HC Deb 24 October 1985 vol 84 cc554-61

Lords amendment: No. 6, insert the following new clause: — (1) This section applies where a health authority propose—

  1. (a) to make or withdraw an application; or
  2. (b) to terminate a scheme which may be operated by virtue of section 3 of this Act (a "preserved scheme").
(2) At least three months before implementing their proposal, the health authority shall—
  1. (a) publish details of the proposal in one or more newspapers circulating within the area affected by the proposal: and
  2. (b) in the case of an authority in England and Wales, give notice of the proposal to every local authority whose area falls wholly or partly within the area affected by the proposal.
(3) Before implementing the proposal the health authority shall consult each of the local authorities (if any) to whom they are required by subsection (2)(b) above to give notice of the proposal. (4) The health authority shall, not earlier than seven days after publishing details of the proposal in the manner required by subsection (2)(a) above, republish them in that manner. (5) Where a health authority have complied with this section in relation to the proposal they shall, in determining whether or not to proceed, have such regard as they consider appropriate—
  1. (a) to any representations which have been made to them with respect to it; and
  2. (b) to any consultations held under subsection (3) above.
(6) The Secretary of State may direct that this section shall not apply in relation to any proposal of a health authority to withdraw an application or to terminate a preserved scheme. (7) Where, at any meeting of a health authority, consideration is given to the question whether the authority should make or withdraw an application or terminate a preserved scheme, section 1(2) of the Public Bodies (Admission to Meetings) Act 1960 (which would have allowed the authority to exclude the public from the meeting in certain circumstances) shall not apply to any proceedings on that question.

Mr. Lawrence

I beg to move, as an amendment to the Lords amendment, in subsection (2), leave out 'three months' and insert 'six months'.

Mr. Deputy Speaker (Mr. Harold Walker)

With this it will be convenient to take the following amendments to the Lords amendment:

In subsection (2)(a), leave out 'one or more newspapers' and insert 'each newspaper registered at the Post Office as a newspaper'.

In subsection (2)(b), after 'authority', insert 'and Community Health Council'.

Leave out subsection (5).

In subsection (5), leave out 'as they consider appropriate'.

In subsection (5), leave out 'they consider appropriate' and insert 'is reasonable in all the circumstances'.

In subsection (5), leave out 'have such regard as they consider appropriate' and insert 'give effect to the clearly expressed majority of opinion, if any, arising from regard'.

Leave out subsection (6).

Mr. Lawrence

The amendment goes to the root of the question whether the consultation process has any meaning, and what is meant by "publicity".

I am afraid that neither the water authorities nor the Government want to publicise fluoridation schemes because they know that the people do not want them, there will be a reaction, discussion and objections, hon. Members will receive letters about it, Colonel Blunt will write, and that that hassle can he avoided if there is no publicity. Pretence that publicity is an issue towards which the Government, water authorities and health authorities are strongly inclined is bogus.

Clearly publicity is not wanted because the authorities wish to go ahead with fluoridation whatever the views of the people. A couple of years ago the National Anti-fluoridation Campaign commissioned the British Market Research Bureau Limited to carry out a public opinion poll. To the question, "Do you think people should be allowed to choose whether or not they and their children will have more fluoride in the water they drink?" sixty-seven per cent. said "Yes", 22 per cent. said "No", and 11 per cent. said "Don't know". That is as clear as a public opinion poll can be. The overwhelming majority do not want fluoride in their water; they want to choose.

When the Government, water authorities or health authorities are faced with such a statistic, they do not want to publicise that that is what most of the public is thinking. They want the antithesis of publicity. That is why the contents of the Bill are a pretence at publicity, and why I have tabled the amendment.

It is no good if the time of publicity is so short that nobody can object. In July and August, in particular, people go on holiday, and if there are only three months for the publicity to take effect we know what will happen during those months—the same as happened when the closure of our grammar schools was publicised. Publicity will be given so late that meetings cannot be organised in time to lobby water authorities. We have seen it all before. It is old hat. The shorter the period for publicity, the less hassle.

To protect the interests of those who do not want this evil substance to be repeatedly flushed down their throats, the Government, if they are genuine about the need for publicity, will give a reasonable period for that publicity. Therefore, the amendment extends the period from three to six months. That seems reasonable and sensible, and I am sure it will have the support of my colleagues.

