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Lord Monson: My Lords, we must all be grateful to my noble friend Lord Baldwin for initiating the debate. This is a subject about which a growing number of people are increasingly concerned as new and worrying evidence comes to light. Few people in this House can have worked so hard on this subject as my noble friend who has sifted through evidence from all parts of the world--not all of which seems to have permeated in this direction--and few can match his acquired expertise.
Perhaps I may turn from the medical to the moral aspects of fluoridation. There are some people who maintain that it is quite wrong to administer a medicine to whole populations via the public water supply, even if it could be proved that not one single individual suffered adverse side-effects. I do not take such a purist view. If there were substantial benefits and absolutely no disadvantages, it would not be easy to argue against the controlled addition of a "medical product", as the noble and learned Lord, Lord Jauncey, described it in his famous judgment.
However, that is entirely academic. No medicines, not even aspirin or sodium bicarbonate, are entirely harmless to everybody. Fluoride is vastly more dangerous than either of those. It is actually more toxic than lead and almost as toxic as arsenic. It used to be used as a rat poison, and the American Food and Drugs Agency requires poison warnings to be placed on the labelling of fluoridated toothpaste in the United States.
Fifty years ago, it was genuinely believed that fluoride in very small doses--in the proportions given by the noble Baroness--was entirely safe, just as it was believed that strychnine in very small doses was safe enough to add to tonics then sold in chemists across the counter without prescription; that DDT was entirely safe; and that asbestos was safe enough to be used in children's playgrounds as a substitute for sandpits, as was revealed on "Newsnight" two or three days ago. Somewhat more recently, it was believed that thalidomide and leaded petrol were safe and that tobacco was relatively safe. It was believed that tranquillisers were safe enough to be prescribed in their hundreds of thousands like Smarties, as they used to be in the 1960s.
Now, strychnine, asbestos and thalidomide are banned. Leaded petrol is soon to be banned, and sales of DDT, tobacco and tranquillisers are heavily curbed. Fluoride is not banned, but even the British Dental Association, in November 1996, admitted that there are risks in fluoride use, even though the association went on to contend that the risks were outweighed by the benefits.
That is where moral considerations kick in. Can it be right to add something to the public water supply which may help some at the expense of others, particularly when there are alternative ways of administering this chemical which would target it much more precisely on the narrow age group--those aged 12 and under--it is supposed to benefit?
Suppose there were to be an epidemic of rape and other sexual assaults carried out by young men in one particular part of the country. Would the Government consider adding bromide to the region's water supply?
If only one person in a million were seriously adversely affected by fluoridation, it might conceivably be justified--but certainly not if the figure were one in 10,000, still less one in a hundred. Yet somewhere between the latter two figures seems more probable than one in a million.
Are Her Majesty's Government aware of recent research in Boston, Massachusetts--not Boston, Lincolnshire--which indicates that fluoride adversely affects the central nervous system? Similar research was carried out during the Second World War, in 1944, which seemed to reveal the same, but because of the war it remained a classified secret. Do the Government agree that fluoridated water leaches lead from old pipes--of which plenty remain in this country? Are they aware that since 1990, 54 American and Canadian cities, together with Brisbane--which the noble Baroness will concede is a major Australian city--have rejected or stopped fluoridation? Are they aware that in the past few years 17 prominent American organisations have withdrawn their endorsement of water fluoridation? They include the American Cancer Society, the American Diabetes Association, the American Heart Association, the National Kidney Foundation and the Society of Toxicology.
Do the Government agree that fluoridated water cannot be used for kidney dialysis anywhere, nor for the manufacture of babyfood in many countries? Do they agree that fluoride is deemed to be a dangerous substance under the 1995 EC dangerous substances directive?
That brings me to my last point. The Government constantly proclaim their determination to be at the heart of Europe. Are they aware then that every single continental EU country, together with Norway, rejects fluoridation? Some have never tried it, some have tried it and found it dangerous and have subsequently banned it, notably the Netherlands. Those countries include such ultra health-conscious countries as France, Sweden and Germany.
