WATER SUPPLIES (FLUORIDATION) (Hansard, 3 March 1964)

§ Mr. John Rankin (Glasgow, Govan)

I beg to draw the House's attention to the serious consequences which could ensue by the addition of sodium fluoride to our drinking water supplies. On 27th November, 1963, when I raised this subject by Question in the House, the Under-Secretary of State for Scotland stated in his reply to me that he had sent to all local authorities copies of the Report on the five-year experiments conducted in Great Britain on this subject and a booklet prepared by the Ministry of Health. I am sure he was aware that two booklets had been prepared by the Ministry of Health. The first one was issued in 1962 and the second in 1963. The booklet issued in 1962 makes no reference to the topic of fluoridation, but concentrates on dental health education, particularly among children, as the method of combating dental decay. First, the need to remove the causes of bad teeth by regular denture drill, and to reduce and control the amount of sweet stuff eaten by young children.

The Scottish Standing Committee on Dental Health Education was appointed by the Secretary of State in 1959 to promote awareness in dental matters in the public mind, and the right hon. Gentleman has commended the encouraging results achieved in a campaign by that committee which was carried out very recently in Dundee, Edinburgh, Peebles-shire and West Lothian.

However, in his reply, the Under-Secretary of State may have been referring to the 1963 pamphlet, and there we have something of a sea change. In less than 12 months the Minister of Health saw a blinding light. As a result, his course was completely changed. Never was conversion so complete. Fluoridation became the order of the day. The Scottish Secretary of State, forgetting his Standing Committee on this matter, fell meekly into line with his big brother, while the right hon. Gentleman, playing the stooge to the manner born, sent out the English 1268 Department's pamphlets to the Scottish local health authorities. Now he is trying to encourage, if not to enforce, their policy.

I wonder whether, in the course of his researches, the Secretary of State has studied the First Report of the Estimates Committee on the dental services issued no later than Session 1962–63 of this present Parliament. I was a member of the Sub-Committee which conducted the inquiry. All aspects of the dental services were considered, both those available under the provisions of the National Health Acts and those available under the provisions of the Education Acts. Oral evidence was heard on 22 occasions from witnesses representing the Ministry of Health, the Ministry of Education, the Scottish Home and Health Department, the Treasury, the two dental estimates boards, the London County Council, several local authority associations, the executive councils associations, and the representatives of the dental profession, with written evidence submitted by Government Departments. Despite the fact that a representative of the British Dental Association said that the whole picture of the dental health of school children is …a national scandal"— that will be found in Question 1460—there was not one mention of the word "fluoridation" in the whole of that Report, in the evidence or statements, oral or written, of these distinguished experts who appeared before us. The emphasis all the time was on dental health education to remedy what was called "a national scandal".

The Report showed that 350,000 children in Scotland had been inspected and 124,000 had been treated, which leaves 220,000 who could not be traced concerning treatment. The Medical Officer of Health for Edinburgh, Dr. Seiler, observed, however, that a greater number of mothers than one would think took their children to a private dentist. But the inquiry revealed another scandal—the shortage of dentists and also the lack of the college accommodation necessary to overcome this shortage. It may well be that fluoridation is the Government's escape route from their responsibilities in this matter.

I turn to ask the question, what is this thing called fluoridation? It is the 1269 employment of public drinking water supplies as a vehicle for introducing a chemical called sodium fluoride into the bodies of consumers in the hope that it will have a beneficial effect upon the teeth of children up to the age of 10 years with no injurious effects to anyone.

It must be noted, however, that sodium fluoride is a cumulative poison. It is a waste product of the aluminium and certain other industries in which, due to its highly poisonous and corrosive nature, its disposal has become a major problem. It has long been used in America as a rat poison, for which it fetched about 1d. per lb. Since it has become useful for fluoridation, its price has risen to 10d. per lb. In my view, this provides a clue to the real inspiration behind the campaign to get it into our water supplies.

