope that we can now proceed to allow as many Members as possible to speak before the debate concludes.
Andy Burnham: In my view, the health arguments do not stack up. They are chucked around by people opposed to fluoridation because they know that the civil liberties argument advanced by the hon. Member for Ceredigion (Mr. Thomas) is not strong enough. That is what it comes down to: a choice between the civil liberties of the individual and the common good, and particularly the common good of our most deprived communities.
I readily accept that there may be a cost to the individual's liberties in drinking one part per million of fluoride in water. But what is the benefit? Water fluoridation has been shown to improve the dental health of an entire population, cutting needless suffering and improving people's quality of life. Given that choice and that cost and that benefit, I will always opt for the common good over civil liberties. It is morally wrong for us to know of a safe and effective means of cutting children's suffering and then not give local communities the power to choose it for themselves. But that is what some propose we do tonight.
New clause 1 is a backward-looking piece of nonsense from the Flat Earth Society that deserves rejecting out of hand. It would end water fluoridation in parts of Birmingham and the west midlands without giving those communities any say about it whatsoever. On what basis does the hon. Member for Ceredigion have the right to do that to the communities that currently have water fluoridation?
Mr. Simon Thomas: Will the hon. Gentleman give way?
Andy Burnham: I have given way a lot and Mr. Deputy Speaker wants us to make progress. Just as
imposing fluoridation would be wrong, so is any effort to prevent local communities from accessing a proven health intervention used the world over.Amendment No. 1, tabled by the hon. Member for Ceredigion, seeks to preserve the status quo, with private water companies in charge of the decision. This is an unashamed attempt to maintain a flawed system simply because the deadlock it will bring—and the choice that it denies to local communities—suits the hon. Gentleman's views. Surely the House should, wherever possible, facilitate local people taking their own decisions.
Amendment No. 8 has more to recommend it. If nothing else, by placing the decision in the hands of a local authority, it passes the democracy test. If passed, it would be a significant improvement to the current system, but it is, I think, superficially attractive for two reasons. First, the practicalities dictate that fluoridating a water supply should be a strategic regional decision, not a local matter. Secondly, it is a public health matter and, as such, should rest with those who are expert in public health matters and skilled at informing the public in these difficult areas.
For these reasons, the Government have rightly placed the decision in the hands of strategic health authorities. It is, of course, vital that SHAs conduct extensive and rigorous consultation before taking a decision to proceed with a regional scheme. If the decision were to go to local authorities, differences of opinion between them may render a scheme impractical. If, in an area such as Greater Manchester, there was one objection, that could be sufficient to render the scheme impractical. That could prevent those who voted in favour of water fluoridation from receiving it, which would be neither democratic nor fair. I suspect that the amendment is a wrecking amendment that has been dressed up to appear more attractive, but it should be resisted. Clause 58 should be allowed to remain as drafted.
I make two appeals to hon. Members on both sides of the House: first, choose the common good over civil liberty, especially given that the liberty concerns a negligible particle of fluoride and the good would substantially improve dental health in the most deprived of our communities; and, secondly, even if hon. Members are not persuaded of the case for water fluoridation per se, basic democracy demands that clause 58 remain unamended. I have seen at first hand general anaesthetics being administered week in, week out at Manchester dental hospital on children as young as five. Although the hon. Member for Ceredigion said that such procedures are not used any more, 2,000 such general anaesthetics are administered each year in Greater Manchester, but none is administered in Birmingham, which has fluoridated water. Should any hon. Member deny my constituents the chance to do something for themselves about that dreadful situation?
Norman Baker: I have two immediate regrets. First, the proposal should not be in the Bill at all because, irrespective of its merits, it belongs in a health Bill. Secondly, I regret the fact that I am only the fifth speaker, despite the fact that we are an hour and a half into a two-hour debate, which shows that we have had
insufficient time. I guarantee hon. Members that my speech will be the shortest of those that we have heard so far.8.30 pm
I am pleased that the hon. Member for Ceredigion (Mr. Thomas) tabled new clause 1, because we danced around the issue of fluoride for some time on Second Reading and in Committee. Is it appropriate to put fluoride in water? That is the nub of the issue and the question that people want answered, so I hope that we shall have the chance to vote on new clause 1 in half an hour.
