Water Bill [Lords]

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Dr. Palmer: My impression, Mr. O'Brien, is that you are allowing us to range reasonably widely around the clauses, so with your permission I will make some remarks that I might otherwise have made on clause stand part. I will try to stick as closely as I can to the amendment.

I am grateful to the hon. Member for Leominster for raising these issues. However, I am still in the dark about whether he is in favour of referendums: he said that he is trying to probe whether the Government are in favour of them, but I am not sure whether he is. Opinion polls suggest that 55 per cent. of the population are in favour of fluoridation. In an individual referendum, the result might be different. I am happy to allow the hon. Gentleman to intervene to clarify his views, if he wishes to do so.

Mr. Wiggin: I am grateful for that invitation. I always seek to clarify my views, although, unfortunately, the decision on this matter will be taken by the Minister rather than me.

I am in favour of referendums on whether fluoride should be added to water, but I do not agree with the provision for holding those referendums. I would hate for fluoride to be added to the water without a referendum, but I am unsure whether the people who would conduct the referendum are the right people. Does that explanation help the hon. Gentleman?

Dr. Palmer: I must admit that I am struggling.

Mr. Wiggin: Shall I have another go?

Dr. Palmer: First, let me explain what I understood the hon. Gentleman to be saying. His amendment is based on the view that referendums conducted by the strategic health authority would be undesirable if the vote was in favour, but he would be happy if the vote was against. Is that right?

Mr. Wiggin: That is very wrong. I said that fluoride should not be added to water unless there has been a referendum—in that respect, I am in favour of referendums. However, I am not in favour of the referendums set out in the Bill, which would be conducted by strategic health authorities, which have very little democratic accountability. I would prefer them to be conducted by people who understand about votes, such as local authorities.

Dr. Palmer: I now understand the hon. Gentleman's position, which I must say, if he will excuse my rudeness, is odd, because most people are more concerned about what they are voting on than about who organised the vote.

I turn to the substance of the amendments. There are four separate issues. The first is whether fluoride is at all helpful to teeth. Although, as with the Burns inquiry on fox hunting, we all quote the bits of the York review that we like, leaving aside all minor

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issues, there is no serious dispute about whether fluoride reduces decay; it does. We can argue about how much it reduces it, but almost everyone agrees that it has a positive effect.

The second issue is whether we can be certain that fluoridation is not harmful to health. One cannot prove a negative. It is possible that chlorination is harmful to health. It is also possible that the electricity network is harmful to health, and I have constituents who believe that, if power lines pass somewhere near their house, that is likely to make them ill. One has to make a judgment about whether such fears are reasonable.

I am not an expert on fluoridation, but the York review and the MRC's comments suggest that there is no good reason to believe that fluoride is harmful to health. There has been extensive correspondence on this matter from different groups. There are issues that continue to be raised, and we should continue to respond to them—to listen attentively and see whether our judgment changes.

The third issue is about freedom, which the hon. Member for Ceredigion mentioned. I was struck by his view that in order to protect freedom it is necessary to abolish freedom. I think that he said that it was necessary to take a stand, but that stand is one of compulsion, regardless of the views of the individual members of Plaid Cymru. That is an original position, but I shall pass over it.

Mr. Thomas: Will the hon. Gentleman tell me the last time that the Labour party gave its MPs a free vote on anything in this place?

10.30 am

Dr. Palmer: Yes, today. Moving aside from what one might call partisan banter, there is a serious issue about freedom. If there was any serious evidence of probable harm, even to a small section of the population, we would need to take the matter seriously. However, as long as we believe that there is no serious evidence of probable harm, the collective cost to all of us of the national health service entitles us to adopt what we believe to be safe ways of improving the nation's health.

Some of my constituents object to safety warnings on cigarette packets: they say that they are nanny stateism, that they are irritating and a waste of public money. The argument in that case, as with the banning of cigarette advertising—some of my constituents object to that as well—is that because we collectively pay for health care, it is reasonable to take steps to protect the nation's health, if those steps do not inflict damage on individuals. Most of us would feel that the damage to individuals of having to read an irritating warning on a cigarette packet is so trivial that we would not worry about it. The question is whether the risk posed by fluoride is equally trivial.

