HL Deb 04 July 1985 vol 465 cc1384-93

8.35 p.m.

Further proceedings after Third Reading resumed.

Baroness Trumpington

My Lords, I beg to move that this Bill do now pass.

Moved, That the Bill do now pass—(Baroness Trumpington.)

Lord Campbell of Croy

My Lords, I should like to thank my noble friends Lady Trumpington and Lord Caithness who for many long hours at various stages of your Lordships' proceedings have carried the burden of the day in explaining the reasons for the Bill and the clauses line by line. I should also like to express appreciation to the noble Lords, Lord Ennals and Lord Winstanley, for the part that they have played in raising good and legitimate points in the course of the Bill.

The other thing I should like to say at this stage is that it has been a Bill which does not follow party lines. The views of Members of your Lordships' House have not been governed by party considerations and the Division votes have shown that individual views have been expressed. But there is one matter to which I should like to draw attention and that is the anti-fluoridation campaign. I am on its distribution list and receive its material. In the letter sent out after our earlier proceedings dated 20th April the chairman of the National Anti-fluoridation Campaign from an address in Thames Ditton wrote as follows: Whereas it was almost heresy to suggest in 1966 that vested interests lay behind the pressure for fluoridation and that doctors who promoted it were serving … as the unpaid agents of big business, scarcely anyone now questions the existence of these vested interests and it follows that everyone who promotes fluoridation is acting as an agent of these interests". The allegation that we are simply serving the interests of "big business", as it has been described, is denied by those of us who over many years have been considering carefully the advantages and possible disadvantages of fluoridation and who have come down in favour of it for health reasons. I received individually this accusation five years ago when I initiated the debate in your Lordships' House on fluoridation. I should like to draw attention to this and point out that it is a monstrous, an absolutely outrageous, suggestion and it discredits that organisation to have put it forward. No one for a moment would think that those of us in this House on both sides who have been considering this matter are motivated by the interests of big business. The reason given is that surplus fluoride arises as a by-product of industry and that this is a way of using it. I utterly reject that suggestion.

It is revealing that the same correspondence sent to me among others says that certain noble Lords in your Lordships' House were "rapidly briefed" on this subject, even though they knew very little or nothing about it beforehand. I leave that for your Lordships to think about. But if the campaign against fluoridation proceeds on those lines, it will thoroughly discredit itself.

Lord Ennals

My Lords, I wish I could be as charming as the noble Lord, Lord Campbell of Croy, has been, though I agree absolutely with the first point that he made. I am not on the hit list, fortunately, but I take, as he does, grave exception—

Lord Campbell of Croy

My Lords, I am not on a hit list; I am on a distribution list. I think they think that I am one of the people apparently being briefed.

Lord Ennals

My Lords, that is what I meant. It was not a misunderstanding. I meant that I am not on their mailing list. I have not had such an accusation but I should take just as grave an exception to that kind of allegation. I do not think there are any vested interests. It is true that it will be a costly operation and that the capital cost will be about £150 million if it is carried out all over the country. But I am afraid that I do not think that will happen.

I believe that the Government have made a mess of their handling of this issue. If they thought with all their experience—which the noble Baroness has displayed and I thank her for doing so—that it was in the best interests of the nation that everyone should have fluoride in their water supplies then why, in Heaven's name, do the Government not decide to do so? They can bring forward a Bill to the House of Commons which says that from now on from an appointed day water authorities will fluoridate the water. Why did they decide simply to be gutless, as I think they were, and put the decision on to other people instead of taking the decision themselves? What they have done is not only to put it on to other people but to put it on to other people who are not accountable to anyone except the Ministers. I believe that that is the coward's way out.

I think that one of the consequences of this for those who strongly believe in fluoride, in whatever form, is that there is not going to be anything like the success that the Government probably would like there to be and which the health authorities would like there to be. I hope that before this Bill reaches another place—which of course it will, because it has been amended by the amendment moved by the noble Baroness—the Government will take reasonable regard (if that is the right word) of the fact that twice this evening they came very close—within less than a handful of votes—to defeat and that they will take reasonable regard of what has been said by the noble Baroness's noble friends behind her as well as by noble Lords facing her.

I have found the responses of the Minister not very satisfactory. I agree with the noble Lord, Lord Monson, that there has been extraordinary inflexibility. My belief is that the purpose of a debate like this is to take the wisdom of the House, where the wisdom of the House proves to be right, and to accept it. I believe that the role of Ministers is really to take what is best out of a debate. My feeling is that the Government have (with the one exception) just sat and fought it out, refusing to give way. I fear that the consequences of this will be a continued argument in the country for years and years. When I was Secretary of State, I was anxious that the matter should be resolved; and I do not think that it has been resolved by this Bill.

