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Ms Jowell: I have already given way to the hon. Gentleman and I hope that he will forgive me if I do not do so again as I wish to cover a considerable amount of information.
Legislation is the problem at the heart of the issue and the final decision on implementing fluoridation schemes rests with the water undertaker. The Water (Fluoridation) Act 1985 was consolidated in the Water Industry Act 1991. Section 87(1) of the 1991 Act states:
Since 1985, 55 health authorities in England--nearly half taking into account the mergers of the past 12 years--have requested water companies to introduce water fluoridation. None of those requests has been accepted. As a result, there have been no new water fluoridation agreements since 1985. The reason is simply that none of the water companies has exercised its discretion to agree to a health authority's request. Since 1985, none of the requests has been accepted and implemented for the benefit of the local populations.
The legislation is also deficient in not specifying how a health authority should test local opinion during consultation. The Act requires only that the proposal be
published in at least one local newspaper and for local authorities to be consulted. Health authorities need to be much more pro-active and we need a much clearer and explicit framework within which consultation is carried out.
My hon. Friend mentioned indemnities, which are clearly another stumbling block in the operation of existing legislation. Water companies are concerned about any liabilities that they may incur from fluoridation. I am aware that some water companies, including Severn Trent, have sought changes to the statutory indemnities that we are able to offer when they implement fluoridation schemes. Our public health White Paper will set out a clear policy framework for fluoridation and we will need to consider any changes to indemnities in that context--it is also in that context that I shall deal with the points about indemnities that my hon. Friend raised. However, in the meantime I would encourage the water industry to work with the health authorities, using the current indemnities available against civil liabilities.
Briefly, on alternative sources of fluoride, to which the hon. Member for Bournemouth, West (Mr. Butterfill) referred, among the other options for improving oral health is the adding of fluoride to selected foods. Both milk and salt have been tried, but their effect is not universal; nor is it as effective as fluoridating water because of personal preference and compliance. Adding
fluoride to school milk has been shown to have beneficial effects throughout all social classes, but the problem is essentially one of compliance and consent.
To sum up, the present situation is a mess. The public health benefits of fluoridation are clear. The overwhelming evidence is that fluoridation of water is safe and effective. Recent opinion surveys have shown that more than two thirds of the public are in support, but, as I willingly acknowledged, there are those who hold alternative views. Doing nothing is not an option. The fluoridation programme is at a complete impasse. We cannot allow decisions on the principle of introducing a fluoridation scheme to be taken by a body that is accountable to its shareholders rather than its local population. That is why our public health White Paper, when it is published in the autumn, will draw on the extensive range of views offered during extensive consultation. The White Paper will set out the Government's intended framework for a way forward on fluoridation that will be recognised as workable, fair and taking account of the wide measure of public support for that practical policy to tackle inequality in oral health.
It being before Two o'clock, the motion for the Adjournment of the House lapsed, without Question put.
1. Mr. Bill O'Brien (Normanton):
If he intends to introduce penalties or sanctions for non-compliance with charter mark objectives; and if he will make a statement. [39789]
The Parliamentary Secretary, Office of Public Service (Mr. Peter Kilfoyle):
Currently, charter mark holders may have their award withdrawn if they fail to maintain the required standard. We have no plans to introduce penalties or sanctions beyond that.
Mr. O'Brien:
I thank my hon. Friend for that response, but I plead with him to consider the matter further. I believe that those who have been awarded the charter mark but whose services subsequently fail to come up to standard--there are instances of this--should have their plaques, and any certificates that they have on display, withdrawn. I hope that he will take the matter seriously. Does he agree that, if the standards that the Government have set are to be maintained, it is important that people recognise that their certificates and plaques can be withdrawn?
Mr. Kilfoyle:
Before people are awarded a charter mark, they have to undergo a rigorous process--they must meet the nine criteria that are set out; they must be assessed by independent professional assessors; and the award must subsequently be approved by the panel. The charter mark is not easily obtained, and it is awarded for only three years--people must reapply if they want it extended. There is also the sanction of withdrawal in extremis. My hon. Friend may recall the examples of British Gas, which was not up to standard in the service that it offered, and of London Electricity, to which we provided the support, help and advice to enable it once again to attain the standard that we expect of charter mark holders.
