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Lord Stoddart of Swindon: I am much obliged to the noble Lord for giving way. I have heard exactly what he said, and I am pleased that the regulations will come forward by affirmative resolution. But he must know that even if there is an affirmative resolution, it cannot be amended by either House. Therefore, the regulations will be put before us for acceptance or rejection, but not for amendment. I am trying to ensure that the Government are aware that there are strong feelings about what the regulations should contain and that the public should be properly and fairly consulted before any decision is taken.
Lord Warner: I am not sure what more I can say to reassure the noble Lord on the processes to be carried out in this area. I am not sure that I do much service to the Committee by continuing along this path.
Perhaps I may move to Amendment No. 10. Our reaction to the amendment is that we have much sympathy with the intention behind it, that no strategic health authority will be permitted to fluoridate, unless the local community is in favour. That will be central to the regulations that I said we shall draw up on consultation and assessing public opinion under Section 89.
On the obvious concerns of the noble Baroness, we shall also consider whether the need for an SHA to show that the population is in favour should be included on the face of the Bill. We recognise the importance of the methods used in assessing public opinion. I have tried to emphasise that. As I said earlier, we shall consult widely on this matter, on the best basis of carrying out the consultation and on the best way to measure public opinion. We can use issues like well structured public opinion surveys; we can talk to the Electoral Reform Society, the Local Government Association and the professional bodies concerned with public health and dentistry. We are resolved to combat social exclusion by means of reaching people who do not normally contribute to opinion surveys.
It is worth bearing in mind again that the people who are suffering from dental decay most severely are people in lower socio-economic groups. In the public consultation and public determination process, we need to work towards a kind of basket of indicators that is likely to provide us with a good picture of people's opinions across the socio-economic groups. I emphasise again that we shall use leaflet drops, telephone help lines, and all the wonders of information technology to help us to tap in to people's opinions. I hope that in the light of that the noble Baroness will be willing to reconsider moving her amendment.
The Countess of Mar: Before the noble Lord sits down, perhaps I could say that he has not addressed the point that was made by the noble Lord, Lord Stoddart. Opinions are formed by opinion formers. We have all been bombarded by letters from a huge number of health authorities and the Minister said that he had not heard any opposition to fluoridation. I have. Perhaps people think that I may be more receptive to some opposition. We have to hear both sides of the story. If the health service is promoting its attitude to fluoridation, the other side must be funded to promote its side, so that people can have an even view of the matter on which to make up their minds. Will the Minister kindly address that point?
Lord Warner: I am drawing a deep breath. I have already said that there will be public funding through the statutory health authorities for the process of consultation. We have said at length what those processes will be. There will be plenty of opportunity for those who oppose the idea of fluoridating water in a particular area to have their full say in the process. I would be very surprised if the noble Lord, Lord Stoddart, in his area, remained silent while such a process was taking place there.
Baroness Byford: Perhaps I may take the noble Lord back to the point made by the noble Countess, Lady Mar. If I recall correctly, the Minister said that £2 billionanyway a large sumwas allocated to the health authorities. That does not mean that money is available to those who might want to put a contrary view. The noble Baroness, Lady Miller of Chilthorne Domer, is trying to make sure that sufficient funding is available so that those with different views can make their cases heard.
Although I have listened carefully to the noble Lord, he has not satisfied me as an individual that the money allocated to the health authorities would be distributed to groups with contrary views. That is where the dilemma lies.
Baroness O'Cathain: Surely the £2 billion is not actually for the consultation, but is solely for dentistry. Suddenly that figure gets around and is in the same discussion about consultation, so please let us get that off the record.
Lord Warner: Let me put the matter beyond doubt: there will not be £2 billion for public consultation. I was saying that by the time we get to 200708, something like £2 billion a year will be being spent on dentistry. So those strategic health authorities in which there are high levels of dental decay will have a vested interest in ensuring that there is a proper public debate about this particular issue.
Baroness Miller of Chilthorne Domer: I thank all noble Lords who have spoken in the debate. I am agnostic about fluoridation of water; I am simply concerned with these amendments to ensure that the non-agnostic public, who probably will not take a strong part in the matter, have a proper opportunity to put their views.
I believe that the Government can understandand have said so on occasions, although I cannot quote whenthat a body should not be judge and jury of an issue. If a health authority is a strong promoter of adding fluoride to water, it certainly is not the body to carry out the consultation.
Lord Hunt of Kings Heath: If the noble Baroness adopts that principle, one would reach a situation in which the strategic health authority would not take any decisions at all because she would say that it could not take an objective view. The strategic health authority and the primary care trust are the public health authorities in this country. It is their job to take decisions.
Baroness Miller of Chilthorne Domer: The difference is that informed consent to medical treatment has until now always been the norm. The move away from that makes this a sensitive and different issue and the reason why another body or bodies should conduct the consultation.
I am grateful to the noble Earl, Lord Howe, for pointing out that in Amendment No. 9 it might have been better to use the words "may instruct". I guess that it was my natural liberal tendencies that made me use the word "request" because it sounded more polite. I accept his point that that wording would be stronger.
I cannot better the arguments of those noble Lords who have said that Amendment No. 1 would be a much better amendment were these amendments to be on the face of the Bill. I have listened carefully to the Minister's reply. It may well be that all the points he makes are in regulations. However, that certainly does not get around the judge and jury point. I believe that when we feel something strongly, it should be on the face of the Bill. For that reason, I wish to test the opinion of the Committee.
Resolved in the negative, and Amendment No. 8, as an amendment to Amendment No. 1, disagreed to accordingly.
The noble Baroness said: I intend to move Amendment No. 9, because I should like to think further about the helpful suggestion from the noble Earl, Lord Howe, that local authorities may be instructed within the area. I shall bring back the amendment on Report. I beg to move.
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