The Whanganui District Health Board’s on-again, off-again debate about fluoridation has been finalised and it will be asking the three local authorities within its borders to consider putting fluoride into their water supplies.
Fluoridation had been discussed by both the community and public health advisory committee (CPHAC) and the hospital advisory committee (HAC) in August and September, and again earlier this month.
Management papers argued that fluoridation was a key factor on the board’s oral health strategy.
CPHAC decided that it was not worthwhile debating fluoridation and rather the board should be persuading councils to attack the causes of poor oral health.
But, in the way health boards operate, management advice to the same board meeting last Friday was that it would be “remiss of us not to support an evidence-based strategy with such potential to reduce inequalities in health”.
The original recommendation from CPHAC (November 4) said it “supports the WDHB oral health strategy seven-point plan, and continue its intersectoral approach to improving oral health outcome in its community”.
But the recommendation to the full board (November 25) said the board: “support an approach … to the three district councils in the WDHB region, asking them to consider the introduction of water fluoridation in support of WDHB’s strategy for improving oral health”.
Philippa Baker-Hogan, who chairs CPHAC, told the board meeting she was “in a bind” because the recommendation was not the one her committee prepared and supported.
“I don’t know whether to be astounded or intrigued that management appears to have taken no notice of the committee’s recommendation,” Mrs Baker-Hogan said.
“It was quite clear what the committee had decided. We know, too, that a district council referendum in 2006 showed that some 74 per cent of those respondents didn’t support the idea of fluoridation.
“That’s where I believe this issue sits with our community,” she said.
She said if the recommendation was approved by the board then it would open up the way to a lengthy and costly process.
“I’d rather put our time and money into the board’s seven-point oral health plan,” Mrs Baker-Hogan said.
Board member Ray Stevens said it was not for the WDHB to decide whether or not the city’s water supply was fluoridated.
Julie Patterson, the board’s chief executive, said she believed the management’s decision to involve itself with the recommendation was “the right thing to do” because members of the management team had looked at the issue of fluoridation in much greater detail than the committee.
“This recommendation is merely suggesting an approach to council and nothing more,” Mrs Patterson said.
Richard Orzecki, another on the board, said while he was personally anti-fluoridation, he supported the recommendation.
“But if you’re going to do this then it needs to be an issue that is led nationally,” he said.
Board chairwoman Kate Joblin said while she would be voting for the recommendation, she suggested the board needed to be putting its efforts “into the big ticket items”.
When it came to the vote Mr Stevens’ was the only dissenting voice.
Yesterday Mrs Baker-Hogan told the Chronicle she wanted it made clear that the final recommendation the board voted on was largely influenced by management.
“I suppose at the end of the day the issue of fluoridation is driven by the Ministry of Health and perhaps our management team is simply reflecting that view,” she said. “But I do have concerns how it unfolded. Our health board appears to have a very strong management influence.”
However, she said it was very hard for any of the board members not to vote against fluoridation “because it could make a difference to a good portion of our population”.
“But any decision will not be made by this health board. It will be decisions made by individual local authorities.”
According to schedule four of the NZ Health and Disability Act 2000, CPHACs are to give their board advice “to … maximise the overall health gain for the population” of the board region. The Act says the committee’s advice “may not be inconsistent with the New Zealand health strategy”.
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