Lord Winstanley

My Lords, I was very pleased that the noble Lord, Lord Campbell of Croy, said what he did, because I think it was necessary to say those words. I too, having been associated with the campaign for the fluoridation of water supplies for some 30 years, have, not surprisingly, received literature and correspondence of precisely the kind described by the noble Lord, Lord Campbell of Croy. How right he is to say that this surely exposes some of those campaigners for what they actually are. Perhaps I could take this opportunity to say that those of us who are in favour of this measure have none of those kinds of criticisms of noble Lords in this House who have taken an opposite view in the course of our debates.

It is true that we have differed, in all parties and some in no party, on the matters. We have had disputes and we have disagreed fundamentally. But I like to feel that we have disagreed amicably and that, while we may still disagree, perhaps at least we understand one another's points of view better than we did before. I think we all appreciate that we hold with total sincerity the views that we hold. As a doctor and as one who has spent a great deal of his life campaigning against pollution of one kind or another—and in another field of activity, as chairman of the Countryside Commission I did a great deal about insecticides, herbicides and pollutants of one kind or another about which I was very fearful—I assure noble Lords that I would not support a measure of this kind without looking at it with extreme vigilance and great care. I say that I have done so as a doctor over many years. Had I not been totally satisfied about the safety of fluoridation I would not have taken the stand that I have taken on this particular Bill.

I should like to say how grateful I am to noble Lords of all parties and no party who have supported this Bill, limited measure though it is. I agree with the noble Lord, Lord Ennals, that it is a limited measure, and I rather regret that. I take the view, after 30 years of discussion, that perhaps it might have been wiser sooner or later to move to a mandatory measure. However, the Government have taken this somewhat hesitant step and I think they are to be congratulated on taking that step; because once the Government got involved in this subject of fluoridation, a highly emotive one, they knew perfectly well that they were going to attract an awful lot of flak of the kind to which the noble Lord, Lord Campbell of Croy, has referred.

Perhaps I may say that when I agreed to become president of the British Fluoridation Society I too knew that I was going to attract a certain amount of flak and correspondence. I have done so, but perhaps I may say to the noble Baroness—and I should like to express my personal appreciation of the manner in which she has handled the debates and the way in which she has obtained a grasp of very complex matters in a very short time—that she is to be congratulated. I assure her that every cloud has a silver lining. Among the correspondence I have received is this letter. It comes from a lady in Pershore in Worcestershire. It is a very pleasant village. The letter says: Dear Lord Winstanley, I was astounded to hear you as a doctor supporting this horrifying scheme for adding fluoride to our water supplies". It goes on and on and finishes: Finally, I should like you to know that never, never again will I vote Conservative". That cannot be bad! It really reinforces me in my view that the efforts we have made on this Bill have been well worthwhile.

Lord Monson

My Lords, I should like to echo the tribute paid by the noble Lord, Lord Campbell of Croy, to the noble Baroness, Lady Trumpington, and the noble Earl, Lord Caithness. Having said that, I must part company with him. It is true that this is not strictly a party political measure; yet I understand that in another place every sort of pressure was brought to bear, every sort of arm-twisting was applied to BackBenchers to make them support the Bill, with the consequences that the noble Lord, Lord Winstanley, has just described. The Conservative Party used to be thought of as the party least hostile of all the major parties to the concept of individual freedom. Now, alas, that perception has, I think, changed very considerably. Conservatives are now thought to be somewhat contemptuous of individual freedom, despite the valiant efforts of so many Back-Benchers in both Houses of Parliament. I think we shall see the results of this tomorrow when the result of the by-election at Brecon and Radnor is announced.

Lord Sandys

; My Lords, I disagree with some of the comments of the noble Lord, Lord Monson, because I do not see this as largely a political debate or a political Bill. I see it as a Bill of great importance arising from the longest case in Scottish legal history. My feeling is not one of levity but one of sorrow at the end of this because, having studied the subject with great concern for over 20 years, I reached the exact opposite opinion from that of the noble Lord, Lord Winstanley. Perhaps I entered at the point at which I was a most enthused opponent of fluoridation; and I do not deny that my motivation for studying it had that in mind.

