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Baroness Ashton of Upholland: My Lords, I agree that it is important to develop excellent leadership and management skills. Such skills are very important in the schools system, but they are absolutely critical in the business environment. That is why we have a new programme valued at 10 million of public money to support leaders and owner-managers, in particular those in charge of small and medium-sized enterprises. My noble friend will know of the chartered manager award from the Chartered Management Institute. It offers managers a welcome opportunity to attain professional recognition. So we are fully supportive of the comments made by my noble friend.

Baroness Carnegy of Lour: My Lords, I have listened with enormous interest to the noble Baroness because, as she probably knows, this has long been an interest of mine. Some time ago I served as a commissioner on the Manpower Services Commission which considered exclusively these matters.

It is interesting to note that the Government have sought to address these issues through yet another initiative. I am not sure which Secretary of State remarked that a day without a new initiative is a day lost, but we do see a great many new ones. However, I compliment the Government on the magazine they have produced to accompany the strategy. It is not illustrated. No doubt a little money has been saved and I am sure that the document is just as convincing without pictures. Although I have not yet had time to read it carefully having collected it only a few minutes ago, I do have a question to put to the noble Baroness which, from my current experience, gives me cause for concern.

The noble Baroness knows that I live in Scotland. Although the initiative is not to apply there, it is my experience that the best way to resolve these problems is for a further education college to have local centres which then become a magnet for people who want skills training. The local centres should be welcoming and should see to it that all the necessary skills training is available, accessible and local so that people do not have to travel too far.

The White Paper pays tribute to further education colleges in England, which I know are doing a great deal to develop their efforts in this direction. Given that, is it

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really a good idea to consider setting up yet another quango on a fairly local basis to do the same thing? Surely it is absolutely critical to ensure that there is a hub to which older learners and those in need of skills training may go, along with younger people and the unemployed. In that way, everyone congregates in one place where they can receive advice and be catered for in a local centre. Are the Government sure that that will not be made more difficult to achieve if another quango seeks to do the same thing?

I fear that this is, above all, just another new initiative and that we may find that it competes with what is already on the ground. Can the noble Baroness explain to the House what is to be the link between the local initiatives to be undertaken by further education colleges and the work of the new councils? How will they avoid the risk of each detracting from what the other is doing?

Baroness Ashton of Upholland: My Lords, I am pleased that the noble Baroness, Lady Carnegy, likes our new document. I would comment only that a picture can be worth a thousand words. On occasion I find that they lighten documents, but perhaps we should leave that discussion for another debate.

As always, the noble Baroness speaks with great authority about the practicalities of what happens on the ground. She is absolutely right to point out that if what we do fails to address the need for local bases where learners can acquire the teaching they want and relate to it in a local way, then we will simply not have succeeded in what we are trying to do.

We have brought together several elements at the national level. A skills strategy requires impetus, which is why we have an alliance chaired by my right honourable friend the Secretary of State for Education and Skills and my right honourable friend the Secretary of State for Trade and Industry, along with the involvement of the Treasury and from the Department for Work and Pensions. Together they bring to the strategy a critical cross-governmental approach. We must link major organisations who have a real interest in this, and not least the Small Business Council which will have much to say on training issues, and then take those links down to the regional level in terms of our requirements for economic development. I say that because the skills strategy is not only for the kind of expertise we need now but, as I am sure the noble Baroness will acknowledge, to ensure that we have in place the skills we are going to need in the future to compete in the constantly changing global economy. That also takes account of the fact that very rarely nowadays do people take on a job which will last them a lifetime.

Given that, I believe that there is a need to deploy strategic thinking at both the national and the regional level. We are not trying to introduce what might be called a "traditional" new initiative, which is perhaps what the noble Baroness suggested; rather we have brought together what already exists, given it new impetus and put in what we think is a relevant and appropriate mechanism. But the fundamental proof will be seen when local individuals are given the

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opportunity to acquire skills—to achieve that much-needed level 2, which is most vital. It is probably worth reminding noble Lords that most people given training by employers are those who are already quite well qualified. Those lacking basic skills tend not to be offered training. So our commitment needs to concentrate on developing the provision of basic skills.

