HC Deb 26 February 1985 vol 74 cc256-64 `Any proceedings of a health authority in relation to an application or proposed application under section 1 of this Act shall be subject to the provisions of the Public Bodies (Admission to Meetings) Act 1960, save that section 1(2) of that Act (power to exclude the public by resolution) shall not apply to such proceedings.'.—[Mr. Dobson.]

Brought up, and read the First time.

Mr. Dobson

I beg to move, That the clause be read a Second time.

The House is clearly in two minds. I do not think hon. Members are clear about whether this is a one-day game or a timeless test. Nevertheless, I hope that the new clause will command the support of all hon. Members, whether they are in favour of, or opposed to, putting fluoride in the water. Whatever one's point of view, there is clearly no case for furtively or secretively deciding to put fluoride in the water. The new clause would require any health authority to discuss and decide on, in a public part of its meeting, the addition of fluoride to the water in its area.

When the matter was discussed in Committee we moved an amendment which would have required any decision or discussion on fluoridation by a water authority to be in a public part of its meeting. That was voted down, partly because there is no such thing as the public part of a meeting of a water authority because this Goverament changed water authorities from public bodies which met in public to private and furtive bodies which no longer meet in public. It was galling to hear various Conservative Members, who had happily gone into the Government Lobby in support of that change, advocating open decisions which were openly arrived at. How could that happen when water authorities, which habitually met in public, have been changed to bodies which perpetually meet in private? However, that does not invalidate our proposed new clause.

When we put forward a similar amendment in Committee the Minister responded that there was no need to make it a legal requirement because the Secretary of State would issue a circular and everything would be all right. I was reminded at the time of the words "The Lord giveth and the Lord taketh away". The fact is that those who issue circulars can withdraw them and issue others in their place. Therefore, we felt that it was unsatisfactory to rely on an undertaking that circulars would be issued. We put down the new clause for the Report stage in the hope that the Government would accept it.

Mr. Robin Maxwell-Hyslop (Tiverton)

The hon. Gentleman will correct me if I am wrong, but is it not the case that a circular is purely advisory and has no mandatory effect, and that it would be within the law for a water authority which did not wish to conduct such discussions in public to read the circular, consider it and reject the advice given in it?

Mr. Dobson

That is right. That is another reason for rejecting the Minister's assurance that he was prepared to meet our point by the issuing of a circular. The hon. Gentleman has taken up one of the reasons why we are not satisfied that the issuing of a circular would meet our point.

I commend to the Tory Members who are still present the proposition that such matters should be discussed openly at the open parts of meetings by drawing to their attention— this may send a shiver through some of them—the advocacy of the Prime Minister, who in 1960 was then the humble hon. Member for Finchley (Mrs. Thatcher). In her maiden speech she introduced a private Member's Bill, which was known as the Public Bodies (Admission of the Press to Meetings) Bill. She advocated that all major decisions by public bodies should be taken in the presence of the press and the public. I think that she was right to do so. She said: I hope that hon. Members will … consider that the paramount function of this distinguished House is to safeguard civil liberties rather than to think that administrative convenience should take first place in law."—[Official Report, 5 February 1960; Vol. 616, c. 1357–58.] It would be administratively convenient to some to debate and decide upon fluoridation in private. As someone who is strongly in favour of putting fluoride in water, it seems that that would not be a good idea. If the legitimate doubts of some members of the public are to be dealt with properly, it is necessary for debates and discussions to take place in public so that everyone knows what is going on and no one has the impression that some hole-in-the-corner decisions are being arrived at.

The once humble hon. Member for Finchley, who is now the right hon. Member for Finchley and the Prime Minister, will, I hope, insist when she is marshalling the payroll vote this evening that the principles she upheld in 1960 be applied. The right hon. Lady claims to be a conviction politician and we must ensure that anyone who makes that claim is not allowed to decide that he or she is covered by the Rehabilitation of Offenders Act 1974. I remind those who are not wholly familiar with that measure that it allows convictions of more than 10 years' standing to be wiped from the public record. I do not believe that people's political convictions should be allowed to be wiped from the public record.

