PUBLIC DEBATE ON WATER

FLUORIDATION

Put your questions to decision-makers from Southampton and Hampshire Councils and
find out about the current legal position and what is happening now with regard to the
proposed scheme.

Panel members:
Cllr Dave Shields, Chair of SCCs Health & Wellbeing Committee.
Cllr Roy Perry, Leader, Hampshire County Council
Cllr David Harrison, Hampshire County Council
Dr Julian Lewis, MP New Forest East
Keith Taylor MEP South East





Council Health Chief to Listen to Public Views

In April 2014, Councillor Dave Shields wrote a leter in the Echo setng out 10 questons regarding water
fuoridaton and invitng local debate on the issue. Hampshire Against Fluoridaton asked Cllr Shields
whether he would be prepared to answer questons from the public. We are pleased that he agreed to
be on the panel so now is your chance to express your concerns and to ask questons at this HAF
chaired forum. Each panel member will be outlining their positon and views on fuoridaton and will
then be answering questons from the audience.

This will be a good opportunity to engage with local politcians from diferent politcal partes on deci-
sions afectng your water supply.


Inside this issue:
Cllr Dave Shields leter
Water fuoridaton: Where are we now?
News from UK and Abroad
Research Roundup
What YOU can do
HAF News and Contacts
hampshireagainstfluoridation.blogspot.com/

September
2014
Saturday 4
th
October 2-4pm
Solent University Conference Centre
Above Bar St, Southampton
Free Admission
Extract from Letter to Echo by Councillor Dave Shields First published April 2014

As chair of the Citys Health and Wellbeing Board I welcome local debate on what our investment priorities
should be in tackling our major health inequality challenges. Big cuts in Council budgets make this even more
important in places like Southampton. As a regular reader of the Daily Echo I am acutely aware of the views
of some local people who are strongly opposed to fluoridation as a solution to our dental health problems.
Any decision about fluoridating the local water supply needs to be informed by the best available evidence
and Southamptons Health and Wellbeing Board will be a firm advocate for such an approach.
To help us with this I pose ten questions for local people to consider:
1. Does Southampton currently experience high levels of poor dental health, particularly in respect of chil-
dren from more disadvantaged backgrounds?
2. Can addition of fluoride to the local water supply have a positive impact in reducing the Citys dental
health problems?
3. Are there any examples from other regions where fluoride has been introduced to the local water supply
where this had positive dental health benefits?
4. Can fluoridation be added to the local water supply with negligible risks to public safety?
5. Can fluoridation be undertaken at a relatively low cost to the taxpayer in comparison with other preven-
tion schemes?
6. Should savings from reduced spending on dental health treatment focus on other important local public
health priorities
7. Do proposals for fluoridation command widespread public and political support?
8. Do fluoridation proposals meet with the Governments legal requirements?
9. Are people satisfied that a considerable amount of time and public money has already been spent on local
consultation on proposals for fluoridation?
10. Is fuoridaton supported by the majority of internatonally-recognised organisatons concerned with pub-
lic health
A Response To the Above Letter:

Water Fluoridation: Where Are We Now?

It is well over 5 years since the now disbanded Strategic Health Authority (SHA) made the unanimous decision
to fuoridate the regions drinking water and 6 years since the public consultaton in which 72% of respond-
ents rejected the controversial plan.

In fact, local oppositon has been overwhelming and the campaign to fght what was widely seen as an unfair
decision forced through by an unelected quango, has been ongoing. Afer all this tme, you would think that
the batle is over and Public Health England would fnally concede that dosing the water supply with industrial
-grade fuoride is a bad idea that will never be accepted by local people. It is high tme to move on and shelve
the plans..

A brief reminder of key events in this saga:
2008 - public consultaton (72% of respondents opposed)
2009 Unelected SHA board members ALL vote to proceed with water fuoridaton
2009 Local campaign grows; 15,000 signature petton handed in to Downing St.
2010 - HAF atends European Union hearing on fuoridaton in Brussels
2011 High Court Judicial Review
2012 Southampton City Council vote to oppose fuoridaton
2013 SHA abolished. Public Health England created.
2013 Legislaton in force giving local councils power over fuoridaton
2014 HAF interpretaton of new rules concludes original decision no longer valid
2014 Hampshire County Council reaches similar conclusion

