HL Deb 20 January 1997 vol 577 cc381-4

2.58 p.m.

Baroness Brigstocke asked Her Majesty's Government:

Whether the board of directors of Northumbrian Water is entitled to refuse to accede to the request from eight health authorities to improve the dental health of their clients by extending fluoridisation of their water supplies to some 1.7 million residents in the north east.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)

My Lords, the interpretation of Northumbrian Water's powers and responsibilities under the Water Industry Act 1991 is a question for the water undertakers initially, but ultimately for the courts.

Baroness Brigstocke

My Lords, I thank my noble friend the Minister for that reply. Do the Government agree that failing to fluoridate water supplies is contrary to the interests of public health? Does the Minister further agree that legislation needs amending in order to make fluoridation mandatory once health authorities have decided that the move would have significant public health benefits to the population and particularly to children?

Baroness Cumberlege

My Lords, we agree with my noble friend that fluoridation is a very cost-effective and clinically effective way of preventing tooth decay. That is especially true in children, but it also has long-term effects in adults. We also believe that it is a matter for local decision. Legislation is already in place to enable water companies to fluoridate at the request of health authorities once they have consulted with the general public. We encourage water companies to consider such requests very carefully.

Lord Dean of Beswick

My Lords, before the water authority took this action were the people in the area receiving fluoridation? If so, is it not high-handed for the water authority to withdraw such a measure, which is a proven health guard for children's teeth on a massive scale?

Baroness Cumberlege

My Lords, I understand that Northumbrian Water is an amalgamation of previous water boards and that parts of the area which it now covers were receiving and continue to receive fluoridated water. However, the areas which were not previously fluoridated remain that way, which is a decision of the water company.

Lord Elliott of Morpeth

My Lords, does the Minister accept that the three water companies in northeast England, which are now joined together as Northumbrian Water, have consistently over many years accepted the guidance of health authorities in this regard and that fluoridation has always been a highly controversial subject? The problem for the companies is that they must make the final decision and, as this is a social rather than a business issue, they strongly believe that legislation needs to be altered. Is my noble friend aware of the recent discussions between the Water Companies Association, the Fluoridation Society and the British Dental Association, all of which agreed that there should be legislative change?

Baroness Cumberlege

My Lords, I am grateful to my noble friend for clarifying the situation as regards Northumbrian Water. We believe that the legislation is adequate. We understand that between water authorities there is some difference in regard to its interpretation and the department has prepared guidance which is almost ready to be circulated. It is still in draft form and we have consulted widely on it. We hope to circulate it in the spring.

Baroness Fisher of Rednal

My Lords, as honorary president of the Fluoridation Society—I receive no emoluments—I am disturbed by the Minister's interpretation of the Water Act. Is the Minister aware that the Act was amended to make it perfectly clear that if the health authorities do their work correctly—that is, get in touch with all the persons concerned, have a public meeting at which fluoridation is agreed, and then ask the water authorities for that to be done—fluoridation can be put into operation and the water companies cannot say, "No, we are not playing the game"? It seems strange that the Government do not know whether they are coming or going.

Baroness Cumberlege

My Lords, I can assure the noble Baroness that the Government are definitely coming. She has clearly stated the situation as she sees it as honorary president of the Fluoridation Society. It is a matter for local decision-making and we believe that Northumbrian Water has acted within its powers. However, we believe that there is room for further clarification and that is why we shall be publishing a circular in the spring.

Baroness Gardner of Parkes

My Lords, the noble Baroness, Lady Fisher, her time being limited, did not of course mention that Birmingham has had fluoridated water for longer than any other area of the country and has by far the best dental health in the country. Has my noble friend seen the press release on this subject which was put out by Northumbrian Water? In that it gives its doubt about the legality as its reason for refusal. Following the lengthy Strathclyde case, it was made plain that there was no clear right to put fluoride in the water. For that reason, in 1985 the Fluoride Act was passed by Parliament. Therefore, is it not wrong for the water authority to make a commercial decision—it is quite entitled to make a decision on such grounds—but then to hide behind the test of possible legal doubt when Parliament has passed an Act to permit the measure?

Baroness Cumberlege

My Lords, I understand that Northumbrian Water acted within its powers. It also acknowledged that fluoridation improves dental health. However, if the health authorities are concerned that the decision was unreasonable they have recourse to the courts.

Baroness Jay of Paddington

My Lords, it is good news that the Department of Health will be issuing further guidance on the matter. However, can the noble Baroness today give a little more clarification to local health authorities? Are the Government prepared to allow the situation which appears to have developed in Northumbria and elsewhere throughout the country, in which local health authorities are spending hard-pressed, much valued NHS resources on local consultation as regards fluoridation, only then to be told by privatised water companies that that cannot go ahead? There appears to be a strange balance of priorities.

Baroness Cumberlege

My Lords, the situation is clear with regard to the Act. As I have said, as with a lot of legislation, people choose to interpret it differently. The guidance which will be issued in the spring will set the matter clear once and for all.

Lord Campbell of Croy

My Lords, can my noble friend confirm that all the water from natural sources in this country contains fluoride—it is a natural ingredient—and that the optimum percentage already exists in certain areas? Does she agree that if the matter is left to individuals to ingest fluoride they can take far too much, resulting in, for example, discolouration of the teeth?

Baroness Cumberlege

My Lords, as my noble friend said, fluoride is a natural product in some water. However, the intention of the Act is to ensure that where there is not sufficient to prevent dental caries more can be added. Mottling occurs when fluoride is at a much higher level. Although that is not harmful it is certainly found to be unattractive. I believe there is nothing further to say.