House of Lords written question – answered on 21st July 2009.

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Photo of Earl Baldwin of Bewdley Earl Baldwin of Bewdley Crossbench

To ask Her Majesty's Government further to the Written Answer by Lord Darzi of Denham on 9 June (WA 143), whether the undertaking by Lord Warner on 8 March 2005 that "fluoridation schemes would only be introduced where the local population were in favour" (HL Deb, col 706) still represents Government policy.

Photo of Lord Darzi of Denham Lord Darzi of Denham Parliamentary Under-Secretary, Department of Health, Parliamentary Under-Secretary (Department of Health)

Section 89 of the Water Industry Act 1991 as substituted by the Water Industry Act 2003 requires strategic health authorities to consult and ascertain opinion before proceeding to make a request to a water undertaker to increase the fluoride content of its water supply. The Water Fluoridation (Consultation) (England) Regulations 2005 (SI 2005/921) make detailed provision about how consultation and the ascertainment of opinion is to be carried out. Regulation 5 sets out the pre-condition to a strategic health authority proceeding to request a water undertaker to increase the fluoride content of its water supply.

Regulation 5 is in the following terms:

"A Strategic Health Authority shall not proceed with any step regarding fluoridation arrangements that falls within section 89(2) of the Act unless, having regard to the extent of support for the proposal and the cogency of the arguments advanced, the Authority are satisfied that the health arguments in favour of proceeding with the proposal outweigh all arguments against proceeding".

The decision under Regulation 5 is to be made by the strategic health authority, not the Secretary of State. Regulation 5 therefore makes clear that it is for the strategic health authority to decide if the health arguments outweigh all other arguments taking into account not merely the cogency of the arguments, but also,

"the extent of support for the proposal".

It is clear that, under Regulation 5, support is a relevant factor, but it is not the only factor or the conclusive issue. It can be outweighed by the health arguments. A majority of local support is not therefore a necessary precondition to the strategic health authority requesting a water undertaker to increase the fluoride content of a water supply.

Government policy is not, and could not be, inconsistent with the regulations. In particular, it could not convert the reference in Regulation 5 to support as a relevant factor into a necessary precondition for a request for fluoridation.

We accept that there may have been a degree of understandable confusion over these issues in the past. However, by way of clarification, the view given by the Chief Dental Officer in February 2008 that,

"a SHA cannot base its decision solely on a simple count of the representations for or against the proposal", correctly represents government policy. Regulation 5 sets out the law and government policy cannot and does not seek to add to it. It is the for the strategic health authority to take the decision to ask a water undertaker to increase the fluoride content of a water supply and to make the judgment required under Regulation 5 as to whether the health arguments outweigh all other arguments. Local support is a relevant factor but is not a precondition for a request.

Does this answer the above question?

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No2 people think not

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Sustianbility Yours
Posted on 28 Jul 2009 8:57 am (Report this annotation)

So consultation on Fluoride means;

1) Don't act democratically
2) Non-health and non-scientist (The SHA Boards) make decisions on potential toxicology and epidemiology issues on our behalf.

Nice touch that, if the majority of the consulted public 'want' fluoridation, and not the real way round, when the majority of the public understand that clean un-molested water is what is wanted, a little ironic that.

When will the SHA understand that all the 'safe and effective' research is faulty, based on a teeth only approach to the study and 1940's corporate science, and not whole body effects, of which all the science points to very real high risks of harm, and first hit, like lead in petrol, are our children.

Fluoride is a poison, not a medicine
Water is for drinking, not for medication

Elizabeth McDonagh
Posted on 29 Jul 2009 10:37 am (Report this annotation)

From Day 1 of the Consultation, NHS South Central had a blind belief in fluoridation’s safety and effectiveness against tooth decay. This is evidenced by the public money they spent on flooding the area concerned with costly promotional material to persuade the public to give support to their totally irrational views. Had 51% of the public acquiesced, they would have claimed victory. 72% said ‘NO’ so they had to find the public’s views ‘non-cogent’. They spent more public money in that process.

The 20 studies indicating that fluoride reduces IQ in children were dismissed on the grounds that they had not allowed for confounding factors – but neither had the comparative studies of tooth decay rates on which SCSHA’s entire proposal was based.

SCSHA dismissed as ‘not relevant to Southampton and Hampshire’ the (US) National Research Council’s report “Fluoride in Drinking Water”, a scientific review of toxicologic, epidemiologic and clinical data on fluoride, which confirms that fluoride builds up in the body throughout life; that excessive fluoride adversely affects the teeth, thyroid gland, bones and brain and that some subsets of society are extra-susceptible to fluoride’s adverse effects.

