Introduction

The Health and Care Bill, currently going through parliament sets out some changes to the water fluoridation legislation in England. If it becomes law, the Bill will allow the Secretary of State, instead of local authorities, to establish new water fluoridation schemes or to vary or terminate existing water fluoridation schemes in England.

In the event that the Bill is passed, there will be a legal duty on the Secretary of State to undertake a formal public consultation before introducing any new water fluoridation schemes or before varying or terminating an existing scheme. Secondary legislation will need to set out the process for consulting and the results from this consultation will inform that secondary legislation.

What fluoride is

Fluoride is a mineral that occurs naturally in the environment – it is found in drinking water and seawater, in the soil and in certain foods. When combined with other minerals, fluoride strengthens tooth enamel, reducing the risk of tooth decay. The addition of fluoride to toothpaste has contributed over the last few decades to an improvement in dental health in England.

What a fluoridation scheme is

A water fluoridation scheme is where additional fluoride is added to the drinking water supply with the purpose of reducing tooth decay. Schemes adjust the naturally occurring level of fluoride in water to the ideal concentration known to reduce tooth decay. The Water Industry Act which provides the legal basis for water fluoridation schemes in England sets a target of 1 milligram of fluoride per litre of water for a water fluoridation scheme.

There is good scientific evidence that fluoride is effective in reducing tooth decay for both adults and children. Research also shows that there is no convincing evidence of health harms from water fluoridation schemes. Water fluoridation is widely supported including by the World Health Organization and the Chief Medical Officers for the UK.

The Secretary of State is under a legal duty to monitor the effects on health of water fluoridation schemes in England and to publish a report every 4 years. The latest water fluoridation: health monitoring report published on 21 March 2022 continues to show that water fluoridation is a safe and effective public health intervention to help reduce tooth decay.

Areas with water fluoridation schemes

After discovering that fluoride helps to reduce levels of dental decay, the first schemes to add fluoride to public water supplies were introduced in the United States of America (USA) and Canada in 1945. Pilot schemes in the United Kingdom (UK) were introduced in the 1950s, followed by permanent schemes, starting with Birmingham in 1964.

Some 6 million people already live in areas with water fluoridation schemes, including many in parts of the North East, as well as the West and East Midlands. There are also water supplies in England, serving around a quarter of a million people, where fluoride is naturally at similar levels to those seen in water fluoridation schemes.

The map above shows fluoridation schemes in and around:

• Birmingham
• Crewe
• Lincoln and Scunthorpe
• Newcastle upon Tyne
• Workington

And naturally occurring fluoride levels greater than 0.5 milligrams per litre near:

• Bath
• Cambridge and Norwich
• Newbury
• Newcastle upon Tyne

Other countries with water fluoridation schemes today include the USA, Canada, Australia, New Zealand, Republic of Ireland, Spain and Brazil. There are an additional 50 million people, worldwide, consuming water with naturally occurring fluoride at or around the same level used in fluoridation schemes.

Future consultation

Public consultation will continue to be an important part of any future water fluoridation proposals.

Under current legislation local authorities have had responsibility for consulting on water fluoridation proposals. These have always been held at local level with individuals who would be directly affected by any water fluoridation proposals and bodies with an interest.

Subject to the successful passage of the Health and Care Bill, if new water fluoridation proposals were developed, we are proposing to maintain local consultation. We would only seek the views of individuals affected and bodies with an interest. The views of individuals not directly affected and bodies without an interest would not be considered. Similarly, where proposals relate to varying or terminating existing schemes, views would be sought only from those people affected and bodies with an interest.

We are seeking your views on this proposal and invite you to answer the consultation questions below.

How to respond

The easiest way to participate in this consultation is by completing the online survey.

Written submissions can be submitted by post to:

Using the results of this consultation

Subject to the successful passage of the Bill, secondary legislation will set out how the Secretary of State must consult on future water fluoridation schemes. The results from this consultation will inform that secondary legislation.

Privacy notice

The Health and Care Bill, currently going through parliament sets out some changes to the water fluoridation legislation in England. If it becomes law, the Bill will allow the Secretary of State, instead of local authorities, to establish new water fluoridation schemes or to vary or terminate existing water fluoridation schemes in England.

In the event that the Bill is passed, there will be a legal duty on the Secretary of State to undertake a formal public consultation before introducing any new water fluoridation schemes or before varying or terminating an existing scheme. Secondary legislation will need to set out the process for consulting and the results from this consultation will inform that secondary legislation. This notice sets out how data collected through this online consultation will be used and respondents’ rights under Articles 13 and/or 14 the General Data Protection Regulation (GDPR).