Nevertheless, I believe that there are most serious matters that even now have not been fully discussed; indeed, it was almost impossible within the scope of the Government's programme for handling this Bill to discuss them. However, there is Lord Jauncey's judgment, and perhaps I may be permitted in these last moments in which the Bill is being discussed before this House to draw attention to page 79 of that very long judgment. I think that to some extent this is the answer to Lord Ennals's question as to why the Government did not legislate firmly on the matter of fluoridation. This is what Lord Jauncey said, and perhaps it is the answer. I only put that tentatively. I quote his words from page 79: Counsel for the petitioner submitted that I could only reject the epidemiological case if I were satisfied that there was no possibility of fluoride causing cancer. I could not be so satisfied on the evidence in this case and, indeed, proof of such a negative would be very difficult if not nearly impossible". The noble Lord, Lord Jauncey, considered many aspects, if not all aspects, of this situation with very great care. I think that in discussing it in your Lordships' House we have attempted to investigate as far as possible the areas of research; but, even now, it seems to me that there are areas of dubiety, of doubt and of uncertainty which we have not fully investigated.

I close my remarks by thanking the noble Baroness for her careful and at times humorous replies to your Lordships. Nevertheless, I feel that the Government have been very resistant to even the most minor of amendments. I hope that as this matter progresses, as indeed it will progress, we may have more fruitful discussions on further consideration of this important subject.

Lord Colwyn

My Lords, althouth I am clutching a handful of notes you will be relieved to hear that at this late hour I have rejected most of them. Having personally been involved with the arguments about fluoridation for over 20 years, I am delighted to be here this evening to set the seal on this enabling legislation. I too congratulate my noble friends Lady Trumpington and Lord Caithness for the way in which they have handled this very sensitive subject.

Those of us who are perhaps more fully acquainted with the facts and figures about the supplementation of public water supplies of the natural fluoride content to bring it up to one part per million and the certain benefit that it can have on our children's and our own teeth, have had a very interesting series of debates. We determined not to intervene too often for fear of prolonging the arguments, but there were times when statements from the opponents of the Bill were just too misconceived to be allowed without interruption. I certainly respect the views of those opponents but I feel that they have failed to examine in detail any of the evidence emanating from the scientific sources, preferring instead to believe the ill-informed comments of a small minority whose views are highly eccentric and based on purely selfish arguments.

Lord Sandys

No, my Lords!

Lord Colwyn

My Lords, I ask myself: why has there been such recurring popular resistance to a simple health care measure of proven benefit to everyone's teeth? More than 10,000 scientific studies have shown that adding one part per million of fluoride to water will safely and effectively inhibit tooth decay, particularly if fluoride is consumed during the first nine years of a person's life. I must stress again that the addition of fluoride at one part per million not only gives benefit to children whose teeth are developing but is also of benefit throughout life, owing to the continuous availability of the fluoride ion. The fluoride content of dental enamel doubles, and of dentine trebles, throughout life, fluoride supplements in the form of tablets, drops or fluoridated milk can theoretically provide fluoride to developing teeth, but continuous availability is not provided.

Why is it that neither studies nor facts convince a determined coalition of anti-fluoridation activists? They have repeatedly challenged the authority of virtually every major national and international health group and campaign to keep fluoride out of the country's water supply. To some degree, the "antis'" success also grows out of a long tradition of popular hostility to tampering with nature. Milk was not pasteurised during the 1920s; nor were children immunised against diphtheria and small pox without an initial public outcry. Chlorine is now routinely added to water supplies to destroy the bacteria responsible for cholera, typhoid and dysentry. But when the idea was first proposed at the turn of the century opposition was fierce. More recently, scientists have encountered similar bouts of public anxiety about gene splicing and artificial heart implants.

What is peculiar about the fluoridation controversy is that it has been going on for 35 years. During an era marked by unprecedented gains in science and medicine, the perils of fluoridation have repeatedly won support from people supposedly well informed about matters of health and quick to applaud other new medical technology. A 1978 issue of consumer reports described the persistence of the controversy as one of the major triumphs of quackery over science.

This reduction of decay is not a trivial matter. Dental caries is responsible for a great deal of morbidity and for an appreciable number of deaths from indisciplined dental anaesthesia and from bacterial endocarditis. The suggestion that fluoridation is unnecessary because there are other equally effective methods of preventing dental decay, such as the daily administration of fluoride supplements by tablets, drops or milk, has the disadvantage of relying on strict adherence to a regimen by children and parents which, from experience, cannot be maintained.

Before I conclude, I should like to mention the work of the British Fluoridation Society, who have worked tirelessly over the years to present information about fluoridation to anyone who is interested or who had questions or doubts which needed answers. In particular, I must also mention the chairman, Professor Douglas Jackson, who has devoted the greater part of his professional life to research, analysis and presentation of the case for the fluoridation of water supplies. I am delighted to see him here this evening and hope that our passing of this Bill will go some of the way towards achieving his ambition of seeing this simple public health measure legalised and eventually in use throughout the country.

