Water Bill [Lords]

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Mr. Drew: I accept what the Minister says, but I think that that wording should be in the Bill, and I hope that it will be redrafted on Report. To me, the term ''appropriate authority'' could mean any body. The drafting should be tidied up.

Miss Johnson: I take that point on board and will discuss it further with officials. I imagine that parliamentary counsel will tell us that the drafting is right and means that the legislation can be clearly understood, but I understand my hon. Friend's difficulty.

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I take issue with my hon. Friend's dismissal of the cards from dentists. One interesting point is that, if we look at the debate from a purely financial point of view, dentists benefit most from dental decay. It is admirable that so many of the dental profession are arguing the case for fluoridating water, because their pockets will be most at risk if people's dental health improves substantially. I have been fortunate throughout my life in having good dental health, so my dentist has not often profited from me.

In response to the hon. Member for Lewes, gum disease and dental health problems are relevant and both need to be addressed. Fluoridation will considerably reduce tooth decay, while gum disease is reduced by many other oral hygiene measures. It is not either/or, it is both.

Norman Baker: I agree that it is not either/or, but hon. Members were concerned that if people knew that fluoride was being added to water as a health benefit, they might conclude that it was less necessary to visit the dentist, and other dental problems not related to tooth decay could increase.

Miss Johnson: I suppose that we could not rule that out in a limited number of cases, but I am not aware of any evidence from fluoridated water areas to substantiate that claim.

I have already sketched out the mechanisms that are relevant for a strategic health authority in considering public opinion and making a decision, and they will be subject to regulations debated under the affirmative resolution procedure. The hon. Member for Leominster was gracious in admitting that the amendment was a wrecking or exploratory one—

Mr. Wiggin: A probing amendment.

Miss Johnson: I see. I trust that the hon. Gentleman will not advocate the 90 per cent. level too strongly outside this Room, because otherwise I imagine that the right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith) might become nervous about both him and his continuing in his present role.

I will run through a couple of the other amendments, which hon. Members have not addressed but which are probably important to mention. Amendment No. 351 is designed to amend and clarify the respective responsibilities of the

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Secretary of Sate and the National Assembly for Wales. As I said, the Secretary of State will make regulations for England and the National Assembly will make them for Wales. The hon. Member for Ceredigion (Mr. Thomas) passed me a note this morning to say that he has another appointment this afternoon and cannot be here, but I am sure he would be interested to learn that.

Kevin Brennan (Cardiff, West): Just to remind my hon. Friend that the hon. Gentleman is not the only Committee member from Wales. I am listening carefully to what she has to say about provisions affecting Wales.

Miss Johnson: I am well aware of my hon. Friend's interest.

On amendment No. 156, I appreciate that hon. Members are concerned that consultations are adequately funded. We will set out in regulations the procedures that the strategic health authority must follow in undertaking a consultation, and it will be advised not to embark on one if it has not identified the funds for so doing.

I am in sympathy with the spirit of amendment No. 110. We want to ensure that as many of the people as possible that would be affected by a proposed fluoridation scheme participate in the consultations. We would hope to consult more widely than just with residents; we would want to include people who work in the area, and who perhaps spend most of their day there.

Mr. Osborne: Amendment No. 110 would add a requirement to consult all households. In the regulations that will be introduced, will the presumption be that the strategic health authority will send consultation literature to every household in the area affected?

Miss Johnson: That is the sort of thing that we have in mind. The regulations will be subject to the affirmative procedure, so I do not have a draft with me and cannot confirm specific details. However, we believe that some sort of door-to-door consultation must be part of the overall consultation.

Mr. Drew: Can the Minister assure me that both sides of the argument will be included in the consultation? Otherwise, it will not be true consultation.

Miss Johnson: I certainly think that we would want to include material setting out both sides of the argument, with input from different places. However, that regulation would again be subject to the affirmative procedure.

Amendments Nos. 338 to 342—I shall not discuss them in detail—all relate to the Secretary of State and the National Assembly for Wales, and the way in which the regulations should reflect the different position in Wales. Amendment No. 341 provides for the Secretary of State and the National Assembly to make a written direction for the termination of all, or one or more specific fluoridation schemes.

The reason for going through all those amendments in relation to Wales and England is to clarify the respective responsibilities. That is essential for the

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implementation of our policy, which is to give local populations a choice over whether they want their water fluoridated.