The next feeble requirement regarding publicity is that one or more newpapers should carry the advertisement. That looks good if one does not know what it means. The Government can get away with advertising in a newspaper that no one reads because the circulation is so small. A newspaper is not defined and it need not be any number of newspapers so that everyone in the area can see it. Only the minimum number of people need be given the opportunity to see the publicity. That is not good enough.

If publicity means what the Government should mean, people should know in advance whether there are proposals to fluoridate. Therefore, advertisements should be circulated in every newspaper operating in an area. If that is too wide a definition, I suggest that it should be circulated in each newspaper registered at the post office. That would be a bona fide newspaper — one which people buy or which people receive in ever larger numbers as a give-away. Every proper newspaper should carry publicity of the proposals. That is what the people expect. They do not expect the advertisement to be hidden in a newspaper with the least possible circulation—a pokey advertisement on a page that no one reads.

The advertisement should be published not only in the local authority area, but in the whole of the area of the community health council. That might mean publicity in a few more newspapers, but if the object of the exercise is as the Government pretend, they should prove to he House that they mean what they say. There is no reason why such publicity should not be given.

The integrity of the Government is at stake. They boast that plans will be well publicised and that they will not sneak up secretly when people are not watching. They say that the opportunity will be given to consult and object. That must mean that the maximum number of responsible, acceptable and respectable newspapers in a certain area will publicise the plans in sufficient time to allow representations to be made.

Secondly, there is the question of consultation. I shall not repeat the earlier debate, although there is a great deal to be said. In essence, the proposals for consultation are absolutely meaningless. They are hollow and have no effect. The Lords amendment has no teeth. If there is no need to act upon the views of the people, that is undemocratic. Water authorities do not have to act on the result of the consultation because the new clause provides: Where a health authority have complied with this section in relation to the proposal they shall, in determining whether or not to proceed, have such regard as they consider appropriate—

  1. (a) to any representations which have been made.….
  2. (b) to any consultations which have been held."
Has there ever been a more feeble provision in any Bill requiring action by an authority respecting the wishes of a democracy? It is hopeless, a pretence and shallow. It is conning the people into believing that there will be some great protection as a result of the Bill. It cons hon. Members. In the early stages of the Bill they asked for the right to be consulted, and the Government said, "Do not bother to read the Bill; we will introduce a consulting measure and make a great concession to the anti-fluoridators." To say, in determining whether or not to proceed, have such regard as they consider appropriate is a pitiful form of words, apart from being a split infinitive. This is the third gross grammatical error in the Bill. It shows that the measure has not been properly examined. It is a bit of rubbish, a pretence at regularising the position with talk of concessions on publicity and consultation. Something should be done because the phrase "as they consider appropriate" means nothing. It is zero, nil, zilch. It means "We are the bosses. We tell you. That is what you will have."

To strengthen the provision and give it some teeth—if only false teeth — I suggest that we remove the subjective test "as they consider appropriate" and substitute the objective test, is reasonable in all the circumstances. The provision would then read: Where a health authority have complied with this section in relation to the proposal they shall, in determining whether or not to proceed, have such regard as is reasonable in all the circumstances … to any representations which have been. made". That would not solve the problem, but it would remove the deception from the clause because it would provide an obligation which could be tested in the courts. The phrase reasonable in all the circumstances is a well known legal test. A court could be asked whether the objections were substantial enough. If, as in the west midlands area, practically every county council, district council, some community health councils and nearly all parish councils say that they do not want it, if public opinion polls such as the Leicestershire one say no, and if there are positive expressions of opinion objecting, all of that can be tested.

A petition has reached me today from the people of Winchester to the Winchester health authority. I have not had an opportunity to consult my hon. Friend the Member for Winchester (Mr Browne), who supports us in this matter, but the petition contains more than 1,000 signatures I now hand it to the Minister, who I trust will respond appropriately. Over 1,000 people in Winchester say it they do not want this law. We should pay attention to what the people want. While the clause remains subjective, using the words "as they consider appropriate," it is a sham.

Mr. James Wallace (Orkney and Shetland)

The hon. and learned Gentleman has really answered my question. I wondered whether there was a judicial interpretation of the phrase that he seeks to substitute and whether the body concerned, if it was faced with the volume of protest that he suggests exists in the west midlands, would have discretion to take a decision against that volume of protest.

