Letter from Michael Howard and Hampshire SHA

Michael Howard has asked me to thank you for your recent letter and to reply
on his behalf.

As you may be aware, the Water Bill, containing clause 58 which deals with fluoridation, has received Royal Assent and has now been enacted. Importantly, it gives the ultimate decision on whether to fluoridate water supplies to Strategic Health Authorities.
Regardless of one's views on this issue, it was important to make the decision on whether to fluoridate as open and as democratic as possible.Strategic Health Authorities are neither accountable nor democratically elected. . Conservative MP Bill Wiggin, the former Shadow Environment Minister, had proposed an amendment to the Bill to give this decision to local authorities as they are - elected- and better positioned to hold referendums on the issue. Unfortunately this decision was defeated narrowly by 243 votes to 200.

The Water Act 2003 states that the Health Authority must consult the local population before it makes its decision, but we are concerned that clause 58 does not clarify how this will happen. The Government states that there will be 'an objective means' of assessing local opinion but they have rejected the idea of using referendums and we will not know the full details until secondary legislation is brought forward. Questions that remain unanswered are what proportion of the public must agree before a decision is taken, how binding will the opinion of the public be on the health authority and what happens it they change their mind years later?

We also believe that the new regulations will encounter practical difficulties in guaranteeing that fluoridated water only goes to those areas where the Strategic Health Authority has asked for it. The boundaries of water companies and health authorities do not necessarily correspond and this could lead to difficulties in ensuring that customers in one authority are provided with fluoridated water whilst ensuring that other customers are not.

Yours sincerely,
Ian Philps

Office of Michael Howard

Hampshire and Isle of Wight
Strategic Health Authority

14 April 2005
Dr Anthony Dunstan Fox

Dear Dr Fox

I am now in the position to reply to your letter dated 6 April
The responsibility for considering the dental health of the local population, and whether this might be improved by water fluoridation, rests with the local Primary Care Trust (PCT). Southampton City PCT Board has decided to approve the principle of water fluoridation and to ask the Strategic Health Authority (SHA) to undertake cost and feasibility studies to see if a viable and cost-effective potential scheme can be identified.

Should this be the case, the SHA would then undertake public consultation, in which everyone living and working in the area covered by the potential scheme would have an opportunity to contribute. If a majority were in favour, the SHA would then ask the water company to proceed.
Although the final piece of the new legislation - Regulations Governing Consultation and indemnities came into effect on 1 April, the Department of Health intends to issue guidance, and we would await this before embarking on public nsultation.

Yours sincerely
Gareth Cruddace
Chief Executive