Further, we must ensure that people are given the opportunity to access, through local further education colleges, through Jobcentre Plus offices, through their employer and so forth, a route to a form of learning that is absolutely right for them. As the strategy filters down it should ensure that from whatever point individuals begin they will find themselves on the road to training. That, I think, will be the proof of the pudding.

Water Bill [HL]

4.26 p.m.

The Parliamentary Under-Secretary of State, Department for Environment, Food and Rural Affairs (Lord Whitty): My Lords, I beg to move that the House do now resolve itself into Committee (on Recommitment) on this Bill in respect of fluoridation.

Moved, That the House do now resolve itself into Committee (on Recommitment).—(Lord Whitty.)

On Question, Motion agreed to.

House in Committee (on Recommitment) accordingly.

[The DEPUTY CHAIRMAN of COMMITTEES (Lord Tordoff) in the Chair.]

The Deputy Chairman of Committees (Lord Tordoff): I shall first call the noble Lord, Lord Warner, to move Amendment No. 1. I shall then call Amendments Nos. 2 to 13, which are amendments to Amendment No. 1. Proceedings on each amendment will be concluded before we move on to the next amendment. When Amendments Nos. 2 to 13 have been dealt with, I shall then put the Question on Amendment No. 1.

The Parliamentary Under-Secretary of State, Department of Health (Lord Warner) moved Amendment No. 1:


    After Clause 58, insert the following new clause—


"FLUORIDATION OF WATER SUPPLIES
(1) The WIA is amended as follows.
(2) For section 87 (fluoridation of water supplies at request of health authorities) there is substituted—
"87 FLUORIDATION OF WATER SUPPLIES AT REQUEST OF RELEVANT AUTHORITIES
(1) If requested in writing to do so by a relevant authority, a water undertaker shall enter into arrangements with the relevant authority to increase the fluoride content of the water supplied by that undertaker to premises within the area specified in the arrangements.

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(2) But a water undertaker shall not be required by subsection (1) above to enter into any such arrangements until it has been given an indemnity with respect to the arrangements in accordance with section 90 below (and any regulations made under that section).
(3) In this section and the following provisions of this Chapter—
(a) references to a relevant authority—
(i) in relation to areas in England, are to a Strategic Health Authority established under section 8 of the National Health Service Act 1977;
(ii) in relation to areas in Wales, are to the Assembly; and
(b) references to water supplied by a water undertaker are to water supplied (whether by a water undertaker or a licensed water supplier) to premises using the supply system of that undertaker.
(4) The area specified in arrangements under this section may be—
(a) in relation to England, the whole or any part of the area of the Strategic Health Authority in question;
(b) in relation to Wales, such area comprising the whole or any part of Wales as the Assembly may determine.
(5) The arrangements shall include provisions designed to secure that the concentration of fluoride in the water supplied to premises in the area in question is, so far as reasonably practicable, maintained at a target concentration of one milligram per litre.
(6) The arrangements shall be on such terms as may be agreed between the relevant authority and the water undertaker or, in the absence of agreement, determined in accordance with section 87A below.
(7) The terms may, for example, include provision—
(a) requiring payments to be made by the relevant authority to the water undertaker;
(b) specifying circumstances in which the requirement to increase the fluoride content may be temporarily suspended; and
(c) for the variation of the arrangements at the request of the relevant authority.
(8) The relevant authority shall consult the Authority in relation to the terms to be included in any arrangements under this section (in particular, terms which affect the operation of the water undertaker's supply system).
(9) The fluoride content of water supplied by a water undertaker may not be increased except in accordance with arrangements entered into by the undertaker under this section, but this shall not prevent—
(a) increases made by a third party on behalf of the undertaker in accordance with those arrangements; or
(b) incidental increases which may occur as a result of operational blending.
87A FLUORIDATION ARRANGEMENTS: DETERMINATION OF TERMS
(1) This section applies if a relevant authority and a water undertaker fail to agree the terms of arrangements requested by the relevant authority pursuant to section 87(1) above.
(2) In relation to areas in England—
(a) the relevant authority may refer the matter to the Secretary of State for determination;
(b) following such a reference, the Secretary of State shall determine the terms of the arrangements as he sees fit; and
(c) the determination of the Secretary of State shall be final.

