Local authorities may be reluctant to push ahead with water fluoridation if they have to meet the costs as they have no responsibility for dental care, government has been warned.

The Health and Social Care Bill will see responsibility for consultations on fluoridation transfer to local authorities. The government will consult on the content of these regulations in the New Year.

But during discussions in the Lords, fears were raised over costs, the evidence base which claims fluoridation is beneficial in reducing decay and local consent before any fluoridation takes place.

President of the British Fluoridation Society, Labour’s Lord Hunt, warned if local authorities do not have a direct interest in the cost of dental health care, it could be a barrier to them paying out on fluoridation schemes.

He added: ‘From my point of view the evidence is convincing. It is important that if local authorities come to a view that they wish to fluoridate or to continue to fluoridate, the money will still flow as smoothly as the fluoride in the water in places that are lucky enough to
benefit from schemes.’

The Bill includes powers to make new regulations which will include the criteria which local authorities should apply in determining when consultations on the continuance of existing fluoridation schemes should be conducted.

Crossbencher Earl Baldwin told the Lords there was not ‘one good-quality study’ into the benefits of fluoridating and said Southampton residents had their water fluoridated against the ‘express wishes of its population’.

He called for government assurances no new scheme will go ahead unless the local population is in favour and that a neutral body be formed to set out the current state of evidence in any future consultation.

Lib Dem whip Baroness Northover responding for government denied suggestions councils would be put off as they have no responsibility for dental care.

‘Dental ill-health would seem to have wider repercussions. The great difficulty, particularly among older people whose teeth have decayed, certainly bears out the necessity of preserving teeth in younger life. It is not simply a matter of looking at children’s teeth and the impact on
them but of seeing dental health as lifelong. Health and wellbeing boards would therefore have a responsibility to consider dental health because of that significance,’ she said.

In addition, she said from 2013-14, the department intends to allocate a ring-fenced public health grant to local authorities and the ongoing costs of fluoridation schemes will be reflected within the grant to those local authorities.

Baroness Northover added: ‘About neutral information this is an area where we should proceed on the basis of evidence. Public Health England might well be the right body to assess such evidence. The noble Earl also asked about schemes going ahead only with the support of the local population.

‘The provisions in the Bill transfer responsibility for consultations to local authorities and include powers for the Secretary of State to specify the steps that local authorities must take in relation to consultation.

‘We expect that the evidence base will still determine a decision to consult. However, putting local authorities in charge of consultations would make decisions on fluoridation more democratically accountable.

She added: ‘We intend to consult on the detail of the regulations, including the process that local authorities must follow when ascertaining public opinion.’

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