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Lord Whitty: My Lords, when the House debated the issue at earlier stages, there was acceptance that public health was a matter for the health authorities—that the strategic health authority would be the body that made the proposition, and that fluoride should be added to the water in those parts of the country where that was not already the case. That was to be subject to major consultation within each health authority's area, but of course that area will not be the same as a local authority area. Indeed, most strategic health authority areas will include several local authorities.

The reference in the amendment to putting the local authority in pole position, effectively, is not appropriate. It is important that local authorities play a major part in reaching the decisions on the proposition from the strategic health authority on whether an area should or should not fluoridate. I understand some of the anxieties about decisions that are taken solely by the strategic health authority. While the burden of science seems to be in favour of fluoridation, there are alternative arguments. In answer to the noble Baroness's specific question, the Government have commissioned two research studies by the MRC and the University of York and neither found any association with cancer. However, we are not complacent about that. Strategic health authorities must make a judgment on the latest science and on how it affects their particular areas, types of water and populations, but it is a public health decision and the strategic health authorities must make it.

However, because it is an issue about which there is uncertainty and some doubt, it is important that strategic health authorities engage in public consultation and that public opinion is assessed objectively. Local authorities must play a full part in the opinion-sounding process, be it by open debate or other forms of participation, but a single local authority within a strategic health area could not make

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or block the final decision. The decision must be taken across the strategic health area as a whole following area-wide public consultation.

On a technical point, the amendment is in the wrong place. It conflicts with Section 89(1) of the Bill, which would require the relevant strategic health authority to ascertain public opinion. That relates to indemnity issues. Even if the amendment were carried, it would not achieve what the noble Baroness apparently seeks, which would be to involve local authorities in the public opinion-gauging exercise, because strategic health authorities would be given that authority by Section 89 of the Bill.

Nevertheless, while the strategic health authority is responsible for assessing public opinion, it is right that local authorities should play a major role in that exercise and ascertain opinion within their own areas to feed into it. Ultimately, however, it is a public health issue and the strategic health authority is the body that should make the proposal and test opinion on it.

Baroness Byford: My Lords, before the noble Lord, Lord Livsey, responds, I must say that I am intrigued. The noble Lord said that several local authorities should be involved. It is true that there will be several different strategic health authorities in exactly the same place, so I do not accept the distinction between local authorities and strategic health authorities. The borders of strategic health authorities do not match those of water companies and different points of view will be expressed for one place.

The amendment is not my own, so I shall weigh in heavily. I am extremely disappointed that the Minister should leave it until the ninth minute of the ninth hour of the ninth day to tell us that the amendment is in the wrong place. That is amazing and very unlike the Minister, who is normally most helpful. His argument is not very good at all.

In response to my question, the Minister said that the research had been continued. He did not reveal what has happened since the research in York and how long it is since it was completed; in other words, has research been going on in the past six months while we have been debating the Water Bill? My understanding is that there has been no more up-to-date research. He certainly did not answer my question on what possible dangers there are. We would like to hear a little more from the Minister before the noble Lord, Lord Livsey, decides whether to proceed with the amendment.

Lord Whitty: My Lords, the most up-to-date research does not show any link with cancer. The noble Baroness referred to the American experience and that is the latest information that we have.

Lord Livsey of Talgarth: My Lords, the Minister has made a number of statements about local authorities and strategic health authorities, as though they did not talk to each other. Often, local authorities consult the strategic health authorities and I believe that the local authority is the right body to conduct a referendum on this issue. The noble Baroness, Lady Byford, is right in saying that there is no coterminousity between water

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companies, local authorities and strategic health authorities. None the less, it is possible to co-operate and for the local authority to be the vehicle through which a referendum is held. I see no problem with that.

In these circumstances, it must be right that the addition or not of fluoride must be tested by public opinion in the district and the amendment is the correct way of achieving that. It may not be in the right place, which I concede, but we saw this as a way of including the provision in the Bill in relation to indemnity. As the Minister has a little more legal fire power than we do, he may well be correct in saying that it ought to be in another place.