Mr. Lawrence

I am afraid so. We have tried throughout the proceedings on the Bill to get the Government to accept that if a district, community or community health council said that it did not want fluoridisation, then it should not have it. Failing that, we are, by such amendments as this, saying that the test should be one of reasonableness. One could go to the courts and say that a decision is unreasonable. My phraseology—that the provision should be reasonable in all the circumstances—is one from which the aggrieved people of Winchester, for example, could say that the provision of the Act says: Where a health authority have complied with this section … they shall, in determining whether or not to proceed, have such regard as is reasonable in all the circumstances and the court could rule. At least they would have something that is not a pretence to sustain them.

The amendment means, for example, that it would not be reasonable to fluoridate where every local authority, the majority of local authorities, or even a significant number of the local authorities were against it. It would not be reasonable to fluoridate where the costs would be great, where the fluoride output from the factories was so high that people's intake of fluoride was great anyway, or in any area where the incidence of dental caries is particularly low. The British people would understand those tests of reasonableness, and I ask the House to support them tonight by voting for my amendment.

Mr. Best

I welcome the insertion of a consultation clause into the Bill, and I congratulate the Government on having inserted it. It does not go far enough, because it still does not give expression to the individual will or to the majority of opinion clearly expressed in a particular area. Nevertheless, it is better to have some consultation than to have none, and I hope that my hon. Friend the Minister for Health will accept my congratulations to the Government.

However, there is no need for consultation in many, if not all, areas that receive artificially fluoridated water. We know the clearly expressed opinion of the people living in those areas. Every form of survey that has been conducted, some more efficacious than others I accept. shows loud and clear the message that people do not want fluoride added artificially to their water supply.

In my constituency, not only is the local authority against fluoridation, although it would be consulted under this provision, — we know the answer there — but the community health council. Despite that, fluoridation continues on Ynys Môn. How would the Government get through their business if they said on the Whip list, or to the pay-roll vote, that such Members could vote "as they consider appropriate". I suspect that it would not be regarded as a particularly effective way of getting Government business through the House. However. through the Lords amendment, there will be a requirement that the health authority should do no more than have regard to representations "as they consider appropriate." That is why I am grateful to Mr. Speaker for having selected my amendments. It ought not to be the health authority which has to pay regard. as it considers appropriate, to expressions of opinion. The individual consumer ought to be asked whether he or she considers it appropriate to have to drink fluoridated water.

2.45 am

It has already been said that if public opinion is overwhelmingly against fluoridation a health authority will bow to that expression of opinion. That is a forlorn hope. Views against fluoridation have been clearly expressed in areas where the water is fluoridated, yet fluoridation continues. Gwynedd health authority continues to fluoridate Anglesey's water supplies, yet every opinion poll and every locally elected body is against it. That shows how much health authorities disregard public opinion. Even if provision were to be made for consultation, I suspect that health authorities would continue to disregard publicly expressed views.

One of my amendments therefore deletes the words "as they consider appropriate". Another amendment seeks to delete the words have such regard as they consider appropriate and to insert give effect to the clearly expressed majority of opinion, if any, arising from regard to those representations. That might have some effect. If a health authority were required to act upon a view that had been clearly expressed by the people in its area, consultation might work, but there is a lacuna in the clause which causes me grave concern. As drafted, it would enable consultation to take place when a new scheme is proposed and also when a health authority proposes to terminate a scheme. However, no provision is made for consultation in those areas which are already receiving artificially fluoridated water. Those areas which are not fluoridated will benefit from the consultation process, as will those areas where the health authority seeks to terminate fluoridation, but that is small cheer for those areas whose water supplies are fluoridated. They will continue to be fluoridated. They will not be consulted.

Mr. David Atkinson (Bournemouth, East)

Can my hon. Friend suggest what form of consultation there should be in those areas which are naturally highly fluoridated? Those who live in areas where the water supply is naturally highly fluoridated may not wish to receive it. Surely they, too, ought to be consulted about whether or not the fluoride that occurs naturally in their water supply should be reduced.

Mr. Best

There is little substance in my hon. Friend's point. One can do little about what occurs naturally. We are debating the artificial introduction of fluoride into the water supply and we are considering whether the artificial fluoridation of that supply should continue.

Mr. David Atkinson

If my hon. Friend is suggesting that it is dangerous for those receiving water which is artificially fluoridated, he must also be saying that it is dangerous for those receiving water which is naturally fluoridated. Surely, therefore, he would wish the same provision to apply to those areas.