I hope, therefore, that the Minister will accept the new clause. If it is imperfectly drafted — I am always ready to accept that something that I have drafted may be imperfect — I hope that the Minister will be willing to say that he accepts the principle that these issues must be discussed and decided in the public parts of meetings and will be prepared to introduce appropriate amendments on these lines in another place.

Mr. Kenneth Clarke

I hope that I can reassure my right hon. and hon. Friends, especially those who felt that I leaped into the previous debate rather precipitately after two hours had elapsed, that on this occasion I intervene early with the intention of being helpful. There is no difference of opinion between the hon. Member for Holborn and St. Pancras (Mr. Dobson), most of my hon. Friends on both sides of the argument and the Government. We share the hon. Gentleman's belief that decisions of this sort should be taken by health authorities sitting in public, subject to one reservation which I hope everyone will accept: we believe that authorities must have the right to close meetings if public disorder is threatened.

I tried to give an undertaking in Committee that we would ensure that this procedure would be followed. I offered administrative guidance, which we intended to be by circular. My hon. Friend the Member for Tiverton (Mr. Maxwell-Hyslop) has rightly observed that circulars are not legally binding. We could use the powers of my right hon. Friend the Secretary of State to issue legally binding directives if health authorities resisted circulars. Given that the new clause has been tabled again, I appreciate that that is not thought to be wholly satisfactory and, indeed, that it could be reversed by some perverse successor to the present Government. Therefore, we are prepared to accept the argument that this should be made a statutory obligation upon the health authority.

9.30 pm

Unfortunately, the drafting is not wholly acceptable. The hon. Member for Holborn and St. Pancras (Mr. Dobson) has closely followed points that arose in the Committee debate. I am advised that section 1(2) of the Act is usually used by health authorities when they close their meetings because of the unfortunate public disorder which breaks out from time to time. It is arguable that they have common law powers to close meetings in any event and that section 1(8) of the Act gives them the necessary powers. Nevertheless, doubt would be raised if this particular provision were enacted in its present form.

I therefore give an undertaking that in another place the Government will table their own amendment, drafted by parliamentary counsel, which will achieve the purpose that I have described, so that health authorities have a statutory duty to meet in public to decide whether to ask that fluoride should be added to the water. But this will be subject to the necessary reserve powers to go into private session if disorder to the proceedings is threatened.

Mr. Maxwell-Hyslop

Will the Government's amendment cover public voting as well as public discussion? It is important that the public should know what advice has been given to the members of the authority by those who have a duty to advise them. The public is also entitled to know about an authority's debate and conclusions, just as we in this place vote in public.

Mr. Clarke

I shall consider that point. My belief is that health authority votes are taken in public. I am certainly familiar with hearing the figures for either side when an authority vote has been taken on a contentious matter. I also believe that authorities can have a recorded vote when someone insists upon it. I shall consider my hon. Friend's point, and I agree that there is no reason why votes on the issue, as well as proceedings, should not be made available to the public.

Sir Hector Monro (Dumfries)

I was surprised that my right hon. and learned Friend did not refer to Scotland, where the procedures are substantially different from those in England. The new clause would not cover Scotland, where, rather than dealing with health authorities, we are dealing with regional authorities which have their own procedures.

I was also disappointed at the fact that my right hon. and learned Friend did not fulfil what I thought to be an obligation to table amendments on consultation before we reconsidered the Bill. In the amendment which I expected him to table, we could have dealt with the issue at the heart of the Bill — consultation between the district and regional councils in Scotland.

My right hon. and learned Friend did not even refer to the regional authorities which in Scotland act as water authorities. He will probably realise from my amendments to the Bill that I want the district councils to have the right to consult the regional councils, hopefully in public. That would ensure that everyone in a region—and everyone in a region also lives within a district in Scotland—has a right to know exactly what the councillors are doing and the arguments that they are advancing on whether or not fluoridation should take place.

That is crucial, because the public in Scotland want to know. They are also anxious to know whether the regional water authorities are prepared to provide differential water supplies to those districts which do not wish to introduce fluoridation.

Will what is proposed in the context of English authorities be equally detailed in respect of Scottish local government and the administration of local government through the regions and districts? Only if my right hon. and learned Friend gives me that undertaking will I be satisfied.

