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Dáil Éireann debate -
Wednesday, 16 Nov 1960

Vol. 184 No. 7

Health (Fluoridation of Water Supplies) Bill, 1959—Committee Stage (Resumed).

Debate resumed on amendment No. 4:—
Before subsection (2) to insert the following subsection:—
"( ) A health authority shall not be required to add fluorine to a water supply unless and until a supply of pure water not containing fluorine shall be readily available at no extra cost to all persons residing in the area supplied with the water to which it is proposed to add fluorine."

Mr. Ryan

Before the House adjourned consideration of this amendment last week I had pointed out that in countries where fluoridation of public water supplies had been introduced it was found necessary for several food processing firms to instal de-fluoridation equipment and I asked the Minister if he had considered this matter and if he would give us figures as to the cost of de-fluoridation and the capital cost of installing the necessary equipment.

The Minister has not replied to that aspect of the matter which is so relevant to this amendment. I now wish to return to a very basic principle in relation to the right of the people not to have enforced medication, and I feel if the Minister wishes to provide fluoridated water for one section of the community, nobody would object to his so doing if at the same time he would ensure for those who did not wish to take fluoride in their water supplies a supply of water free of that substance or with an amount of fluoride far below the amount he proposes to add under the provisions of this Bill.

I think it pertinent to this question for the House to consider how the City of New York treated this matter of fluoridation of water supply. I have a report which deals with the position of the City of New York Department of Water Supply, Gas and Electricity, dated April, 1956. It begins:

Under the City Charter, the Commissioner of the Department of Water Supply, Gas and Electricity is charged with the responsibility of maintaining the purity and wholesomeness of the city water supply. The matter of purity has a direct bearing on the people, and involves the determination and evaluation of the tolerance of suspect, hazardous or toxic substances which may, in some manner, gain access to the water supply. Fluoride is a toxic substance.

The department has extensive laboratories staffed by reputable scientists and competent sanitary engineers, with a massive library in which is contained over five thousand references on the subject of the fluorides alone. We have continued to study and evaluate the effect of toxic substances as related to water supply. The matter of fluorides has been under our scrutiny for over 20 years.

The addition of fluorides to the water supplies is not coupled with the concern of maintaining or improving the quality of the water or making it safe. No one has suggested that dental caries is a waterborne disease or that water is a cause of dental decay. No satisfactory reason has ever been advanced to show why everyone in a community must be compelled to risk life-long extraordinary exposure to the toxic action of fluorides, particularly when safer, more effective and more economical ways of administering fluorides for caries reduction in children's teeth have been pointed out and are available.

Again, I must emphasise that the main point of my amendment is to ensure that here we do not compel anybody to involve himself or those under his care in the lifelong consumption of the toxic substance of fluoride. No matter what the cost may be of providing a supply of water without fluoride, I feel if we are going to take away from the people something they have at the moment, we should provide them with a reasonable alternative which will be safe. I feel quite sure that the majority of the people will not give a hoot whether the supply of water they get is fluoridated or not, but there will be individuals—and I believe a considerable number—who will take a very strong exception to fluoridation on medical and moral grounds. I believe we will be taking a most retrograde step if we impose on all the people who have piped water the necessity to consume fluoride.

The New York City Commissioner went on:

Our concern is primarily with the safety of the water supplies for each and every individual of our entire population of 8,000,000 people throughout the city.

I, as well, feel that we are obliged to ensure that there is a safe water supply for each and every individual in this country, and we can only do that by the adoption of this amendment. If you believe that, you must accept my amendment no matter what the cost, you must ensure that the rights of the individual are maintained by giving each one the supply of water he requires.

If the Minister is prepared to give grants for the sinking of wells, or to allow each local authority to permit the erection of a pump in every garden, then I think that would meet my amendment. I am not asking that there be a supply of pure water everywhere, but that such a supply will be easily and readily available, at no extra cost, to every individual who does not want to consume water which has been artificially fluoridated. All the amendment seeks is a reasonable alternative—that people who do not wish to consume fluoridated water be, at least, provided with flasks of water or beakers of it provided at their hall doors.

The Minister suggested on this amendment that it was quite clear it was not seriously intended. It is quite seriously intended. It is well known that 50 per cent. of the farms in this country now have a piped water supply, free of artificial fluoride content. By this Bill the Minister seeks to take that away from them—a facility which our modern civilisation has given them—a supply of water free from this toxic substance. As far as the Almighty has had any hand in it, I believe our natural water in this country contains a very small percentage of fluoride—infinitesimal by comparison with the one part fluoride to one million parts water which the Minister seeks to impose.

