ROLE OF LOCAL AUTHORITIES
Decisions made at local level
Decisions about whether to fluoridate public water supplies to help promote oral health are made at a local level in the UK by public bodies with statutory responsibilities for public health.
Local authorities took the decisions up to 1974, when public health became an NHS responsibility. It meant that between 1974 and 2013 health authorities took decisions on fluoridation. From 2013, in England and Wales the responsibility has reverted back to local authorities.
One in a Million
Our One in a Million online database includes a comprehensive section on making decisions.
PRIMARY LEGISLATION AND REGULATIONS
Legislation on water fluoridation
The Health and Social Care Act 2012 is the most up-to-date piece of legislation regarding water fluoridation in England. It incorporates, in an amended form, the provisions of earlier Acts of Parliament on this subject, including the Water Fluoridation Act 1985, the Water Industry Act 1991 and the Water Act 2003. Statutory regulations are also in place for public consultations on water fluoridation proposals.
Statutory regulations on water fluoridation
The Water Fluoridation (Proposals and Consultation) (England) Regulations 2013 lay down a process that local authorities with fluoridation responsibilities are required to follow if they propose to introduce a new scheme to serve their area. The local authorities with such responsibilities are ‘upper tier’ or unitary authorities, including metropolitan districts councils, county councils, unitary authorities and London boroughs. Regulations also cover consultation arrangements on proposals to vary or terminate existing fluoridation schemes.
ROLE OF PUBLIC HEALTH ENGLAND
Monitoring, information, technical advice and legal agreements with water companies
Public Health England (PHE) is an executive agency of the Department of Health. In this capacity it fulfils many of the Secretary of State for Health’s statutory functions with regard to water fluoridation. These include monitoring and reporting on the health effects, providing information and technical advice to local authorities and negotiating the terms of legal agreements with water companies requested by local authorities to implement new fluoridation schemes.
Fluoridation toolkit for local authorities
In March 2016, PHE published Improving oral health: a community water fluoridation toolkit for local authorities. This sets out in detail the responsibilities of local authorities, PHE and other agencies (including the Drinking Water Inspectorate) for water fluoridation. It describes tooth decay as “a serious health problem” and “the most common cause of hospital admissions among children aged between five and nine”.