Draft Water Fluoridation (Consultation) (England) Regulations 2022 Draft Health and Care Act 2022 (Further Consequential Amendments) Regulations 2022

Debate between Chris Green and Will Quince

Monday 24th October 2022 General Committees

[Chris Green (Bolton West) (Con)]

The fact that this power is being taken from the local authority level up to the Secretary of State would suggest that the Secretary of State, or the previous Secretary of State, believes that the decisions on—or progress of, as it might be seen—the fluoridisation of England’s water have not gone far enough. The Government clearly start with an intent to fluoridise more of England’s water. The intent is already there and the direction is being pushed in regardless of what consultation there is. It is not clear that local voices will be represented, as opposed to the establishment will that currently exists.

[Will Quince]

I note my hon. Friend’s concerns. I will come on to address them, and if I do not do so immediately—because I am going to talk about the consultation and how we propose to undertake it—I will do so in my closing remarks about the duty of the Secretary of State. My hon. Friend is right that it is important that localities have a say on such things as water fluoridisation.

[Chris Green]

The question of localities is important. I am a Greater Manchester MP; will Bolton be the local authority that makes the decision for my area? How much influence will the integrated care board have? Will it be a Greater Manchester Combined Authority decision, or will it be a mayoral decision?

[Will Quince]

My hon. Friend is right to push us on those issues. I will touch on them all, because it is about not just local authorities, metro Mayors and others having a say, but all those who live, work and study in an area. No doubt they will have strong views, notwithstanding me as a Health Minister having a view when it comes to tooth decay and the difference that fluoridation will have in that respect.

We launched a public consultation on 8 April that ran until 3 June. We sought views on whether future water fluoridation consultations should be restricted only to people affected locally and bodies with an interest, such as those referenced by my hon. Friend the Member for Bolton West—incidentally, that had been the case under legislation—or whether we should move to a model in which consultation would open to all, especially given the shift of responsibility from local authorities to central Government. Some people with strong views on water fluoridation may not live in a particular area but may have certain expertise or a particular interest.

We received 1,228 responses to the consultation; of those, 94% came from individuals and 6% came from organisations. The majority of respondents favoured a consultation open to all. The draft regulations will not restrict who can respond to any future consultation on water fluoridation, which I hope my right hon. Friend the Member for East Yorkshire and my hon. Friend the Member for Bolton West agree is the right approach.

To come to the crux of my hon. Friend the Member for Bolton West’s points, we understand that the views of those who are directly affected and living, working and studying in an area in question are incredibly important. For that reason, the regulations also provide for consideration to be given, as part of the decision-making process, to whether additional weight should be given to consultation responses from those who may be particularly affected by any future proposals.

Public opinion and the extent of support for a water fluoridation proposal will continue to be important but, as my right hon. Friend the Member for East Yorkshire rightly pointed out, consultations are not referendums. It is right that regulations provide for a range of other factors to be taken into account when considering a water fluoridation proposal.

[Will Quince]

The honest answer is that I am not aware of any, but no doubt my officials will look that up and I will be able to respond in my closing remarks.

The wider factors that have to be taken into account in the consultation include but are not limited to the strength of evidence underpinning an argument made by the respondents. It is absolutely right that due regard is given to those arguments and that they are properly supported by sound evidence.

On evidence, a point that my right hon. Friend the Member for East Yorkshire alluded to, we are committed to scientific evidence on water fluoridation. It has to underpin any proposal that we put forward. The Department continues to review scientific papers published both in this country and internationally as part of the continuous monitoring of the evidence. That includes papers on the epidemiology and toxicology of water fluoridation. Every four years, the Department will continue to publish a summary report on our knowledge, in line with the Secretary of State’s responsibility for monitoring the effects of the water fluoridation arrangements on the health of the populations that are served by existing schemes.

[Chris Green]

What is the Government’s view of side effects? As far as the Government are aware, are there zero side effects from the fluoridation of water?

[Will Quince]

I will come to that point. The common finding of several authoritative scientific reviews is that there is no convincing scientific evidence that fluoride in drinking water, at levels used in fluoridation schemes, is a cause of adverse health effects. Let me provide further assurance that if the balance of evidence in favour of water fluoridation as a public health measure were to change, a review of the current water fluoridation policy would take place.

I am conscious that I was not the Minister when the Act was passed, but this same point was made during the passage of the 2022 Act. We have 57 years of experience in England and 75 years of experience internationally of water fluoridation schemes. There continues to be no convincing evidence of health harms associated with the levels of water fluoridation use in this country. In fact, what we have seen internationally is more countries moving in that direction because of the benefits of tackling tooth decay, particularly in children.