Mr. Gwilym Jones (Cardiff, North)

I do not find myself completely happy with new clause 13, proposed by the hon. Member for Holborn and St. Pancras (Mr. Dobson). On an initial reading of the clause I saw nothing wrong with it in principle but, on further consideration and particularly after listening to the hon. Gentleman, I feel that the clause serves only to confuse the more fundamental issues that should be considered here. After listening to the hon. Gentleman's speech in support of his new clause I feel that it is because of his own prejudicies in the matter that our attention is being diverted from the important points.

Mr. Marlow

I am very interested to see the way in which my hon. Friend is developing his speech. We have heard from my right hon. and learned Friend that he intends to accept the amendment. I wonder if my hon. Friend will agree with me that such is the state of the new clause now before us that, although it would be a good thing if my right hon. and learned Friend brought forward a proper amendment of this sort, the safest thing to do in all the circumstances would be to vote against this new clause.

Mr. Jones

I take the point made by my hon. Friend and we shall be watching with keen interest the form of the Government's official response to new clause 13, or even to new clause 1, which was all that we managed to debate this time last week. The hon. Member for Holborn and St. Pancras (Mr. Dobson) referred to a substantial area — he glossed over it, but I would think it a substantial area — of public doubt over the whole question of fluoridation. He felt that people would want to know about the decisions being taken.

How does this clause help to assuage public doubts on this matter? The hon. Gentleman wants to make sure that health authorities take these decisions in public, but this touches on the fundamental fault of the Bill — that a nominated body should be given the power to take a decision on such an important subject. In my definition — and I would have thought the definition of many, particularly the people who have doubts about this—the health authorities are established to administer the National Health Service, not in any way as policy decision taking bodies. That cannot be the function of a nominated body which owes no allegiance to a democratic electorate.

The National Health Service is only a part, although a substantial part, of the health care of the nation. The responsibility for public health clearly involves the responsibilities of others. My own feeling in this matter is that the local authorities should be brought into this field—even completely to replace the health authorities and their involvement in this. I feel that in no way can a health authority, as a nominated body, be regarded as responsible for the public or be thought of by the public as responsible when taking decisions in this matter of the fluoridation of water. I am unhappy with this new clause. I do not feel that it adds a real safeguard.

Mr. Dobson

Many Members of the Opposition, certainly including myself, are extremely doubtful about the current functions and the processes of appointment of members of district health authorities. Can we count on the hon. Gentleman's support if we think there ought to be rather more local influence brought to bear in such matters as hospital closures, whether renal units are open or whether, just south of the river, the cardiac unit at Guy's hospital is going to be closed down for four months? Does he not think that those are similar significant matters which perhaps ought not to be left to the nominated health authority?

Mr. Jones

I note what the hon. Gentleman says and I will, of course, listen closely to any argument that he puts forward. But my response to those arguments may be the same as those that he put forward this evening which convinced me that new clause 13 should not be pursued. I regard health authorities as administrative bodies and not as policy decision-making bodies.

Sir Dudley Smith

I shall be extremely brief. I am glad that my right hon. and learned Friend the Minister proposes to accept the new clause. Modest as it is, it is a step in the right direction after some of the other proposals that have been put forward.

I intervene only to say to the hon. Member for Holborn and St. Pancras (Mr. Dobson) that I was present on the day when my right hon. Friend the Prime Minister moved her private Member's Bill admitting the press to public meetings. It was a brilliant speech that presaged great things to come. It helped members of the press to get into quite a number of public authority meetings from which they had previously been banned. Over the years the position has improved, and I should have thought that it was just about right today. There are always claims that other authorities should be open to the media, but the situation was regularised in 1960 and has improved since then.

Perhaps there is a good case for giving admission to the meetings of water authorities. I know that a private Member's Bill on the subject is in limbo and probably will not reach the statute book, but it is important that the media should be able to attend meetings where important issues such as fluoridation are discussed. The same applies to health authorities. There are many instances when it is right and proper that the press should not attend, but there are other occasions when the press should act as a safeguard for the people.

In those circumstances, I welcome the new clause, but I am afraid that it does not go quite far enough.