Data controller

The Department of Health and Social Care (DHSC) is the data controller.

What personal data we collect

You can respond to the consultation online or by post.

We will collect data on:

• whether you are responding as an individual member of the public or on behalf of an organisation
• the name of your organisation, where your organisation operates or provides services, and the sector of your organisation, if responding on behalf of an organisation
• the country you live in and the first part of your postcode
• your internet protocol (IP) address (this is for security purposes and will not be attached to your survey response)

If volunteered by you, we will also collect data on:

• your personal characteristics (including your age, sex, gender identity, ethnicity, and whether you consider yourself to have a physical or mental health condition)
• your email address
• any other personal data you may provide in response to open-ended questions in the survey

How we use your data (purposes)

Your data will be treated in the strictest of confidence.

We collect your personal data as part of the consultation process:

• for statistical purposes, for example, to understand how representative the results are and whether views and experiences vary across demographics
• so that DHSC can contact you for further information about your response, to allow you to amend or delete your response and/or to send you a reminder before the consultation closes if you have not submitted your final response, if you have given consent

Legal basis for processing personal data

The legal basis for processing your personal data is to perform a task carried out in the public interest, that of consulting the public to inform secondary legislation.

The legal basis for processing your sensitive personal data is that it is necessary for reasons of public interest in the area of public health (namely to ensure that secondary legislation setting out the process for consulting on future water fluoridation schemes takes into consideration the views and experiences of different demographic groups and experts in the field).

Data processors and other recipients of personal data

Responses to the online consultation may be seen by:

• data analysts and officials in DHSC supporting water fluoridation policy
• DHSC’s third-party supplier (SocialOptic), who is responsible for running and hosting the online survey

International data transfers and storage location(s)

Storage of data by DHSC is provided via secure computing infrastructure on servers located in the European Economic Area (EEA). Our platforms are subject to extensive security protections and encryption measures.

Storage of data by SurveyOptic is provided via secure servers located in the United Kingdom (UK).

Retention and disposal policy

DHSC will only retain your personal data for as long as either:

• it is needed for the purposes of informing the future approach to consultation and the secondary legislation that will be brought before Parliament later this year, subject to the successful passage of the Health and Care Bill
• the law requires us to

This means that personal data will be held by DHSC for up to 1 year.

SurveyOptic will securely erase the data held on their system 5 years after the online consultation closes, or when instructed to do so by DHSC if the data has served its intended purpose (whichever happens earlier).

Data retention will be reviewed on an annual basis. Anonymised data will be kept indefinitely.

How we keep your data secure

DHSC uses appropriate technical, organisational and administrative security measures to protect any information we hold in our records from loss, misuse, unauthorised access, disclosure, alteration and destruction. We have written procedures and policies which are regularly audited and reviewed at a senior level.

SocialOptic is Cyber Essentials certified.

Your rights as a data subject

By law, you have rights as a data subject. Your rights under the General Data Protection Regulation and the UK Data Protection Act 2018 apply.

These rights are:

• the right to get copies of information – individuals have the right to ask for a copy of any information about them that is used
• the right to get information corrected – individuals have the right to ask for any information held about them that they think is inaccurate, to be corrected
• the right to limit how the information is used – individuals have the right to ask for any of the information held about them to be restricted, for example, if they think inaccurate information is being used
• the right to object to the information being used – individuals can ask for any information held about them to not be used. However, this is not an absolute right, and continued use of the information may be necessary, with individuals being advised if this is the case
• the right to get information deleted – this is not an absolute right, and continued use of the information may be necessary, with individuals being advised if this is the case

Comments or complaints

Anyone unhappy or wishing to complain about how personal data is used as part of this programme, should contact data_protection@dhsc.gov.uk in the first instance or write to:

Anyone who is still not satisfied can complain to the Information Commissioners Office. Their website address is www.ico.org.uk and their postal address is:

Automated decision making or profiling

No decision will be made about individuals solely based on automated decision making (where a decision is taken about them using an electronic system without human involvement) which has a significant impact on them.

Changes to this policy

This privacy notice is kept under regular review, and new versions will be available on our privacy notice page on our website. This privacy notice was last updated on 6 April 2022.

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*Online at https://www.gov.uk/government/consultations/water-fluoridation-seeking-views-on-future-consultation-process/water-fluoridation-seeking-views-on-future-consultation-process