Water Bill [Lords]

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Mr. Thomas: I believe that we agree on the York review, but it is worth making one point that has not been made so far, which is that adding fluoride to water may or may not cause harm, but there is an identifiable cosmetic effect. In America, for example, fluorosis is prevalent at about 12 or 15 per cent. That is predicted to be much the same as the levels at which the Government are considering introducing fluoride into the water supply. We are talking about harm to health, and the hon. Gentleman's comments were perfectly correct in that regard, but we should put on record that we at least acknowledge the cosmetic effect on teeth as well.

Norman Baker: I am happy to accept that in conjunction with the point that I made, which is no demonstrable harm is done. We know that, although the jury is still out and the York review says that further work is required. Equally important, however, there needs to be quantification of the benefits. If we are going to impose this on people, there will have to be very clear, undeniable and substantial health benefits. Those are the two tests that I have.

I spoke to my hon. Friend the Member for Oxford, West and Abingdon (Dr. Harris), who was the Liberal Democrat spokesman on health until quite recently.

Mr. Key: Totally unbiased then.

Norman Baker: I wanted some input on health issues; it is important that I understand the health benefits, so I had a long chat with him. If I may say so, he is very keen to believe men in white coats, and

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whatever doctors and scientists say. That is a matter of dispute between us on issues such as GM crops. I asked him what he thought of the matter. His view, as a doctor as well as our health spokesman, was that the benefits from fluoride are not necessarily substantial and certainly not proven to be so, although the benefits are there.

The issue is whether what my hon. Friend regards as a marginal benefit justifies such action. We are asking the country to accept fluoridation—which many people object to on civil liberties grounds—for a questionable or marginal health benefit. I do not think that that is justified.

In conclusion, I cannot support the Government's wish—and it is a wish—to have fluoride added to water. However, if we are to go down that road—I come back to the amendments—it is important that the consultation process is open and exhaustive, seen to be unbiased and is held in such a way that people feel comfortable with it even if they do not like it.

Mr. Drew: I shall try to keep my remarks to what has not been said rather than to what has been said. I start with the point on which the hon. Gentleman finished. I am somewhat confused and concerned as to the Government's position on fluoridation.

With such a controversial issue—and it is controversial; there is substantially more opposition to fluoridation than some people would have us believe—it is only right for the Government to say exactly where they stand on the matter. Yet a clause was introduced in the House of Lords in a rather confusing debate. It was not clear whether that clause was Government-inspired or whether, as I had been led to believe, there was all-party support for the proposition that it was about time for the debate and for the legislation to be introduced. I cannot recall reading in any Labour manifesto—I admit that I do not carry one around with me—or in any Labour party policy document that the policy of fluoridation has been advocated.

I am sure that my hon. Friend the Member for Birmingham, Northfield will get the opportunity to speak at this or a later stage, He will say that fluoridation is extant in his area and has been for a considerable period. There is some agreement in the Committee that, although the medical case is not proven, fluoridation does considerable good. No one can, hand on heart, make the allegation that it does medical harm. However, that is not the issue. The issue is this: if the Government genuinely believe that fluoride is an important part of health policy, indeed public policy, they should be honest and open enough to say, ''That is what we believe in; that is what we are supporting.''

I always welcome the freedom to vote as a matter of conscience. However, if the matter is such an important policy item, I would have expected the Government to say, ''This is what we are advocating and putting forward.'' Although the Minister has made a valiant attempt to provide a rationale, I am not convinced.

Mr. Simon: Surely the logic is exactly the same the other way round. One could say that in not making it

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compulsory, the Government see fluoridation as a positive thing, but not as something so definitively important that they will legislate so as to make it compulsory. They will leave it up to people.

Mr. Drew: I am not sure whether that intervention was a help or a hindrance. We either legislate, or we do not. At the moment, it is left to the water companies to generate enthusiasm for putting fluoride in the water, which is unsatisfactory. However, there has not been much enthusiasm because, since the original fluoridation scheme of many decades ago, no water company has advocated it. In fact, I and my hon. Friend the Member for Birmingham, Northfield, have the same water company, and correspondence that we have received on the subject suggests that people do not want to go along that route. However, the Government seem to be sitting on the fence. They seem to be saying that even if fluoridation is wanted, and even if we can see a better way of doing it, and even if they concede the benefits to the public, they will get someone else to push it forward.