Mr. McGuire

I have an apology to make. I think that the hon. and learned Member for Burton (Mr. Lawrence) was on his feet when I scribbled him a note saying, "Keep it going, I am going for my dinner." When I returned to the Chamber, I found that we had moved on a bit. We are now discussing a new clause that I support. I apologise to my hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) and to you, Mr. Deputy Speaker, for the fact that I was not in the Chamber to hear my hon. Friend, who wants to aid the Bill's passage—I shall not quibble with that yet, as that is probably a matter for Third Reading—make a no doubt brilliant and lucid speech about the new clause.

My hon. Friend referred to this issue in Committee. I have no doubt that he has now added to the brief speech that he made in Committee, pressing the Minister to allow more public ventilation of this subject. The more we allow the public to listen to what I hope will be compelling arguments as to why the water should not be fluoridated, and the more light we can throw on the matter, the less fluoridation there will be. I know that that is not the view of my hon. Friend the Member for Holborn and St. Pancras, and that he firmly believes that, if people listen to the arguments, they will be persuaded. But, like me, he is a democrat. Incidentally, all hon. Members should be careful, when making party points, not to impugn the integrity of other hon. Members. But I am sure that, like me, my hon. Friend does not want things that affect millions of people—we are told that 5 million people in this country receive fluoridated water — to be done secretly, because that would offend against a deeper principle of democracy that all hon. Members subscribe to. The House has not given a green light to that. Fluoridation may be carried out, but all the facts must be known. The drift of the argument is that it is a good thing to fluoridate. I am offended that undemocratic bodies can make the decision. The least we can do is to allow the public to listen to the reasons why the authorities are so persuaded.

The Bill is a bad Bill and we should not have touched it with a barge pole. However, in one or two cases it is written into the Bill that there must be unanimity. The district health authorities and the area and regional health authorities must be persuaded that fluoridation is a good thing. The water authorities must also be persuaded of that.

Although I wanted to speak before the closure, the matter was no doubt fait accompli because time was pressing and the Government wanted to move on. Last Tuesday night and early on Wednesday morning the Government could not carry the payroll vote. I would have liked to speak on other amendments that touched on this principle. We should allow the public into the meetings so that secret deeds cannot be done which will affect many people. At present, 5 million people receive fluoridated water. I doubt whether those people were seriously aware of what was debated when the decision was taken to put artificial fluoride into the water to the presently permitted degree. If it had been known that the matter was to be publicly debated in a committee, the public would have attended in great numbers. If the public could not be persuaded then, they would have sought to influence the authorities later that it was not a good thing to do.

Mr. Gwilym Jones

I wish to raise a point with the hon. Gentleman before he moves from the concept of unanimity, which he referred to as being enshrined in the Bill. He talked about the health authorities and the water authorities having to agree. He may be overstating the case. As I understand it, the water authority is more in the position of being required to add fluoride to the water supply, if it is so directed by the health authority. The grounds for deciding not to do so are related to the concept that, in the opinion of the statutory water authority, something is reasonably practical and that it does not increase the fluoride content of the water supply to areas outside that covered by the application. That does not fit in with the hon. Gentleman's concept of unanimity that includes the water authorities.

9.45 pm
Mr. McGuire

The hon. Gentleman seems to suggest that unanimity is not required, and that a district or regional health authority can decide to fluoridate. The authority will have arrived at that decision democratically, although the methods of gaining membership of those bodies are undemocratic. The majority of members are appointed and are not subject to public recall or the public invigilation of why they reach their decision. The hon. Gentleman seems to say that such an authority can persuade an unwilling water authority, providing it is technically feasible. I understand from our deliberations in Committee that the water authority and the district or regional health authority must both be persuaded. There must be unanimity. It is not a question of whether a water authority believes that there is a technical impediment to fluoridating the water to the required level. It could hardly put fluoride in if that requirement was not met. I understand that the matter goes a little deeper than that. In Committee, some hon. Members believed that one of the best things to come out of a bad Bill was the fact that the area for which a water authority was responsible had to be conterminous with the district health authority area and that they could not overlap, although there is a provision in case of emergency.

Mr. Maxwell-Hyslop


Mr. McGuire

I shall give way to one of the foremost lay experts in the House, who I hope will confirm that I am right.