The amount of fluoride sought to be added by the Bill looks very small, but even the experts who are in favour of fluoridation agree that it may have a cumulative effect, building up in the system over the years. I think the necessity for a supply of water without artificially added fluoride is emphasised by the experience of several water authorities in America whose cases I cited last week. Several authorities have rejected fluoride, having had it for some time, because they found it was having a corrosive effect on the pipes and that the building up of the fluoride at some points in the gridwork meant an uneven distribution of fluoride.

I would refer again to the report of the New York Committee on the matter. It points out:

The problem of managing the control of dosage of fluoride chemical to obtain uniformity throughout a grid-work of more than 5,000 miles of pipe and tunnels involving different sources and pressure gradients as in the New York system is formidable. None of those who have made statements to the contrary have ever had the experience nor do they possess knowledge of what the exact result would be. Our concern and responsibility in the department is to provide the people of our City with a dependable supply of the purest and safest water possible. No one can guarantee similar safety to all the people in the City of New York under a programme using the water supply as a fluoride vehicle.

Unfortunately, the forum on the subject of fluoridation is not as open as it should be even among professions. There has been too much of emotion, blind following and lack of objective thinking by too many people on both sides of the question.

The people of the City of New York are entitled to know the risks they are being asked to assume before endorsing a programme involving so many questions yet unanswered.

If those of us who are opposed to this Bill need any authority, a statement of that kind coming from a body which has spent 20 years in research on fluorine is sufficient authority for us. The New York Committee said that their concern and responsibility was to provide a dependable supply of water. Our concern and responsibility in this Oireachtas should be to provide the people of our country with a dependable supply of the purest and safest water possible.

If it be that there is a body of opinion that we have a right to use our present piped supply of water for the purpose of providing fluorine, I would urge that they should at least provide those who want it with a supply of water which would not have been tampered with. We have at the moment a relatively dependable and safe supply of piped water for 50 per cent. of our people. We ought to maintain that for those who want it no matter what the advantages may be in relation to the intake of fluorine through water supplies.

If the Minister does not propose saying anything, I just want to be very brief on this amendment. I appreciate the difficulties which the Minister envisaged of putting an amendment of this sort into effect. I would ask him to treat the idea contained in the amendment as a serious matter. The Minister has had his way as far as this Bill goes by having the Bill carried through the Second Stage and having certain amendments on Committee Stage defeated so as to ensure that the Bill will be mandatory in character when the regulations under it have been made by him. Having had his way on that point, I would ask him at this stage to give very serious and sympathetic consideration to the many people throughout this city and the country as a whole who feel deeply on this subject, who feel that they should not be forced by Ministerial decree to drink fluoridated water. If the Minister does not see his way to accept this amendment either in the letter or in the spirit, I would ask him to give very serious consideration to some alternative means of meeting the point of view which has been put forward by Deputy Ryan on this amendment.

There are various aspects from which this can be considered. The Minister, probably, has thought of some of them himself. I should like to know, for example, is it possible once fluorine has been added to a water supply to extract it by any process. There is a large number of food and drink manufacturers who will be affected by this provision who may prefer to give the public their commodities without the addition of fluorine to the water used in their manufacture.

I should like the Minister to tell the House, and to use this amendment as the occasion, whether or not it is possible for such manufacturers—beer manufacturers, for example; there are various kinds that the Minister will think of himself—to treat the water in such a manner as to extract the fluoride from it.

It is not the Minister's intention, I take it, to ensure that every article of diet, everything that is eaten and drunk, in this city, should contain fluorine but that, possibly, will be the effect of carrying this legislation to its logical conclusion as a result of the mandatory manner in which it is being dealt with. I would ask the Minister to let the House have some information as to whether or not it is possible to extract fluorine once it has been added. If it is not possible, I would again ask the Minister, in the spirit of the amendment moved by Deputy Ryan, will he consider making provision so that manufacturers who make food or drink for sale to the public out of water to which fluorine has been added will put some type of label on their product so that the public may know that it contains in part, be it big or small, fluoridated water as against water which has not had fluorine added to it.

I propose to confine myself to answering the question which has been put by Deputy Michael O'Higgins. I understand that there is apparatus available whereby water can be defluoridated.

Could the Minister elaborate on that?

I do not propose to elaborate. After all, I am not the technical adviser to this House.

The Minister is bringing in this Bill as though he knew all about it and I assume he does. All I want to know is, is it an expensive process or a comparatively simple one?

I do not know. I do not think it is necessary to defluoridate.