Despite that--and this may answer some of the noble Baroness's points--Denmark, Sweden, Finland and the Netherlands have as good a record where the health of children's teeth is concerned as the UK, and a better record than the heavily fluoridated Republic of Ireland. Will the Prime Minister, Mr. Blair, at the next EU summit, be trying to convince the other 13 EU countries that they are all wrong and that the United Kingdom and Ireland alone are right?
Lord Stoddart of Swindon: My Lords, I too congratulate the noble Earl, Lord Baldwin, and I welcome the debate in advance of possible public action. I am sorry that the noble Baroness, Lady Gardner of Parkes, feels incensed that the matter should have been raised again. I would have thought that if she is so
The noble Earl, Lord Baldwin, made an authoritative and well researched case against fluoridation on scientific and medical grounds, as did the noble Lord, Lord Monson. So there is no need for me to go over it again, except to say that in my view any evidence that the addition of fluoride to water supplies assists in preventing tooth decay in children is not conclusive. I shall go no further than that. The medical risks to the general population cannot be ignored, particularly since, as we have heard, fluoride accumulates in parts of the body over time.
My noble friend Lord Rea and I are so often at cross purposes. It is a shame because he is such a nice fellow. He says--and he made it part of his case--that the credentials of those who support fluoridation are good. He cited 39 of them. But how can he say, and who is he to say, that the credentials of the people on the other side are not equally good? After all, when Darwin brought forward his great theory of evolution, all or most of the great scientists and religious people were against him at the time. Should he have dropped his ideas? How the world would have suffered if he had.
In addition, try telling that to the noble Countess, Lady Mar. She has been fighting on the issue of organophosphates. Time and time again she has been told by the experts that there is no danger. We are now discovering, and the experts are coming around to the fact, that organophosphates are dangerous and may have been responsible for many diseases and injuries to people who worked with them. Let us not be so confident that the experts are always right. That is another reason why we should have a public inquiry.
Even if the evidence of benefit to children up to the age of 11 is overwhelming, the case for forcing the remainder of the population, throughout the rest of their lives, to ingest a known poison, whose long-term effects on the human body are not really known, is weak. Dental decay is not a life-threatening condition. Why on earth, for the benefit of perhaps as few as 1 million children, should the remaining 58 million have to ingest this substance throughout their lives when there are other ways to ensure that children's teeth and dental care are good?
In a free society mass medication cannot be right in any circumstances. Noble Lords should ponder that. Once we start along that road where do we stop? No doubt all kinds of claims can be made for various substances that benefit one minority section of the population or another, whether it be the young, middle-aged, old, or male or female. The proposition that we mass medicate the whole of the population in order to benefit only a small proportion of children up to the age of 11 is preposterous and one that every person who believes in individual freedom should reject out of hand. Furthermore, it is inefficient and potentially dangerous for the rest of the population.
Tooth decay among children and adults has declined dramatically over the past 25 years. That is due not to artificially fluoridated water but to better dental care, education, diet and free dental treatment, particularly for children. It is upon those factors that we should proceed, not mass medication. There should be better education about the care of teeth, regular check-ups at the dentist and diets that promote healthy teeth. That is what the Government should concentrate upon, not the slipshod and potentially dangerous route of compulsory mass medication.
My noble friend said that the worst cases of dental decay occurred in deprived areas. Let us get rid of the deprived areas, not feed the rest of population with fluoride. I believe that that is the sensible approach to take and I hope that my noble friend agrees with me.
I emphasise "compulsory" since in any given area there is no choice as to the water that a person drinks. There is no escape from the ingestion of a substance that one believes is harmful to oneself and others. Furthermore, individuals cannot give up drinking water if they believe that it contains poison. Water is a life-supporting substance, unlike tobacco or alcohol. We must drink or we die. I hope that noble Lords will recognise the force of the argument about compulsory fluoridation. The supporters of compulsory fluoridation say that the concentration is only one part per million and therefore it cannot do any harm. It can, because it accumulates over a period of time. In addition, because virtually all toothpastes now contain fluoride the amount that is ingested particularly by children may be very much more than one part per million.
