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(05/01/16) A summary of 'Cochrane Collaboration systematic review of water fluoridation 2015' has been posted in Reports.
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(16/04/14) A critique of 'One in a Million: The Facts' has been posted in Reports.
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(16/04/14) 'Fluoridation: Popularity' has been posted in the Archive.
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(18/04/10) New fluoridation scheme for Southampton

(18/04/10) The Reports and Archive sections have been updated with further documents and links

(11/07/09) A critique of Prof. Newton's report to South Central SHA has been posted in Reports.
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(28/09/08) A critique of the South Central Strategic Health Authority Consultation Paper on Water Fluoridation in Southampton, has been posted in Reports.
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(07/09/08) A response to the Chief Dental Officer's 'Dear Colleague' letter of guidance for new schemes, endorsed by scientists from the York review, has been posted in Reports.
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(23/06/08) Isle of Man has announced on 12th June that it will not be fluoridating its water supply
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SHA Public Board Paper HA09/019: Fluoridation

18th May 2009

Dear Olga Senior,

Thank you for your reply of 24th April to my letter about your paper of 18th February. I am glad that you accept Lord Jauncey's finding on fluoride in water.

I do think a significant misstatement was made to the SHA board about the 1983 Strathclyde case. The precedent from it is that fluoride in the water was held to be a medicinal product under the UK Medicines Act 1968, whether or not the petitioner took the wrong party to court on the issue. The board should surely have been told this.

I find there is much careless argument about the status of fluoride. The need for consent does not apply solely to medication as suggested in the last paragraph of page 3 of your February paper ("As it is not accepted that fluoridation is medication, consent is not required", 4.2). Surgery is not a medicine; yet "Every human being of adult years and sound mind has a right to determine what shall be done with his body; and a surgeon who performs an operation without his patient's consent commits an assault . ." This can be found on the MHRA's website, as a case-law citation of "the absolute right of a patient not to be treated against his or her will". It is periodically reinforced in statements by the British Medical Association, for example over vaccination. While no one can be sure how a court would decide if fluoridation were challenged on this basis, or on the basis that the MHRA should have complied with the European Directive whose definition of a medicinal product you quoted in February, it was wrong to give the SHA board reassurance on the matter, and your comparison with chlorine as I pointed out on 25th March was misconceived.

It may not be the SHA's role, as you state it, to explore other options for reducing caries. Nevertheless the Cabinet Office's Code states that "As far as possible, consultation should be completely open, with no options ruled out". The goal is to reduce caries, rather than to introduce fluoridation. It would have been possible in pursuit of this to follow the Code and let others in the consultation probe the PCT's reasoning if the SHA would not. As an example, the same kind of argument arose in London in 2003 and the Assembly, which was able to probe the arguments for improving dental health, was not satisfied that enough was being done locally to prevent caries and rejected fluoridation as an option. It would be perverse if under the more thorough procedures of the Water Act 2003 it were not possible to test the arguments in the same way.

I should be grateful for your further observations on this matter. I may copy this letter more widely and/or post it on a website, but would not of course include your own side of the correspondence without permission.

Yours sincerely,

Olga Senior
Director of Communications and Corporate Affairs
South Central Strategic Health Authority
Rivergate House
Newbury Business Park
Berks. RG14 2PZ.

cc. Dr. Geoffrey Harris, Chair, South Central SHA
Jim Easton, Chief Executive, South Central SHA

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