Excerpts from pages at
http://www.publications.parliament.uk/pa/cm200809/cmhansrd/cm091014/debtext/91014-0017.htm

and

http://www.publications.parliament.uk/pa/cm200809/cmhansrd/cm091014/debtext/91014-0018.htm

Mike O’Brien [The Minister of State, Department of Health] [North Warwickshire, Labour] If we really want to deal with the issues associated with child tooth decay, we will find that the better way to do so is to ensure that we have fluoridated water supplies and that we make changes in the way in which dental health is examined to ensure that we target those in the most deprived areas for the additional help and support that they need. We are examining ways in which we can identify and put help into areas where there are the most problems ……………

Sir Paul Beresford [Mole Valley] [Con]: I am pleased that the Minister has finally got round to mentioning fluoride, because fluoridation in the water supply and in toothpaste has been the biggest single factor, over and above any dentistry, that has brought about the change that he is proclaiming as an asset to his Government. He ought to realise that countries that have a school dental service ……………

Dr. Lewis:[New Forest, East] [Con)] The Minister has nailed his colours to the mast in favour of fluoridation. Does he accept the principle that no community should have its water fluoridated if a majority of the members of the community do not wish its water to be fluoridated?

Mr. O’Brien: We need to make judgments on fluoridation based on the evidence. Stories always go round that can frighten people, and we have seen in this country a whole series of scare stories about vaccinations that resulted in a significant number of people being frightened out of giving those vaccinations to their children. We need to ensure that we consider the evidence, that we base our judgments on the clinical evidence and that we ensure, too—

Mr. Lansley [South Cambridgeshire[ [Con]: Will the Minister give way on that point?

Mr. O’Brien: Let me answer the hon. Member for New Forest, East (Dr. Lewis), and then I will give way. As far as vaccination was concerned, there were some stories and as a result we are paying the price. We need to ensure that we consider the evidence on fluoridation and make judgments based on that evidence. We have already seen that there have been some moves towards fluoridation in the water supply, particularly in Southampton, although that is the subject of a judicial examination ……………

Mr. Lansley: The Minister will know, not least from what my hon. Friend the Member for Mole Valley (Sir Paul Beresford) said, that there are Conservative Members who agree with the principle of fluoridation. However, the point is not that we should judge the evidence that suggests that it makes a positive contribution, but that the legislation makes it clear that there should be a process of public consultation. There was such a process in Southampton and Hampshire, but it began with the strategic health authority setting out the evidence in support of fluoridation and it ended with the SHA saying that it remained convinced by the same evidence.

The consultation process therefore added nothing at all: what is the point of consultation when a decision has been made already? The Minister and the health authorities need to think about that again and accept that, if evidence is to be presented in a public consultation process, people must be given a more objective opportunity—either through a referendum or some other means—to make their views known.

Mr. O’Brien: The difference between the hon. Gentleman and me on this is not as great as he makes out. I agree that the people who make decisions must take on board the views expressed by local people in the public consultation process. The process is not a referendum—

Mr. Lansley: It should be.

Mr. O’Brien: By the sound of it, the hon. Gentleman is committing the Conservative Front-Bench team to referendums all over the country. I believe that, when local people are consulted, those who make decisions need to take on board the views that are expressed—and, indeed, the votes that are taken—by people in local areas. Those views are important, and the people who make decisions must consider them and give them due weight, but they are not binding in the way that a referendum would be.

Dr. Julian Lewis: Will the Minister give way again?

Mr. O’Brien: I will, but this really is the last time.

Dr. Lewis: The Minister is very kind to give way again, but 72 per cent. of respondents to the consultation said no to fluoridation, even though the local PCT had sent out a great many postcards, first-class postage paid, to get people to say yes when they replied. Presumably, if 72 per cent. of people saying no can be ignored, the same would be true of 82, 92 or even 100 per cent. What is the meaning of a consultation when an SHA can tell the overwhelming proportion of people saying no that the answer is nevertheless yes?

Mr. O’Brien: People who have to make a decision have to give due weight to the views of local people. They must ensure that all the arguments are taken into account, and that the views of local people are reflected but, in the end, they still have to make the decision.

I should have known, when I mentioned fluoridation, that we would get the reaction that we did from the reactionary side of the House. Fluoridation is an issue that, like Europe, produces an immediate reaction.

Mr. Lansley: We should have a referendum on it.

Mr. O’Brien: The Conservatives are proposing referendums once again. They want one on Europe, and now they seem committed to one on fluoridation as well. The important point is that we are working with the dentistry profession. There were difficulties following the 2006 contract—I do not dispute that for a moment—but we are now working with the dentistry profession to ensure that we produce a system of NHS dentistry that is right for England and the whole UK ……………

Charlotte Atkins (Staffordshire, Moorlands) (Lab): The Opposition motion proposes the reintroduction of school dental screening programmes. I agree with the hon. Member for North Norfolk (Norman Lamb) and the Minister that that is just window dressing. Those programmes have been proved to be ineffective, which is why they were stopped. If the Opposition are really interested in increasing preventive care, improving children’s dental health and reducing dental health inequalities, they should be proposing to increase investment in Sure Start and similar initiatives and pushing the fluoridation of water supplies. Sure Start brings together health, education and social services to help pressurise mothers with children under four. It is the perfect vehicle to promote good, early oral hygiene alongside good access to NHS dentists. Fluoridation of water in Birmingham has provided huge benefits to children, compared with unfluoridated Manchester. The figures are very clear on the benefit of fluoridation.

Fluoride toothpaste has also made a significant difference, and I commend my local PCT, NHS North Staffordshire, for its work to promote good dental health. I have joined it in wet and windy supermarket car parks and in town centres where its representatives have engaged with shoppers on oral health issues. It also attended my recent health MOT days, which are events that I have organised to promote public health, and I am grateful to NHS North Staffordshire for having the forward thinking to provide the health professionals who carried out health checks, such as on blood pressure, body mass index, cholesterol and blood sugar levels. We had an amazing response. During the two MOTs that I organised, more than 800 people turned up, and the dental health team played an important role at the events. I put on the record my thanks to PCT chief executive Tony Bruce, to Lesley Goodburn and to all the health professionals, including health visitors and district nurses, who worked so hard to make those events such a success ……………

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