The Minister does not agree that it is necessary—if he thought it was necessary, he would not bring in this Bill—but there are a number of people who will be affected by the Minister's action in bringing in this Bill who may regard it as necessary and surely the Minister would feel that it is his duty and that he owes some responsibility to these people to give the information for which I am asking?

I have not got it. I am not, as I say, the technical adviser of this House or of any person outside this House. I understand that apparatus can be procured which will defluoridate water if that should be desired. A letter to any manufacturer of water treatment apparatus would get all the information the Deputy requires.

Is the Minister prepared to seek the information and make it available to the public? After all, it is he who is putting them to the trouble of doing it if they want to do it.

I am not going further than I am doing in this Bill.

I cannot compliment the Minister on being very helpful about it.

Mr. Ryan

If any evidence is needed to condemn this Bill surely it is the Minister's manner of treating this House. He is informing us he is introducing a Bill to fluoridate the public water supply. At the same time he cannot give us any indication, so that we can judge the merits or demerits of the Bill, as to the cost of taking fluorine out of the water. As I have pointed out, of the other countries which have introduced fluoridation some of them have kept it on but most of those which introduced it rejected it later on because they found the cost of de-fluoridation was prohibitive. There are several food processing firms in this country who are providing very useful employment here in supplying goods for the home market, in the first instance, and secondly, for the export market. It is most important that we should encourage these industries. There are certain States in America which prescribe the fluorine content of foodstuffs and some of our foods which have been processed here with fluoridated water supplies will be in jeopardy and may not be allowed into the Amercian market. If they are on the American market already they may be excluded and if they are not on it they have very little hope of getting on it.

The Minister obviously does not give a hoot as to the difficulties of these manufacturers. It may well be that if his colleague, the Minister for Industry and Commerce, has any objection to it another Bill will be introduced here and we will be asked to pay the cost of providing the machinery for de-fluoridation. It is appalling that the public health department of this State should have such a poor brief for the Minister that he is not able to give the cost to the House. It is either that or the Minister knows the cost and does not want to give it. The figures given by the Minister already as to the annual cost of fluoridation in Dublin are entirely wrong. He based the figures on the population of Dublin city but the Dublin Corporation water supply also supplies Dún Laoghaire and Dublin county and, when all that is added, you will find the bill will be considerably more. No serious consideration has been given by the Minister (a) to the cost of fluoridation and (b) to the cost of defluoridation.

If there is any person who wants to have a drink of water without fluorine he ought to be able to defluoridate the water. Obviously, it would be an uneconomic proposition for the individual to do it, but the Minister is imposing that obligation on him. There are many religious sects which have very strong objection to this form of mass medication, but we do not need to rely upon any particular religious sect to find authority for the natural law. The natural law provides that a man has a right and an absolute right to the integrity of his person. It is a right which may be qualified only in one way and that is when that man's physical condition is a danger to the rest of the community. A bad tooth is not a danger to the rest of the community. You could live all your life with a person who had a mouthful of mouldy teeth and you would not catch a bad tooth from him. If there is even one person in our State who objects to mass medication, we believe he has a natural right to the integrity of his person.

The Minister has accused me of misquoting a high authority on moral law. It was the Minister, in the first instance, who challenged us on this side of the House to produce any authority for our arguments regarding the ethical objections to fluorine. It is no answer for him to accuse myself or anybody else of trotting out these misquotations of what the late Holy Father said. However, it is the Minister who asked for it and he will get it. In the course of an address to the First International Congress of Histopathology of the Nervous System His Holiness Pope Plus XII pointed out:

In so far as, in the cases mentioned, the moral justification of the intervention is based on the mandate of the public authority, and, therefore, from the subordination of the individual to the community, of the individual good to the social good, it rests on a mistaken application of the principle. It must be pointed out that man, as a person, in the final reckoning, does not exist for the use of society; on the contrary, the community exists for man.

The community is the great medium ordained by nature and by God to regulate the exchanges by which mutual needs are met, to help each one to develop his personality according to his individual social capacity. The community, considered as a whole, is not a physical unity which subsists in itself. Its individual members are not integrating parts of it. The physical organism of living beings, of plants, animals, or men, possesses as a whole a unity which subsists in itself. Each of the members, for example, the hand, the foot, the heart, the eye, is an integrant part, destined by its whole being to be a part of one complete organism. Outside the organism it has not, of its own nature, any meaning, any purpose: its being is wholly absorbed in the complete organism with which it is linked.

A quite different state of affairs obtains in the moral community and in each organism of a purely moral character. The whole has not here a unity which subsists in itself, but a simple unity of purpose and of action. In the community, the individuals are only collaborators and instruments for the realisation of the ends of the community.

