Polio: Pakistan and Afghanistan

Baroness Eaton Excerpts

Thursday 24th October 2019 Lords Chamber

[Baroness Sugg]

The noble Lord is quite right; we have recently seen two confirmed outbreaks of vaccine-derived polio in the Philippines, which is such a shame, coming 20 years after the country eradicated that disease. We are running a campaign in the Philippines, in collaboration with the WHO and UNICEF, to launch a widespread immunisation campaign to give millions of children the polio vaccination there. The noble Lord is quite right that we must ensure that we continue to invest in water, sanitation and hygiene in the poorest parts of the world to ensure that this disease is not spread. It also shows that we must not take our foot off the pedal on this; we have seen a country that has not had an outbreak in 20 years suffering, so we must continue until we completely eradicate this disease.

[Baroness Eaton (Con)]

My Lords, as has already been said, today is World Polio Day. Will my noble friend join me in paying tribute to Rotary International for being in the forefront of the work on eradication for over 30 years?

[Baroness Sugg]

I am very pleased that my noble friend highlights the work of Rotary International. As she said, it has been at the forefront of the work to eradicate polio for more than 30 years, and it is a founding member of the WHO Global Polio Eradication Initiative. I will certainly join my noble friend in paying tribute to it today and I sure that many noble Lords will want to do the same. Rotary International has contributed more than £1.3 billion to the global initiative, which includes more than £32 million raised in Great Britain and Northern Ireland alone. My Secretary of State, Alok Sharma, was pleased to attend an event with Rotary International yesterday, where he met fundraisers and survivors of the disease.

Queen’s Speech

Baroness Eaton Excerpts

Monday 21st October 2019 Lords Chamber

[Baroness Eaton (Con)]

My Lords, I declare my interests as a vice-president and former chair of the Local Government Association.

The Queen’s Speech has set an ambitious agenda, and quite rightly so. Life in the communities of this country continues irrespective of the trials and tribulations of the Brexit issue. There is much in the Queen’s Speech that I welcome, as many of the proposals are signs of progress. As we implement these changes, we must ensure that we listen to the needs of our local communities. Because time is short, I will focus on only two issues which I believe my insight into local government leaves me well equipped to talk about: the Domestic Abuse Bill and the devolution White Paper.

Domestic abuse is a hugely important issue, one which I know we all take very seriously. The LGA and others have long supported the need for a domestic abuse Bill. This Bill is a legislative landmark. It will provide the first definition of domestic abuse that is not limited to violence. Women’s Aid has said that it has the potential to create a step change in the national response. I am sure all noble Lords would agree that this is promising.

The creation of a domestic abuse commissioner will also help to raise the profile of this issue and ensure that the momentum behind it continues. For their part, councils will work collaboratively with the commissioner to support good practice across the country. However, I want to highlight that there also needs to be a greater focus on prevention and early intervention, to tackle the root causes of domestic abuse in the first place. Councils are best placed to lead on this agenda, but their ability to provide support services is currently limited by significant budgetary pressures. The Government must ensure that councils, and their partners, are given the resources they need.

Ahead of the Queen’s Speech, the LGA also called for a new devolution settlement. Across the board, services can be delivered better when councils have the freedoms and funding to make local decisions. Devolution is the key to progress for local communities. The Prime Minister has shown his commitment to the devolution agenda and I welcome the Government’s proposed White Paper. It is particularly important as there have been no new devolution areas agreed in the last two years. When deals have been agreed, we have seen a focus on cities and individual negotiations. With this White Paper, we must go further. The mayoral combined authorities have already begun to demonstrate the real, tangible benefits of devolution, but that model does not suit everyone. We cannot continue to leave the rest of the country behind.

I was delighted to hear the noble Lord, Lord Bichard, refer to Total Place. Having been involved in discussions on Total Place and its early stages, I support his desire to see it being reconsidered and brought forward. The noble Lord, Lord Scriven, who believes that the Treasury does not deal well with local government, might find that Total Place could be part of a good solution to that issue. As the White Paper is developed, I hope that national and local government can work in partnership to ensure that they work for all local areas. We need to move towards a package of sustainably funded devolved powers, available to all English local government. This in turn will ensure prosperity and growth across our country.