Mr. Maxwell-Hyslop

I would not plead guilty to that description, but the hon. Gentleman is wholly right. This is not a matter of opinion but of what the Bill states. Clause 1 makes it clear that the health authority simply gives permission. It does not require the water authority to put fluoride in the water. Nor need we waste time about what "health authority" means, because clause 7 shows that in England and Wales it means any district health authority. There is no nonsense about regional health authorities having any locus standi in this matter.

Mr. McGuire

I am grateful to the hon. Gentleman, who is a formidable expert on such matters, for confirming what I said to the hon. Member for Cardiff, North (Mr. Jones) and what I said before he intervened. The best way to throw light on such matters is to allow the public to attend water authority meetings. The English disease is secrecy.

The hon. Member for Warwick and Leamington (Sir D. Smith) mentioned the Bill which the Prime Minister introduced in 1960, when she was just a slip of a girl. When he replied to that debate, the then Secretary of State for Education and. Science rather overdid the alliteration. He was especially fond of the letter "c", and he said that the right hon. Lady's speech was cogent, composed and courageous. My hon. Friend the Member for Holborn and St. Pancras said that the right hon. Lady's speech was an example which we should all follow. Let us eliminate secrecy as far as possible. Let us tear down the iron curtains of secrecy and let more public light be shed on decisions that affect the public. In many cases, decisions detrimental to them are made secretly at meetings which they cannot attend.

Sir Dudley Smith

The person who replied to that debate was the late Lord Brooke, then Mr. Henry Brooke, who at that time was the Minister for Housing and Local Government.

Mr. McGuire

We sometimes have to correct the footnotes of history. I was led astray by my hon. Friend the Member for Holborn and St. Pancras.

Mr. Dobson

Both recollections are correct. The hon. Member for Warwick and Leamington (Sir D. Smith) was talking about a Second Reading debate. The over-fulsome tributes were made by the right hon. Member for Leeds, East (Sir K. Joseph), who was then the Under-Secretary, now the Secretary of State, for Education and Science, who was replying to the Third Reading debate.

Mr. McGuire

We are all right. It is something that we can agree with one another. Whoever made the speech to which I referred went overboard with alliteration when he said that the right hon. Lady was courageous, composed and cogent. We could add other "c"s and say that she has "considerably changed".

Mr. Marlow

The amendment suggests that at any meeting of a health authority on the subject there should be public participation and discussion. My right hon. and learned Friend the Minister said that the Government would accept the spirit of the amendment and bring its own participation amendment before the House of Lords.

The Bill seeks to allow a water authority, when a health authority says that it is OK, to put the wretched stuff in the water. Does the hon. Member for Makerfield (Mr. McGuire) believe that the best place for that public participation and discussion is, as suggested, at the area health authority when all the specialists and health hygiene experts are together, or later when the water authority makes the decision?

Mr. McGuire

No undemocratic body has the right to mass-medicate people when they have no recourse. The Government enjoy a terrific majority, but I hope that as the night goes on those subjected to a payroll vote will leave us free men and women to talk about a matter of great importance. I believe that I am acting in the interests of my constituents. I see that the hon. and learned Member for Perth and Kinross (Mr. Fairbairn) wishes to intervene; I shall give way, since his interventions are usually spot on.

Mr. Fairbairn

We are discussing a matter of principle. The hon. Member for Makerfield (Mr. McGuire) has fallen into the Government's trap by using the term "mass medication". We are talking not about mass medication but about forcing the whole population to swallow medicine under the fantasy that, however poisonous that medicine might be, it might cure toothache in children.

Mr. McGuire

I do not want to cross swords with the hon. and learned Member for Perth and Kinross (Mr. Fairbairn). I defer to the hon. and learned Gentleman's greater knowledge and command of the English language and to his ability to deploy arguments. Since I am a poor old sponsored miner, I cannot hope to compete with him. The hon. and learned Gentleman has many inbuilt advantages. I use the term "mass medication" because the proposal affects the mass of people and because fluoride is not put in water to make it wholesome, but to treat an assumed medical condition. The phrase "force feeding" is more emotive than the term "mass medication". We share a common aim to bring to the attention of the public the fact that something has been done which will be accepted as mass medication or force feeding.

Mr. Fairbairn

If I may illustrate the matter, when I was studying medicine—

It being Ten o'clock, the debate stood adjourned.