Vitamin B6 (Hansard, 18 March 1998)

§ The Minister of State, Department of Health (Baroness Jay of Paddington)
My Lords, I feel that I must say to the noble Earl, with great respect, that in this instance he is simply not comparing like with like. We are back in the territory, familiar to your Lordships' House, of comparative risk assessment, but to engage in that rationally we really do need to compare apples with apples, and not apples with oranges. The more appropriate comparison would be the safety factor of five applied by the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment to the lowest intake of Vitamin B6 reported to have an adverse affect on humans. A safety factor of 300 was applied to the lowest level of Vitamin B6 causing adverse effects in dogs.

Earl Baldwin of Bewdley
My Lords, I am grateful for that reply. However, I would still press the noble Baroness as to whether there is not something askew in this matter of risk assessment. The understanding, according to the papers that have been issued, is that the risk of 300 is calculated on proposals for humans. I still ask how the Minister can possibly justify treating an essential vitamin which we all need as though it were a dangerous drug and at the same time permit a substance, for which, and I quote from the Department of Health's Report No. 41, Dietary Reference Values: No essential function … has been proven in humans", to be distributed through the water supply where we all drink it at a level not far below the toxic dose. They cannot both be right.

§ Baroness Jay of Paddington
My Lords, I hesitate to get into detailed discussion of those two facts at Question Time. Perhaps it would be more appropriate to arrange a longer debate through the usual channels, as the noble Earl and I have already discussed. Vitamin B6 is not prohibited like a dangerous drug. It continues to be sold in food supplements at the level which is widely regarded as appropriate for human consumption.
On the question of fluoride, perhaps I may quote to the noble Earl from the Government's latest statement in the Green Paper, Our Healthier Nation, published last month, which states that the Government are, concerned to explore ways of bridging the gap between those who are opposed to any fluoridation of the water supply and those who believe that only in this way can the children most at risk be protected against the damaging effects of tooth decay … but it is of the view that fluoridation offers an important and effective method of protecting the population from tooth decay".

Lord Campbell of Croy
My Lords, as all water in Britain contains fluoride—in some areas, in the optimum proportion for the protection of teeth—are the Government making it publicly clear that fluoridation is intended simply to top up the fluoride that is already there naturally in water?

§ Baroness Jay of Paddington
My Lords, as I said in answer to the noble Earl's supplementary question, we are aware of the strong views which exist on both sides of the argument. That is why we have issued the Green Paper as a consultation document rather than taking a specific view although I have indicated the Government's overall position. The noble Lord is right in saying that fluoride exists naturally in water and that the fluoridation of the water supply to one part in a million can reduce the amount of tooth decay in children from similar backgrounds from one-third to one-half.

§ Lord Avebury
My Lords, can the Minister say how many millions of people in the United Kingdom are now drinking fluoridated water and whether she agrees that there is not a single iota of epidemiological evidence to show that any harm is being caused to any individual by drinking such water? Will the Government now take steps to persuade all those local water companies which have not yet done so to extend the benefits of fluoridated water to the rest of the population so that a great deal of suffering and dental treatment can be avoided?

§ Baroness Jay of Paddington
My Lords, I am afraid that I cannot answer the noble Lord's first question about how many millions of people are now drinking water containing fluoride because, as the noble Lord, Lord Campbell of Croy, mentioned, a great deal of our water contains fluoride naturally. On the noble Lord's question as to whether studies have shown any adverse effects from drinking fluoridated water, as I understand it, studies in the United States have shown that where there is a high concentration of fluoride, there might be the potential for visible markings on the surface of the teeth of children and others drinking it. However, that is not true of those low levels of fluoride in the water which I have suggested are appropriate to reduce tooth decay.

§ The Countess of Mar
My Lords, am I correct in my understanding that the general sale of Vitamin B6 is being limited because there is the possibility of neurological damage to people taking very high doses but that that is reversible when they stop taking the medication? How many people have been found, on epidemiological studies or clinical examination, to have neurological damage, and what proportion of people are suffering from neurological damage because of organophosphates?

§ Baroness Jay of Paddington
My Lords, I shall have to write to the noble Countess and provide the precise statistics on the relative numbers. I am sure she will be aware of the suggestion that 1.2 milligrams of Vitamin B6 as a daily intake for women is sufficient to maintain their health and certainly will not cause any neurological condition. That is the safe level at which it can be taken to good effect.

§ Lord Stoddart of Swindon
My Lords, does my noble friend agree that the Government's policy on this and other matters is quite irrational? Does she agree that many children and adults use toothpastes that contain fluoride which over a long time builds up in the body? If that is supplemented by the addition of fluoride to drinking water it may constitute a health hazard. Does my noble friend agree that the addition of fluoride to drinking water is mass medication and that children's teeth would be better taken care of if they had an improved diet and parents were advised accordingly?

§ Baroness Jay of Paddington
My Lords, I certainly do not agree that the Government's position on this or any other policy is irrational. In this very complicated area of relative risk assessment, which noble Lords and I have discussed on many occasions, we seek to assess the extremely expert scientific advice that is given to the Government. It is not rational for Ministers to try to second guess the scientific evidence of those in an expert position to advise the Government. As to the specifics of fluoride in children, as I said in reply to the noble Lord, Lord Campbell of Croy, there are varying views. For that reason, although the Government have expressly stated their opinion about low levels of fluoridate in water, they have asked for wider consultation so that all views can be taken into account.

The Earl of Clanwilliam
My Lords, does the noble Baroness accept that the fluoride which occurs naturally in water is a sulphide whereas that which is added by human beings is a sulphate? Does the Minister accept that there is some concern over the Committee on Toxicity? Has that committee been instructed to examine the use of fluorides and, if so, what was the result?

§ Baroness Jay of Paddington
My Lords, no, the COT has not been asked to advise on fluoride. I understand the scientific point that the noble Earl raises, but I refer him to evidence, particularly that from 710 the United States, which suggests that it is only with very high doses of fluoride in water occurring naturally or with supplements that ill effects are recorded.

Earl Howe
My Lords, is the Minister aware that the subject of Vitamin B6 is one which over the past few months has caused great concern to a large number of people and that those individuals feel that the Committee on Toxicity has not considered all of the relevant evidence? Does the noble Baroness have any comment to make on that? Is it too late for the Committee on Toxicity to reconsider the whole question?

§ Baroness Jay of Paddington
My Lords, I am aware that there has been considerable interest in this matter particularly on the part of those who represent the industry and the complementary medicine interests. However, the COT considered over 100 scientific papers from national and international journals before reaching its recommendation. As I said in answer to my noble friend Lord Stoddart, the Government see no reason to reopen that inquiry.