I conclude by once again welcoming this Queen’s Speech. Its proposals will allow us to work together to protect our most vulnerable residents and ensure our long-term success and prosperity as a nation. For this to happen, the Government must work with local leaders, who are best placed to understand our communities and the challenges they face. I look forward to hearing the Minister’s thoughts on a new collaborative approach. Together we can continue to make a difference for people across England.

Offensive Weapons Bill

Baroness Eaton Excerpts

Committee: 1st sitting (Hansard): House of Lords
Monday 28th January 2019 Grand Committee

[The Earl of Listowel]

I thank the noble Baroness for her intervention. I think we are saying the same thing: we need to put the money where it can be effective. We can put money into the community in many different ways, including increasing the number of community support officers or police officers on the beat. In particular, young men—so many of whom are growing up without fathers in the home—need to find mentors they can identify with and so begin to turn their lives around, as I have seen so often myself. Those services are effective, but they are easily cut. I am concerned that, in progressing with short prison sentences, we are actually throwing money down the drain. However, I see that the Government are in a difficult position. They need to be seen to be making a robust response to something that so many people are afraid of.

[Baroness Eaton (Con)]

I support the words of my noble friend Lady Newlove. Much of what the Committee has heard this afternoon about corrosive substances has referred to the appalling use of them by young people. Statistics on this are more difficult to find than on some of the other offences that we will be discussing later. I have serious concerns about the connection with drugs. The threat of acid attack is regularly used on young people involved in county lines.

One thing we have not mentioned this afternoon is the terrible situation of violence against individuals in domestic abuse situations, which is less frequent and not often reported. Surely short-term sentences will not deal with that. This is not the same as the pressures on young people to conform to gangs and so on. This is something quite different and I would like to think that there are very serious responses to that in our system.

[Lord Paddick]

If I could assist the Committee at this stage, these amendments relate to the offences of selling and delivering to young people, not to the possession of corrosive substances by young people. We are talking about sending the owner of the corner shop or the Amazon delivery man to prison for delivering these substances into the hands of people who are under 18. I want to ensure that noble Lords are aware that that is what we are talking about in this group of amendments.

Offensive Weapons Bill

Baroness Eaton Excerpts

2nd reading (Hansard): House of Lords
Monday 7th January 2019 Lords Chamber

[Baroness Eaton (Con)]

My Lords, I am pleased to be able to contribute to today’s Second Reading debate on this welcome and very necessary Bill. Violence in all forms is unacceptable, particularly when dangerous and offensive weapons are involved. Such violence gives rise to serious harm and has a traumatic impact on individuals and their families. There is a serious likelihood that in an environment where individuals carry and use weapons, this will contribute to an increase in weapons carried by others, who will feel the need to defend themselves from unlawful violence or to protect a criminal enterprise and the proceeds of that enterprise.

The Bill has been widely welcomed as being overdue and very necessary. In a changing environment the Bill provides a set of norms and makes it very clear what is not acceptable in a civilised society. I was most interested to hear the excellent speech of my noble friend Lord Bethell, as I share his interest in crimes associated with acid attacks. The Centre for Social Justice has collected evidence in relation to corrosive substances, to identify current attitudes and evolving norms and codes of behaviour. Its work involved networks of victims and self-identified at-risk groups. It received 236 responses to a short survey, some of the highlights of which showed some very surprising and concerning information. Some 78% were in fear of being subject to an acid attack; 78% said there were areas where they would not go for fear of being attacked with acid or a knife; 89% felt that the Government were not taking the issue seriously; 75% believed that the police were not taking the issue seriously; 89% believed that police should routinely test substances being carried by suspects; 94% wanted to see tougher penalties for those carrying acid; 73% believed that carrying acid should be treated more severely than carrying a knife; and 90% believed that we should tackle the root causes behind such crimes. As many speakers today have recognised, behind these crimes are things that we need seriously to address.

Additionally, a charity working with the CSJ provided information that some of those at greatest risk of being involved in serious youth violence—as an offender or a victim—reported that acid is easier to conceal than a knife; for example, by transporting it in a water bottle. Acid can be used at a greater distance than knives or other points or blades. Acid causes serious and potentially lifelong injuries but is unlikely to result in death. An individual can use acid more effectively than a knife against a group of individuals at once. Acid is often readily accessible. Corrosive substances can often be found under the kitchen sink, or equally easily as bleach on a supermarket shelf.

