Water fluoridation consultation

The Board of South Central Strategic Health Authority (SCSHA), decided on 26 February 2009 to instruct Southern Water to fluoridate the local water supply. SCSHA is the organisation responsible for carrying out a public consultation towards the end of 2008 on a proposal to increase the level of fluoride in the water supply in Southampton and parts of south west Hampshire.

The consultation took place following a request in 2005 from Southampton City PCT to a previous SHA to explore the feasibility and cost effectiveness of water fluoridation to help improve dental health in a city which has a worse rate of tooth decay than the national average*.

Members of the SHA Board, comprising Executive and Non-executive Directors, voted unanimously in favour of the proposal to increase the level of fluoride in the local water supply from 0.08 parts per million to 1ppm – the optimal level for tackling tooth decay.

To help the SHA make an informed decision on the issue, Board members received an independent report providing an analysis of over 10,200 responses received during the consultation along with the results of a phone survey of over 2,000 people. The Board also received presentations from representatives of Southampton City PCT the organisation with responsibility for assessing local health need and Hampshire Against Fluoridation – the local anti-fluoridation campaign group. Following the presentations Professor John Newton, Regional Director of Public Health for NHS South Central and an epidemiologist, gave his professional view of the scientific evidence.

The SHA Board was satisfied that water fluoridation at 1ppm is a safe and effective way to tackle tooth decay in Southampton, and that the health benefits outweighed all other arguments against water fluoridation.

Jim Easton, Chief Executive of South Central SHA said: “We recognise that water fluoridation is a contentious issue for some people, but we have welcomed the opportunity that this public consultation has given us to debate this important public health issue fully with the people of Southampton and south west Hampshire.

“The Board was satisfied that, based on existing research, water fluoridation is a safe and effective way to improve dental health. It is something which has been added to the water supply in parts of the UK including Birmingham for many years, and despite the best public health monitoring available no significant health problems have been identified.

“Written responses to the consultation indicated opposition to the proposal but it was clear from the results of the independent phone poll which highlights the opinion of a representative cross section of local people that, despite some groups claiming to represent the majority view, there is no clear majority of opinion amongst the public in the local area.”

Jim Easton, continued: “During the consultation the SHA received responses from all of the local authorities across the local area. The responses showed a split in opinion between elected members in Southampton City and those representing the parts of south west Hampshire covered by this proposal. The Board gave full regard to the views of each council and local MPs. The Board acknowledged the fact that the majority of people covered by this proposal lived within SouthamptonCity where the council supports the proposal.”

Professor John Newton, Regional Director of Public Health said: “As the Regional Director of Public Health, charged with protecting and improving the health of everyone in the South Central region I am pleased with the board decision.

“This consultation highlights the role of the NHS in addressing public health issues – it sometimes has to balance individual rights against the benefits to society as a whole. These are complex issues and I have no doubt that this debate will continue but for future generations of children in Southampton and parts of south west Hampshire they will benefit from this decision through improved dental health.

“The consultation also highlights the challenge of discussing public health issues in the age of the internet where people need to try and evaluate the mass of information available on water fluoridation, some of which is unreliable and inaccurate. The results of the phone survey showed that a quarter of those people who opposed water fluoridation did so because of a fear that it would damage their health. Some of the support for the proposal is likely to have been eroded by misinformation.

“As an epidemiologist I am convinced by the available evidence and by the experience of water fluoridation across the world over 60 years that there is no basis for these concerns.

“Local people should be reassured that every major professional medical organisation including the British Dental Association, British Medical Association and World Health Organisation all fully endorse water fluoridation as a safe and effective way to improve dental health.

“The SHA will monitor the water fluoridation scheme when it is put in place.”

Next steps

SCSHA will write formally to Southern Water to instruct them to add fluoride to the water supply at one part per million. The SHA will then begin working with Southern Water to implement the scheme. Due to the work required to establish the scheme it is anticipated that it will be no earlier than 2010 before fluoride is added to the local water supply. The NHS will ensure information is provided to the local public through the local media prior to the commencement of the water fluoridation scheme.

*The number of decayed, missing or filled teeth in 5 year olds, the measure of the level of dental decay in Southampton is 1.76 compared to a national average of 1.47.
In Southampton 42% of children at the age of 5 have dental decay.
Every year about 500 children have teeth taken out under a general anaesthetic – most of these children are under 10 years
To view the papers for the Board meeting click here

About the proposal

The water fluoridation scheme will supply approximately 195,000 residents with fluoridated water. The areas that will recieve fluoridated water are: Central Southampton, Lordshill, Freemantle, Polygon, Totton, parts of Eastleigh, Weston, Shirley, Portswood, St Denys, Netley, Aldermoor, Millbrook, Bassett and Woolston. For a map of the area click here. To check to see if your household is covered by the scheme click here.

The consultation was co-ordinated by South Central Strategic Health Authority (SHA) following a request made by Southampton City Primary Care Trust, the organisation responsible for the health of the people in Southampton. Southampton City PCT is very concerned that dental health in the City is amongst the worst in the country, and believes that raising the level of fluoride in the water supply from 0.08 parts per million to one part per million would significantly improve the dental health of local people, particularly children.

This area of the website contains some of the information available during the public consultation.

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