Finally, my Lords, the fluoridation question is almost tailor-made for endless controversy in a democratic society. Fluoridation, unlike chlorination, is not a life or death matter. Its scientific rationale has little emotional appeal. When it comes to a vote, fluoridation is largely a symbolic issue. Arrayed against its adoption have been, and always will be, not only the fanatics and the fearful but also a goodly proportion of those who simply distrust authority, government and science. Those people will not go away—nor, in all respects, would the nation be better off if they did. As long as the issue is left to local determination, we should expect the fluoridation controversy, in all its bizarre and time-honoured variations, to crop up in towns and cities for many decades to come. This is one of the prices—not the dearest, but not the smallest either—that we have to pay for having our kind of open political system.

Lord Houghton of Sowerby

My Lords, the noble Lord has probably listened a great deal more than he has spoken during our debates, but he has just made up for it in a most impressive way. We all listened enchanted by the catalogue of medical achievement and argument in favour of this Bill. It sounded very much like what the doctor ordered, but we are used to that from doctors. Even my noble friend Lord Winstanley sounds like a doctor occasionally.

I rose really in a spirit of thanksgiving to the noble Baroness, tinged with a little forgiveness, for the number of rejections which she has had to offer to various well-intentioned and suitable amendments. Frankly, it is a gruelling task being on the Front Bench and dealing with all the arguments of those who believe their amendments contain the gems of wisdom and the fruit of long experience. We much appreciate how the noble Baroness takes all this and, if I may say so, she is a very pleasant Minister to deal with—

A noble Lord

Hear, hear!

Lord Houghton of Sowerby

My Lords, may I say just one word to the noble Viscount the Leader of the House, whom I see in his place. He must be feeling that this has been a very long day and that he has taken enough, thank you very much. I offer just one humble word of advice; that I think we are moving into a different regime in this House. We have become more important and more publicised, and there is a desire to become more powerful and to take a more definite place in the combined activities of the two Houses of Parliament. I think that what we are suffering from is the inability of our present arrangements occasionally to respond, as I think is needed, to the mood of this House. That is due to the fact that the Government Front Bench in this House comprises people of great ability who are gaining in experience but who do not have the authority to do what a Minister in their place would very frequently feel bound to do, or at least feel that it was desirable to do.

I think we are lacking here the art of parliamentary activity, because the Ministers are not here. We have to put up with that—we cannot have all the Ministers here; but I think that greater authority, more flexibility and more room for manoeuvre should be in somebody's hands in this House; otherwise I think we are going to get rather more fractious than we should do. On this Bill, and indeed on other Bills recently, I do not think we have been quite as happy as we ought to have been; and that is due to the fact that we feel that although the voice is the voice of Jacob the hand is the hand of Esau, and that is not here.

It is very difficult indeed to do business on that basis. I was in Government for quite a time and have been in Opposition for many years in another place—but how the wheels of Parliament are lubricated by accommodation, by the gesture to Oppositions, who after all have got the most difficult role in Parliament! Our parliamentary system deprives the Opposition of any responsibility for the affairs of the nation. Very often it is packed with experience and knowledge and yet it is unable to make any impact on the Government. There is no power sharing under our Parliamentary system. I think that that is a great drawback.

I offer those observations. I think that the Government will have a rougher time from your Lordships' House as time goes on because that is how it will develop. I think that it will require great wisdom and study to see what the solution may be. I feel, however, that the longer we leave tackling the reform of your Lordships' House the more difficult it will become. I am sure that something has to be done in the next two or three years about this House if we are to know what its function is to be and if people here are to get more satisfaction out of it.

9 p.m.

Baroness Gardner of Parkes

My Lords, as the second dentist in this Chamber I must, of course, say how delighted I am that this Bill has reached this point. I take issue with the comments of the noble Lord, Lord Ennals, as to why the Government did not go ahead and compel everyone to have fluoride everywhere. I think in fact it is evidence of the genuineness of this Bill that it is simply to put into a correct legal position those authorities which have fluoride in their water and are presently not in such a position. When the noble Lord says that it should have been a compulsion—and indeed he went on to say he wanted it resolved when he was Secretary of State—I cannot see, if he wanted it so much, why it did not happen then, because I believe that every standing dental and medical advisory committee since the war has voted in favour of this measure.

