On 26 February 2009 the Board of South Central Strategic Health Authority voted unanimously in favour of a proposal to fluoridate water supplies. The SHA will now formally instruct Southern Water to fluoridate supplies for Southampton and parts of South West Hampshire, and will work with the water company towards a likely 2010 start date.

The SHA’s decision - the first under the provisions of the 2003 Water Act – followed a three month public consultation requested by Southampton City PCT. The 2003 Act gave strategic health authorities the power to instruct their local water companies to fluoridate the local supplies if, after widespread public consultation, they are satisfied that the health benefits outweighed all arguments against water fluoridation.
Following the Board’s decision, Regional Director of Public Health, Professor John Newton, said

“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 South Central decision was warmly welcomed by the National Alliance for Equity in Dental Health, a national alliance of over 60 health organisations. Speaking for the Alliance, Professor Alan Maryon-Davis, President of the Faculty of Public Health, commented:

“The Strategic Health Authority made absolutely the right decision.  Four major systematic reviews of the worldwide evidence in the past nine years have confirmed that water fluoridation significantly reduces the amount of tooth decay suffered by children and adults, and is a major step forward for the public's health.”

Professor Mike Lennon, Chairman of the British Fluoridation Society, said the South Central SHA Board had rightly put the health needs of children first, and that tangible benefits to dental health would be seen within five years of the start of the new fluoridation scheme.

He added: “The courage and foresight displayed by the SHA board should pave the way for progress elsewhere in England – especially the North West and Yorkshire.”

Professor Newton’s Board paper on the scientific evidence is available online at:  http://www.southcentral.nhs.uk/document_store/12351421641_ha09-020(i)_water_fluoridation_-_the_scientific_evidence.pdf

The South Central SHA ’s consultation documents can be found on its website at http://www.southcentral.nhs.uk/fluoridation/page.php?area_id=9996&id=2

The papers for the Board’s 26 February meeting are at http://www.southcentral.nhs.uk/page.php?id=364, and, the announcement of its decision can be found http://www.southcentral.nhs.uk/news.php?news_id=177