Why vote Green? Part Seven

We believe health and wellbeing should be the measure of progress in society. Public health issues are thus a high priority for Greens and above all we favour the prevention of ill-health and the promotion of good health. We would: abolish prescription charges; re-introduce free eye tests; ensure NHS chiropody is widely available; fight to restore free dental care; provide everyone with the choice of an NHS dentist.

A poor quality environment produces ill-health, so Greens lead on campaigning against all pollution and for high air, water, land and food quality. We very strongly favour sex education, health education and economic incentives to cut the abuse of alcohol, tobacco and other drugs. Greens were prominent in opposing genetically modified food, including keeping them out of school dinners. We oppose the fluoridation of our water supplies, an issue that has reared its head last year in Bristol, because it does not work, is not safe, is unethical and is not wanted.

More information:

http://www.greenparty.org.uk/policies/nhs_2010.html

http://www.greenparty.org.uk/policies/nhs_2010/nhs_detail.html

Green Party | Fair, free and effective: Green Party proposals for the dental health service

Green Party Fair, free and effective: Green Party proposals for the dental health service

The Greens are committed to the founding principles of the NHS - including free dental healthcare, which they say could be provided for an extra £1.8 billion a year.

A party spokesperson said today, "£1.8 billion a year is a trifling sum for a huge improvement in Britain's dental health service. Everyone who wants one should have access to an NHS dentist, and we must end the scandal of British children in the twenty-first century suffering the pain and misery that come with poor teeth."

Update: water fluoridation for Bristol issue

Following my email (here) to NHS Bristol and the South West Regional Health Authority expressing concern on the issue of water fluoridation I have received a reply and have the permission of its author to reproduce it (below - I've emphasised some parts in bold type).

I dont agree with Dr Annett's judgement that it is a 'reasonable...means' and would much prefer that full consideration is given to the ethical issues involved right from the off as opposed to just looking at technical matters. Issues like this should be looked at as a whole, as all its various aspects interact.

It may just be inexact writing but I'm also somewhat concerned at this statement '...NHS Bristol will ensure that the public have every opportunity to understand why fluoridation could be an effective public health intervention...' because its far from sufficiently balanced by the words that follow '...and also learn of some of the concerns people may have.' - not the strong emphasis on looking at both sides without bias that I would advocate. Having said this I have since had a message from NHS Bristol which makes reference to presenting a balanced case for and against and asking me if I would be interested in featuring in this process (which I've said yes to).

Dear Mr Vowles,

Re: Fluoridation of Bristol’s Water Supply

Thank you for your recent correspondence regarding the potential fluoridation of Bristol’s water supply.

To avoid any confusion, I assume the release to which you are referring is titled: “Call for public consultation on fluoridation”. This release (or rather statement) was issued by the Department of Health on February 5 2008.

However, you are correct about NHS Bristol considering the fluoridation of Bristol’s drinking water. In recent months, NHS Bristol and our neighbouring PCTs have considered whether the fluoridation of drinking water could be a reasonable and cost-effective means of improving overall dental health and help reduce dental inequalities.

Dr Annett has concluded that it could, and he is recommending that the PCT request NHS South West to commission a technical feasibility study.

At this stage I would like to reassure you that no decisions have yet been made. Requesting a feasibility study is the first step in a process which may, or may not lead to a decision to fluoridate Bristol’s water.

If, and only if, the feasibility study supports fluoridation then the next stage of the process is a rigorous and transparent public consultation where we seek the views of as wide a representation of Bristol’s (and the surround areas) population before any decision is made.

We are committed to ensuring that the debate will be an open and transparent process ensuring the public have their say and will make final representations based upon the consensus of the views of the population. The consultation is externally regulated, and we are bound – by a legal and moral obligation – to ensure that we consult as widely and as completely as possible, and that it is the citizens of Bristol and potentially the wider neighbouring regions that make this important decision.

Throughout the process NHS Bristol will ensure that the public have every opportunity to understand why fluoridation could be an effective public health intervention and also learn of some of the concerns people may have.

