Submission to All Party Group on Primary Care and Public Health 1999 Inquiry into Health Improvement Programmes

Health Improvement Programmes (HImPs) place a statutory duty on health authorities to improve the health of their population, and to work in partnership with local authorities and others to identify how local action on social, environmental and economic issues will make the most impact on people’s health.

The public health White Paper Saving Lives: Our Healthier Nation highlights the persisting wide inequalities in dental health in the UK, and refers to the Acheson report which recommends the fluoridation of the water supply as the most effective way of reducing these inequalities. Tooth decay remains a significant problem in socially deprived areas of the UK where there is no water fluoridation, including large parts of the North West of England, Scotland, Northern Ireland, Wales, the North, Yorkshire and parts of inner London. It is essential that HImPs drawn up for these communities address this particular oral health need. To this end, the National Alliance for Equity in Dental Health would expect to see the relevant HImPs contain a commitment to fluoridate the water supply; this being the single most effective measure available to health authorities to reduce tooth decay rates in areas where they remain unacceptably high.

The Alliance is a consortium of more than 40 leading scientific, medical and voluntary organisations (see list attached). These organisations support water fluoridation, and wish to see extension to cover those areas in greatest need (detailed above).

Health authorities, local authorities and other partners should be obliged to justify both inclusions and exclusions in their HImPs in terms of expected outcomes. For example, it has come to our notice that a number of local authorities have refused to sign up to their local HImPs until the reference to water fluoridation has been removed. This Alliance believes that such authorities should be required to justify this action and demonstrate awareness of the likely consequences of this decision for the population i.e. continued unacceptably high levels of tooth decay.

NATIONAL ALLIANCE FOR EQUITY IN DENTAL HEALTH