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Baroness O'Cathain moved, as an amendment to Amendment No. 1, Amendment No. 2:

"(b) references to a water undertaker shall include and apply to any licensed water supplier which supplies water to premises within a specified area."

The noble Baroness said: I declare an interest as a director of a very small water company. I am not speaking today as a member of that board but, having been briefed by Water UK, for the industry as a whole—namely, water companies and water suppliers.

I am grateful to the Minister for his clear exposition of what is intended by the amendments. Obviously, there is a great body of opinion which wishes to have the complete fluoridation of water throughout England. However, before I speak to the amendments, I should point out to the Minister that the reason the water companies were reluctant to bring in fluoridation after the 1985 Act was because they were convinced that the health authorities had not properly consulted affected customers. I am grateful that the consultation now will be extremely wide through the press, radio, discussion groups, helplines and websites. That will cover many of the problems. It was not a case of finance or necessarily of indemnities; it was that they did not wish to get involved. The emphasis that the Minister placed on it was not quite how I understood it to have been.

The industry's position is that the legislative regime needs improving. First, decisions on and responsibility for fluoridation should be entirely matters for the health authorities and the Department of Health, subject to the following safeguards: maintenance of security of supply and, to that end, operational flexibility for the water companies, taking into account that supply zones may vary seasonally and in consequence of operational exigencies. Again, the Minister made the point that if there was a drought situation or specific local situations, there would be flexibility.

Another point is that it should be a prerequisite to the initiation of fluoridation schemes that health authorities should co-operate with each other and consult the water companies. For example, a water company could supply a very large area which was covered by two or three health authorities. It is

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important that that point is not missed out. If they are to have all the responsibility, they need to find out whether those who would be affected are in favour of the proposal and there has to be joint acceptance by the local health authorities.

There needs to be updated guidance on the specifications and procedures required to be achieved in relation to the construction and operation of fluoridation plant. There needs to be provision for the reimbursement by health authorities of all water companies' capital and operational costs of fluoridating water supplies. There also needs to be provision for full indemnities by the Department of Health to water companies for any liabilities that they may incur as a result of, and in any way connected with, the fluoridating of water supplies other than in respect of their own negligence, which one would not expect to be indemnified against.

That point is essential to the whole issue of fluoridation. First, I accept without question the comments in the briefings. It is appalling to think that 50 per cent of the population of this country do not own a toothbrush. From that point of view, there is a very strong case for fluoridation to avoid the really awful problems of dental decay and dreadful toothache. As the Minister said, those usually occur in areas of social deprivation, where people may regard toothbrushes and toothpaste as unaffordable luxuries.

I know that the noble Lord, Lord Balfour—

Noble Lords: Lord Baldwin.

Baroness O'Cathain: I am sorry, I am getting my Prime Ministers mixed up. I know that the noble Earl, Lord Baldwin of Bewdley, will be talking about the dangers that could result from fluoridation. We must always, in this House, avoid the law of unintended consequences. We really do not know about this. We have had experiences in the past with, dare I say, thalidomide, as well as asbestos, which were regarded as absolutely safe until way down the line.

I know there has been fluoridation in the Birmingham area for the last two decades or more, but one still does not know. There is great anxiety among the water companies and the industry as a whole as to whether, if they are to introduce fluoridation on a widespread or, indeed, a token scale, any epidemiological studies show that people in Birmingham have a higher rate of Alzheimer's disease or bowel cancer. That might satisfy some of the concerns but there is still a latent fear that, in this litigious era, the water companies could be done out of business if such problems arose.

The industry supports the principles of the Government's tabled amendments on the grounds that these meet, to a considerable extent, the concerns I have expressed. However, they need tightening up in certain respects, which is why I have tabled my amendments.

The reason for tabling Amendment No. 2 is that in order that the fluoridation provisions may be effective it needs to be made clear that they apply in full to licensed water suppliers as well as to water undertakers.

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On Amendment No. 3, for the reasons I have already described, it is considered that the arrangements required to be entered into between the health authority and the water company ought to deal with all the matters listed in subsection (7).

On Amendment No. 4, again as mentioned, I believe it needs to be made clear that the health authority should be responsible for all the water company's costs of effecting fluoridation. This is for the protection of the company and its customers. If it has huge capital investments which cost an enormous amount of money, the price of water will necessarily increase, and the increase might not be fair or equal throughout the country.

Amendment No. 5 deals with the point that it is important that before initiating any fluoridation scheme, the health authority should first consult the water company on the practicalities. That is quite different from consulting the water company on the basis that it has consulted the local populace and there is a strong case for fluoridation. It is the practicalities we are concerned with here.

On Amendment No. 6, given that the existing technical guidance is now 15 years old, the industry believes that there should be a legal requirement for the Government, after consultation, to provide up-to-date technical guidance on the specifications and procedures to be observed in relation to the construction and operation of fluoridation plant. This is for safety purposes and for the avoidance of disputes over what standards should be met and funded.

Although the Drinking Water Inspectorate is now putting in hand revision of the technical guidance, the importance of having up-to-date standards is such that it should be put on a statutory basis. Chapter III of Part 3 of the Water Industry Act 1991 is the authority for the drinking water standards/regulations.

Amendment No. 7 is in the interests of security of supply and operational flexibility, already mentioned in my introduction. It is important that proposed new Section 87B(3) and (4) should be extended to take account of all the operational exigencies described in the amendment.

On Amendment No. 11, in the proposed new Section 90, if the scope of any permitted indemnity that may be provided by the Secretary of State is to be prescribed by regulations under proposed new subsection (2), then proposed new subsection (1) needs to be modified to take account of this. In this connection, on the basis that the Department of Health should take full responsibility for fluoridation, surely it should be mandatory for the department to provide indemnities to water companies.

On Amendment No. 12, following on from Amendment No. 11, I believe there should be a duty on the Government to make regulations defining the scope of the indemnities that should be provided. To use the word "may" is an option; there cannot be an option on this.

Already there is concern about the long-term effects of fluoridation, not only from the health point of view. At a dinner on Monday night, which was totally

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unconnected with the subject of water, someone who knew of my involvement as a marketing adviser to MAFF two decades ago asked whether I realised that fluoridation was going to cause a real problem for the growing of tomatoes by hydroponics. Hydroponics was the great thing two decades ago—tomatoes were grown solely in water. But there are concerns in the horticultural sector that adding fluoride to water could cause some problems with the fruit—tomatoes are a fruit, I am told. It could also cause problems to the hoses and pipes and all the kit involved in hydroponics. That is not part of my amendment, but these matters must be considered.

Finally, I come to Amendment No. 13. Since the revised fluoridation provisions will be dependent on regulations made by the Secretary of State, I suggest that it needs to be a precondition of water companies being required to fluoridate water supplies that such regulations should first be made. I beg to move.

Lord Dixon-Smith: I support my noble friend, at least to some degree, but I should make it clear that my support for her amendments should not be taken to imply that I support the principle in the first instance. It is only fair to point out that, should Amendment No. 1 fail, all the other amendments that we are debating cannot be called. We are in something of a procedural dilemma.

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