Water Bill [Lords]

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Miss Johnson: I shall give what I think is an accurate reflection of the hon. Gentleman's comments. Much of the water in Birmingham comes from large dams in Wales, and some small areas in Wales receive fluoridated water as a result of being linked to that system. That is nothing new, nor is the question of fluoride being left in water and going into the waste systems. The only difference is that it is not an issue for the 6 million who already have fluoridated water.

Mr. Wiggin: It would be easy to leave it at that, but we are talking about a small amount—one part per million is a very small amount—going into the environment. That is not something that the Government, or any hon. Member present, would normally encourage. Having made the point, I am prepared to leave it at that. There were a couple of points that I thought it important to pick up.

Dr. Iddon: In the water cycle, if fluoride gets into the ground, it will be washed out eventually; it is soluble in water. I ask the hon. Gentleman to remember that there is rainfall all the time, which will wash the fluoride away. I do not understand his point about contamination of the ground. In any case, at one part per million, we are talking about one person in a town four times the size of Bolton, which has 261,000 people. We must get things in proportion. The amount of fluoride going into the ground, even over decades, would be trivial.

Mr. Wiggin: I am grateful for the hon. Gentleman's intervention; of all hon. Members who have been most informative he has probably been the best. I was talking about fluoride going into rivers, not the sea, but as I said earlier, it is a very small amount. The issue is not so much the quantity as the principle that we are putting a toxin back into the environment when normally people in our position are trying to do the opposite.

Finally, I should like to chide the Minister, if I may, for something that she said. I am sure that she regrets it, too, because after hearing speeches such as that of the hon. Member for Bolton, South-East, about children, surely nobody would want people to stop using their toothbrush. Unfortunately, that seems to be what she said.

Miss Johnson indicated dissent.

Mr. Wiggin: A headline in The Independent was ''Dump your toothbrush, says health minister''. Words from the Minister's letter are quoted. I shall give her the article. I am grateful to her for denying that people should dump their toothbrush, because I am sure that she—

Miss Johnson: May I put the record straight? I believe very strongly in the use of toothbrushes, and encourage my children to use them from the earliest possible age. In response to a question from the hon. Member for Guildford, I endorsed her enthusiasm and the importance of continuing to brush teeth. I have no idea where that report came from.

Mr. Wiggin: I can help the Minister. The report says:

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    ''Melanie Johnson wrote to MPs last week informing them that brushing requires 'ongoing positive personal action by the individual'. But people who drink fluoridated water can protect their teeth 'without needing to take any personal action'.''

I accept that that is wrong.

Miss Johnson: This refers to a letter that all hon. Members have received.

Mr. Wiggin: Indeed. The Minister is right, and I am glad that she has taken the opportunity to set the record straight. It is most unfortunate that she should be quoted in such a way, and I am sure that all members of this Committee agree with her that toothbrushing must continue. I thought that she would be aware that she must be careful, because obviously she would not want to send the wrong message.

Norman Baker: May I request a vote on amendment No. 158? I will say something if the Committee wants me to, but in the interests of speed, I am also happy not to. The amendment would simply require public opinion to be

    ''clearly in favour of such an addition''

before fluoride could be added, following a consultation process. The Minister said that she wants that to happen, and as it is a very important point of principle, it should be in the Bill, notwithstanding the fact that it may be in regulations.

Miss Johnson: We will not support the amendment in a Division, but I repeat my assurance: the phrase will be included in the regulations when they are introduced, but it should not be in the Bill.

Mr. Wiggin: Will the Minister ensure that the regulations provide for every household to be consulted?

The Chairman: What does the hon. Gentleman want to do with the amendment?

Mr. Wiggin: As the Minister has nodded to indicate that all households will be consulted, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

The Chairman: Amendment No. 158 will be dealt with towards the end of the sitting.

Mr. Wiggin: I beg to move amendment No. 301, in

    clause 61, page 76, line 33, leave out from 'a' to end of line 35 and insert 'local authority'.