Norman Baker: The hon. Gentleman has correctly identified the three issues at the heart of the debate. They are the quantifiable benefits and risks, such as they are, and the melding together of those two aspects with the question of individual freedom—that is the crux of the Bill. However, I do not agree with his

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application to tests. He has not mentioned the precautionary principle, which is the standard approach taken to environmental and health matters, and I ask him to address that point.People may have concerns about power lines, for example, but they do not have to live next to them. They may object to the warnings on cigarette packets, but they do not have to buy the cigarettes, or they can buy them and still object to the warnings. The difference with fluoride in water, and what makes it such a sensitive issue, is that once fluoridation has taken place, people have no alternative but to drink that water. That is my greatest concern, and suggests to me that the test that is applied should be a lower test than in cases in which there is genuine freedom of choice.

Dr. Palmer: I appreciate the logic of what the hon. Gentleman says, but the cases are less different than he thinks. If people feel strongly about wishing to avoid power lines, they may be forced to live in a less attractive property than they otherwise would, and may feel that they are losing out. Constituents who object to fluoridated water do not object because they would be forced to drink it, but because they would be forced to buy bottled water or filters, and they do not see why they should have to put up with that extra cost. It is not that they are being forced to consume it, but that they are being forced to pay something because of their beliefs.

Mr. Swire: I am following carefully what the hon. Gentleman says, but the logical conclusion of his argument is that we have responsibility for the nation's health. If that is the case, and there was an explosion of disease as a result of the lack of, or a decline in MMR inoculation, as is currently occurring, at what point should the state step in and say that, in order to protect the whole, it must insist on compulsory vaccination? Surely it is a fundamental medical principle that no one should be forced to accept medication?

The Minister for the Environment (Mr. Elliot Morley): It is not medication.

Mr. Swire: The Minister may say that, but—

The Chairman: Order. This is an intervention, but it is becoming lengthy.

Mr. Swire: What the Minister says is contrary to what the EU says. I invite the hon. Member for Broxtowe to reflect on the logical outcome of his conclusion, because I find what he says worrying.

Dr. Palmer: I appreciate that there are important issues around MMR, but I think you would lose patience with me, Mr. O'Brien, if I went down that route. Although I have strong views on the issue, I shall not ventilate them today.

Mr. Osborne: The hon. Gentleman is making an interesting speech. I am not tempting him into a debate about vaccination, but my hon. Friend the Member for East Devon (Mr. Swire) made a good point: some countries have compulsory vaccination. In the United States a child cannot go to a public school without having had the MMR jab. There may be a

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case for compulsion with regard to public health issues, whether it concerns fluoridation, vaccination or any other matter.

Dr. Palmer: There is a case for compulsion in respect of vaccination, but we are not discussing that today. As I said in my reply to the hon. Member for Lewes, we are not discussing compulsion on consumption of fluoridation, but whether the cost should lie principally with those who want to have fluoride, by forcing them to buy fluoridated toothpaste, or with those who have an apparently unreasonable fear of fluoride, who would have to buy bottled water.

I realise that I forgot to respond to what the hon. Member for Lewes said about the precautionary principle. I apologise for that. We all use the words ''precautionary principle'', but in practice we accept that a reasonable limit must be applied. There are some people who believe that practically any substance known to mankind is dangerous and that they are constantly at risk from everything around them. It is possible that we are all developing cancer as a result of sitting in this warm Room. The precautionary principle might suggest that we should not sit in warm rooms, but one has to draw the line somewhere. The question is whether the line is being drawn at a reasonable point in the Bill.

Ultimately, somebody must decide. We must decide whether the risks outweigh the benefits, or whether they are negligible, as far as we can see, and are outweighed by the benefits. Who decides that currently? It is the boards of the privatised water companies. That is totally bizarre. I am not one of those who bash industry. I worked in private industry for 18 years and I have absolute respect for people sitting on the boards of private companies. If they take their job seriously, let them get on with it—that is fine. However, people are not selected as directors of Severn Trent for their medical expertise.

The arguments against fluoridation would lead to a proposal to ban it. However, the proposal before us is not to insist on fluoridation but to transfer the decision-making competence from the board of privatised water companies to the health authorities. If somebody has to make the decision in the light of the amount of fluoride in the local water supply, the state of the local teeth, and so on, the best option is likely to be the health authority.

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