Reference has been made to research and America has been mentioned. Noble Lords have also said how good are the teeth of people in Birmingham because fluoride has been added to the water for the past 40 years. As far as I know, no tests have been undertaken in Birmingham as to the possible impact of that on other aspects of human health, nor has Birmingham been compared with somewhere else of similar population which does not add fluoride to its water. As the noble Baroness, Lady Byford, correctly said, scientists are not agreed on the situation in York, and I quoted that in detail in Committee.

In my opinion, it is important to test the opinion of the House because it is one of the most important amendments we are discussing today.

9.17 p.m.

On Question, Whether the said amendment (No. 50A as an amendment to Amendment No. 50) shall be agreed to?

Their Lordships divided: Contents, 26; Not-Contents, 57.

Division No. 7


Attlee, E.
Barker, B.
Bridgeman, V.
Brooke of Sutton Mandeville, L.
Brougham and Vaux, L.
Byford, B.
Carlisle of Bucklow, L.
Cope of Berkeley, L.
Craigavon, V.
Dixon-Smith, L.
Geddes, L.
Howell of Guildford, L.
Livsey of Talgarth, L.
Miller of Chilthorne Domer, B. [Teller]
Montrose, D. [Teller]
O'Cathain, B.
Palmer, L.
Pearson of Rannoch, L.
Phillips of Sudbury, L.
Rennard, L.
Roper, L.
Selborne, E.
Thomas of Walliswood, B.
Wallace of Saltaire, L.
Watson of Richmond, L.
Williams of Crosby, B.


Acton, L.
Amos, B. (Lord President)
Andrews, B.
Archer of Sandwell, L.
Ashton of Upholland, B.
Bach, L.
Bassam of Brighton, L.
Bernstein of Craigweil, L.
Borrie, L.
Bragg, L.
Brett, L.
Brooke of Alverthorpe, L.
Brookman, L.
Burlison, L.
Carter, L.
Chandos, V.
Crawley, B.
Davies of Coity, L.
Davies of Oldham, L. [Teller]
Donoughue, L.
Dubs, L.
Evans of Parkside, L.
Evans of Temple Guiting, L.
Farrington of Ribbleton, B.
Faulkner of Worcester, L.
Gale, B.
Gilbert, L.
Golding, B.
Goldsmith, L.
Graham of Edmonton, L.
Grocott, L. [Teller]
Hannay of Chiswick, L.
Hayman, B.
Howells of St. Davids, B.
Hoyle, L.
Hughes of Woodside, L.
Hunt of Chesterton, L.
Lea of Crondall, L.
Macdonald of Tradeston, L.
McIntosh of Haringey, L.
McIntosh of Hudnall, B.
Mackenzie of Framwellgate, L.
Massey of Darwen, B.
Morgan, L.
Pitkeathley, B.
Ramsay of Cartvale, B.
Rendell of Babergh, B.
Rogers of Riverside, L.
Scotland of Asthal, B.
Sewel, L.
Simon, V.
Stone of Blackheath, L.
Turnberg, L.
Warwick of Undercliffe, B.
Whitaker, B.
Whitty, L.
Wilkins, B.

Resolved in the negative, and amendment disagreed to accordingly. On Question, Motion agreed to.

13 Nov 2003 : Column 1696

9.27 p.m.


51Clause 61, page 77, leave out lines 3 to 6
52Page 77, line 10, leave out "The terms may, for example," and insert "Those terms shall"
53Page 77, line 11, leave out from "requiring" to end of line 12 and insert "the relevant authority to meet the Amendmentable capital and operating costs incurred by the water undertaker in giving effect to the arrangements;"
54Page 77, line 20, at end insert— "(8A) If two or more relevant authorities request a particular water undertaker to enter into arrangements in respect of adjoining areas—

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