Rev. Martin Smyth (Belfast, South):
Although I appreciate the thrust of the question and response, does the Minister accept that a number of groups involved in hospital care in Northern Ireland that have deservedly been awarded the charter mark have found that, given the pressures under the previous Administration, and even currently, they cannot reach the standards set for waiting lists, for example? I was given to understand that there would be no change in the standards, but I hope that those groups will not be punished if, because of an absence of finance, they cannot meet some of those standards.
Mr. Kilfoyle:
I welcome part of what the hon. Gentleman says, but I stress that we maintain very high standards for charter marks. Without such high standards, charter marks would not have the credibility which last year led to 947 applications--an increase of 28 per cent.
2. Mr. David Hanson (Delyn):
What progress has been made with regard to millennium compliance within Government. [39790]
The Chancellor of the Duchy of Lancaster (Dr. David Clark):
The progress reports that I published on 3 March show that many central Government organisations have reached the testing stage or, in some cases, completed work. An update on progress will be made in June, when I shall also make available information on progress in the wider public sector.
A new year 2000 team has been established in the central information technology unit, in my Department, to chase progress and to help spread best practice across Government Departments and the wider public sector. The new team is also managing a study undertaken by Ernst and Young, which will initially define and map those processes that are key to the maintenance of essential public services in the United Kingdom, including those run by private sector companies.
Mr. Hanson:
I thank my right hon. Friend for that full reply and for the work that he and his team are clearly doing to ensure that Departments are millennium compliant by 2000. Does he agree that, as with many private sector businesses, the key to millennium compliance rests with the testing period? He has mentioned that not all Departments have reached that stage. What does he intend to do to ensure that they do, and what further action is planned?
Dr. Clark:
My hon. Friend is right to highlight that issue. Experience in the private sector has shown that difficulties often emerge at the testing stage. I have drawn that to the attention of all my ministerial colleagues and have requested them to undertake internal audits on the tests and to bring in external assessors, so that we have a belt-and-braces approach to the whole affair.
Mrs. Cheryl Gillan (Chesham and Amersham):
Has the Chancellor of the Duchy of Lancaster had the opportunity to read today's Financial Times, which says that the national health service is failing to act on the millennium bomb? The software house Prove It 2000 has produced a survey showing that more than a third of NHS trusts, hospitals and general practitioner surgeries have spent nothing on ensuring that their systems can cope with the millennium and that, so far, only 24 per cent. of NHS administration systems are millennium compliant. Does he still maintain that the NHS will be ready for the millennium, and is he prepared--right now--to give a Government guarantee that all NHS services will be fully operational by the first week of 2000?
Dr. Clark:
Every health authority and national health service trust has responded to the 31 March 1998 deadline. The summary information from the survey suggests that good progress has been made overall, but, as the hon. Lady said, and as has been reported in the press, a minority of NHS organisations have further work
Mrs. Gwyneth Dunwoody (Crewe and Nantwich):
Will my right hon. Friend make an urgent attempt to point out to several Departments and agencies that there are major problems with their computer systems? There is a problem at the Inland Revenue and a severe problem with air traffic control, and there is clear evidence that some Departments will face the same difficulties. Will he please talk severely to those in charge and say that it is now well beyond the 11th hour, and that the 12th hour may be very painful indeed?
Dr. Clark:
My hon. Friend is right to make the point that the problem has to be solved. We have never pretended that it is easy: it is not. We have established a Cabinet Committee to consider the problem overall, and we are working with Ministers to try to ensure that plans are in place to ensure that Departments are compliant on 1 January 2000. Indeed, we have done more than that: we have published all the details in the Libraries of both Houses and on the internet, and I shall return to the House every three months to give an update on the plans. It is clear that we need to be absolutely open and show the world that we are tackling the problem.
"Where a . . . Health Authority have applied in writing to a water undertaker for the water supplied within an area specified in the application to be fluoridated, that undertaker may, while the application remains in force, increase the fluoride content of the water supplied by the undertaker within that area."
That is the legislative framework, but it is clear that there are shortcomings in the effectiveness of the legislation--the Act has not worked.
Sitting suspended, pursuant to Standing Order No. 10 (Wednesday sittings), till half-past Two o'clock.
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