What follows with regard to the physical organism? The master, the person who uses this organism, which possesses a subsisting unity, can dispose directly and immediately of the integrant parts, the members and the organs, within the framework of their natural finality. Likewise he can intervene, when and as far as the well-being of the whole demands, to paralyse, destroy, mutilate, separate its members. In contrast, however, when the whole does not possess a unity of finality and of action, its head, that is to say in the present case, the public authority, retains without doubt a direct authority and the right to impose its demands on the activity of the parts, but in no case can it dispose directly of its physical being. Moreover, every direct injury attempted against its essential being by public authority, is a departure from that sphere of activity which rightly belongs to it.

Now medical intervention, of which We are treating here, affects immediately and directly the physical being, either of the whole or of the individual organs of the human organism. But in virtue of the principle which We have just stated, in this domain, the public authority has no right; it cannot pass it on, therefore, to investigators and doctors.

Likewise, I say it cannot pass it on to any local authority officials. We have no right to subject any person to medication where it is not necessary to prevent a communicable disease. No matter what views anybody else may have in the matter, there are plenty of people who believe in the integrity of the individual and, even though what the Minister has suggested may be of some advantage in delaying the onset of dental caries for a couple of years, that advantage does not justify this House, does not justify any society, in so destroying the integrity of the individual as to subject him to mass medication.

The Minister has deliberately remained silent on this amendment despite our having emphasised the vital necessity for it. The Minister ridicules the idea of the amendment because he says it would cost too much to put it into effect. Our answer is that we have given the people a pure water supply at considerable cost and that money should not be just thrown away in favour of the very doubtful advantage the Minister has to offer, particularly when that doubtful advantage is coupled with very significant dangers. The dangers have been pointed out by experts throughout the length and breadth of the world.

I wonder what the Minister will do if, within a few years of compulsory fluoridation of water supplies, we find ourselves faced with 300 people suffering from serious diseases because of that fluoridation. Suppose a hospital in the State were to plead with the Minister for the provision, free of cost, of water which contained no artificial fluorine in the interests of some of their patients, I wonder would the Minister be prepared to provide that pure water? I feel that he would, in conscience, be bound to do so.

Certain tests carried out in America and elsewhere have proved that certain people are allergic to fluorine. The number may only be one in 100,000. The number of people who die from the dreadful scourge of polio is one in 100,000. Yet society is rightly concerned about the number of deaths from polio. The number who are left physically incapacitated in some degree as a result of polio is one in 10,000. Yet we spend considerable sums of money and effort in encouraging people to take the necessary precautions against polio. But we do not compel them to do so although polio is a disease which any one of us might catch.

These are matters that ought to give us to think. What right have we to say to hundreds of thousands of people that they must expose themselves to the risk of some toxicity as a result of fluoridated public water supplies and that we will not allow them any readily available supply of water without artificial fluorine? I believe it is very wrong that we should do that. Even though the cost might be considerable I believe that, in conscience, pure water should be made available to those who prefer pure water. Taking the calculation one in 100,000 the number affected in our community will be 30; 30 people will die as a result of fluorine poisoning. On the calculation that one in 10,000 will suffer some physical damage, the number affected will be 300. In our community those are frightening statistics. It might be any one of us here who will suffer.

Have we any right to say to people that they must take fluoridated water? I do not believe we have that right. If the Dáil and the Seanad approve this provision, I sincerely hope the President will refer the matter to the Courts for decision. It is a very, very vital matter and one which deserves far more serious consideration than I believe it has been given. Whatever the rest of the world may do, we are taking a backward step when we fail to appreciate the rights of individuals in a matter of this kind. I urge the Minister to consider ways and means by which pure water, without artificial fluorine, may be made available to the community. If it only means a dozen depots in Dublin, then I hold those depots should be available. It may mean inconvenience but, if people want pure water, they will put up with the inconvenience.

In the United States there have been movements of population from areas in which water is fluoridated to areas in which it is not. We could not have the same mobility of population here. It would be an intolerable burden to compel people to leave the city of Dublin and go to live on the top of the Dublin mountains in order to get fluorine-free water. At the moment we have water which does not contain any artificial fluorine. I do not believe we have any right to take that away unless we are prepared to make readily available an alternative source of pure water. That is why we are pressing this amendment.

Amendment put and declared lost.
Amendment No. 5 not moved.