Vested commercial interests are sponsoring the British Dental Association campaign for fluoridation. In a supplement to the British Dental Journal of 3rd September, 1963, we are told that: The Council have agreed that a publicity campaign should be launched in the name of the Association on the subject of the fluoridation of water supplies; this has become possible through the generosity of three firms of toothpaste manufacturers who will remain anonymous. If the co-operation of the proprietors of certain newspapers can be secured, it is hoped that a campaign may be conducted by means of advertisements in the Press and in magazines. The donations have also made it possible to proceed with the circularisation of letters and pamphlets to all local councillors, and the distribution of posters for display in waiting rooms, clinics, out-patient departments, factory notice boards, canteens and interviewing rooms in factories. This to be done using various journals, including the British Dental Journal. In my view, the financing of such propaganda by anonymous commercial interests is a new and highly reprehensible development in British public life which should be sternly condemned and strenuously resisted.

The hon. Gentleman in his reply to me also referred to the five-year experiments. The only one in Scotland was carried out at Kilmarnock. After a careful assessment of the results of this long experiment, the town council abandoned the scheme. It cost the council £22,383 in all. For the sodium fluoride which was added to the water supplies 1270 consumed by the people of Kilmarnock they paid£6,273, a huge sum to pay for rat poison.

Treasurer Wallace, in addressing the Council, said: At seven years of age before fluoridation the average child had seven had teeth, whereas after five years of fluoridation six bad teeth. Does any member here consider that achievement of fluoridation, outstanding, convincing or worth while. The council said. "No".

Ayrshire County Council has rejected the idea of fluoridation very decisively, so have twelve other local authorities in Scotland, while Ayr Burgh, the non-fluoridated partner in the Kilmarnock experiment has shown no inclination to assume the opposite rôle.

We are reminded that to our benefit we chlorinate our drinking water. We do so because we cannot keep birds off the surface and shores of our storage lochs, nor animals from the surrounding hills; and chlorination does us no harm. Therefore, fluoridation, we are told, will have a similar beneficial effect because chlorine and fluorine are very close together; belonging to the same group of elements. So do bromine and iodine. All these halogens have their use. But because some people need a bromide to steady their nerves, it does not follow that we should put it into our drinking water and make everyone else swallow it. If some happen to need Epsom Salts, we do not compel everyone to take them with their cup of tea or drink of lemonade. But that is precisely what the disciples of fluoridation want to do.

Because it may be good for children up to about 10 years of age in preventing dental decay, then everybody else must take it, including those who have no teeth at all. As the Prime Minister said in the House this afternoon, we do not want controls for all; but that is exactly what the hon. Gentleman and his Government are seeking to do.

In the British Medical Journal of last Saturday, 29th February, Dr. Hugh Sinclair, of Oxford, launches a powerful attack against the fluoridation of water supplies in which he says that: water containing 0.05 parts per million of fluoride inhibited significantly the growth of two clones of cells. 1271 He also criticises those who wish Parliament: to order general fluoridation in the same way that calcium was put back into the white bread in 1953. Dr. Sinclair points out, however, that: the addition of calcium to white bread is an important prophylactic measure that does not force anyone to consume it if they do not wish to do so". He also reminds us that by law: no calcium is allowed to be added to whole-meal bread. The addition of a medicament to a public water supply is an entirely different principle". It has been said that those who object to its use might use bone fluoride filters. But, asks Dr. Sinclair: Might not possible helpful substances against dental caries or coronary heart disease. present in hard water, thereby be removed? No proponent of fluoridation has yet even tried to face up to that problem, though they may have thought about it, nor has any one of them provided us with sufficient experimental information about the chronic toxicity to man of fluoride under different circumstances. For example, it may be decreased by the absence of calcium, aluminium or magnesium ions. On the other hand, it may be increased by malnutrition caused by lack of vitamins C and D. It is to help those suffering from malnutrition that a leading medical officer of health said to me that we must fluoridate water.

