There are fears a Government move to make district health boards, rather than councils, responsible for water fluoridation decisions will take the decision away from the community.
Health Minister Andrew Little said the Government was considering the proposal. “I can’t give you a timeline but it’s kind of front and centre of the public health issues that we’re dealing with so there will be a decision.”
Many dentists are keen to see fluoride added to water supplies to reduce tooth decay but numerous district and city councils don’t fluoridate their supplies.
Christchurch is the largest council in the country without fluoride in its water, and two of the city’s councillors who are also both on the Canterbury District Health Board have opposing views on the Government’s proposal.
Aaron Keown said moving the decision-making to DHBs would be better than leaving the decision up to councils.
On councils everyone was “quite political”, while on DHBs half were elected and half appointed, and boards also tended to follow health advice much more, while on councils decisions were usually politically based, Keown said.
The science was in favour of fluoridation, and health boards needed to communicate that to the people in their area. “I would not vote for it until we had the public on our side.”
While some people were strongly opposed to fluoride “by far the large majority don’t seem to have a view on it. That’s what we need to change.”
In contrast, James Gough – also a Christchurch councillor and Canterbury DHB member – said his preference was for the decision to stay with councils.
”I feel it more appropriate that whomever is paying for the cost of the infrastructure upgrade to be the ones making the ultimate decision,” Gough said. Cost implications were connected to decision-making so a separation could prove troublesome.
”Given the significance of such a decision, councils are already well equipped to undertake robust consultation with their community, given it is a core part of their function.”
Sheryl Mai, Mayor of Whangarei, where the water isn’t fluoridated, said she thought her community would be disappointed if the DHB forced the council to put fluoride into the water.
In a poll taken some years ago, residents were “resoundingly” against adding fluoride to the supply, and she didn’t think that had changed.
If the Government gave the decision-making power to DHBs “that’s another decision one step removed from the people impacted by it.”
Stuart Crosby, a former Tauranga mayor and now member of the Bay of Plenty Regional Council and president of Local Government New Zealand, said his personal view was that the Government’s proposal was the right move.
When the issue first arose most councils and mayors were supportive of decision-making going to the DHBs, which would take accountability and responsibility for any outcomes. “That was the basis of it,” Crosby said.
DHBs would have to consult their communities in the same way councils did. “It was very divisive every time it was raised in any area of New Zealand,” he said.
”It’s a health issue and the general feeling in councils of the day was it’s not their job to mass medicate communities.”
NZ Dental Association president Katie Ayers, a pediatric dentist, said she had treated six children under general anaesthetic on Friday morning.
The Community Oral Health Service – previously the school dental service – had fallen behind as a result of Covid-19 disruptions and was still not working at full capacity, Ayers said.
”Something like mandating water fluoridation makes total sense in trying to reduce the number of children who have active tooth decay and are needing fillings and removal of teeth,” she said.
National health spokesperson Dr Shane Reti said the party supported fluoridation. There was no reason fluoridation couldn’t progress now, he said. Reti believed councils were looking to DHBs to take the lead, which was appropriate.