In conclusion, off and on over the past 30 years or so I have entered the debate on fluoridation. When I was leader of Reading County Borough Council in the 1960s I helped to resist compulsory fluoridation of Reading's water supplies, and I am glad that I did. Later, when I was chairman of the Land and Works Committee of Thames Valley Water Board, I had some influence in resisting the fluoridation of water supplies in Berkshire. I still believe in what I did then. It is wrong compulsorily to medicate people's water supplies. But I am prepared to support the call of the noble Earl, Lord Baldwin, for a public inquiry. That is the least that the Government should do before they embark on any further measures to introduce the compulsory fluoridation of the water supplies of this country.
Lord Craigmyle: My Lords, I thank the noble Earl, Lord Baldwin, for bringing the issue of fluoridation before the House today. The noble Earl has steeped himself in the science of the debate, none of which I care to tackle. I believe that all sides of the argument have been well shaken out this evening. The case that I make for a review of the evidence is made on behalf of the consumer. I declare an interest, for I am a poor, bewildered consumer. My dentist tells me to use fluoride but my doctor is unenthusiastic, while a steady stream of evidence through the media over 20 years or more on balance appears to warn against the use of fluorides. The consumer needs guidance on this subject and that needs to come from a disinterested party.
Just last week in your Lordships' House the noble Countess, Lady Mar, introduced a debate on organophosphates. I do not dwell upon the medical aspects of organophosphates, but the noble Countess expressed disappointment at a report on organophosphate sheep dips. That has a parallel with the present debate. The noble Countess was concerned about the membership of the working party which produced the report, and its terms of reference. She believed that both predisposed them to a particular conclusion. We face similar problems in examining the issue of fluoridation. The consumer knows that a fishmonger will sell him fish. We all know with equal certainty that the BDA and the Fluoridation Society will sell us fluoride. I do not question the good work of those bodies, any more than I question the good intentions of my fishmonger. However, the case for a review of the evidence for and against fluoridation needs to be not only scientifically defensible, but also defensible before the consumer, particularly as the latter may be told to accept fluoride whatever his wishes.
What we appear to lack is a random blind trial with sensible controls. I have asked the British Dental Association for help in this matter and it has provided me with a good deal of information. I have picked out what I believe to be one of its most promising statistics to try to improve its case. It begins by saying that poor dental health is a disease of social deprivation--a true and brave admission. But we are then asked to compare the tooth decay rates of children from Bolton with those from fluoridated south Birmingham. The comparison may well be valid. It may well make a good case for fluoridation. But there are regional and social variations in tooth decay rates. We need to know where Bolton fits into the pattern. We need to know the histories of dental care in the two areas. We need to know the histories of health care for pregnant women. Quite simply, there are too many variables in such comparisons. Even the opinions of individual dentists can vary as regards which teeth need to be filled and which should be pulled. As I say, that point, and indeed other points raised by the BDA and the BFS, may be valuable. But if the proponents of fluoridation want to persuade people of their case, they must share their evidence, not just their opinions however well founded.
Gone are the days when a man in a white coat on a public information film was enough to quell public anxiety. If people feel that fluoride is a poison which should not be in their water, they will need full and open debate to persuade them otherwise before the Government move forward on the matter. That is a case for a review of the evidence.
The Earl of Clanwilliam: My Lords, I enter the debate with a strong sense of deja vu, and thank the noble Earl, Lord Baldwin, who is at the forefront of our search for healthy living and clean medicine, for his telling speech in support of a review of the evidence. I well remember discussions at home when the subject was first debated. My mother, who was a devoted adherent of Lady Eve Balfour, took up the cudgels against her brother who was MP for Abingdon and a
The futility of fluoridation has been well demonstrated. Upwards of a quarter of all water is lost through leakage, and of the remainder most is used by industry so only a minimal amount gets into the drinking water. Reports of the success of fluoride are largely anecdotal. Therefore, if the need is to protect against tooth decay the way to do so is not through a massive waste of the product. Ironically enough, the fluoride used is itself a waste product of the agricultural fertiliser and nuclear industries, among others, so all we are doing is to recycle a corrosive chemical back into the environment through our river system. That is hardly something that we should be doing today.
