New powers to enforce fluoridation

Public health: White Paper to give authorities fresh remit in `biggest single step' to protect children's teeth

HEALTH AUTHORITIES are to be given new powers to demand that water companies fluoridate the water supply to protect children's health.

The proposal is contained in a government White Paper as a response to those privatised water companies which refuse to fluoridate for fear of legal action by anti-fluoride campaigners.

Public health minister Tessa Jowell said in an interview with The Independent that fluoridation was the biggest single step that could be taken to protect children's teeth.

She also said she was planning young people's health centres - which will be able to issue contraceptives under the strict guidelines already applied to GPs - to tackle the high level of under-age pregnancies. Britain has one of the highest rates in Europe.

But the action to enforce water fluoridation will arouse the greatest controversy.

About five million people in Britain receive water that has been artificially fluoridated but the opponents of mass health care have prevented other water authorities from adding fluoride to the water supply for more than a decade

Since the Water Fluoridation Act was passed in 1985, 55 health authorities in England have asked water companies to add fluoride to the supply but none has done so.

Ministers are convinced of the benefits of fluoridation after a study compared the dental health of children in the West Midlands and in Blackburn, Lancashire.

In the West Midlands, tooth decay in children has more than halved; in Blackburn,where the water company is refusing to add fluoride to the water, there has been little change in the health of children's teeth.

The Fluoridation Act gave water companies discretion over whether or not to add fluoride to the water supply. Under the new powers proposed in the White Paper, health authorities and councils will have a clear duty to carry out consultation exercises with the public, through meetings, before they can demand fluoridation.

Ministers are against local referendums and they are not impressed by the water companies' demands for the Government to indemnify them against possible legal challenges in the European Court of Human Rights.

Ms Jowell said there had been 5,500 responses to the Green Paper on public health. A majority backed the Government and were in favour of fluoridation of the water supply.

"The present situation is completely unacceptable. In the White Paper in the autumn we are going to set out the approach we intend to take. The figures are absolutely clear. If you want to tackle health inequality, fluoridation is one of the best ways."

She said the Government would not be issuing a national edict to the water companies. "This has to be done on the basis of genuine and systematic consultation and with effective local support.

"We will set out the way forward in the White Paper.

"It is a controversial issue and, as public health minister, I have got to be the guardian of a process that people see as being fair.

"That is what I intend to do. I will come up with proposals in the White Paper that will resolve the present logjam."

In addition to the White Paper on health inequality, Ms Jowell is preparing a paper on tobacco control, including proposals for reducing smoking in pubs, clubs, and restaurants, and a programme for tackling Britain's record rates of pregnancies for girls under the legal age of consent.

Children's health centres will be targeted in the areas of greatest deprivation, such as her own constituency in south London, which is covered by the Lambeth, Southwark and Lewisham health authority and has the highest rate in the country for under-age pregnancies - 16.1 for every 1,000 girls aged 13 to 15.

The action to deal with health inequalities will be boosted by Gordon Brown, the Chancellor, and Tony Blair allocating more than pounds 8bn extra to the health service as part of the comprehensive spending review, as previously revealed in The Independent.

Frank Dobson, the Health Secretary, will announce the cash in mid-July

But Downing Street confirmed the reports at the weekend to underline Mr Blair's commitment to the National Health Service in the week when it is celebrating its 50th Anniversary with a Buckingham Palace Garden Party and other events.