Water Bill [Lords]

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Sue Doughty (Guildford): Much of our discussion concerns the heart of the reason for debating the controversial subject of fluoridation. We are talking about the dental health of children and adults. The hon. Member for Bolton, South-East (Dr. Iddon) made a powerful case, with which I am sure the Committee sympathises. One or two of us attended a scientific event today and were paired with scientists, and the insight that it provided on fluoride has been helpful.

Some questions remain, and I would appreciate help with them. According to the table provided by the British Dental Association, children in Birmingham constituencies are still at risk even with fluoridated water. That problem also exists in Manchester, and I know that the people of Manchester are anxious to put that right. Anomalies still exist over the outcomes in areas where we are putting fluoride in water, and I would like to understand the discrepancy. I do not want to undermine the case for or against fluoride; the question merely comes from my ignorance.

Other issues regarding the dental health of children and adults are beginning to give us reason for hope, in particular for the plight of children under the age of five. I agree that some problems arise from deprivation, ignorance, or poor health care during pregnancy, never mind when the child is born. There are also problems with nursing, and ignorance as to whether to give children fizzy drinks or chocolates at an early age. I remember my in-laws being deeply upset when I would not let my children have chocolate before they were five. That was the only time that my children did something I wanted: I could give them a piece of fruit instead and they would be grateful. Those days are long gone, but we had a stay of execution before they were sucked in.

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There are problems with junk food being advertised to children, particularly the under-fives. Many substances that damage children's teeth are advertised, and I hope that the Government will carefully examine the work being done on the private Member's Bill on TV advertising of food to children. I am sure that that work could have a beneficial effect on children's teeth.

Surrey schools, among others, are working towards encouraging children, not to stop drinking fizzy drinks but to drink lots of fresh, tap water through the day as a beneficial health aid that will also help teeth. I understand and agree with the hon. Member for Salisbury that prevention does not always work. I sympathise with that view and support my hon. Friend the Member for Lewes (Norman Baker) in saying that we are not against fluoride, but we question how the decision is made. I am the sort of person who would have taken my children to get their teeth painted—in those days that was available on the national health service and would have sorted the problem for many people. There is a lot of work, and I understand the problems of parenting.

Will the Minister further consider what will happen with children's centres? In—

The Chairman: Order. I draw the hon. Lady's attention to the fact that the amendments are about consultation and referendums. Her speech is really for a clause stand part debate rather than relating directly to the amendment. If she will refer to consultation and referendums, that will bring us back to the amendments.

Sue Doughty: I was drawing attention to this subject, because I feel that, as part of the wide-ranging debate, we are left with a problem over health. I will not dwell on that much further, other than to say that I hope that children's centres will provide an opportunity to deal with parentcraft, diet and other problems. We must avoid the scandal of under-fives having problems with extractions, which lead to pain and problems in adult life.

I support the need for consultation, but any decision must be democratic, or as democratic as we can achieve. I certainly cannot support the idea of 90 per cent., but I appreciate why it was included. We need to consider the means by which we consult local people. We must ensure that where there is an overpowering case—I am sure that there is in Manchester—that decision can be made sensibly. With good health service support, too, we can get the best outcome for children.

Mr. George Osborne (Tatton): I found this one of the most difficult issues to decide on in the short period that I have been in Parliament. It is a classic case of the overwhelming medical and scientific evidence coming up against a quite proper public feeling that reacts against the view that Whitehall knows best about public health and how we should be treated. We encounter that on other issues, such as GM crops, all the time in Parliament. That illustrates one of this country's problems in addressing many

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scientific and medical issues. I did not come into Parliament with a fixed view about fluoridation, and I have made an effort to read all the evidence for and against. To be honest, my mind changes with each new piece of evidence that I read.