This is the argument.
The aboliton of the SHA in April 2013 was a key factor in stopping any proposed scheme. According to the
new legislaton, if a scheme was not fnalised BEFORE the demise of the SHA and no agreement or contracts
were in place at the tme, then it is deemed that no scheme exists. This is clear from a detailed analysis of the
Health & Social Care Act (2012) which HAF has scrutnised in forensic detail. Dr Julian Lewis MP who is aware
of the HAF interpretaton, has pursued this with various health ofcials at the Department of Health and it has
been interestng to see some of the correspondence. It seems Public Health England disagrees with this view
and has been repeatedly claiming that it has the remit to contnue where the SHA lef of

HAFs opinion on the legal interpretaton is also shared by Dr Julian Lewis MP, Cllr. David Harrison. And Cllr.
Perry, Leader of Hampshire County Council:

Statement from HCC Roy Perry in correspondence with HAFs Bill Edmunds (27
th
June):
We are currently in a process of legal argument with Public Health England and it would be inappropriate for
me to say more at this point- other than we have not yet seen a legal argument in favour of the view that
Public Health England can implement such a scheme.

Public Health Englands Response:
A recent Freedom of Informaton request to Public Health England from HAF Chair, John Spotswoode gener-
ated the following reply from PHE:

If PHE (on behalf of the Secretary of State) was minded to proceed with this proposed fuoridaton scheme to
cover parts of Southampton and South West Hampshire, it could do so on the basis of the power that the Sec-
retary of State has, by virtue of s.87(1) of the Water Industry Act 1991 (WIA and Artcle 7(1) of the Health &
Social Care Act 2012 (Commencement No.4, Transitonal, Savings and Transitory Provisions) Order 2013, to
enter into arrangements with Southern Water PLC to implement the fuoridaton schemeGiven that no
decision as to whether or not to proceed has been made, PHE has not progressed the formal request to the
water company to enter into arrangements.
It gets complicated.

PHEs justfcaton for their ability to contnue to implement fuorida-
ton is very strange. They cite a power under transitonal arrangements
relatng to the Health & Social Care Act 2012. However, this is at odds
with the relevant clause of the Health and Social Care Act 2012 that
refers to arrangements being in place - which guidance refers to as a
contract with the water company. This is the point of disagreement
between the Councils' legal opinion and PHE. Clearly PHE do not at the
moment, want to test their legal opinion - presumably they would go
ahead if they felt they had strong legal grounds.

However, they need to factor in the politcs - it would not look good for
PHE to ride roughshod over local Councils' views when the thrust of policy and general premise of the legisla-
ton on public health is to give local councils decision-making powers. An alternatve reading of the relevant
legislaton could be that under transitonal arrangements, power to request implementaton stll lays with the
local councils and not PHE as no fnal scheme had been produced by the SHA before 31st March 2013.

The procedure that PHE appear to be pinning their hopes on would be correct in other areas where there is
already an existng scheme. But there isn't one in Southampton. First, because South Central Strategic Health
Authority weren't able to formally hand any contracts to PHE when they went out of existence on 1 April
2013, and secondly because they didn't have a workable scheme in the frst place
PHE don't even have one now, so how can they claim that the SHA had one?

What has changed?

The recent reply to the FOI from HAF makes it clear that PHE is now undecided about proceeding. This is the
frst tme they have taken this approach - no longer repeatng the mantra that fuoridaton is stll defnitely
going ahead. So we will have to wait and see if PHE are minded to proceed

Councils are Key
Everything changed following the Health & Social Care Act which was enforced in 2013. Local councils be-
came responsible for decisions about fuoridaton. But because the Southampton decision was made under
the old rules, it seems it is no longer applicable. With Southampton City Council votng to oppose fuoridaton
in 2012, the situaton locally meant that there was no county, city or district council support for the proposal.
This has proved to be vital.
In correspondence between Dr Julian Lewis and the Department of Health earlier this year, Minister for Pub-
lic Health, Jane Ellison MP , reiterated the importance of the city council changing its stance regarding fuori-
daton: With respect to the proposal by the SHA to fuoridate Southampton and surrounding areas of Hamp-
shire, I understand that Southampton City Council has altered its positon during this process, having previ-
ously been supportve. PHE is understandably keen to contnue to discuss this issue with the relevant local
authorites.However, I have stressed to them the importance of having the support of the local authori-
tes, especially the City Council.
Copies of these leters and FOI responses can be found on the HAF blog.



hampshireagainstluoridaton.blogspot.com
Whats happening elsewhere?

