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Health Inequalities

Part of the debate – in the House of Commons at 5:23 pm on 4th March 2020.

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Photo of Paul Beresford Paul Beresford Conservative, Mole Valley 5:23 pm, 4th March 2020

I congratulate Mary Kelly Foy on her maiden speech. It was interesting; funnily enough I did not agree with a considerable amount of it, although that is to be expected.

I am the second working medical professional to speak, following my hon. Friend Dr Poulter. We are both from the same party and speak with some knowledge of the difficulties that we face. The moment that this sort of debate comes up, health professionals from our own particular field have a go at us.

I was delighted that the Minister referred to child dental health, on which I feel a push from behind every time there is a health debate. When I first came to this country, I worked in a really deprived area of east London. Trying to treat children there was like trying to fill a bath with the plug out. The statistics for child dental health are still grim today: 23.3% of five-year-olds have tooth decay, rising to 33.7% in deprived areas. The rate drops to 13.6% in less deprived areas, but it is still bad. Tooth decay is the single greatest reason for hospital admissions for five to nine-year-olds. Last year, 25,702 children went to hospital because of tooth decay. Worse than that, 45,000 children and young people aged up to 19 went to hospital because of tooth decay.

The estimated cost of treating these children in hospital is about £50 million annually. Virtually all children will require a general anaesthetic. Every anaesthetic, especially for little ones, carries a risk—an unnecessary one. The cost is made worse because those cases occupy trained health professionals and hospital facilities that could be used for other NHS services. It makes me very cross because dental caries, as the Minister has said, are virtually entirely preventable. Put simply, the cause is acid from sugar and dental plaque. Britons eat about 700 grams of sugar a week—an average of 140 teaspoons. That intake is not spread evenly; it is higher in the north and lower in the south-east. As Members might expect, teenagers have the highest intake of all age groups, consuming, probably, about 50% more.

The Government are taking action and the sugar tax is helping. Sara Hurley, the chief dental officer, along with many charities and organisations, has a drive to teach children, even down to day nursery children, how to brush their teeth. It is helping but, as the Minister mentioned, far and away the best proven method to reduce tooth decay among children—and even, to some degree, among adults—is the fluoridation of the water supply. Fluoride increases the resistance of tooth enamel to decay dramatically. In the United Kingdom, approximately 330,000 people have naturally occurring fluoride in their water supply. Traditionally, another 5.8 million in different parts are supplied with fluoridated water. But that covers only 10% of the total population. The cover in the United States is about 74% and rising. In Canada, it is 44% and rising, in Australia, it is 80% and rising, and even little New Zealand has managed 70% and rising.

We do have fluoridation legislation, but it is left to local authorities to instigate the process and to compel water companies to fluoridate their water supplies. There is no financial advantage for local authorities if they take such action, but the savings that come through to the NHS are considerable.

The second problem with the legislation is that few local authority boundaries are coterminous with the boundaries of the water companies, which means that the direction and implementation get difficult, complex and sometimes nigh on impossible. To my mind, the simple and sensible answer would be for the application to be put into the hands of the Department of Health and Social Care so that the policy could be applied step by step across the country, going for the most deprived areas first. That is a big ask and it will require a brave Government, but from reflecting on the Labour party’s previous position on fluoridation, I would hope for Labour’s support.

Whenever I raise the issue of fluoridation, the green ink flies. Letters come in and broomsticks whizz around my house as people come up with extraordinary contrary points. The latest Department of Health figures show that the odds of experiencing dental health decay in fluoridated areas were reduced by 23% in five-year-old children in the less deprived areas, and by 52% in those living in the most deprived areas.

Water fluoridation reduces hospital admissions for dental extractions for children by 59%, and in deprived areas by as much as 68%. We have the opportunity to be world leading, to give our children this chance, and to combat health decay and children going to hospital.