It is welcome that the Bill makes it an offence to sell a corrosive product to persons under 18 or for a seller to deliver to a residential premises when the sale is made remotely. However, I do not believe that all violent attacks involving corrosive products have been committed by someone under 18. Extending the age to 21 is something we should consider. The Bill provides law enforcement officers with appropriate investigative and enforcement powers in relation to the offence of possessing a corrosive substance in a public place. It will be vital for the Home Office to give appropriate support to police forces most affected by the rise in acid attacks, and to equip front-line officers with testing kits. The kit will need to allow for the routine testing of substances carried by suspected offenders or those who might be at risk of carrying acid in preference to other weapons. The Bill should send a clear signal and curtail the growth in this offence, and sentencing should be more severe. The sale of corrosive substances should be subject to the same standards of checks as those for the sale of knives. To change behaviour, there needs to be an increased risk of detection. The testing equipment needs to be low-cost and available to the majority of front-line police officers.

The Bill is an important strand of the Government’s serious violent crime strategy. The strategy is being led by the Home Office, but there needs to be work across all government departments and agencies. Tackling serious violent crime requires multiagency partnerships across education, health, social services, housing, law enforcement and local government. Most importantly, it requires a strong emphasis on and investment in early intervention. For the Bill and the serious violence strategy to be successful, sufficient resources for all agencies with an essential role must be made available.

Economy: Budget Statement

Baroness Eaton Excerpts

Tuesday 13th November 2018 Lords Chamber

[Baroness Eaton (Con)]

I declare my interests as a vice-president and former chairman of the Local Government Association.

It is a pleasure to make a brief contribution to this debate on the Government’s set-piece financial statement. The 2018 Budget contained a range of measures that can be welcomed. The Chancellor’s Statement shows that the Government are beginning to listen to local government’s call for much-needed investment in local services. Much more investment will certainly be needed in the long term, but it is good that the Chancellor has acted to provide some new money for councils.

Having served as leader of Bradford Metropolitan District Council and as chairman of the LGA, I know of the pressures facing local services. Indeed, the LGA’s analysis shows that there will be an overall funding gap of £7.8 billion facing local government by 2024-25. Of this, adult social care services face a £3.56 billion gap, just to maintain existing standards of care. It is pleasing, therefore, to see a cross-party consensus that adult social care is in desperate need of support, which is why the additional funding of £240 million for winter pressures is welcome. It will allow councils to better plan their services. Although vital, that funding will address only some of the short-term pressures facing adult social care. That is why a sustainable funding model is now long overdue. I refer noble Lords to the LGA’s timely green paper, and ask the Government to work with councils as they develop their own proposals.

Children’s services are also facing significant funding pressures. The LGA’s latest study shows that social workers are starting new cases for more than 1,000 children each day. The investment of £84 million for children’s social care over five years for programmes in some areas is good news, but councils face a £1 billion shortfall in the next year alone just to keep services running at current levels. With demand rising for special educational needs and disability support, it is important that the Government consider whether adequate funding is available to councils. The proposed changes to high-needs funding should address this. As local leaders gather for the National Children and Adult Services Conference in Manchester this week, I am sure that government Ministers will be taking their messages on board.

Investing in infrastructure is also an important objective of any Government. I am glad, therefore, that Budget Day marked the official abolition of limits on councils’ borrowing to build houses. We must not underestimate what a difference this will make to many communities. Councils are now eager to get on with the job of helping to tackle the housing crisis. It is welcome that they are moving towards resuming their historic role as major housebuilders.

It was also pleasing to see the Chancellor allocate £420 million in additional spending to local roads in 2018-19. This will help councils tackle one of the most important issues for local residents, and will make an impact immediately. The LGA’s latest resident satisfaction survey found that public satisfaction with the condition of local roads is falling. Taking urgent steps to plug the £9 billion roads repair backlog will help to reverse this. Everyone is affected by damaged roads and areas across the country will benefit from the initial funding provided. To maintain our local network, we must now move towards a strategic funding stream for road maintenance.