The argument made by the hon. Member for Bolton, South-East is extremely compelling. I represent a constituency on the edge of Manchester, and the state of tooth decay in Manchester is shocking. It is difficult for any person living near Manchester not to be at least forced to think hard about their position when it is pointed out that in Birmingham tooth decay is, on average, much less. On average, children of five do not have tooth decay there, whereas in Manchester the average child has three fillings by that age. When confronted with that evidence, it is difficult to say, ''Well, I'm going to ignore that. People should look after their own dental care, buy toothpaste and brush their teeth.'' In an ideal world, we want people to look after themselves, but we do not live in an ideal world. Tooth decay affects the most deprived communities in the country. That is not just because such communities cannot afford toothpaste and toothbrushes. There is a broader problem of getting people in those communities to take an interest in their health care; that applies to many other things, such as smoking and the kind of foods that they eat. The argument is compelling.

Equally compelling is the argument that people should not be medicated—I know that the Minister will dispute my use of that word—or given health treatment without their consent. That is a powerful argument about freedom in our society, and about being forced by Government or Parliament to do things that they do not want to do.

I tried to resolve the issue—although, as I shall explain, it did not help—by writing a column. I have a regular column in the Manchester Metro News, which I am sure all members of the Committee have read.

Dr. Palmer: Send us a copy.

Mr. Osborne: I shall be happy to read out the whole column. By the way, nobody ever writes to me after I write the columns; I receive no reaction at all—except to this one. I wrote, quite straightforwardly, that an issue was being debated in the House of Commons, I did not know what to think about it and, what was worse, there was to be a free vote on the issue, so the Whips—I am a Whip—would not tell me what to do. I set out as fairly as I could the arguments for and against fluoridation. I had an amazing response. I have here all the letters that I received from people in Manchester and, as I also put the column in papers in my constituency, from people there too. The letters are very compelling. The overwhelming majority were against, and they were not fanatics, as the hon. Member for Bolton, South-East suggested that some people involved in this argument are. They were sensible, well-written letters.

For example, a Ms Yates said:

    ''I buy organic food as much as possible, but would have no choice available to me if the water supply was fluoridated''.

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An e-mail from a Mr. Brumby in Manchester said:

    ''Please vote against adding fluoride. I live in a democracy and I believe I have the right to drink water without someone else telling me I have to drink it with fluoride in. Parents should be responsible for their own children''.

Equally, I received some letters in favour of fluoridation, including from a senior lecturer in primary dental care at Manchester university dental hospital, to which reference has already been made in this debate. It is just the nature of my constituency that I tend to represent all the dentists. They live in Cheshire and commute to their practices in Manchester.

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I also have almost all the Manchester hospital consultants in my constituency. My constituents are a well-informed bunch. This senior lecturer says that he sees

    ''the consequences of the non-fluoridation of the water supply at the sharp end. We hold regular extraction sessions for children under general anaesthetic and I have to listen to the poor kids being escorted out with their families, usually in tears and all in pain.''

However, he concludes that

    ''the benefits of fluoridation outweigh the negative aspects of the mass medication''—

he uses that word—

    ''argument, although I have fierce arguments with my wife on this issue! She is a homoeopath and believes that people should be more responsible for their own health.''

The matter divides families. The way I have resolved the issue, which is not necessarily to come down on one side of the argument or the other, is to criticise the way that the Government are doing it. Whatever the arguments for and against, it is a decision that should be left to local communities—a phrase that the Minister has used several times today. However, I do not think that the strategic health authority is the right vehicle.

My constituency comes under the Cheshire and Merseyside strategic health authority, which covers a vast area that obviously includes millions of people. When my constituents talk about the local community they do not think of themselves as being in the same local community as central Liverpool, Knowsley, St. Helens or even Chester at the other end of the county. One cannot fairly say that the strategic health authority is a representative body of the local community, however good the consultation exercise it carries out. The other problem with giving it to strategic health authorities is that they are seen as having parti pris. They obviously have an overwhelming self-interest in promoting fluoridation. They are not seen as neutral in the argument.

Two things would greatly improve this deeply controversial piece of legislation. First, there should be a genuine local referendum. The Government have nothing to fear from such referendums. They have been carried out in the past in this country on this issue. They would be easy to organise. It would be a genuine debate in many cities and regions. In Manchester one could well get a strongly positive vote for fluoridation with the kind of arguments we have heard today. Secondly—this strays slightly into

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the next group of amendments—this is best dealt with by local authorities. They would be seen as more neutral.

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