The Water Fluoridation (Proproposals and Consultation) (England) Regulations 2013, drafted by the Department of Health for the Secretary of State for Health, came into force on 1 April 2013. They will regulate how upper tier local authorities will carry out consultations and decision-making regarding proposals on existing and new fluoridation schemes. The Regulations supplement the provision for the fluoridation of water supplies made under Part 3 of the Water Industry Act 1991 (as amended). The Regulations also make provision for the circumstances where there must be consultation on whether to maintain existing arrangements for fluoridation, where maintaining the scheme would involve upgrading or replacing a fluoridation plant, except where the purpose is to meet operational requirements or health and safety standards.
The DoH reveals its bias in regulation 17 that provides for a minimum term of 20 years between termination proposals. There is no minimum term for proposals of new schemes.
NPWA responded to the Department of Health’s consultation on the above regulations which ran from 4 September to 27 November 2012. Links to the relevant documents including our response can be found at the end of this article. We have have published part of our response to accompany our 2013 issue of Watershed. Called The Dean Study, it counters the Department of Health’s reliance on British Fluoridation Society’s publication – One in a Million, 2012, to support its fluoridation policy.
Also drafted by the DoH for the Secretary of State for Health were The Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013. These regulations came into force from this year, will commence through to 2015 and will modify provisions in primary legislation relating to a committee appointed under section 102 of the Local Government Act 1972 in so far as those provisions relate to Health and Wellbeing Boards and provides that certain provisions do not apply to Health and Wellbeing Boards. The modification and disapplication provisions also apply to sub-committees of Health and Wellbeing Boards and joint sub-committees of such boards.
Amongst other provisions, these regulations make provision for health scrutiny functions to be conferred on local authorities directly with powers to enable those authorities to make various arrangements for the discharge of those functions, including discharge by overview and scrutiny committees.
The DoH consulted twice on different aspects of the draft of these regulations.
As reported in Watershed, Spring/Summer 2012, the Health and Social Care Act 2012 abolished Strategic Health Authorities (SHAs) and Primary Care Trusts (PCTs), and required upper tier and unitary authorities (LAs) to establish Health and Wellbeing Boards (HWBs). The authorities that are subject to this requirement are primarily county councils, London borough councils and unitary authorities. District councils in counties with a county council are not subject to the requirement but could have appointees to the HWB of the county council.
HWBs, whose 21 commissioning responsibilities will include dental public health, will comprise of at least one councillor, the Directors of Adult Social Services, Children’s Services and Public Health for the LA; a representative of the local HealthWatch organisation; representatives from each relevant clinical commissioning group and such other persons, or representatives of such other persons, as the local authority thinks appropriate. According to the consultation document Healthy Lives, Healthy People: consultation on the funding and commissioning routes for public health (2010), Directors of Public Health (DsPH) will be employed by local authorities but jointly appointed by Public Health England (PHE), an Executive Agency of the NHS. Oral health surveys will continue to be carried out to criteria set by the British Association for the Study of Community Dentistry (BASCD) used by the fluoridistas for their infamous and unscientific oral health league tables. The Network of Public Health Observatories, that served as regional repositories for health indicators, including oral health, will now be incorporated within PHE and the Association of public Health Observatories has been formally dissolved.
So, members and supporters will see that when the results of an oral health survey data become available you can be sure that somewhere in England a DPH will, at the next meeting of his or her HWB, present the data with an unscientific and statistically questionable claim that children in a particular area have some of the worst dental health in the country, which will inevitably lead to discussion about fluoridation. But, the stage is also now set for the termination of existing schemes which is obviously what NPWA will be working towards, as well as the repeal of Part III, Chapter IV of the Water Industry Act 1991.