Regardless of the fatuity of the scheme, there is the problem of the ethics of mass medication, which noble Lords have discussed in detail. Were such a scheme necessary it would still be debatable whether it should be done by enforcement, leaving the individual in the area concerned no option but to be subjected to the use of contaminated water. It may be said that chlorine is used in that way, but at least we can filter out that chemical. We cannot filter out fluoride.
Calcium fluoride, which most importantly occurs naturally in our diet and daily life, is beneficial in the quantities supplied by nature, whereas the waste byproduct of our farming and nuclear industries which is fed into our water system contains trace minerals such as lead, and its cumulative properties have been shown to have a deleterious effect on several of our bodily organs. It has also been described as a cumulative proto-plasmic poison. That surely should be enough for us. Indeed, it is not even a nutrient; and, in addition, it inhibits important enzymes in the human system.
Is fluoridation necessary in any event? Caries may be distressing but it is not life threatening, as the noble Lord, Lord Stoddart of Swindon, pointed out. Is this not a case of nuts and sledgehammers?
So much for fluoridation in principle. The social reason often given to excuse this waste of resources is that the less well off are the ones who need help with the protection of their children and they are less able to define the need. Besides being supercilious and condescending, the principle is no longer true except perhaps among teenaged single mothers, who can surely be approached in a number of other ways. The noble Lord, Lord Rea, mentioned the use of toothpaste.
The real problem is simply one of diet in general and rationing of a child's sugar intake in particular. Perhaps supermarkets, which claim that they are so beneficial to society, could display sugar-free sweets at the checkout. That might have an instant effect, but whether that would be greatest on the children's teeth or the supermarkets' profits I am not sure.
The noble Lord, Lord Monson, pointed out the number of poisons which have been introduced into our society from chemical companies in the past 50 years, many of which we have been persuaded were vital to the success of the world in the future and which have now been put in the dustbin. There may therefore be some benefit from harmonisation if it comes about since the Commission will undoubtedly find an early opportunity to ban the use of fluoridation. In the meantime, we need a scientific review of the matter. I support the noble Earl's Motion.
Lord Dean of Beswick: My Lords, I compliment the noble Lord on initiating the debate. However, my appreciation of the subject ends there because I totally disagree with everything that he said. I have been involved in the issue of fluoridation since it first became a topic in the 1960s when I was a young councillor on the health committee in Manchester. In those days Manchester was the biggest water authority in the United Kingdom outside the metropolitan authority.
We agonised over the issue. In fact, I almost have a feeling of deja vu because the same tactics were used then as now, only the lead figure is a different person. Every few months we had a different scare as to what fluoridation was supposed to do. We had run out of steam at one stage so Mongolism was dug up; and the argument that fluoridation produced children with Down's syndrome. That was totally blown out of the water when investigated. There was also an argument about bone malformation. We have had a plethora of those types of argument.
The noble Earl graciously sent me a document today containing certain statistics and names. I cannot find anything modern in it; it is history. It goes back to the early 1970s. I believe that it mentions someone from the 1950s. I am sad that some noble Lords who are anti-fluoride seem to denigrate the professional people, medical people of high standing, who happen to be in favour of fluoridation. Those noble Lords seem to rubbish them as though only those names they put forward--I have never heard of some of them--are the people of conscience.
The noble Earl calls for an independent review. I hope that he will not be a member of that review body, having heard the biased and unsubstantiated remarks that he made today. I have a document--other noble Lords may have received it--from the British Dental Association. It is fairly recent--2nd November. I did not ask for it. The document is available in the Library. It states:
Within that organisation is the National Alliance for Equity in Dental Health. It consists of 39 national medical, dental and voluntary organisations, including the British Medical Association, the British Dental Association, the National Health Service Confederation, the Health Education Authority and Mencap. How dare anyone discount almost entirely, as the noble Earl tried to do today, evidence from such outstanding bodies?
I believe that we should move forward. It is certain that in non-fluoridated areas of the UK the decay in children's teeth is five times as high as in fluoridated areas. That statistic is no coincidence; it has been tested and tested again. That is one argument that needs to be put to rest.