If the feasibility study confirms that fluoridation is feasible and cost effective in treatment of water for Bristol, NHS Bristol’s opinion that the population – particularly those in deprived areas – would benefit from a combination of fluoridation of the water and the ongoing commitment to raising awareness of dental health issues which NHS Bristol demonstrates.

If implemented, the fluoridation of Bristol’s water supply will sit alongside a great deal of ongoing pro-active, community facing initiatives we have at improving dental health.

Interestingly, in the near future we are running a campaign aimed at filling NHS Dental entitlements at surgeries throughout Bristol – it may surprise you to note that a large number of surgeries struggle to attract enough NHS patients to their doors.

I appreciate you contacting me and hope that I have answered some of your questions and outlined more clearly the decision making process for fluoridation.

Yours faithfully,

NHS Bristol

You can contact NHS Bristol here info@bristolpct.nhs.uk , and the Strategic Health Authority via go@southwest.nhs.uk

Water fluoridation for Bristol??

In late January Bernard J Seward, a campaigner from the National Pure Water Association and the Safe Water Campaign for Avon, Gloucester and Wiltshire had a letter in the local paper about a possible public consultation in the Bristol area on putting fluoride in all our drinking water. It seems that there is a drive for more water fluoridation from central government. There are therefore understandable concerns that consultations on the issue would not be genuinely open as to the outcome.

I’ve spent a few days looking from all angles at as much information as I can on the issue. There are, however, significant problems obtaining a decent amount of high quality research showing that putting fluoride in drinking water safely and effectively does what it is supposed to do – reduce tooth decay. Available research is often categorised as of only moderate quality because bias and lack of control are evident and analysis is lacking. No clinical trials have been conducted. No license obtained for fluoridated water. Why not? Fluoridated water aims to create bodily changes to fight tooth decay does it not?

Other aspects of the issue defy good scientific practice too. The dose of fluoridated water received by each person depends on the amount of water we drink. Since we all drink different amounts the dose is highly variable – and will be received over a long period of time. Further, the people receiving the dose are highly variable too and unlike being prescribed a treatment by a GP, wont be seen beforehand and wont have their medical history checked. The whole scenario lacks control.

Most of Europe has seen falling rates of tooth decay for several decades – without a policy of widespread water fluoridation. Fluoride is available by choice in toothpaste. Salt containing fluoride could also be made widely available alongside non-fluoridated salt. Those who don’t want to consume fluoride, or have no need to, have a choice now but obviously cannot choose not to drink water and fluoridation is not essential to supplying safe water unlike chlorination to kill bacteria!! If all our drinking water was fluoridated they would therefore be consuming something designed to create bodily changes without their consent. It is the norm in our society to consent to treatment and we should stay consistent with this.

There is no substitute for regular dental check-ups where all sorts of medical issues can be covered. One wonders, given the difficulties people have experienced in recent years with getting an NHS dentist, whether the focus should be there and not with water fluoridation!!

The maximum concentration of fluoride currently allowed in our water is 1.5 mg/l. Any water fluoridation system would have to stay below this legal limit or perhaps an even lower limit would be set. There is always going to be debate over what ‘safe’ levels are. Its clear that the substances used to fluoridate water (sodium fluoride, fluorosilicic acid and sodium fluorosilicate) are, as pure substances, most unpleasant to say the least. That fluorosilicic acid is a by-product from phosphate fertiliser manufacturing hardly adds to the case for its use! Overfeeding of such substances into drinking water has caused serious health problems, as at Hooper Bay in Alaska in the 1990’s, where equipment and human failure resulted in 1 death and 295 cases of fluoride poisoning(details here). Overfeed precautions and plans for defluoridation if limits are exceeded are of course not needed if you don’t fluoridate in the first place!

Key local and regional decision makers and further information:

http://www.southwest.nhs.uk/membersoftheboard.html

http://www.bristolpct.nhs.uk/thetrust/board/profiles.asp

http://www.dwi.gov.uk/

I've written to Dr Hugh Annett, Director of Public Health for NHS Bristol and Bristol City Council via info@bristolpct.nhs.uk , and the Strategic Health Authority via go@southwest.nhs.uk on this issue and hope others will too.