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Lord Dixon-Smith: We have an on-balance decision to make tonight. I have been trying very hard to make up my mind whether it is an advantage that the majority of those who are going to vote tonight are not actually in the Chamber. However, as long as the Minister gives an assurance in his response that he will not adduce our voting practices as an adequate form of determining opinion on public consultation, I shall be content, at least on that particular matter.

There are just three or four points that I wish to pick up. A number of Members of the Committee have mentioned fluoride that occurs naturally in some places in water supplies. That is in the form of calcium fluoride; it is not hexafluorosilicic acid or disodium hexafluorosilicate. Those are the only two substances that are permitted to be added to water under this group of amendments. We should be clear that we are talking about different things. Calcium fluoride is a relatively innocuous substance. But that is neither here nor there.

The noble Earl, Lord Baldwin, did the Committee a considerable favour with his resume and summing up of Professor Sheldon's study which I have also come across. Other noble Lords also mentioned it. There is no point in my repeating the noble Earl's remarks except to say that the study raises serious questions.

There is always a problem with scientific evidence. I ran into that for the first time when the Science and Technology Select Committee examined medical uses of cannabis. Some 5,000 years' use of cannabis in the pharmacopoeia was not considered to be scientific evidence. There is no doubt that if you put fluoride into water there is some reduction—that is what we are talking about—in dental caries. It does not prevent dental caries and it does not cure them but there is some reduction in their occurrence.

We are not solely putting these substances into water for human benefit. The bulk of the water we use in our homes is used in baths, toilet cisterns, washing machines and so on. From there it goes down the drain into the sewage plant where all the nasties are cleaned out. However, the Minister did not respond to my question of whether it was possible to get the fluoride out of water in the sewage treatment process. If he could give me an assurance that that could be done, I would say no more and we could perhaps stop the debate. So far as I can see we are putting that fluoride into the general environment. We do not know the consequences of that. Evidence acquired over a limited period of time suggests that that is not a problem. However, that is all that we have. We may not have studied the matter for long enough.

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My noble friend Lord Fowler and the noble Lord, Lord Hunt of Kings Heath, referred to the 1995 Act. It was said that that Act constituted the decision of Parliament and that it was correct. It may have been right then but in the light of subsequent developments and advances in knowledge is it still correct? The noble Lord, Lord Monson, said that the vast majority of other countries in Europe have ceased adding fluoride to water. The United States is ceasing to add fluoride to water, as is much of Canada.

At the very least we are rowing against the tide although someone suggested to me that perhaps Europe is not a good precedent for us to follow. That is neither here nor there. As I say, we have to take a decision on balance. It is not straightforward. Having heard what Professor Sheldon had to say, I come down on balance against the amendment.

Baroness Miller of Chilthorne Domer: Earlier this evening the noble Baroness, Lady Trumpington, called my noble friend Lord Livsey a typical Liberal. If being a typical Liberal involves recognising benefits—we have heard some very powerful arguments concerning benefits which I do not question—and asking for adequately funded public consultation, which I deeply regret the Government chose to oppose, I, for one, am pleased to be a typical Liberal Democrat. This is a difficult debate which will engender deep public interest. The Government have introduced the measure in a hurried manner and we have not had an adequate opportunity to debate it. I understand that in the short term the measure is a good thing. However, as the noble Lord, Lord Stoddart, said, the Government should have introduced the measure in a Bill. In such a Bill we could have asked for strategic health authorities to apply the measure for, say, five years.

One day this matter may be addressed through diet. Many noble Lords who support the measure admitted that in other countries—I believe that Switzerland and France were mentioned—fluoridation is not such an important issue as people's diets are not deficient in the relevant substance. It is awful that we cannot ensure that our children's diets are adequate in that regard.

In the light of the Government's intransigence with regard to my amendments, I am minded to vote against this amendment. I do so as I do not believe that there will be adequate public consultation on the issue and the way in which the Government introduced the measure was not satisfactory.

Baroness Byford: I have waited patiently to speak. I express my own view. These Benches have a free vote on the issue. I hope that applies to the other Benches. I stress that I express very much my own views.

I shall not rehearse the arguments for or against the measure as they have been explained fully. I shall not indulge in such repetition although I have a six-page speech which I shall obviously have to save for another day unless the Committee wishes me to start on it.

Noble Lords: No!

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Baroness Byford: We know where we stand. I wish to make a few serious comments. We would not have had this debate had I not insisted that the Government could not simply bring this matter before the House on recommendation from another place. The fact that we have already spent four hours in discussing a few amendments reflects what others have said; namely, that the measure ought not to have been introduced in the way that it has. It is a bolt-on, an adjunct to the Bill. That is shabby and regrettable.