I commend the Government on a Budget that starts to deliver for local areas. The Chancellor has laid the groundwork for the spending review to address some of the long-term funding issues in areas such as children’s services, adult social care and infrastructure. We must all speak up for these vital services. Investing in local government is good for the nation’s health and well-being, as well as for our economic growth. I know that the Government are listening to this message and I look forward to seeing them work with councils to deliver the much-needed funding for our communities.

Budget Statement

Baroness Eaton Excerpts

Monday 4th December 2017 Lords Chamber

[Baroness Eaton (Con)]

I declare my interest as a vice-president and former chairman of the Local Government Association. It is a pleasure to follow the noble Lord, Lord McKenzie; in the past, it has usually been on matters of local government, where I take my hat off to him for being one of the most informed people on the subject. I have not always agreed with his decisions but I have been impressed by his knowledge.

To help the country to meet the challenges ahead, local government need the funding and fiscal freedoms to get on and deliver the high-quality public services and infrastructure that help our communities to thrive. The Chancellor made announcements in his Budget that will make a positive difference to local areas. Perhaps most importantly, as mentioned by many speakers today, he has recognised that our housing crisis is one of the most pressing issues we face as a country. It is good news that there will be more investment in housing and infrastructure, support for SME builders, and a greater focus on tackling rising homelessness. The Government have shown that they can be ambitious about tackling the country’s problems head-on by committing to building 300,000 homes a year.

However, we must remember that councils must be allowed to play their part if we are to meet these kinds of targets. We heard from the noble Lord, Lord Skidelsky, about Harold Macmillan building 250,000 to 300,000 homes a year, but he did not mention that 40% of them were built by councils. Back then, local government was trusted to get on with things and to deliver. It is therefore encouraging to see that councils in areas of high affordability pressure will receive additional borrowing powers to deliver much-needed homes for their communities. That is an important first step, but I would like to see the Government be much bolder and give every council in the country greater freedom to borrow to build new homes.

I believe that there are areas where the Government could go much further, especially in child and adult social services. I know that the Chancellor mentioned the local government finance settlement in his Statement to the other place. I would like to put on record some areas that I think the Government should prioritise as Ministers agree funding allocations for councils. Above all else, the Government must find the funds to ease the financial difficulties facing adult social care and children’s services—service areas that other noble Lords have already mentioned. Funding gaps and rising demands are placing hugely increasing pressures on councils. As the Local Government Association has highlighted, almost 60p in every £1 of council tax could have to be spent caring for children and adults by 2020, unless there are changes. It is not just councils saying this. In its report on the country’s economic and fiscal outlook, the Government’s Office for Budget Responsibility wrote:

“Local authorities remain under pressure as demand and costs for both adult and children’s social care rise”.


Such pressures are taking money from other services that keep our communities running, such as cleaning streets, gritting roads and many other services that communities rely on. In order to build desperately needed homes, create jobs, improve health and care support for our most vulnerable and boost economic growth, all councils need greater freedom from national government to take decisions over services in their areas. They also need the long-term resources to meet the demanding financial position in adult and children’s services.

The Budget made some progress, most notably on housing. I welcome that, but I hope that the Government will use the upcoming local government finance settlement to tackle the other issues that I raised today, which were not included in the Budget Statement.

Gaza Strip

Baroness Eaton Excerpts

Tuesday 21st March 2017 Lords Chamber

[Lord Bates]

I reiterate that the Government will continue to make representations to ensure that the suffering of the Gaza people is alleviated as far as possible. We are doing a number of things, such as in the area of reconstruction. We are contributing to the Gaza Reconstruction Mechanism, which has rebuilt 2,100 houses destroyed in the 2014 conflict. We are urging the Israelis to honour the obligations they gave in 2015 about the supply of water, which is critical to Gaza. We are also urging them to progress with the connection of the high-voltage 161 kilovolt transmission line to the area. At the same time, we urge those militant organisations in Gaza to restrain themselves and resist and renounce those violent attacks that are at the heart of the cause of this conflict.

[Baroness Eaton (Con)]

Will the Minister outline what steps, if any, are in place to ensure that none of the £25 million that the UK has pledged to the Palestinian Authority for 2017 to fund salaries for 30,000 officials in the West Bank health and education sectors goes towards rewarding terrorism and teaching hate?

