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Fluoridation – a game changer?

Clauses in new Health and Social Care bill could remove responsibility to introduce, vary and terminate fluoridation schemes, from local authorities

Tucked away at the back end of the Health and Social Care Bill currently making its way through Parliament are two clauses which have the potential to significantly alter the landscape in relation to the fluoridation of water supplies.

Fluoride is a naturally occurring substance, present in some water sources. Its addition to water supplies, in the few areas where this occurs, takes place under tightly controlled arrangements as to its concentration, as a means of preventing tooth decay and improving dental health. The relevant water undertaker is not responsible for the decision to add fluoride but acts as a contractor to the health or local authority.

Fluoridation arrangements have operated in discrete parts of England since at least the 1960s. The existence of these arrangements, and the addition of fluoride to public water supplies, has been and continues to be a highly emotive issue with sections of the population. The principal grounds of opposition are the civil rights assertion that enforced medication is wrong and claims that fluoride is harmful to health, in particular (it is claimed) causing mottling of teeth and brittle bones.

The powerful counter position, supported by many leading scientists and health officials, is that fluoride in water supplies is both safe and is an effective means of combatting tooth decay, which is a problem particularly in deprived urban areas.

The view of successive governments has generally been that fluoridation of water supplies should be a matter for local consultation and determination, which has meant that regional health authorities (under various guises) and local authorities have been able to propose and consult on new fluoridation schemes. In practice this has not happened at all frequently, partly because the boundaries of these authorities are not coterminous with water distribution zones and therefore numerous authorities would need to be involved; this complexity has prevented new schemes getting off the ground.

Statutory provisions dealing with the addition of fluoride to water have their origins in the 1985 Water (Fluoridation) Act and now sit in the Water Industry Act 1991 (as subsequently amended). 

Clauses 128 and 129 of the Health and Social Care Bill give power to the Secretary of State for Health and Social Care to introduce, vary and terminate fluoridation schemes, in place of local authorities, thus removing the difficulty created by the mismatch of authority boundaries and water supply areas.

The Bill was introduced into Parliament in July this year, received its second reading in the House of Commons on 14 July, and was sent to a Public Bill Committee for line-by-line scrutiny of its many provisions. The Committee is expected to report by 2 November.

These clauses, once enacted, will provide a platform for greater use of fluoridation arrangements as a means of improving the nation’s dental health, albeit accompanied, it is to be expected, by much arguing about the merits.

For further information on this Bill or to find out how we can assist you, contact our specialist water sector lawyers

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