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(3) In relation to areas in Wales—
(a) the Assembly may—
(i) determine the terms of the arrangements itself as it sees fit; or
(ii) refer the matter for determination by such other person as it considers appropriate; and
(b) the determination of the Assembly or, as the case may be, the other person shall be final.
(4) Following determination under this section of the terms to be included in any arrangements—
(a) the relevant authority shall give notice of the determination to the water undertaker in question; and
(b) the undertaker shall be deemed to have entered into the arrangements under section 87(1) above on the terms determined under this section with effect from the day after the date of the notice.
(5) References in this Chapter to arrangements entered into under section 87(1) above shall include arrangements deemed to have been entered into under that section by virtue of subsection (4)(b) above.
87B FLUORIDATION ARRANGEMENTS: COMPLIANCE
(1) It shall be the duty of each water undertaker to comply with any arrangements entered into by it under section 87(1) above.
(2) Where, pursuant to any such arrangements, the fluoride content of any water is increased, the increase may be effected only by the addition of one or more of the following compounds of fluorine—
hexafluorosilicic acid (H2SiF6)
disodium hexafluorosilicate (Na2SiF6)
(3) Subject to subsection (4) below, water to which fluoride has been added pursuant to any such arrangements entered into by a water undertaker (with a view to its supply in an area) may be supplied by that or any other undertaker to premises in any other area (whether or not that other area is the subject of arrangements under section 87(1) above).
(4) Subsection (3) above applies if (and only if) the undertaker or undertakers concerned consider that it is necessary for the water to be supplied in the other area—
(a) for the purpose of dealing with any serious deficiency in supply; or
(b) in connection with the carrying out of any works (including cleaning and maintenance) by the undertaker concerned or, as the case may be, by the undertakers concerned, or by a licensed water supplier supplying water using its or their supply system.
(5) In this section—
(a) the reference, in subsection (3) above, to water to which fluoride has been added pursuant to arrangements includes a reference to water to which fluoride has been added by Scottish Water in exercise of the power conferred by section 1 of the Water (Fluoridation) Act 1985; and
(b) in relation to a supply of such water by a water undertaker, the reference, in subsection (4) above, to the water undertakers concerned shall have effect as references to the water undertaker and Scottish Water.
(6) In subsection (4) above, "serious deficiency in supply" means any existing or threatened serious deficiency in the supply of water (whether in quantity or quality) caused by an exceptional lack of rain or by any accident or unforeseen circumstances.
(7) Arrangements entered into under section 87(1) above shall remain in force until the relevant authority, after giving reasonable notice to the water undertaker, terminates them."

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(3) In section 88 (power to vary permitted fluoridation agents), in subsection (1), for "87(4)" there is substituted "87B(2)".
(4) After section 88 there is inserted—
"88A POWER TO VARY TARGET CONCENTRATION OF FLUORIDE
(1) The Secretary of State may by order made by statutory instrument provide that section 87(5) above is to have effect as if for "one milligram per litre" there were substituted a lower concentration specified in the order.
(2) An order under subsection (1) above may make different provision for different geographical areas, or for some such areas and not others.
(3) A statutory instrument containing an order under subsection (1) above shall not be made unless a draft of the instrument has been laid before, and approved by a resolution of, each House of Parliament."
(5) For section 89 there is substituted—
"89 CONSULTATION
(1) Before taking any step mentioned in subsection (2) below, a relevant authority shall—
(a) consult and ascertain opinion in accordance with regulations made by the Secretary of State; and
(b) comply with any prescribed requirements.
(2) The steps are—
(a) requesting a water undertaker to enter into arrangements under section 87(1) above;
(b) requesting a water undertaker to vary any such arrangements in, or except in, prescribed circumstances or cases;
(c) giving notice to a water undertaker under section 87B(7) above to terminate any such arrangements;
(d) maintaining any such arrangements in prescribed circumstances.
(3) The Secretary of State shall by regulations make provision about—
(a) the process which relevant authorities are to follow for the purposes of subsection (1)(a) above;
(b) the requirements which must be satisfied (with respect to the outcome of that process or otherwise) before a step mentioned in subsection (2) above may be taken.
(4) Subsection (1) above shall not apply in relation to a proposal by a relevant authority to take the step mentioned in subsection (2)(c) above if—
(a) in relation to England, the Secretary of State so directs the relevant authority;
(b) in relation to Wales, the Assembly so determines,
in each case, either generally or in relation to a particular proposal by the authority."
(6) For section 90 of the WIA (indemnities in respect of fluoridation) there is substituted—
"90 INDEMNITIES IN RESPECT OF FLUORIDATION
(1) The Secretary of State may, with the consent of the Treasury, agree to indemnify any water undertaker in respect of liabilities which it may incur in complying with arrangements entered into by it pursuant to section 87(1) above.
(2) The Secretary of State may by regulations make provision with respect to—
(a) the matters in respect of which an indemnity may be given under subsection (1) above;
(b) the form and terms of any such indemnity; and
(c) such ancillary matters as he sees fit."
(7) Section 91 of the WIA (pre-1985 fluoridation schemes) shall cease to have effect.
(8) Schedule 7 to the WIA (pre-1985 fluoridation schemes) shall cease to have effect."