Stephen Hesford: Will the hon. Gentleman give way?
Norman Baker: I shall not give way to any hon. Member who has already spoken, although I shall give way to hon. Members who have not spoken, if necessary.
Does fluoride give health benefits? I conclude that it does but that the benefits are limited. Are there health risks from fluoride? Probably not, but there might be risks, so we need to do further work on that. That equation is not sufficient to justify overriding civil liberties and the genuine opposition of at least a minority of the population to the adulteration of water—as they see it—by adding a medical substance. The hon. Member for Leigh (Andy Burnham) talked about choosing the common good over civil liberties, but civil liberties are the common good, so we should not mix up those two concepts.
In Committee, the Minister said with some sophistry—without wishing to be rude—that fluoride is not medication because it is not classed as a medicine. The whole purpose of adding fluoride to water is to derive a medical benefit. Hon. Members clearly have a view of whether that is right or not, but let us not pretend that fluoride is not a medicine. For the purpose of the Bill, it is treated as a medicine. Let us concentrate on whether it is appropriate to use the mass-medication process suggested in the Bill.
Mrs. Patsy Calton (Cheadle): Will my hon. Friend consider medication a little more? What does he think should be done about the fluoride that occurs naturally in some parts of the country?
Norman Baker: The hon. Member for Ceredigion dealt with that point when he drew a parallel with radon gas, which is naturally present in some parts of the country. We encounter environmental hazards during our lives about which we can do little—they are part of living on this planet. However, we do have the opportunity to decide whether to enhance or minimise those hazards. Some people believe that fluoride, as a man-made addition to water, is unwelcome because of its potential hazards. Adding fluoride to water is not necessary when one considers the ultimate behaviour of man.
Amendment No. 1 is superficially attractive. Although I happen to be against fluoridation, in Committee I voted against removing what was then clause 61—it is now clause 58—because it does not relate to whether it is right or wrong. New clause 1
relates to the principle of whether fluoride should be in water but clause 58 contains mechanistic provisions for the bodies that should decide the matter—the water companies, as is the case at present, or strategic health authorities, as the clause would provide. Hon. Members who want to vote against fluoride should vote in favour of new clause 1 because clause 58 relates only to who should make decisions on the matter. I am clear that it would be better, although not perfect, for the decision to be made by a strategic health authority rather than a water company, which is the basis of clause 58. That is why I favour new clause 1 but oppose removing clause 58.Having said that it would be preferable for a strategic authority to make the decision, it would not be the best solution. If fluoride is to continue to be added to water, it is better for that to be decided by common consent with popular support. The decision will receive popular support if it is taken independently. However, SHAs are not independent because they have an agenda. They are not democratically elected and there is only a thin line between them and the Secretary of State for Health, which shows their democratic credentials. SHAs would not take a local decision because they are not local. It would be quite wrong to impose a measure that many people would consider to be an infringement of their civil liberties by a mechanism that was not independent, democratic or local, which would be the case if SHAs made the decision. If new clause 1 is unsuccessful and the House accepts the principle of adding fluoride to water, it is important for us all that there is a means of dealing with its addition in a way that commands public support. In that way, even those who do not want it will know that they have had an opportunity to have their say and had an input into the decision. That can be achieved by involving local authorities. They might not be perfect but they are local, democratically elected and accountable, which is more than can be said of strategic health authorities.
The drafting of amendment No. 8, for which I have considerable sympathy, is faulty. It refers to one local authority. There is, of course, no coterminosity between local authority boundaries and water company boundaries or even water supply areas within water companies. South East Water uses several different sources to supply people in my constituency. The direct link between a local authority and the water supply is not necessarily right. A combination of local authorities would be necessary to bring about a decision-making process. I do not pretend that that would be easy. It is better to have a difficult but justifiable situation, however, than an easy but unjustifiable situation, which is the case with the strategic health authorities.
I hope that we will vote on new clause 1 so that we determine the principle of the matter. It is a free vote for my colleagues, as I imagine it is for other parties, although I am not sure about Plaid Cymru. The Government Whip, the hon. Member for West Carmarthen and South Pembrokeshire (Mr. Ainger), shakes his head. Perhaps he has inside knowledge of Plaid Cymru's workings. I also hope that we will vote on amendment No. 8 because the accountability of those who take the decisions is important.
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