On 4 September 2012, the DH launched a consultation on the process that local authorities should follow when considering water fluoridation schemes.
As readers may be aware, from April 2013, responsibility for proposing new fluoridation schemes or varying/ terminating existing schemes will transfer from strategic health authorities to local authorities. This shift in responsibility for fluoridation schemes is part of the wider reorganisation of public health introduced by the Health and Social Care Act 2012 (the Act), which gives local authorities responsibility for health improvement.
Under the new arrangements, a local authority which identifies an oral health need within its area will discuss it at its Health and Wellbeing Board and incorporate it into its joint strategic needs assessment and Health and Wellbeing Strategy before deciding to formally pursue a fluoridation proposal.
The new formal process, introduced by the Act, is that the proposing local authority, rather than the strategic health authority, will obtain feasibility reports from the water company, and consult with the Secretary of State on the proposal before notifying other local authorities that will be affected by it. The local authorities will then decide together by joint committee or a joint committee of Health and Wellbeing Boards, whether to proceed. Once they have done so, they are required to consult to ascertain public opinion before deciding whether to ask the Secretary of State to make the arrangements, and enter into a contract with the water company to fluoridate the water.
The 2012 Act provides that the process that local authorities should follow when considering fluoridation schemes and consulting to ascertain public opinion on them is left to regulations. The consultation document is about the detail of these regulations and is split into four broad themes:
- Participation in initial decision-making on a fluoridation proposal
- Committee membership and procedures
- Fluoridation decision-making (including consultation and ascertaining opinion)
- Variation, termination and maintenance of fluoridation arrangements
For each of the themes, the DH proposes a range of options and also often suggests a preferred option. The consultation questions include whether the proposals for joint decision making are appropriate, whether particular groups in deprived areas should be encouraged to participate in the public consultation and whether, in deciding to ask the Secretary of State to make arrangements to fluoridate, the authority or committee should specifically be required to have regard to the views of the local population and the financial implications of the proposal.
The consultation closes on 27 November 2012.