Mr. Best

No. We are debating amendments to a Bill which will give power to health authorities to introduce a noxious substance into the water supply — [Interruption]. It is a poison. If noxious substance is not an adequate description, perhaps another can be found. We are debating whether fluoride should be introduced into water supplies which do not have the fluoride poison in them and whether people should have a say on that.

The consultation clause enables people to have a say, but it gives no consolation to my constituents or to the people in other areas which already have fluoride added artificially to the water supplies. Consultation with them will not be required after the passage of this Bill into law. That is a serious matter which is made more serious by the fact that this is a clause de novo. Consultation has not been required of health authorities in the past when they applied to a statutory water undertaker to introduce fluoride.

People who already receive fluoride under existing schemes will never have had the opportunity of consultation and they will not be offered a facility for consultation under the Bill. I like to think charitably that that was an oversight by the Government. I believe the Government were exercising good will in introducing a consultation clause. Therefore, it is an oversight that an opportunity for consultation will not be given to people who already have fluoride added artificially to the water supply.

I want my constituents to have the right under the Bill to say whether they want fluoridation to continue and for the health authority to have regard to their wishes. Whether they have regard to it as they consider appropriate is a matter for debate. In any event, surely my constituents must have the right to express their view in such a way that it will be taken note of, if nothing more. At present there is no facility for that.

Subsection (6) of the proposed new clause says: The Secretary of State may direct that this section shall not apply in relation to any proposal of a health authority to withdraw an application or to terminate a preserved scheme. If I were a pro-fluoridationist I would be upset about that, because it does not give people the right to say that they want to keep fluoridation. Under that provision the Secretary of State will be able to say, "Do away with consultation." If a health authority proposes that fluoride should be removed from the water supply, the pro-fluoridation lobby may have no say. I do not know whether the Government introduced that provision in an overzealous manner to try to buy off the anti-fluoride vote, but, if I were in favour of mass medication by means of fluoridation, I would be upset at the inclusion of that provision in legislation.

Consultation is a good concept but it is meaningless unless it has some bite. The consultation proposed in the Bill, sadly, has no bite, but even more seriously it has no relevance to people like my constituents, who already labour under artificial fluoridation and have clearly expressed their opposition to it at every opportunity given to them. Under the Bill they will still have no right to be consulted.

Mr. Hayhoe

I am grateful to my hon. Friend the Member for Ynys Môn (Mr. Best) for his welcome to the clause covered by Lords amendment No. 6. I contrast his kindly comment, although I understand that he would like the clause to go rather further, with the rather sour comments of my hon. and learned Friend the Member for Burton (Mr. Lawrence).

Before commenting on some of the amendments, I should say that the new clause results from Government commitments made on Report by my predecessor and the then Parliamentary Under-Secretary of State that the Bill should place upon health authorities and boards a statutory obligation to undertake general public consultation before deciding to apply to a statutory water undertaker for fluoridation, and that the Bill should require health authorities to discuss these matters in public.

My hon. and learned Friend the Member for Burton was unduly pessimistic, and in much of his comment discounted many of the public bodies concerned in this process. His amendment (c) suggests that the consultation period should be extended from three to six months That is rather unreasonable. Three months is sufficient to carry out a reasonable consultation process. At times, we have managed to hold general elections within three weeks, and certainly more normally within six weeks. This is allowing double that time.

My hon. and learned Friend also suggested that the information should be given in each newspaper registered at the Post Office as a newspaper. That would extend the field in a most remarkable fashion, and it would mean that one would have to advertise fluoridation proposals in papers like The Sporting Life and various religious newspapers. That is obviously absurd and, given the public interest in matters of this kind and the various pressure groups, these proposals will not be carried through in the still of the night with no one knowing. They will be the subject of considerable public debate, and it is right and proper that should be so.

My hon. Friend the Member for Ynys Môn suggested that the words, "as they consider appropriate" should be deleted from subsection (5) of the new clause. If he reads it carefully, he will see that that would render the new clause meaningless, and the state that his amendment would leave it in would be even worse, by his own judgment, than it is at the moment. The new clause carries through the commitments given by my predecessor and our hon. Friend the Parliamentary Under-Secretary of State at that time, and I commend it to the House. I hope that the House will resist the various amendments to the proposed Lords amendment.