My anxieties concern four items, some of which have already been dealt with. I refer particularly to the Government's amendment. First, I refer to indemnity. I would have made a strong plea for that to be considered. However, the noble Lord, Lord Warner, indicated that the Government were willing to consider that matter.

Secondly, as regards the supply of fluoridated water to customers within the same supply area, I should be grateful if the Lord, Lord Warner, will explain how he envisages that process operating. For example, my area may not wish to have fluoridated water but the area where the noble Lord, Lord Hunt, lives may so wish. However, we may get our water from the same supply system. I do not think that the amendment addresses that issue. I should be grateful for some guidance on that matter. I have read the amendment carefully. Unless I have missed something, I cannot see how one can supply one area with fluoridated water but not another if they share the same supply. That is a practical problem.

I hope the noble Lord, Lord Warner, will explain how, if an area decides to cease having fluoridated water, the system will cope with that and whether the Government think that it is possible to achieve that situation. My noble friend Lady Gardner said that she did not wish those areas that already have fluoridated water even to have the option of voting.

Baroness Gardner of Parkes: No, I am sorry, that was not so. I consider that they should have such a right. I do not want them to have a referendum.

8 p.m.

Baroness Byford: I shall come to that. I apologise to my noble friend if I misunderstood her. It seems unfair that what is good for the goose is not good for the gander. I think that all of us in this House feel that there should be a fair deal for those people in deciding this issue.

Lord Hunt of Kings Heath: Perhaps I may intervene. Is the noble Baroness suggesting that Birmingham, for instance, despite the fact that 40 years ago a proper process was gone through by the public authorities, should be forced into another consultation now on whether fluoridation should continue?

Baroness Byford: No, I was not suggesting that. But my noble friend stressed the fact—if I get it right this time—that she felt that a referendum should not be required. I think it was partly a matter of cost or

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because fluoridation is believed to be good for a particular area. That is why I raise the issue. But with places such as London, which will have several authorities within their supply system, the question is how the provision will be applied and dealt with. There may be a very easy answer. I should merely like clarification. That would be enormously helpful.

I turn to the process. Earlier, we had a vote, which the noble Baroness, Lady Miller, lost. I do not understand from the amendment exactly how the Government intend to seek and get the public view. The provision is vague. We are told that this matter can be set out in regulation. I do not know how many times I have stood at this Dispatch Box and objected to matters coming through in regulation which we cannot debate and cannot alter. I record my dismay again that here is another such occasion. Had this provision come through in a separate piece of legislation, we should not be in this position. We are in this position because the Government have tried to rush this matter and add it to this Bill. Therefore, I should be grateful if the noble Lord would explain matters more fully.

In another place, the Minister's colleague said:

    "We are enabling local communities to decide what they want to do on this matter".

She went on to say:

    "I emphasise that no fluoridation scheme will take place unless there has been wide-ranging consultation in which both the proponents and opponents of fluoridation have been encouraged to participate and in which the majority of the population have indicated that they are in favour".—[Official Report, Commons, 1/7/03; col. 163.]

I therefore ask again what I asked earlier. Does that mean over 50 per cent of those who vote, or 50 per cent of all those who are eligible to vote? How do the Government envisage the practicalities being engaged? It worries me that if the result is based on the kind of turnout we have seen at general elections, it will be very slight. The Government need to give thought to the point.

When we first raised the issue, the noble Lord, Lord Whitty, on 22nd May in response to my letter—I am grateful for his response—said:

    "We have to consider further suitable measures to publicise and consult in order to obtain, and how best to assess, a genuinely representative response from the local population".

I think all noble Lords would agree. What we cannot find out is how that is to be done. That is why I am pushing the Minister to go further.

Those who have spoken share the desire to reduce tooth decay in children—I should like to place that on record—whether through fluoridated water or through encouraging people to have better dental care. I would like to have seen a provision to encourage people to use toothpaste containing fluoride, even if the water is fluoridated, because the use of a toothbrush helps to stimulate good gums. We should not lose sight of that.

I have set out the difficulty that the Government have. I referred earlier to the survey undertaken by the Leicester Mercury. It approached our nine Members of Parliament. Four supported the Government's proposals, three were against, and two were undecided.

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I humbly suggest that they are reasonably well versed in this topic. But I fear that many people will not know the nuances but will merely see that there are two sides to the argument. Therefore, we need to make sure that the arguments for and against are put forward in a fair manner.

In conclusion, the fact that the Government have brought this provision through so quickly, even before some of their own inquiries on the implications of fluoridation for health are completed, is a mistake. I take issue, as I said, with the undefined way of seeking public opinion. I take issue with the Government that they were originally not willing to put this amendment before the Committee in a proper manner. I believe that we should have choice. We all agree on the desirability of reducing tooth decay. What divides us is the method of achieving that choice.

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