9 Jul 2003 : Column 299

The noble Lord said: In moving Amendment No. 1 standing in my name, I shall speak also to Amendments Nos. 14 and 15. Fluoridation is a sensitive issue and I welcome this opportunity to debate the Government's proposals to give local communities a real option of deciding whether fluoride should be added to their drinking water. Although we believe it is right for local communities to decide whether to fluoridate their water, we have every confidence in the briefing paper on the fluoridation of water and dental decay produced by the Chief Medical Officer and the Chief Dental Officer, copies of which I have circulated to all Members of your Lordships' House.

Dental decay among children and adults remains an extremely common disease which is largely preventable. It is closely related to socio-economic status. As the briefing paper points out, from a public health perspective water fluoridation is the delivery method of choice to bring about population improvements in dental health and should be considered locally when it is desired to reduce inequalities in levels of dental decay.

There have been two recent newspaper articles by the same journalist raising concerns about fluoridation and health risks. The circulated briefing paper draws attention to the University of York and Medical Research Council reviews of evidence in this area. As the paper says, the York team found no evidence of an association between bone fractures, infant mortality or cancer and water fluoridation. The 2002 Medical Research Council review identified no particular research priority in this area. Moreover, the Chief Medical Officer and the Chief Dental Officer are to report to Ministers in the autumn on the implications of the MRC report for government policy on fluoridation, well before any local consultations could take place.

The main reason for Amendment No. 1 is that the Water (Fluoridation) Act 1985, consolidated in Sections 87 to 91 of the Water Industry Act 1991, has not achieved the policy intention of successive governments of letting local communities make decisions on fluoridation. In summary, Section 87(1) of the Act states that where a health authority applies to a water undertaker for its water to be fluoridated the undertaker "may" increase the fluoride content of the water supplied by it within that area. The effect has been to give water companies discretion over whether to agree applications to fluoridate and, on every occasion that a health authority has made an application, the water undertaker has turned it down. As a result, there have not been any new fluoridation schemes agreed since the Water (Fluoridation) Act was passed in 1985.

This, I should hasten to add, is not because water companies have concerns about the effects of fluoridation; it is because they do not feel qualified to make decisions on what is essentially a public health issue. The water industry's representative body, Water UK, has asked on repeated occasions for the Act to be amended to put water companies under a statutory obligation to accede to requests from strategic health

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authorities to fluoridate their water where they can show that their populations are in favour. Hence our proposed amendment requires that the water undertaker "shall" enter into arrangements with the relevant authority to fluoridate. The "relevant authority" in England would be strategic health authorities but in Wales it would be the National Assembly for Wales. This is the main change we are proposing.

We do not intend that water should be fluoridated come what may in those areas which do not currently receive naturally or artificially fluoridated water at a level capable of reducing dental decay. In fact, the enactment of the amendment may not lead to any new fluoridation schemes—that would depend on what people decided locally—but it would give local communities the choice of having their water supply fluoridated.