My noble friend Lord Rea dealt with the argument concerning cancer, which is the latest scare. There is no definite evidence, but it is said that fluoridation causes a high incidence of cancer. My noble friend referred to a woman doctor who carried out the most recent research on that subject, which showed that it was a load of nonsense. That theme is carried through. They talked about India as if they were talking about the whole continent of nearly three-quarters of a billion people, but they were actually talking about one village which had become polluted not only with an overdose of fluoride gas but with other deadly chemicals which cause other illnesses.
When I was involved in Manchester, I asked our distinguished medical officer of health what he would do regarding his family. He said, "I have grandchildren and I hope that the area where we live will be fluoridated". I asked how much water must a person drink per day before becoming adversely affected by fluoride. He said, "Twice the amount of water which you would use for a bath". That is the volume of water we are talking about according to distinguished medical experts.
I shall not take any longer because all the statistics are evident. The noble Earl has made up his mind. Anyone who is agin him is talking rubbish and anybody who is on his side is brilliant and a genius. There are three of us on these Benches so the die is cast over here. The noble Earl is not going to persuade anyone to his point of view. I believe that it is an act of mischief, it is unnecessary and will affect an increasing number of children and adults. I hope that the Government will not give way on the issue. They have evidence from the most distinguished medical experts in this country and in other parts of the world who have been dealing with the problem for years.
Lord Harris of High Cross: My Lords, I join other noble Lords in thanking the noble Earl, Lord Baldwin, for initiating the debate. It has been interesting, lively and mostly good-natured. With a few exceptions, it has even been moderate in the claims of the opponents of fluoridation as compared with an earlier debate when the opponents seemed to blame fluoridation for almost every ailment, with the exception of housemaid's knee.
I am not concerned to offer evidence or proof one way or another about the possible unintended effects of a fluoridated water supply. But I believe that the debate has already established that there is sufficient evidence of conscientious doubt about whether the private water companies should make themselves responsible for undertaking such a measure of compulsory indiscriminate mass medication. Anyone with doubts might ask the noble Earl for a paper written by a man with a Scots name which inspires confidence, Dr. John Colquhoun, first published by the University of Chicago Press, which tells a most impressive story of a former zealous enthusiast for fluoridation, an active professional advocate of the idea, who has gradually come round to see the opposite of the noble Lord, Lord Dean. He had been involved in a mischievous activity and wished to declare his guilt and to atone for it by joining the ranks of the noble Earl, Lord Baldwin.
There are serious doubts about the issue. The Government may take refuge in saying that they have expert scientific advice. The trouble is that scientists do not necessarily agree on the matter. That has been exposed by several contributors today. I am impressed by the idea that tooth decay, which the noble Baroness told us was a painful and distressing condition, is not a lethal, life-threatening disease. On the whole, you would tend to take the prudent view and refrain from artificial fluoridation.
The problem with fluoridation is that it is one of those causes which busybodying interventionists are attracted to like moths to a candle. The single issue pressure groups, which are the curse of modern politics, pick it up as a holy crusade that all water should be fluoridated by government decree. If zealots persist in urging fluoridation, it may not be sufficient for the Government to shield behind their scientific advisers. After all, scientific advisers are not eunuchs; they are infected by irrational enthusiasm, especially when one particular view becomes established as received wisdom and then the voice of the establishment.
I apologise for raising the matter, but I have spent much of this year studying what I now regard as the pseudo-science of passive smoking in connection with a book I helped to write called Murder a Cigarette. I have absolutely no doubt whatever that the scientific committee on tobacco and health was so carried away by its initial antipathy to smoking that it has exceeded its brief by introducing into what should be a scientific discourse opinionated, biased, fraudulent surveys which are based on no acceptable scientific canons. Close scrutiny of the papers, the original research reports, and then the summary of those reports, demonstrates that there is absolutely nothing in the idea that second-hand tobacco smoke can cause non-smokers to die of cancer. And yet 11 academics, doctors and others on the scientific committee on tobacco and health unanimously signed an official report supporting the received wisdom of the establishment view of the matter.
