My Lords, Amendment 156 is in my name, and I declare at the outset that I am co-chairman of the All-Party Parliamentary Water Group. This is a simple amendment, and I would like to cover ground that has possibly not been covered at earlier stages of the Bill.
I understand from the Bill and, more particularly, its Explanatory Notes that the purpose of the clause to which this amendment relates is to transfer from local authorities the power, which they have had since 2013 through the Water Industry Act 1991, to propose and consult on new fluoridation schemes and variations to or terminations of existing schemes. It transfers that authority to the department, the reason being that local authorities and the NHS, which previously had responsibility for water fluoridation schemes, have faced difficulty in implementing them. This includes, most recently, the fact that local authority boundaries are not coterminous with water flows, which requires the involvement of several authorities in such schemes in a complex and burdensome way.
The first question, to which I will return later is: if this authority is passing from the local authorities to the Secretary of State for Health and Social Care, where in the scheme of things do water companies fit? Presumably, it is the water companies themselves that will perform the act. In Amendment 156, I therefore ask simply that the Secretary of State does not exercise the powers within the Bill until such time as
“an impact assessment has been published setting out the impact on health and the environment, including a cost-benefit analysis”.
I was very grateful to my noble friend the Minister for arranging a teach-in, if you like, with the officials in the department and my noble friend Lord Reay. We both benefited from that and were very grateful for it. Subsequently, I also thank the officials for providing, in the first instance, a number of responses to my questions. In particular, I query with my noble friend the level of expenditure, which is significant. We know that we are facing a time of additional pressures—not just an energy crisis but a cost-of-living crisis—and the expenditure incurred by each fluoridating local authority in the financial year 2020-21 is not insignificant.
I will pick out those councils that relate to the largest area, broadly speaking: the West Midlands. I will round the figures up, rather than giving each individual figure. Birmingham City Council spent over £290,000 in that calendar—or, presumably, financial—year. Coventry City Council spent over £206,000. Dudley Metropolitan Borough Council spent over £198,000. Sandwell Metropolitan Borough Council spent over £188,000. Solihull Metropolitan Borough Council spent over £56,000. Walsall Metropolitan Borough Council spent over £167,000. Finally, the City of Wolverhampton Council spent over £121,000. How is this financing passed on to the consumers in those local councils? If adding fluoride to the water supply is passed in the Bill, it is for the Department of Health and Social Care to pick up the cost, so how will it do so? From which part of the budget will this come? Perhaps I have missed it, but I do not see anything in the Bill or the Explanatory Notes that says how water companies have been consulted and how they are expected to enter fluoride into the water supply.
Clearly, the debate on which I have not reached agreement with my noble friend the Minister and the department is on the extent to which it is legal to add fluoride to the water supply. In the court case that I was involved in in my training for the Scottish Bar, in preparation for joining the Faculty of Advocates, I sat through pretty much the whole of the McColl v Strathclyde Regional Council case. The petitioner could see no benefit from fluoride being added to her water supply because she had dentures and was not in need of fluoride for that reason. In fact, it was deemed ultra vires. I shall quote the relevant passage of the judgment:
“In my view the word ‘wholesome’ falls properly to be construed in the more restricted sense advocated by the petitioner as relating to water which was free from contamination and pleasant to drink. It follows that fluoridation which in no way facilitates nor is incidental to the supply of such water is outwith the powers of the respondents. The petitioner therefore succeeds on this branch of her case.”
If my recollection is correct, although they lost on the ultra vires point, the Scottish Government—I cannot remember whether it was in the UK Parliament or the Scottish Parliament—reintroduced a water Act that
made legal provision in Scotland that gave them the authority. However, and as my noble friend Lord Reay rehearsed in Committee, I understand that Scotland has chosen not to go down that path. I will come on to that in a moment.
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I contend—I put this to my noble friend the Minister—that adding fluoride to the water supply is a profoundly un-Conservative thing to do because it removes the element of choice. You are asking people to prevent caries; I argue that it would be better to do this through public health education by encouraging parents to teach their children to brush their teeth. I accept that removing and reducing dental caries is a public health issue, but having caries is not in itself a fatal condition, whereas fluoride is a carcinogen so adding it to the water supply is, I would argue, inherently dangerous. One thing Lord Jauncey confirmed in the case of McColl v Strathclyde Regional Council was that fluoridation potentially causes the mottling of teeth, which is surely not a public health benefit.
I want to refer briefly to Professor Vyvyan Howard. She submitted a letter to the Prime Minister in September 2021 in which she skilfully argued from a scientific basis that fluoride creates a danger of causing bone fractures. In a subsequent letter in which she put research to the Prime Minister, she said that it potentially causes damage to children’s brains. That evidence has yet to be refuted by the Department of Health and Social Care, I believe, so I look forward to hearing my noble friend respond to that this evening.
Another academic practitioner, Paul Clein BPharm, MRPharmS, has raised a number of issues, perhaps the most alarming of which concerns the main substance used in the fluoridation process in admitting fluoride to the water supplies of those councils to which it is already applied in England. Through his persistence and freedom of information responses, it has been confirmed that hexafluorosilicic acid is not a legal source of fluoride in food products. I am in possession of a letter from the MHRA that dates from as far back as 22 September 2005. It clearly states:
“Drinking water (whether fluoridated or not) clearly falls within the definition of ‘food’ for regulatory purposes. Food safety and food labelling regulations control the claims which may be made for foods.”
My understanding is that the regulations to which the Government subscribed when we were in the European Union have been transferred into retained EU law, and we are therefore still covered by the ban introduced in the EU in 2006. The position has not changed since we left the European Union: if hexafluorosilicic acid is used for these purposes as a biocide, it is strictly illegal. I want to understand on what legal basis the Government are using that substance—“hexa” for short, because it is easier to pronounce—because it would seem to be a complete abuse of, and in breach of, the Control of Pesticides Regulations and the retained EU law to which we have subscribed.
I will also refer briefly to the Scottish example of Childsmile, which has had a very vigorous and highly successful programme of ensuring that children brush their teeth by encouraging them to do so through a public health and public education campaign. As a result, the incidence of dental caries has been reduced in Scotland.
With those remarks, my opposition to the fluoridation of the water supply remains. I would like to understand further the reasons for which this power to fluoridate the water supply is being transferred away from the local authorities—which, to me, would be a better and more local way of accepting or rejecting this. What consultation has there been with the water companies and from which budget of the Department of Health and Social Care will this come?