Dr. Elise Bassin PhD, in 2006, published a study showing that osteosarcoma, in teenagers, is seven times more likely to occur if fluoridated water was drunk between the ages of 5 and 8. We are still awaiting publication of the study which South Central SHA indicated would contradict Bassin’s findings. So much for SCSHA’s insistence that the public should back their arguments with impeccable peer-reviewed scientific evidence.

Fluoride is a poison, not a nutrient. With fluoridation, there is no control on the amount of fluoride anyone consumes as people drink different amounts of water and receive fluoride from other sources such as food, drinks, toiletries and prescription medicines. There is no adequate margin of safety to protect vulnerable individuals and groups from overdose. Infants are at particular risk if their formula feed is mixed with fluoridated water.

Campaigners seek the early repeal of the legislation which allows public opinion to be so shamefully disregarded. Prospective Parliamentary Candidates should be questioned as to whether they support mass medication via the water supply. We urgently need a return to democracy, reason, sound science, and above all, ethics. The State should not be allowed to medicate anyone without fully informed consent.

Elizabeth A McDonagh

Posted on 30 Jul 2009 12:55 pm (Report this annotation)

Only if fluoridation practice were demonstrably entirely safe and self-evidently dentally - and thus economically - effective might it be considered to be 'worthwhile public dental health policy' - and Government might conceivably then be justified in legislating so as to override people's right to refuse a form of compulsory medication via the public water supply that they did not want - most probably because they had heard other views from independent sources, whose statements they felt very strongly were both cogent and reliable.

To clarify these points:

re Safety: York CRD (2000) stated that, in view of the paucity of high quality research into all of the possible negative health effects identified, they could come to no clear conclusion about any specific adverse health effect. They then recommended that high quality research must be conducted in a number of specific areas before any Government could justifiably recommend fluoridation practice as 'safe'. Since then the U.S. National Research Council Report (2006) has been published, detailing high quality evidence of harmful effects (including evidence from sources that were not even considered by York). These harmful effects would certainly apply to specific vulnerable sub-groups of any population if they were exposed to artificial fluoridion at 1 ppm. This means that the best available scientific evidence does not find mass fluoridation to be 'safe'. The NHS relies exclusively for its views regarding safety on periodic 'expert reviews'- conducted under the auspices of public health dentists, who are clearly insufficiently qualified even to appreciate the quality of all the evidence they choose either to review, or to ignore. Such biased reviews are not worth the paper they are written on in the context of any serious public debate of this key issue of safety.

re dental effectiveness: York CRD could find no high quality evidence, but only evidence of moderate quality for any possible beneficial effects of fluoridation in reducing both the prevalence and the subsequent rates of change of dmft/DMFT carious decay statistics. But the most recent studies identified were notable principally for reporting, accurately, the derisory dental benefits that can currently be derived in the countries under mass fluoridation, now that far more effective topical fluoride dental preparations are in almost universal use throughout all fluoridated and non-fluoridated populations alike.

This data also shows clearly that artificial fluoridation schemes, costly to set up, to maintain and to run, cannot possibly be considered 'cost-effective' under the conditions that prevail today. Most of the caries statistics used by public health dentists in their attempts to make a viable case for further fluoridation schemes, as are now happening across the country, were ruled out of consideration as reliable evidence of benefit by York, simply because they signally fail to consider all the relevant confounding factors. Evidently, then, there is no reliable evidence today for any worthwhile dental health benefits across any child or any adult population. To prevent socially deprived families from succumbing to 'runaway caries' it is clearly necessary to target such families with sound advice, effective preventive measures and sufficiently early dental treatments as required. This properly funded approach has been shown to cost far less than the inevitably poorly targeted fluoridation schemes that have been recommended largely for the specific problem of child populations suffering from extreme social deprivation.

Conclusions: any public health official who today declares that fluoridation really is 'safe and very effective' and that 'it also represents the best available use of scarce NHS dental funds' would find it extraordinarily difficult to explain under oath to a Court how he/she could ever have become genuinely convinced that these statements, and many more similar ones, were indeed truthful.

The National Pure Water Association is committed to achieving the total dismantling of all U.K. Government legislation that is currently in place to support the propagation of mass fluoridation - and it will, indeed, go to Court if necessary in order to obtain justice, under the effective law of the land, for every individual member of the European Union who happens currently to reside in England, Wales or Northern Ireland.

Ian E Packington MA Cert Tox
Science Adviser to NPWA