Mr. Lawrence

I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Amendment (h) proposed to the Lords amendment, in line 23, leave out 'they consider appropriate' and insert 'is reasonable in all the circumstances'.—[Mr. Lawrence.]

Question put, That the amendment be made:—

The House divided: Ayes 10, Noes 109.

Division No. 304] [2.59 am
Beith, A. J. Skinner, Dennis
Best, Keith Stevens, Martin (Fulham)
Brown, M. (Brigg & Cl'thpes) Wallace, James
Cocks, Rt Hon M. (Bristol S.)
Ground, Patrick Tellers for the Ayes:
Howarth, Gerald (Cannock) Mr. John Golding and Mr. Ivan Lawrence.
Jones, Gwilym (Cardiff N)
Alison, Rt Hon Michael Lyell, Nicholas
Ancram, Michael MacGregor, Rt Hon John
Atkins, Robert (South Ribble) MacKay, John (Argyll & Bute)
Atkinson, David (B'm'th E) Major, John
Baker, Rt Hon K. (Mole Vall'y) Malone, Gerald
Baker, Nicholas (N Dorset) Mather, Carol
Biffen, Rt Hon John Maude, Hon Francis
Boscawen, Hon Robert Mawhinney, Dr Brian
Bottomley, Peter Mayhew, Sir Patrick
Brittan, Rt Hon Leon Mellor, David
Brooke, Hon Peter Mills, Iain (Meriden)
Brown, N. (N'c'tle-u-Tyne E) Moore, John
Buchanan-Smith, Rt Hon A. Moynihan, Hon C.
Burt, Alistair Newton, Tony
Butcher, John Nicholls, Patrick
Carlisle, Kenneth (Lincoln) Normanton, Tom
Chalker, Mrs Lynda Norris, Steven
Channon, Rt Hon Paul Ottaway, Richard
Clark, Hon A. (Plym'th S'n) Page, Sir John (Harrow W)
Clarke, Rt Hon K. (Rushcliffe) Page, Richard (Herts SW)
Colvin, Michael Patten, Christopher (Bath)
Cope, John Patten, J. (Oxf W & Abdgn)
Couchman, James Pawsey, James
Currie, Mrs Edwina Pollock, Alexander
Dobson, Frank Raison, Rt Hon Timothy
Dorrell, Stephen Renton, Tim
Douglas-Hamilton, Lord J. Ridley, Rt Hon Nicholas
Dunn, Robert Rifkind, Malcolm
Durant, Tony Robinson, Mark (N'port W)
Edwards, Rt Hon N. (P'broke) Roe, Mrs Marion
Eggar, Tim Rumbold, Mrs Angela
Fenner, Mrs Peggy Ryder, Richard
Fowler, Rt Hon Norman Sackville, Hon Thomas
Fraser, Peter (Angus East) Shaw, Giles (Pudsey)
Garel-Jones, Tristan Soames, Hon Nicholas
Goodlad, Alastair Spicer, Michael (S Worcs)
Gow, Ian Squire, Robin
Gregory, Conal Stanley, John
Gummer, Rt Hon John S Stern, Michael
Hamilton, Hon A. (Epsom) Stewart, Allan (Eastwood)
Hanley, Jeremy Stewart, Ian (N Hertf'dshire)
Hayhoe, Rt Hon Barney Thompson, Donald (Calder V)
Henderson, Barry Tracey, Richard
Howard, Michael Waddington, David
Howe, Rt Hon Sir Geoffrey Wakeham, Rt Hon John
Hunt, David (Wirral) Waldegrave, Hon William
Hurd, Rt Hon Douglas Walden, George
Jenkin, Rt Hon Patrick Wardle, C. (Bexhill)
Jessel, Toby Watts, John
Jopling, Rt Hon Michael Whitney, Raymond
Joseph, Rt Hon Sir Keith Wood, Timothy
King, Rt Hon Tom Young, Sir George (Acton)
Lang, Ian
Lennox-Boyd, Hon Mark Tellers for the Noes:
Lilley, Peter Mr. Michael Neubert and Mr. Tim Sainsbury.
Lloyd, Peter, (Fareham)
Lord, Michael

Question accordingly negatived.

Lords amendment No. 6 agreed to.

Lords amendments Nos. 7 and 8 agreed to.