[Lord Bates]

This is a very good example of where we are working with our European colleagues. We work through the EU PEGASE fund to distribute that part of aid. There is strict vetting to ensure that the only people who receive that salary support are legitimately providing healthcare and other medical services and teaching support in those areas. It is very important that we make sure that British taxpayers’ money ends up exactly where it is intended, helping those in need, and not funding people who have been guilty of terrorist acts.

Gaza: Reconstruction

Baroness Eaton Excerpts

Wednesday 29th October 2014 Lords Chamber

[Baroness Northover]

We urge restraint, as we always do, on both sides. Peace is in the interest of both sides—of the Palestinians and the Israelis.

[Baroness Eaton (Con)]

My Lords, last month Israel, the Palestinian Authority and the UN agreed to a tripartite mechanism to enable vital reconstruction materials to reach Gaza, while also ensuring they do not end up in the hands of the terror group Hamas. Does the Minister agree that this is welcome news and that we must encourage further such co-operation, which recognises the concerns of both parties?

[Baroness Northover]

I would agree with my noble friend.

Children and Families Bill

Baroness Eaton Excerpts

Wednesday 30th October 2013 Grand Committee

[Baroness Hughes of Stretford]

My Lords, I shall speak to Amendment 112, standing in my name; to Amendment 118, tabled by my noble friend Lady Wilkins, to which I have added my name; and to Amendment 114, tabled by the noble Lords, Lord Low and Lord Ramsbotham.

All the amendments reflect the strong view that the local offer should be strengthened to ensure that it is a statement that parents, children and young people can rely on and for which, particularly—the noble Lord, Lord Low, stressed this—the local authority can be held accountable. In order to do this, the amendments would create the minimum standards that have been called for both by the SEN sector and by the Education Select Committee.

It is right to acknowledge that in the lead up to the Bill arriving in this House, and, indeed, while it was in the other place, there was considerable debate across the sector as to whether minimum standards for the local offer were a good idea. People tried to evaluate the impact of having minimum standards or not. It is also fair to say that the broad and strong consensus now is that minimum standards are necessary to ensure reliability and accountability, otherwise there is a danger that we may end up with a postcode lottery of services. Again as the noble Lord, Lord Low, said, this is not about being prescriptive with local authorities but rather ensuring that no child or young person is left behind or suffers from a poorer service because of where they live.

The Government have said, and probably will say again, that they feel that minimum standards will create a race to the bottom, that they will constrain parents’ and young people’s ability to influence the local authority to increase service provision, and that that is to be avoided. The opposite is true. Equally one could argue that if you do not set a minimum there is a risk that councils will deliberately weaken their offer and undercut other councils to avoid families moving in because of resource constraints. There is a real risk that the quality of service locally will be entirely dependent on budgets and will be reduced.

Some organisations within the sector, for example, the RNIB, NDCS and Sense, have said that in the absence of any expectations on minimum standards, local authorities with better provision could reduce it in line with poorer neighbouring provision, and that too many services—I agree with this—are already at the bottom or below what parents should reasonably expect. The Government should move on this.

[Baroness Eaton (Con)]

My Lords, I seem to be a lone voice in the Committee today as I support Clause 30 in its current form. We should resist making any further amendment to the clause that would make the measures more prescriptive than they are already. To do so would needlessly hinder local provision for local issues that are not foreseeable from a national point of view. I therefore cannot support Amendment 118 and the others in the group which seek to introduce minimum standards for the local offer.

It is of concern to me that by introducing central prescription we would reduce the flexibility of local authorities to allow for local solutions. Government departments are unable to see the detail that is based on the daily contact and conversations with parents and young people and are unable to respond to individual and local needs. They cannot do that in the way that a local authority can. With a variance in funding for education, including SEN provision, across the nation’s local authorities such prescriptive measures could damage in a very real way the ability of local government to cater for the needs of local residents.

SEN provision varies between local authorities due to the nature and size of the local population, with greater needs for levels of service in some areas and much less requirement in others. By allowing local authorities to control their own provision, which these amendments would restrict, those authorities will be better able to provide those required specialist services. I always think of the example of a child with severe autism, who may require ballet lessons which would not be part of an offer. If a local authority is stretched to provide financial support for the things that it has to do, this removes its flexibility to deal with individuals on the basis of their need.

