HL Deb 02 May 2001 vol 625 cc693-6

2.50 p.m.

The Lord Bishop of Durham asked Her Majesty's Government:

Whether they have any plans to amend the law so that decisions about fluoridation of water rest with them rather than local authorities or the water industry.

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)

My Lords, a review of the research evidence on fluoride and health undertaken by the University of York reported last September. The report confirmed that the fluoridation of water reduces tooth decay and found no evidence of serious risk to overall health, but was critical of the quality of the evidence available. We asked the Medical Research Council for advice on how the research base might be strengthened and we are consulting the water industry about the report. Once we have its responses, we will decide if changes should be made to the current legislation.

The Lord Bishop of Durham

My Lords, I am grateful to the Minister for that reply. However, I should like to press him a little more in view of the fact that, as long ago as 1998, the Minister for public health said that the legislation was a mess and the White Paper published in 1999 said that the legislation needed revising. How much longer are we to wait while the responsibility lies with those bodies which are accountable to their shareholders rather than to the public?

Lord Hunt of Kings Heath

My Lords, the right reverend Prelate is right to point out that health authorities have found it a major problem in that they went through a proper consultation process and requested water companies to add fluoride to the water but found themselves frustrated. However, we committed ourselves to a course of action which included asking the University of York to undertake this review. As I said, while overall the conclusions were satisfactory, York did identify weaknesses in the whole fluoride research base. It is appropriate therefore to ask the Medical Research Council to review what further research might be undertaken. On the basis of those findings and discussions with the water companies we shall consider whether or not legislation needs to be brought forward.

Lord Glenarthur

My Lords, how many current local authorities or water authorities who are responsible for these matters either do or do not undertake fluoridation of water? Can the Minister say a little more about whether or not there are adverse effects from fluoridation in view of the fact that it was promulgated strongly in the 1980s that it was a major benefit and appears largely to have been just that?

Lord Hunt of Kings Heath

My Lords, I am happy to give the detailed information to the noble Lord in writing. Essentially, around 5.5 million people in this country are covered by fluoridation schemes and another 500,000 receive fluoride because it is naturally present in the water. A number of health authorities would like to add fluoride to the water but have been frustrated because of the policies of water companies.

The York review looked at a number of studies and found that, in essence, there was no evidence of adverse effects other than dental fluorosis. I say again that, because there was concern about the quality of the evidence reviewed, we felt it right to ask the Medical Research Council to give us further advice.

Lord Tomlinson

My Lords, perhaps I can declare a non-financial interest as president of the British Fluoridation Society. Is my noble friend aware that the parts of the West Midlands that I represented formally, both in another place and in the European Parliament, benefited substantially from the fluoridation of water supplies by Severn Trent Water? Is he aware also that the benefits of that fluoridation are well reflected in dental health statistics for individual health authorities in the West Midlands? Should not those benefits be more widely available and soon?

Lord Hunt of Kings Heath

My Lords, I agree with my noble friend that a number of districts in the West Midlands which have fluoridation schemes have a low incidence of dental disease, particularly among young people. That is why the Government still recommend to health authorities that in those areas where dental disease is high, fluoridating the water remains the most effective way of improving oral health. However, it is right in an evidence-based approach to ask the Medical Research Council for further advice on potential further research evidence.

Lord Clement-Jones

My Lords, while broadly supporting the Minister in his referral of the matter to the Medical Research Council, does he agree that the key issue is that these decisions should be taken locally? Will he undertake, before the MRC comes up with its conclusions, to investigate whether or not these matters can be determined by local referendum, which in many ways would be the most satisfactory way of determining the matter?

Lord Hunt of Kings Heath

My Lords, the noble Lord's comments will always be given the utmost consideration. The current position is that health authorities are responsible for consulting with the local community before making a formal decision on whether or not to apply to a water company for fluoridation. When my right honourable friend Mrs Tessa Jowell developed the policy of the current Government, she said that one part of a review of legislation would be to see whether or not we should transfer the responsibility for fluoridation to local government. We will of course consider that matter. It is also worth making the point that in the current Health and Social Care Bill we envisage local authority overview and scrutiny committees taking on a scrutiny role in relation to health service matters and that may be an issue we need to look at in relation to fluoridation.

Lady Saltoun of Abernethy

My Lords, I have always understood that a high level of fluoride in the water supply may have an adverse effect on the kidneys. Has that issue been properly investigated?

Lord Hunt of Kings Heath

My Lords, the work undertaken by the University of York looked at a total of 31 studies which considered the possible negative effects of fluoride in relation to various potential diseases. Overall the studies examining those negative effects indicated that they provided insufficient evidence on any specific outcome to permit confident conclusions and that further research needed to be undertaken in those areas. That reinforces our decision to seek further advice from the Medical Research Council. Overall the York review concluded that, apart from fluorosis, there was no evidence of serious diseases being caused by fluoridating the water supply.

Baroness Trumpington

My Lords, is the Minister aware that I took the fluoridation Bill through this House in order to clarify the legal position for new areas to become eligible to introduce fluoridation? Is he further aware that, as a result of fluoridation, which Birmingham started in the 1960s, Birmingham now has the best teeth in England? I wish that I had lived in Birmingham in those days so that I did not have to smile at myself at night!

Lord Hunt of Kings Heath

My Lords, it is not too late for the noble Baroness to join us in Birmingham. I pay tribute to her work in taking that Bill through the House of Lords. If only the word "shall" had been in that Bill instead of "may"!

Lord Stoddart of Swindon

My Lords, does my noble friend agree that the University of York study showed that only a moderate 15 per cent of the children's group benefited from fluoridation? Is not that scant reward for compulsory mass medication, which I believe to be against the interests of the whole of the population of this country?

Lord Hunt of Kings Heath

My Lords, a 15.5 per cent reduction in the prevalence of dental disease is a worthwhile result from the fluoridation of water. The debate on mass medication has been well and truly aired in this House. The fact is that almost all water contains some naturally-occurring levels of detectable fluoride. That is not mass medication.