When the British Dental Association tried to throw some light on the matter it ended up by committing, in the words of Dr. Sinclair, …the elementary error of confusing acute and chronic toxicities". The Ministry of Health is in no better position. It poses the question, "Is fluoride a poison?" and answers. "Not at the level used in fluoridation" and goes on to tell us that it would be necessary to drink at one time two and a half bathfulls of water at a concentration of one part per millium before any harmful effects due to fluoride would be experienced.

The gentleman who nearly spoiled the Flood by drinking up the water did not face a greater task. The Ministry is talking about acute toxicity. Dr. Sinclair points out that this is irrelevant unless the Ministry is assuming that a 1272 person will drink deep only once and never again of the Ministry's doctored water.

The Chairman of the Dental Health Committee of the B.D.A. came to the rescue, however, by pointing out that when water contained one part per million fluoride it would be necessary to drink two and a half bathfuls per day to ingest a toxic amount. Why the difference? The answer is simple. Our two authorities are talking of different toxicities. These be our guides in the attempt to enlighten the public.

I pay my tribute to the magnificent work of the medical profession yet we cannot ignore the fact that the exposure of the drug thalidomide, sold under a host of different trade names, did not arise from general practitioners. No medical journal would accept the article exposing it. Its author was successfully sued for libel in a German court but the fight went on and the German manufacturers were forced to give up selling it in Germany although not in the United States and Britain.

It was nearly six months later, in the summer of 1962, before it was stopped in this country and in America and we know the terrible penalty that we paid for the use of that drug. Note, too, how long it has taken the medical profession to establish the close relationship that exists between cigarette smoking and lung cancer—nearly a century.

Therefore, when some doctors recommend that fluoridation should continue let us remember their attitudes to thalidomide and to nicotine. Like these two drugs, fluoride is a poison. Norway, Sweden, France, Switzerland and Denmark have had to ban fluoridation of water and after five years of experiment Kilmarnock has done the same. The children in Quarriers Homes, at Bridge of Weir, who do not suffer from fluoridation, have one quarter the dental decay found in the rest of Scotland. The case for adding sodium fluoride to drinking water has not been proved. I ask the Under-Secretary of State to remember two points.

First, fluoridation, if proved to be necessary for any child, can be given by pills in measured doses under medical supervision. Secondly, dental decay is due to errors in diet and not to lack of 1273 fluoridation in drinking water. I trust, therefore, that the Secretary of State will proceed no further on the perilous course on which he is now embarked.

§ The Under-Secretary of State for Scotland (Mr. J. A. Stodart)

I should like to begin by saying how glad I am to have the opportunity to reply to this debate, because it arises out of a Question which I answered on my baptism at this distinguished Dispatch Box. I should also like to express the support which my right hon. Friend the Secretary of State for Scotland gives to the policy of fluoridation—and I should like there to be no misunderstanding about this—ot the public's water supply which is necessary to bring the level of fluoridation up to one part fluoride per million of water.

The hon. Member for Glasgow, Govan (Mr. Rankin) has said that the case for fluoridation has not been proved. I believe that all the evidence lies in its favour, and I shall endeavour to tell him why. We know from studies which have been carried out in Great Britain and extensively in the United States, where questions of public health are taken very seriously indeed, that where the public water supplies reach the level of fluoridation to which I have referred the teeth of children are quite remarkably improved. There is very strong ground for believing that if one's teeth are good when one is young they are likely to stay good as one gets older. There is no question but that fluoridation does what we claim it does—it improves the quality of children's teeth. In Scotland this is of vital importance, as the hon. Member has agreed, because the teeth of many of our children at present are remarkably bad.

It is often said by the opponents of the policy that fluoridation may do harm to some other part of the body. There is no evidence of this. In the studies to which I have referred, both in America and in our own country—and surely this goes without saying—particular care was taken to watch for any evidence at all of ill health which might result to children or adults from the effect of this minute quantity—for minute quantity it is—of fluoride. No such evidence appeared and we have the authority of the Standing Medical Committees of the Health Service Councils for both Scotland and Eng- 1274 land and Wales to the effect that nothing has come to light to support the view that fluoridation causes any hazard to general health in the concentration of one part per million.