A serious concern regarding these amendments is that they would place duties on local authorities to secure a minimum level of health provision, when the body responsible for this is not the local authority but the National Health Service. It is entirely understandable that local authorities should be very wary of being responsible for provision over which they have no direct control. I agree with the references made earlier to the Minister’s view that too much prescription can severely limit flexibility and innovation in service provision.

We often heard negative comments today about local authorities’ provision. There is of course always room for improvement but with so many good quality provisions being made and so much work going on with parents and children in local authorities, our view should be that the aim of local authorities in this area is to provide a good service. We should not set expectations at a level that just will not be available but allow flexibility, and allow local authorities to create the right services for the people in their locality.

[Baroness Howarth of Breckland]

My Lords, the noble Baroness, Lady Eaton, is not alone in having some reservations about setting minimum standards as they may well stifle innovation and individual programmes. Perhaps more thought could be given between now and Report to how we ensure that local authorities provide a range of services. I know that the code says quite a lot about this. My great worry is that if you do not have something which can be inspected and monitored, and an expectation of a range of services, some local authorities might end up with very little indeed in their local offer—and it will be a postcode lottery. There is a real dilemma in how you maintain that flexibility yet ensure that families have something they can turn to which is monitored by either Ofsted or the Care Quality Commission. It would be quite useful to give some thought to this between now and Report so that we can come up with a better solution than a rigid framework, but with something ensuring that the services are there.

Health and Social Care Bill

Baroness Eaton Excerpts

Monday 5th December 2011 Lords Chamber

[Earl Baldwin of Bewdley]

My Lords, I support what the Government are doing here, though with some reluctance, for reasons that will not surprise the noble Lord, Lord Hunt. I am reluctant for two reasons that lie at the heart of a fluoridation policy: the scientific evidence for it and the medical ethics. It will pay to revisit those briefly this evening.

It is now 15 years since I started putting down Questions to the Government, chiefly on the evidence surrounding fluoridation. In the late 1990s the previous Government conceded that the studies they relied on were old and not of very good quality. Sir Iain Chalmers, a leading healthcare scientist who was then director of the UK Cochrane Centre, joined me in pressing for a high-quality systematic review. The Government agreed. That review, which came to be known as the York review, was conducted by the NHS Centre for Reviews and Dissemination at the University of York. I served on its advisory board as it examined 50 years of the world literature. The results, published in 2000, surprised many people.

Not one good-quality study could be found. This meant that nothing could be stated with clear confidence: not efficacy in preventing caries—though that did appear likely—not safety, and significantly not the hoped-for evidence that fluoridation might even out the inequalities in dental health between social groups. So poor was the evidence for that question that the four senior research scientists who were involved in the review described it in a letter to Health Ministers at the time as “weak, contradictory and unreliable”.

I know from the previous amendment that it is dangerous to quote the noble Earl, but I was interested to reread the speech of the noble Earl, Lord Howe, on the regulations of the Water Act in 2005, and to read that he, too, was impressed by the lack of good evidence as shown by York. I emphasise that the York review was not just any old review—there have been plenty of those. This was a Rolls-Royce systematic review, conducted to the highest international standards, the only one of its kind in the field. A more recent Australian systematic review has been unable to find anything that would change York’s conclusions.

I wish I could say that this better understanding of the evidence had influenced policy. Having accepted York’s findings, through gritted teeth, governments have downplayed them and, at times, subverted them. For the past 10 years the York scientists, when they had the time to do so, and I have been trying to point people back to what the known evidence shows. In the face of deeply held beliefs, this has been quite an uphill task.

The question of ethics, which is my second objection, can be put in a nutshell. In our society, a person faced with a healthcare intervention is free to accept or reject it. This is the principle of individual informed consent. We find it in case law and in pronouncements from all kinds of medical bodies. Fluoridation is invasive and unavoidable. Therefore fluoride designed to protect teeth should not be delivered by this method. I could say much more, as indeed I have many times in your Lordships’ House, but now is not the time or the place. These twin objections, evidence and ethics, are what motivate most of the large number of people who oppose community water fluoridation.

Given, however, that such schemes exist, and that the Government are determined to provide for new schemes, how best should they be structured? I believe that what the Government are proposing here is a significant improvement on what went before. The old system where water companies had a veto over new schemes was clearly not ideal. Since the Water Act 2003, strategic health authorities have been in the driving seat. Curiously enough, the All-Party Group against Fluoridation that I subsequently chaired was given an assurance by Health Ministers in the previous Government that they would put elected local authorities in charge, as is now proposed. However, when it came to their Water Act, it did not happen.