However, I think times have changed over the years. That is why the day may come when we do not see fluoridation everywhere in such a universal way as we should have if the measure had been passed, say, 20 years ago because a number of other measures are improving teeth now. We have all heard about vested interests. Indeed, at the beginning someone accused me of having a vested interest. I said that I had a vested disinterest because, after all, it will do me out of business as a dentist. The reason your Lordships have heard quite a lot from the dentists in this House, who, like my noble friend Lord Colwyn, have been rather restrained, is because there are no dentists in the other place. Therefore the dental voices have to speak up here.

I would say that this has been a very non-party political issue. The noble Lord, Lord Sandys, for example, has been completely sincere in everything he has said. No one has given me greater help and assistance since I came as a new Member to this House. I therefore appreciate his sincerity and I respect him for it. I think that he is wrong; and I hope when the Bill is passed to persuade him of that.

I would congratulate the noble Baroness, Lady Trumpington, because she has this marvellous good humour which has carried us through many tedious hours on this Bill; and of course the noble Earl, Lord Caithness. As regards the statement of Lord Monson that proof of such a negative is difficult, this has been one of the difficulties throughout this Bill. People have been trying to prove things that are negative and it is almost impossible to do so.

When the noble Lord, Lord Houghton of Sowerby, tells us about parliamentary activity, and the art of it, he is rather an expert on that; but when he talks about people being fractious—well, again, perhaps he is rather an expert on that. I thank your Lordships for passing this Bill to this point. I thank those in the Front Bench for doing so.

Lord Burton

My Lords, this debate has continued in an amazingly good-natured manner on what has been a very contentious issue. The good nature must reflect on those members on the Front Bench. On this question of whether this is non-political or not, I think some of us on this side would certainly have lost the Whip had it been political. Indeed, I never expected on an amendment of mine to be supported by the number of noble Lords who supported me. Perhaps in particular I may mention the noble Lord, Lord Houghton of Sowerby. We have crossed swords on many issues before but I was pleased to see that we were at one on this. I came fairly open minded to this subject. I am afraid I have left a firmly convinced antifluoridationist.

Baroness Trumpington

My Lords, I should like to pay tribute both to those who have supported the Bill from all sides of this House and indeed to our opponents for the very high standard of debate we have enjoyed. It has been, let me remind you, a free vote throughout.

Before I move on, may I just pause in order to express my very real sorrow concerning the death of the noble Lord, Lord Energlyn. He was, of course, one of our opponents to whom I have just referred. Like all really clever men, he never made one feel a fool—charming and modest, and a very distinguished Member of your Lordships' House. We will all miss him greatly.

It has been rightly stressed by several of your Lordships that there is much public interest in the subject of fluoridation. For the Government, the Water (Fluoridation) Bill has provided the opportunity to submit to your Lordships' scrutiny the current arrangements for water fluoridation and to discuss in detail the dental and general health issues. I am sure that this in itself has been a very worthwhile exercise and that we have been able to raise the level of public knowledge on this most important issue.

I hope your Lordships will agree that we have been able to improve the Bill during the various stages of our consideration. Indeed, as a result of our deliberations the Bill has doubled in length! I would single out for particular comment Clause 4 of the Bill, where I hope the Government have been able to meet the legitimate concerns expressed by your Lordships and in another place that there should be specific statutory procedures for public consultation in advance of any decision by a health authority to apply for or seek to terminate a fluoridation scheme. In addition the Government have responded to your Lordships' wishes by providing a specific role in the consultation process for elected local councils, while leaving the final decision to health authorities to take in the light of all the representations they receive and the authoritative medical and dental advice available to them.

We have also amended the Bill in several respects to meet concerns expressed to us by the water industry. In particular, we have added to Clause 1(6)(b) to repair an oversight in respect of the routine maintenance of the water supply. Clause 3 of the Bill also I am sure, represents a major improvement in laying down a specific statutory framework for the existing fluoridation schemes. I feel that this would be an appropriate point for me to pay tribute to the water industry for their assistance over the Bill and also for their efforts in administering water fluoridation schemes. We in the Government recognise that this constitutes an additional burden for the industry, and we are particularly appreciative of the achievements of those water authorities and water companies who carry out water fluoridation.

I feel that I cannot do better than repeat what my noble friend Lord Glenarthur said at the Second Reading of this Bill, that it is an intentionally modest measure designed solely to provide specific legal powers for arrangements for fluoridation which have operated in this country for nearly 30 years.

On Question, Bill passed, and returned to the Commons with amendments.

House adjourned at eight minutes past nine o'clock.