UK: Existing Schemes: Cumbria and Bedford

Since April 2013, PHE has swifly moved to re-introduce fuoridaton to West Cumbria and Bedford where
technical problems had led to the water companies ceasing fuoridaton a few years ago. Fluoridaton was re-
commenced in West Cumbria in 2013 and will be re-introduced in Bedford by the end of the year.

PHE are able to do this because the schemes are considered to be in existence and thus, do not require a deci-
sion by local councils. What is interestng however, is that in both places, the dental health of children has
improved despite no fuoridaton scheme being in place. Both Bedford Borough Council and Cumbrias Al-
lerdale Council had previously voted to end water fuoridaton. Unfortunately, at that tme they did not have
the power to stop the scheme being re-instated as it was the NHSs responsibility. In West Cumbria, Cumbri-
an Health Choices are working to try to end fuoridaton by getng Cumbria County Council to discuss the is-
sue. In Bedford, Cynthia Bagchi of Bedford Safe Water has been trying to get the Council to debate the issue
and hold another vote so that PHE can be stopped. John Spotswoode has writen to Cynthia on behalf of
HAF ofering support and HAF members Joy Warren and Professor Stephen Peckham have been actvely help-
ing the Bedford campaign.

Scotland Shows the Way Forward in Caries Prevention for Children

One of the main arguments used by those promotng fuoridaton is that it will reduce
inequalites in dental health. They argue that children in more deprived areas will ben-
eft despite no good quality evidence to support this view. In fact, studies show tme
and tme again that inequalites in dental decay persist whether water is fuoridated or
not. In fuoridated Birmingham, for example, some areas have more than twice the na-
tonal average of dental decay and substantal numbers of children have teeth extract-
ed under general anaesthetc. In fuoridated Wolverhampton more children have teeth
extracted for decay than in Southampton despite similar populaton sizes.

By contrast, recent evidence from the ChildSmile scheme in Scotland has shown that this preventon pro-
gramme has not only drastcally reduced the inequalites in dental health but has also reduced dental costs
and the numbers of children sufering tooth removal under general anaesthetc (.htp://
news.scotland.gov.uk/News/Dental-programme-saves-6-million-5f9.aspx). At 1.8 million this scheme is
cheaper than the cost of fuoridatng the West Midlands.

International: More Communities End Fluoridation

Since the beginning of 2014 nearly 7.7 million people had fuoride removed from their water supplies, joining
the majority of people in the world who enjoy the benefts of fuoride-free water.

This includes Australia (Oberon, New South Wales) 2,500 people; Canada (St John, New Brunswick) 76,550
people; New Zealand (Roturua) 70,000 people; USA (9 communites state wide) over 300,000.
See the FAN website for full details (www.htp://fuoridealert.org/).

Israel Bans Fluoridation

The most signifcant development this year has been the total ban on water fuoridaton announced in August
this year by the Health Minister Yael German. On 26th August she issued a decree discontnuing water fuori-
daton arguing that the safety of fuoridaton cannot be completely assured and that it is an infringement on
personal rights. Israel has now joined the ranks of countries such as Finland, Germany, Japan, the Nether-
lands, and Sweden, which have abandoned or outright banned water fuoridaton altogether.

The latest research roundup.


Beware of Cheap Tea
It has long been known that tea contains fuoride. A study published at the end of
2013 showed that the level of fuoride in tea varies considerably. In partcular the
authors highlight that UK supermarket economy teas contain higher levels, ranging
from 3.60 to 7.96 mg/L. This means that people who daily drink 1 litre or more of
economy brand tea, made with non-fuoridated water, will exceed recommended levels of fuoride. Obvi-
ously when made with fuoridated water the daily intake will be substantally increased.
Chan, Laura, et al. Human exposure assessment of fuoride from tea: A UK based issue? Food Research In-
ternatonal 51.2 (2013): 564-570.

Fluoride should be added to the list of Neurotoxins that affect Childhood Development
A review of developmental neurotoxins identfed fuoride as one of a number of chemicals that could cause
developmental disabilites. The authors Philippe Grandjean, and Philip J Landrigan from Harvard University
and Mount Sinai medical School argue that fuoride should be included within internatonal monitoring of
neurotoxins.
Grandjean, P & Landrigan, PJ. Neurobehavioural efects of developmental toxicity. The Lancet Neurolo-
gy 13.3 (2014): 330-338.

