Water Bill [Lords]

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Norman Baker: Will the Minister confirm, if she can at this stage, who will be responsible for producing the literature that will doubtless be part of any informative campaign to help people choose? Will it be the strategic health authority?

Miss Johnson: The hon. Gentleman is pressing me a little too hard on the detail. That is the sort of thing that could be part of the regulations that will be introduced subject to the affirmative procedure.

Partnerships, which are already represented through the scrutiny committee arrangements, and using the organisations that are part of those same partnerships throughout local authorities and the health service more widely are useful ways for a body, such as a strategic health authority, to move forward consultation and engagement of the kind that we are discussing in relation to the proposal to fluoridate water in a given area. The role of local authorities, strategic authorities and other health organisations will be to hold the ring to ensure that comprehensive consultations take place and that there is an objective assessment of people's views.

I reassure the hon. Members who tabled the amendments that we are not very far apart in where we want to be on these matters. However, I believe that they are best addressed not in the Bill but through the detail of regulation. In light of my assurances, I hope that the hon. Member for Leominster will withdraw his amendment.

Mr. Wiggin: The Minister was kind to be so sympathetic towards the amendments. Unfortunately, these amendments need to be added to the Bill. It is as simple as that.

Question put, That the amendment be made:—

The Committee divided: Ayes 8, Noes 12.

Division No. 13]

Baker, Norman Doughty, Sue Drew, Mr. David Lansley, Mr. Andrew
Liddell-Grainger, Mr. Ian Osborne, Mr. George Swire, Mr. Hugo Wiggin, Mr. Bill

Ainger, Mr. Nick Brennan, Kevin Burden, Richard Iddon, Dr. Brian Johnson, Miss Melanie Key, Mr. Robert
King, Andy Knight, Jim Morley, Mr. Elliot Organ, Diana Palmer, Dr. Nick Tipping, Paddy

Question accordingly negatived.

4.30 pm

Miss Johnson: I beg to move amendment No. 320, in

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    clause 61, page 77, leave out lines 3 to 6.

The Chairman: With this it will be convenient to discuss the following:

Amendment No. 214, in

    clause 61, page 77, line 6, after 'of', insert 'up to'.

Government amendments Nos. 325, 326 and 334.

+ Amendment No. 352, in

    clause 61, page 79, line 8, after 'State', insert

    'as regards England and the National Assembly for Wales as regards Wales'.

Government amendments Nos. 335 to 337.

Miss Johnson: I have a detailed speaking note, but I might not inflict all of it on the Committee, depending on their interest in the detail of the amendments.

The Minister for the Environment (Mr. Elliot Morley): There may not be any.

Miss Johnson: Well, that is another way of putting it.

Government amendments Nos. 320, 325, 326 and 334 to 337 consolidate and refine the provisions implementing target concentrations of fluoride. Amendment No. 320 deletes the reference to targets that is now provided in amendment No. 326, and amendment No. 325 omits section 87(9) of the Water Industry Act 1991, which provided for third parties to add fluoride to a water supply and for operational blending. We originally thought that we would need a reference to third parties to provide for licensed water suppliers supplying fluoridated water, but we now realise that that can be covered by the access agreement between the undertaker and the licensee.

I am happy to hear what interest members of the Committee have in the detail of the amendments, and I will then be able to respond to their remarks.

Mr. Wiggin: The amendment in my name seeks little from the Bill other than to limit the amount of fluoride to a concentration of 1 mg per litre. The amendment would insert ''up to'' after ''of'' in line 6 on page 77.

Miss Johnson: One milligram per litre? Or 1 part in a million?

Mr. Wiggin: The Minister should read what it says on page 77, line 6: ''milligram per litre''. However, I think that we know what we are on about. [Interruption.]

Miss Johnson: Yes, I think that we do know what we are on about, but my hon. Friend the Member for Bolton, South-East knows better than anyone else.

Mr. Wiggin: What an extraordinary statement! I hope that the Minister is right. I was reading from the Bill.

When we have studied evidence—and hon. Members have referred to the pictures of teeth that they have been sent—we have compared areas of Britain where the water is fluoridated with those where it is not, but we have not looked at the same thing in the United States. Some of the evidence from the US shows that as the concentration of fluoride rises, the number of fluorosis cases rises. At levels of about

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3 parts per million, the number of cases is extremely high.