I say to the Government: beware of official science; beware of politicised science; beware of secret science; beware of pressure group science; and beware of consensus science. If we are to have a review, which I very much favour, let it all be above board.
I hope to bring an original note to the debate by recalling a paper published by my old firm, the Institute of Economic Affairs, back in 1960. It was by a name that some will recognise as APH, A.P. Herbert. It was called Anything But Action?. It was a marvellous, passionate but witty study of a whole range of Royal Commissions and committees of inquiry.
He thought of having a "committees of everybody", selected almost at random, on the model of a jury, which would hear rival pleadings on fluoridation and everything else and then decide which was most to be trusted.
I close on that note. This would be an ideal subject on which to put to the test the suggestion made by A.P. Herbert almost 40 years ago. We should have two committees. We should allow the noble Earl, Lord Baldwin, to appoint his team and the noble Lord, Lord Rea, to try to assemble a quorum to represent his view. We should then have two committees taking evidence. They would then present the matter in a way which would allow ordinary people, as well as the Government, to reach a better understanding and decision.
Lord Dixon: My Lords, it is not my intention to cover the scientific points or the very strong case against fluoridation which has been put so ably by the noble Earl, Lord Baldwin. I congratulate him on successfully securing this debate this evening, and I pay tribute to him for all the work that he has carried out on this important issue.
I am opposed to fluoridation and the more I read and hear about it--indeed, the more I have heard in this debate--the more I am opposed to it. The noble Lord, Lord Monson, was correct to talk about the civil and moral liberty argument. It is very important. The concept that fluoride can be added to drinking water supplies for entire populations constitutes a threat to people's individual rights. It is mass medication without consent. Once the state starts to say that it will enforce the addition of medicine to the water supply, we are in a very dangerous area. What right has anyone to compel another person to consume fluoride? That encroaches on individuals' rights to the extent that persons will be forced to drink water containing a substance which they do not want to drink.
If I--or anyone else--wish to use fluoride, there are many sources available--toothpaste, mouthwash, floss, fluoride tablets, to name just a few. If fluoride is good for health, why is it that Ireland is the only democracy in the world which forces fluoride on all its citizens by law? I am informed also that in Ireland, one tonne of fluoride is put into the drinking water every day. Of that, 99.5 per cent. is not drunk with the water so all that fluoride, which is toxic waste, is effectively dumped into the environment without any environmental audit or research into its effects.
If fluoride is good for health, as the noble Lord, Lord Monson, said, why has continental Europe virtually none? Holland has banned it. Germany, Denmark and Sweden have stopped using it. Portugal, Greece, Belgium and Austria ended fluoride experiments long ago. France, Italy and Norway never even tried fluoridation and rejected it out of hand. No one is going to tell me that in the many European countries which do not add fluoride to the drinking water, their teeth are worse than those in Ireland which forces fluoride on all its citizens. The noble Lord mentioned parts of India. In parts of India now, attempts are being made to take fluoride out of the water by installing plants and equipment to carry out that task.
If fluoride is good for health, why do we see so much bottled water being used? Most local government officers, and even people in this building, use bottled water. I have never seen anyone in the dining rooms or the tea-room putting fluoride tablets into bottled water. If it is that good, why not?
I am a diabetic and was concerned to learn of the effects that fluoride has on people suffering from diabetic mellitus--they are at increased risk from fluoride. It is also important to point out that of the many national organisations in America who have withdrawn their endorsement of fluoride in recent years, the American Academy of Diabetics and the American Diabetics Association are but two.
The truth is that no one has yet proved that a low-level dosage of fluoride is safe. The one-part-per-million level enshrined in the pro-fluoridation propaganda has never been established and was not established in the debate this evening. As my noble friend Lord Stoddart said, the whole case for adding fluoride to drinking water is based on tooth decay and that is caused by poor dental hygiene and poor diet, especially one high in sugar.
I feel that the case has been made by the noble Earl, Lord Baldwin, for having a public inquiry before any further fluoridisation takes place in this country. I was pleased to hear that the Newcastle and North Tyneside health authorities' applications to force Northumbria Water to add fluoride to its water were turned down.
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