Mr. Key: I have received perhaps 10 letters and e-mails on the subject. How many letters or e-mails has the hon. Gentleman received?

Mr. Drew: Hundreds in opposition, but as the hon. Gentleman will know, things are somewhat different in Stroud.

Mr. Key: Hundreds?

Mr. Drew: Hundreds in opposition to it. Certainly, campaigns against it are now collecting signatures.

Dr. Iddon rose—

Mr. Drew: I give way to my hon. Friend, who can give us some scientific advice.

Dr. Iddon: I am sure that my hon. Friend must be aware of the recent NOP poll that showed that 67 per cent. of those who were polled were in favour and only 22 per cent. were against. That is one of several NOP/Gallup polls that have been taken across the country during the past 18 years that have shown a substantial majority in favour of the fluoridation of water.

Mr. Drew: I am always willing to take advice from opinion polls when they tell us what we want to hear. I see no reason why people should not be informed on the matter. We should have an open, honest and meaningful debate on whether fluoridation is the way forward. However, I feel more passionate about the fact that what we are talking about will do little to advance dental health care. The only way to do that will be to rebuild the national health service dentistry service.

As I said, it is most unfortunate that the body that we are asking to engage in so-called consultation and to make an appropriate decision is the strategic health authority. Indeed, I am annoyed, because it was only recently set up, and has no expertise or experience. I would not say that it has no interest in the subject, but it has no practical way of gauging people's opinions on it.

Andy King: Is it possible for the Minister to ask the strategic health authority to act as an honest broker, but to engage instead the primary care trusts? In my

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experience, they are champions acting on behalf of the health of my local communities. In their short life, they have already proved to be a good ally of the community.

As for the opinion poll, it may have found that only 22 per cent. are against fluoride, but they are a strong minority who have given the subject much thought. The 67 per cent. who say that they are in favour have been brainwashed by years of fluoride toothpaste advertising, and being told that fluoride is a wonderful thing that can only do good.

Mr. Drew: I thank my hon. Friend for being much more helpful than I expected when he started his intervention. I cannot comment on his second point, because I do not know what questions were asked. However, his first point, which was well made, was that there were other bodies that could better gauge the health of the community. The primary care trust has the authority to commission health policies for its local population. I shall not rehearse the argument, but being local means that the community has some recourse, and it can be done at a much lower level. Certainly, without organising a huge referendum, my strategic health authority of Avon, Gloucestershire and Wiltshire has no way of gauging whether people think that this is an appropriate way forward.

11.15 pm

How do we gauge the view of the health communities on that? What will the Government do in response? Is this the appropriate way to go forward? One of the points that have not been picked up at all is why the Government have tabled amendment No. 338, which replaces ''Secretary of State'' with ''appropriate authority''. This is about the process of consultation. I am not sure what it tells us. It seems that who will drive this forward will come out of the ether. It will not be the Secretary of State. The Secretary of State will still have the power to look at the regulations by which the process may be kicked off, but I am confused about where the Government come in. Will they drive their health policies forward or will be it some other agency? If so, which agency, and what powers will it have?

The health authorities, according to their representative bodies, have made up their minds about fluoridation. The British Medical Association has written to us all and told us that it is categorically in favour of fluoridation, apparently largely because of equity. It wants targeted help to be given where poor dental health is a problem. It argues that it can be targeted through fluoridating the water supply. The British Dental Association is even keener. Indeed, to go back to the point made by the hon. Member for Salisbury, to counteract those from the National Pure Water Association and anyone else who may have organised a campaign against fluoridation, the BDA is running a campaign in favour.

I receive many things through the post, but the two sets of dentures did not impress me. I should like to know how it can be proved that the state of the two children in the photographs is entirely the result of fluoridation of the water supply. Perhaps the people who sent them will write to me. The last time I made

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comments about dentists I received quite a lot of correspondence, so I am wary. When I opened up my computer screen today I had a message from ''The Dentist''. Thankfully, it was a spam message, but I feared that they were looking at ways of dealing with me.

 

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Prepared 23 October 2003