The amendment would not prevent fluoride from being put in water, but it would make sure that the chemical concentration was limited to 1 mg per litre or 1 part per million. I think that it is a worthy amendment. In high concentrations, fluoride is a poison. It is concentration that determines toxicity, and so it is right that such a chemical be regulated properly. That is what the amendment would do.

Mr. Lansley: I have one question, and I hope that the Minister can respond to it. The issue with target concentrations is that everything, including Government amendment No. 326, seems to be based on there being no difference between naturally occurring fluoride and fluoride that is artificially introduced into the water supply, and no variation in the impact of such concentrations on water hardness, for example.

The Medical Research Council's first recommendation for research—which, I understand, is ongoing and has not yet been published—is about what is termed the bio-availability of fluoride. I understand that to mean the take-up into the body tissues of fluoride that occurs naturally rather than artificially. The assumption underlying further research is that the bio-availability of artificial fluoride may be higher than that of natural fluoride. I do not understand why that would chemically be so, but I will not linger on it. Assuming that they are not the same—research may show that to be right or wrong—it would be reasonable for target concentrations to vary according to the level of naturally occurring fluoride in areas in which it was intended to supplement it with artificially added fluoride.

Miss Johnson: We do not yet have the detail of bio-availability, but topping up naturally occurring fluoride in water to a certain level, or watering it down because the water is naturally fluoridated at a much higher level than desirable, can both take place. The Government do not want to see the level rise above 1 part per million. I am not sure about the basis of this debate, because the points being made on the amendments all suggest that we might allow the level to exceed that, but we are clearly saying that we will not.

Mr. Lansley: My argument was not that there should be a different level, but that if the bio-availability of forms of fluoride differs, we should work to a range rather than a specific target. We should vary the extent to which we top up the levels with artificially occurring fluoride according to the bio-availability of those different forms.

Amendment No. 326 covers what is reasonably practicable, but that does not relate to what is desirable for achieving the optimum level of fluoride, taking into account its different properties. The legislation ought to follow the research rather than the research following the legislation. The drafting should include a range, perhaps 0.8 to 1.2, or 0.6 to 1 part per million, as a better mechanism for allowing for the results of future research.

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Miss Johnson: I understand the drift of the hon. Gentleman's remarks, but 6 million people receive fluoridated water, some of which is titrated down to 1 part per million, some topped up to that level—I am not sure how much is topped up—and some artificially added to. On that basis, we have not felt obliged by any evidence to reduce the level not to be exceeded from 1 part per million.

The phrase,

    ''so far as reasonably practicable''

is designed to allow for the fact that, when fluoride is added to water, it may be slightly watered down. If we were to demand exactly 1 part per million, it would be difficult and expensive for water companies. The passage of fluoride through the water supply and the position at which the supply is fluoridated will mean that the figure may drop below 1 part per million. As the Minister for the Environment has reminded me, we do not want the level to exceed 1 part per million, and that is what the arrangement is designed for.

Mr. Wiggin: I suggest to the Minister that the statement in amendment No. 326 that fluoride concentration in the specified area should be

    ''maintained at the general target concentration''

is worrying Opposition Members. If she could provide tighter wording, as my hon. Friend the Member for South Cambridgeshire suggested, we would be content with a phrase such as ''a range'' or ''not greater than''. When we are dealing with a chemical as contagious as fluoride, it is only fair to have tight wording about its concentration. That is good government, and I hope that the Minister takes the point seriously.

Miss Johnson: I understand the hon. Gentleman's point, which is probably about the word ''target''. The target level is a form of words used to encapsulate the difficulty of keeping the rate at precisely 1 part per million.

Mr. Wiggin: It does not have to be exactly that.

Miss Johnson: No, it could be slightly different. I take the hon. Gentleman's point, and we will examine whether the wording could be better devised. I should point out that a power to change the level of fluoride by order is given under new section 88A. I can tell the hon. Member for South Cambridgeshire that if new research, such as the bio-availability work, showed that we should adjust the level, it would be possible to use new section 88A to do that.

I take the point made by the hon. Member for Leominster; I think that I understand it now, and I undertake to consider further the wording that we are using.

Amendment agreed to.

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