The problem with the unelected SHAs was—is—that they almost inevitably reflected the dominant medical view. Fluoridation was a classic case of premature consensus, on weak evidence from the 1950s and 1960s, and it became a kind of sacred cow, resistant to new evidence, as I have indicated with the York review. The regional director of public health who advised the SHA that recently decided to fluoridate Southampton, against the expressed wishes of its population, described fluoridation correctly as the “professional orthodoxy”. Sir Iain Chalmers, who knows more about medical evidence than most people, has described it publicly as a “religion”.

A most unfortunate feature in all this is that so many prominent bodies should have signed up with the National Alliance for Equity in Dental Health as campaigners for fluoridation—not just supporters, campaigners. The website of the British Fluoridation Society shows the British Dental Association, the British Medical Association, the Faculty of Public Health Medicine, the NHS Confederation, the UK Public Health Association, among dozens of other such bodies, including some royal colleges and about 60 primary care trusts. If you have signed up to a campaign, not only are you compromised in terms of impartial advice but it is very hard to draw back. It is much easier to keep going forward with your professional peer group. And, if you are the people whose advice is being sought and heeded, there is likely to be only one outcome.

While fluoridation continues, these clauses may offer the least worst way forward. In parenthesis, referendums would show more clearly what local people want. There have been quite a number in America, but as they have tended to reject fluoridation the Government may be wary of them. Even here, to have your healthcare treatment decided by a majority vote of your neighbours is not a principle known to medical ethics. At least local authorities are accountable to the populations they serve and, while quite properly taking advice from all quarters, should be better able to gauge than the SHAs have been what is right for their communities. People should not have to accept what Big Brother, or rather Big Doctor, thinks is good for them. I broadly support these clauses, but the devil will be in the regulations.

I conclude by putting three questions to the Minister. First, will she consider providing for a neutral body to set out the current state of the evidence in any future public consultation? This was suggested by Iain Chalmers back in 2003. Some of the misstatements during the Southampton consultation were pretty terrible. Secondly, will she include in that a revision of the Chief Dental Officer’s guidance letter of February 2008 to decision-makers over fluoridation? I think that the noble Earl, Lord Howe, suggested to me that this would happen. Thirdly, will she give the undertaking, given by the previous Government during the passage of the 2003 Act and the regulations in 2005, that no new scheme will go ahead unless the local population is in favour? If so, will she ensure that any undertaking given—the noble Lord, Lord Warner, who is not in his place, was one who gave it at the time—will not be watered down in the regulations so as to lose its effect, as happened last time?

[Baroness Eaton]

My Lords, like the noble Earl, Lord Baldwin, I feel that there is an improvement in the fact that fluoridation of the water supply should be determined locally. Local authorities are democratically accountable bodies, and surely they are the best placed to make decisions on behalf of the local population.

My concern, not just about this section of the Bill but about the amendment of the noble Lord, Lord Hunt, is around consultation and the ethical issue, which we have already heard mentioned, about the fluoridation of water and what that creates. I would appreciate hearing whether the processes by which the public are consulted about the fluoridation of water could enable communities to reject proposals to do so.

Members of the public are very cynical about consultation. They believe that, whenever their opinions are requested by any public body, no one takes action based on those opinions. It is important that communities are consulted and that the results of those consultations are taken notice of. The effect of fluoride on teeth may be a matter for dentists, just as the effect of fluorides on the rest of the anatomy may be a matter for scientists or doctors, but the question of whether it is right to use public water supplies to convey to the entire population a medication that is intended to influence the bodily development of 0.4 per cent of the population—that is, children whose teeth are forming—is surely an ethical question. The views of water consumers should carry just as much weight on this matter as the views of dentists and scientists.

I would be grateful if the Minister could reassure the House that consultation as referred to will actually have meaning and that local authorities, consulting on the matter of water fluoride with the residents, should be bound by the results of such consultations. It appears that the Bill allows the Secretary of State to ignore the results of consultation. Would the Minister explain this and give examples of where she envisages the Secretary of State taking decisions that disregard the results of the consultation?