I am often told that calcium fluoride is all right—"it is natural"—whereas sodium fluoride, which is what is added to the water, is dangerous. This is not so, because the only difference is that calcium fluoride dissolves much less easily and far more of it has to be handled to achieve the same concentration.

It is also frequently said that fluoride taken in excess is harmful and cumulative. There is no evidence to support the latter view and taking it in excess has no bearing on its presence in water in minute quantities. All hon. Members will agree that those harmless substances iron and vitamin D—if taken in normal doses—can be extremely harmful to man if they are taken in gross excess. The same can be said about chlorine.

The hon. Member referred to the Kilmarnock experiment when the local authority carried out a five-year experiment. When the five years were up, the great benefit to the Kilmarnock children's teeth had been amply demonstrated by the figures. I must remind the hon. Gentleman that the Kilmarnock Medical Officer of Health reported in 1962 that the average number of decayed teeth in six-year old children, who by then had had fluoridated water all their lives, fell by a much greater amount than that shown in the report on the U.K. studies as a whole.

The town council of Kilmarnock changed its policy, and it dropped fluoridation. Personally, I regret that decision. The Secretary of State has publicly regretted it. But what does that decision pro re except that this is a free country and that every local authority in Great Britain is free to decide whether to have its water supplies fluoridated?

May I say a word about the water supplies of Scotland's largest—hon. Members will forgive me if I am sufficiently prejudiced not to say greatest—city, the City of Glasgow. That water comes from Loch Katrine and, if I may say so, it is splendid water. It has some fluoride in it but, alas, not quite enough 1275 to have the one part per million in its natural state.

The Corporation of the City of Glasgow has as yet made no decision about fluoridation, but the Corporation is deeply concerned over the health of its children's teeth. This was proved, if any proof were needed, by the leading part which the Corporation, together with Bailie John Davis, the Convenor of its Health and Welfare Committee, took during the very successful recent dental health campaign. That campaign was run by 14 local authorities in the West of Scotland, with the support of my Department and the Scottish Information Office.

If the Corporation eventually decides, as I hope it will, to fluoridate its water supplies, that will in no way affect the taste of Glasgow's water. The quality of the water, as water, will not be affected. What will happen, will happen quite unobtrusively. The fluoridation of the Glasgow water will do a power of good to the teeth of Glasgow's school children in all the years to come.

The hon. Member said that dental decay is the result of a wrong diet and not lack of fluoride. Surely both are contributory. It is true that what is so bad for children's teeth is the number of sweets and biscuits which they eat, particularly when they eat them between meals, but we have found no way of stopping children from this bad habit, apart from the dental health education which Scottish local authorities have been conducting with great vigour. Education by itself, however, cannot do the whole job, and that is why we have to supplement it by fluoridation.

The hon. Member made the further point that fluoridation does not provide for each child precisely the amount of 1276 fluoride which the condition of its teeth at any one time might require. He must know, if he faces this problem honestly, that he is asking here for something which it would be impossible to provide.

Some people advocate that fluoride should be administered in tablets or in toothpaste so that individual mothers could then decide whether they wished to provide it. But I am sure that parents would agree that this method would offer no guarantee of the regular, daily intake of the very small quantity of fluoride which is required for the good of the child's teeth.

What is more, I should like to dwell for a moment on what the taking of fluoride tablets would entail. Dissolved in a glass of water they would taste horrible. It is true that we could put a tablet in a glass of fruit juice or, as it grew older, a child could swallow a tablet, but for its success fluoridation depends absolutely and entirely on a fixed amount being taken day by day, day in and day out, from birth onwards. The washing of hands before meals is something which many parents find it very difficult to discipline their children to do. To get them to take their fluoride tablets would be ten times harder.

To sum up, of course this is no party matter. I respect the sincerity of those who oppose fluoridation, but I believe that they are wrong and that in not very many years' time we shall take the policy of fluoridation, as we take compulsory education, for granted. It will be true of the one as of the other that we may not all like it but that we all need it.