The Chairman: With this it will be convenient to discuss amendment No. 157, in

    clause 61, page 79, line 20, at end insert

    'request the elected local authorities within its area to'.

Mr. Wiggin: We now come to thorny issue that the Minister mentioned earlier: the fitness of a strategic health authority to carry out the full consultation that we want, including every household.

Will the Minister tell the Committee how a strategic health authority is appointed? My understanding is that worthy people are nominated and appointed to it, essentially by the Government. I am happy to stand corrected if I am wrong about that.

Miss Johnson: I do not have the details, but historically, certainly before the Labour Government

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took office, there was a great deal of potential, and perhaps actual, political involvement. To reassure the hon. Gentleman, my understanding is that the process is now entirely separate from the political process, and appointments are made through the public appointments mechanisms, which are independent.

Mr. Wiggin: I am reassured in one respect, but not that the quality of consultation will be as local as it might be. That is the reason for the amendment. I touched on my sense of distance from the strategic health authority when I said that it was in Coventry, which is a considerable distance from Herefordshire. Despite the qualities of the public appointments mechanisms that the Minister valiantly described, they are not accountable in the democratic sense as a method of selection.

Strategic health authorities do the best they can. They have a clear mandate, and they get on with what they do, but if they did not it would be difficult to discover where they went wrong and what they had not done. To a great extent, that is because the primary care trusts are at the sharp end of local health delivery, and that is why the proposal needs to be localised.

There is another reason, which arose in earlier debates. The perception is that dentists, doctors and scientists—people in white coats—are all in favour of fluoridation. One might think that that is also a strong argument in favour of fluoridation, and I would accept that, with due respect to those professions, but when we are dealing with such an emotive issue, we should start from scratch. The consultation process should not be run by people with an agenda.

It is well known that returning officers do not vote, and if they appear to have any political allegiance they are ruled out. We need a fair consultation process. We need it to be seen to be fair, transparent, open and straightforward, as I know the Minister would like it to be. That is why local authorities are the right people to run the consultation process and the strategic health authorities wrong.

There is another fundamental problem. Strategic health authorities do not coincide with the water authorities. The reason for choosing strategic health authorities is perhaps that the Government could not think of anything else for them to do or any other body they could have started with.

Miss Johnson: May I be bold on behalf of the strategic health authority and suggest that it would welcome a visit from the hon. Gentleman?

Mr. Wiggin: It takes me less time to get from here to Hereford than it does to visit my strategic health authority. One day I shall make that trek to visit them.

Miss Johnson: Bold man.

Mr. Wiggin: Well, I have to say that I have never been invited to visit my strategic health authority. This matter does not give me sleepless nights.

Mr. Key: I visited my strategic health authority only last month and I found it a rewarding experience, which I recommend to my hon. Friend.

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Mr. Wiggin: I am delighted to hear that. For that reason alone, I will make every endeavour to visit my strategic health authority. No doubt it will wish to consult me on fluoridation when the time comes. The important point is that such authorities are not local in any sense of the word. The strategic health authority in the west midlands is more than 100 miles from many places in its remit.

Dr. Palmer: The hon. Gentleman suggested that the local authority should conduct the consultation. Does he suggest that local authorities should take the final decision, and how many local councillors does he know who know more than even we do about medicine?

Mr. Wiggin: The hon. Gentleman makes an important point about who makes the final decision. That is why I pressed earlier for a clearer consultation process so that the people making the decision were the people who would drink the water, not a panel of experts. That is the same reply that I gave when he asked me about referendums. That is the next part to the argument. Should we appoint a strategic health authority to make a health decision in what is essentially supposed to be a democratic process? That cannot possibly be the right way of handling it.

I can understand why the Government want to handle it in that way, but I do not think that that gives the individuals who consume the water the freedom of expression that they should have. That is why I will press the amendment. It is an extremely important debating point for the Committee. We must get this part right. We have had to concede that the consultation process will not be a referendum. It will be more arbitrary. Therefore I should like to see a neutral platform conducting—

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