The remainder of the section provides details of the arrangements between the water undertaker and the relevant authority, including payment, and, as at present, the target concentration of fluoride. Proposed new Section 87A introduces provision for determination where the relevant health authority and a water undertaker fail to agree the terms of an arrangement to fluoridate. We are not expecting disagreements but it is good legislative practice to include such a provision to avoid negotiations reaching a deadlock.

Proposed new Section 87B restates the chemical compounds which are permitted to be used in fluoridating water and provides for water companies to suspend fluoridation for temporary periods due to operational exigencies such as droughts or plant maintenance.

Proposed new Section 88A introduces a regulation-making power to reduce the target concentration of fluoride in drinking water below the one milligram per litre specified in Section 87(5) of the Act. This might be appropriate if it was found that, as a result of increased use of discretionary fluorides such as toothpaste and mouthwashes, the desired reductions in tooth decay could be achieved at a lower concentration of fluoride in water.

The reason for using regulations is to provide additional flexibility in making changes of a technical nature which currently can be made only by amending primary legislation. However, because this is an important public health issue meriting debate in Parliament, we propose that the regulations are subject to affirmative resolution. The National Assembly for Wales would exercise the powers in relation to Wales and its scrutiny procedures will apply.

Proposed new Section 89 provides for consultations. As I indicated, no new fluoridation scheme would go ahead without the support of the majority of the local population determined by local consultations conducted by strategic health authorities in England and the National Assembly in Wales. It is essential that the procedures followed command public confidence. We do not consider that the present provisions in Section 89 of the Water Industry Act for publicity and consultation go

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anywhere near far enough. For this reason we propose to introduce a regulation-making power to cover the detailed requirements.

Taking into account the advice of the Delegated Powers and Regulatory Reform Committee we have decided that these regulations should be subject to the affirmative procedure and we will table an amendment to this effect in another place. The National Assembly for Wales will determine the content of the regulations for Wales and will no doubt consider and develop regulations that best meet the needs of Wales. Also on the advice of the Delegated Powers and Regulatory Reform Committee, we have decided that these regulations should be subject to the affirmative procedure and we will table an amendment to this effect in another place.

We intend that regulations should provide for the dissemination of the proposals through, for example, the press, radio, TV and leaflet drops, and for consultations involving public meetings, discussions on local TV and radio, helplines and websites, culminating in an objective means of measuring public opinion which ensures that the views of people from a wide range of backgrounds are represented. We will consult widely among those with expertise on the best methods of measuring public opinion, particularly among social groups which stand most to benefit from fluoridation but which do not always participate in public consultation exercises.

The proposed new Section 90 proposes that the present provisions for indemnifying water companies are made more specific through a regulation-making power. We have in mind the use of model indemnities for England in the regulations which we would discuss with the water industry. The broad objective is to ensure that the liabilities of a water company which is required to introduce a fluoridation scheme are no more weighty than those of companies without schemes for England. The regulations in Wales will be a matter for the National Assembly for Wales.

I turn now to Amendments Nos. 14 and 15. Amendment No. 14 removes the provision which would have enabled the Secretary of State to issue indemnities to licensed water suppliers. Our current thinking is that the relevant health authorities should only make arrangements with water undertakers and that the indemnities to the water undertakers would cover any sub-contracts they made with licensed water suppliers. We intend to discuss this assumption further with the water industry and, depending on the outcome, may make further amendments in another place. Whatever is decided, we will find a different drafting solution, so I shall still need to move Amendment No. 14.

Amendment No. 15 is a provision which adds Schedule 7 to the Water Industry Act to the list of provisions which are to be repealed. That schedule regularised the position of pre-1985 water fluoridation schemes in the light of the provisions of that Act. It is proposed that there will be new provision in the Bill to deal with existing schemes by converting them to the new style of arrangement. Amendments to this effect

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will be introduced in another place. What is certain is that the existing Schedule 7 to the Water Industry Act will no longer be required.

I remind the Committee that these amendments are being moved in response to the strength of opinion in another place on this issue and a commitment that the Government gave to do so. There is a strong body of opinion that local communities should have the right to make the choice to fluoridate their water to reduce dental decay, particularly among children. I have had many letters—as, I suspect, have other noble Lords—over the past week supporting the Government's approach on this issue and none opposing it. The Government are responding to people's concerns in a practical way. I beg to move.


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