Critical Review of Water Fluoridation
In a paper reviewing the research on fuoridaton published in The World Scientfc Journal in March this
year, HAFs Professor Stephen Peckham and Professor Niyi Awefeso concluded that the available evi-
dence suggests that fuoride has a potental to cause major adverse human health problems. As part of
eforts to reduce hazardous fuoride ingeston, the practce of artfcial water fuoridaton should be reconsid-
ered globally.... Public health approaches for global dental caries reducton that do not involve systemic in-
geston of fuoride are urgently needed.
Peckham, Stephen, and Niyi Awofeso. Water Fluoridaton: a critcal review of the physiological efects of
ingested fuoride as a public health interventon. The Scientfc World Journal (2014).
(htp://www.hindawi.com/journals/tswj/2014/293019/abs/)

Action Urgently Needed to Reduce Sugar Intake
Researchers from University College London (UCL) and the London School of Hygiene and Tropical Medicine
advise that sugar consumpton should be drastcally reduced to just 3% of dietary calorie intake, which is
contrary to current WHO guidelines (10% for adults). They found that sugar intake which accounted for 10%
of energy intake, or calories, "induces a costly burden of caries (tooth decay)".
Sheiham A, James WPT. A reappraisal of the quanttatve relatonship between sugar intake and dental
caries: the need for new criteria for developing goals for sugar intake. BMC Public Health. Published online
September 16 2014. htp://www.biomedcentral.com/1471-2458/14/863


Childsmile
Evidence is emerging from Childsmile showing not only dramatc reductons in caries amongst children, but
that that the natonal toothbrushing programme has substantally reduced inequalites in dental health.
Blair, YI, McMahon, AD.& Macpherson, LM. (2013). Comparison and relatve utlity of inequality measure-
ments: as applied to Scotlands child dental health. PLOS one, 8(3), e58593.






hampshireagainstluoridaton.blogspot.com

What You Can Do

Remember that water fuoridaton could stll go ahead in Southampton. PHE appear to be unsure what to do
next. If they are minded to proceed, we could be faced with an on-going batle. The original proposal and
consultaton is now so out of date that the whole procedure would have to be re-run with a new feasibility
study and costngs which would involve large amounts of public money added to what has already been spent
and wasted on this unworkable plan.

The Councils are really important players since the change in legislaton that took place in 2013. ALL councils
in the area oppose the scheme so lets hope that this is enough to further discourage PHE from taking things
any further. However, it is important to keep the issue on the agenda this is what you can do:

Write to your local councillor
Keep a check on SCC and HCC websites to check agendas to see if the issue is coming up at future
council meetngs.
Look out for any planning applicatons for dosing sites
Write to your local MP outlining your concerns
Write to PHE asking for their positon (it changes from tme to tme)
Write to The Daily Echo
Atend the HAF Public Debate and distribute fyers to publicise it.
Write to Southern Water to see if any further developments are taking place


Support Hampshire Against Fluoridation

HAF is a non-politcal campaign group opposed to the fuoridaton of local water supplies. We aim to highlight
the dangers of this outdated practce and disseminate the highest quality evidence-based informaton.
HAF promotes alternatve preventon strategies to combat poor oral health and inequalites such as the
Scotsh Childsmile scheme which ofers an ethical, efectve and cost-saving programme with a proven
track record of successfully reducing dental decay rates.

HAF networks with other groups both natonally and internatonally so that we can pool our expertse and ex-
perience and we became a proud founding member of the Worldwide Alliance to End Fluoridaton back in
May joining other communites from across the world as part of an internatonal movement to end the
practce of water fuoridaton (for more about this see www.fuoridealert.org).

HAF would be interested in any replies you receive that state a diferent positon from the latest outlined in
this newsleter. If you wish to receive the newsleter or fyers for the meetng, please let us know and they
will be sent electronically to you. HAF relies on donatons. You can donate by Paypal
(hampshireagainstluoridaton.blogspot.com) or cash/cheque payable to Hampshire Against Fluoridaton
and posted to the treasurer/membership secretary (see below).

Contacts:

Chairman: John Spotswoode: 02380 789230 john.spot@openworld.com
HAF blog: Bill Edmunds bill@edmunds92.freeserve.co.uk hampshireagainstluoridaton.blogspot.com
Donatons and membership: Ann Richards 4 South Road, Hayling Island, PO11 9AE
Tel: 02392 463761 annpeter@richards177.fsnet.co.uk
Newsleter: Anna Peckham amgpeckham@gmail.com
Research: Professor Stephen Peckham peckhams@yahoo.com
hampshireagainstluoridaton.blogspot.com