I commend amendments Nos. 338 to 342 to the Committee. I also thank hon. Members for their contributions to the debate. Many of us feel that the matter under discussion is important, but I hope that Opposition Members will not press their amendments.

Mr. Wiggin: I have also enjoyed the debate, which has been informative. We have had some useful expert opinions, and much of what I have heard has been reassuring. I am grateful to the Minister for her support for amendment No. 110, which would ensure that every household is consulted. I thought, and she confirmed, that if a majority were in favour of fluoridation, that would provide a much more compelling argument for it to proceed. My hon. Friend the Member for Tatton neatly explained how individual Members may find the decision-making process difficult on a subject in which the science is debated.

I should like to put the Minister on notice, so to speak, because the next amendment deals with local authorities and strategic health authorities, and I was not comforted by the comments that she made about the strategic health authorities in her opening remarks. However, in the light of the fact that they would be forced to accept a proper majority—

Miss Johnson: Perhaps I can be clear with the hon. Gentleman, because he picked me up on this issue and I said that we were saying that no strategic health authority should fluoridate unless local opinion was in favour. As long as he is interpreting my remarks in that context, I am happy with his paraphrase of them.

Mr. Wiggin: The next amendment will give us an opportunity to debate what a local population is, but surely the phrase ''in favour'' is the key. If 49 per cent. are in favour and 51 per cent. are against, surely the Minister will accept that that is not acceptable for what we are discussing. Does she agree that there will be a numerical way of defining who is in favour and who is against?

Miss Johnson: The issue is not as clear-cut as the hon. Gentleman makes out, for the reasons that I sketched out when I referred to the Bedfordshire, Hertfordshire and north London consultation discussion about the future of hospital and other services. How does one weigh up a signature on a petition against someone attending a meeting or writing a letter? One cannot simply do a straightforward crude summary and say that there was a majority one way or the other. We have to consider these things in balance.

Mr. Wiggin: I agree, but that is why consulting all households would include everyone in a satisfactory way. I accept the criticisms of consultation. Personally, I would prefer a referendum. I was asked earlier whether I would prefer a referendum and I want to say categorically at this stage that I would. I am sorry that I did not say that more strongly at the time, because it is becoming increasingly clear that, when dealing with a subject as emotional as this—no one could fail to be moved by the case of the children in Bolton—we must

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ensure that it is pinned down in a proper and clear way.

I remind the Committee that the consultation will be

    ''in accordance with regulations made by the Secretary of State''.

That is why we have to keep returning to the Minister to clarify exactly what she means about the consultation and how it is interpreted. That is why I personally prefer a referendum. It is less difficult to understand how the consultation has been weighed up when there is simply a straight numerical vote. That said, I recognise that the amendment, with its 90 per cent. numerical weighting, would be impractical.

There are good arguments in favour of fluoridation. Equally, there are good arguments against. The only way in which we can ever get a satisfactory response is to ensure that everyone has their say and, more importantly, that there is a fully informed debate. Therefore, when dealing with all households or whatever form the consultation takes, it is very important that whoever is in charge is clearly seen to be neutral. I am glad that the Bill says

    ''made by the Secretary of State'',

because obviously one person will declare an interest if they are not neutral. We can trust the Secretary of State to take a neutral stance—well, I hope we can. I find that much more comforting than allowing what we are discussing to be done by the strategic health authorities.

There is another side to the issue, which local communities will have to deal with. We have touched on the leakage problem that water authorities and water companies have, and there is an element of accumulation with fluoride. It goes into someone when they drink it and it is absorbed through the skin when they are in the bath. Some of it is excreted and some remains in the teeth. However, if there are large amounts of leakage, we will be putting a toxin into the ground or wherever the leakage takes place, which is a serious issue. In addition, I hope that when water is taken out of and put back into rivers, the fluoride will be taken out, because it can constitute hazardous waste in a more concentrated form.

The Minister referred to who would take precedence if two authorities overlapped and one local community clearly wanted fluoride and one did not. She led us to believe—I am sure that she will intervene if I am wrong—that efforts would be made to provide fluoride to the areas that wanted it and not to those that did not. The situation in my area is particularly difficult. The strategic health authority is in Coventry, and it takes me nearly as long to get to Coventry as it does to get here. It is a huge area across the west midlands with a vast number of people. Much of the water in my constituency comes from Wales, and would come under a different strategic health authority. There are difficult problems with that, and I am not sure that the Minister's guidance has been sufficiently clear.

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