Health Inequalities

Paul Beresford Excerpts

Wednesday 4th March 2020 Commons Chamber

[Sir Paul Beresford (Mole Valley) (Con)]

I congratulate the hon. Member for City of Durham (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 the Member for Central Suffolk and North Ipswich (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.

[Several hon. Members rose—]

Health and Social Care

Paul Beresford Excerpts

Thursday 16th January 2020 Commons Chamber

[Sir Paul Beresford (Mole Valley) (Con)]

I thought, Madam Deputy Speaker, that immediately I stood up you would announce that the time limit was down to three minutes.

The number of medically trained professionals who have come into the House has apparently risen dramatically. I am one of them, but I have been here a wee while. I warn the new ones that their profession will lean on them to put the case until they are driven to it, as I am today.

I wish to pick on child dental health in particular. For decades, the statistics have been absolutely appalling. Deciduous teeth—baby teeth—are particularly susceptible to decay: their enamel is much thinner than that of permanent teeth. Before SNP Members stand up to tell me about it, I should say that action has been taken on care and education, particularly in schools, and to some degree it is working, but those children for whom it does not work, or works only partially, will require extractions. I can remember looking at little kids in east London with appalling mouths—broken-down teeth, abscesses—who were crying and having sleepless nights, and having to refer them to hospital for a general anaesthetic.

The statistics today are terrible. Last year, more than 45,000 children and young people aged up to 19 were admitted to hospital because of tooth decay. They included 26,000 five to nine-year-olds, making tooth decay the leading cause of hospital admissions for that age group. Last year, there were more than 40,000 hospital operations and extractions for children and young people. That is 160 a day. It is a complete waste of money, it is completely preventable and it is occupying space in our national health service.

Education is starting to make a difference, but far and away the best-proven method to reduce tooth decay among children, and even more so among adults, is fluoridation of the water supply. In the United Kingdom, approximately 330,000 people have naturally occurring fluoride in their water supply. In addition, another 5.8 million in different parts of the country are supplied with fluoridated water. But that covers only 10% of the total population. The percentage covered in the United States is 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%. We have fluoridation legislation, but it is left for local authorities to instigate and compel companies to fluoridate their water supplies. There is no financial advantage for the local authorities, but the savings to the NHS would be considerable.

The second problem with the current legislation is that few local authority boundaries are coterminous with the boundaries of the water companies. That makes direction and implementation complex. The sensible answer is for legislation to apply nationwide. That is not in the Queen’s Speech. It could be put into a Queen’s Speech, but it will take a brave Government, I hope supported by the Opposition, to include and implement that. I warn that whenever I speak about fluoridation, the green ink letters fly and broomsticks whizz around my house as people complain. However, it works for child dental health care, which is deplorable in this country.

[Madam Deputy Speaker (Dame Rosie Winterton)]

It is a great pleasure to call Amy Callaghan to make her maiden speech.