I move amendment No. 6:—

To add to the section the following subsections:

"(4) Before making regulations under this section, the Minister shall—

(a) cause to be made—

(i) a survey of the incidence of dental caries in a representative sample of pupils attending full-time day schools in the functional area or functional areas of the health authority or health authorities to whom the regulations relate, and

(ii) an analysis or series of analyses of the quantities of fluorine and such other constituents as the Minister may determine in the water supplied by sanitary authorities through pipes to the public in the functional area or functional areas of the health authority or health authorities to whom the regulations relate, and

(b) cause to be presented to each House of the Oireachtas a report on the survey and analysis or analyses so made,

and such report, in relation to the survey, shall include particulars of the procedure adopted in making it and the numbers, classified by age and otherwise, of the pupils to whom it relates but shall not include any information in respect of any indentifiable pupil.

(5) Any information in relation to dental caries in individuals which is obtained in the course of a survey under subsection (4) of this section shall be treated in a confidential manner.

(6) Nothing in subsection (4) of this section shall be construed as imposing an obligation on any person to submit himself or any person for whom he is responsible to examination or as requiring the controlling authority of any school to afford facilities for the making of a survey under that subsection, and accordingly where, in the case of any such survey, information regarding the pupils attending one or more of the full-time day schools in the area or areas concerned is for any reason not available, the survey shall be made by reference to the pupils attending the other full-time day schools in the area or areas."

The additional subsections which this amendment proposes to insert will have a twofold object: first, to establish before the regulations introducing fluoridation are made, the exact position regarding the incidence of dental caries in children and adolescents attending whole-time day schools and, secondly, to ascertain by analysis the fluorine content and the other constituents of the public water supplies it is proposed to fluoridate. It had been intended to have these surveys carried out and analyses made under the provisions of Section 6 as originally introduced, but that section is permissive.

The purpose of this Section is to make it mandatory on the Minister to demonstrate the grave problem which dental caries represents to the communities concerned and, at the same time, to demonstrate by analysis what has been found as a result—I repeat it again—of 70 years' investigation—to be one of the primary factors in making the teeth of certain sections of the community more liable to the onset of this disease than they otherwise might be.

I have said that research has been carried out over a period of 70 years, and I commented upon that fact when I was speaking here on the 27th October, referring to the plea which Deputy Manley had made that he would like to have the very fullest information about this problem. I said:

Deputy Manley went on to say that we ought to be fully acquainted with the subject. This is a complex scientific subject; it is a problem which is widespread and on which there has been a great deal of scientific research. It is not something that has been suggested here for the first time nor has it been developed merely over the last 15 years. I shall show in due course that this problem has been the subject of numerous and close investigations for almost three-quarters of a century; but it is only in the past 15 years that the results of these investigations, experiments and researches have come to be applied in a controlled way. Therefore, this is a subject which it would be quite impossible for an assembly such as this, which is not composed of scientific or professional men—and much more so, a county council or urban district council or a health authority which again is not composed of persons who have a specialised knowledge of this matter — to become thoroughly acquainted with, as Deputy Manley said he wished to be.

I am repeating that statement to the House because I have already shown, speaking on this day week the extent to which those opposing this Bill can distort and misrepresent the truth. On that occasion I had particularly in mind Deputy Ryan's statement about the president of the United States not drinking fluoridated water.

The Minister did not get very far with that argument last week and he will not this week.

I know I shall not get very far because Deputy O'Higgins is sheltering behind Deputy Ryan's irresponsible statements. He is now trying to cover up——

On a point of order, I submit, as I did on three occasions last week, that it is in order for the Minister to address himself to the amendment before the House and not to go back over the Second Reading discussion for the purpose of answering arguments made then.

Major de Valera

Why is the Deputy so keen to cover up a statement which is untrue?

The rules of order ought to be complied with.

Major de Valera

It does not hurt to tell the truth.

Mr. Ryan

It hurts the Minister.

The purpose of this amendment, among other things, is——

To remedy an error in the White Paper, and nothing else.

The purpose of this amendment, among other things, is to demonstrate to the people of this country the need for the measures which it is proposed to take to deal with dental caries. In countering the proposals, in contesting the need for this, in misrepresenting the effects of fluoridated water, in working upon the fears of people who are otherwise uninformed——

Mr. Ryan

Because the Minister will not inform them.

——it has been necessary for Deputy Ryan, in particular, to distort the truth. On this day week I was referring to a statement which he made about the President of the United States and I showed—it is on the record, and I am speaking now without reference to the Second Stage of the Bill, but to the Committee Stage——

A previous amendment.

——and I pointed out on that occasion——

What amendment are we discussing?

——how Deputy Ryan—I shall not say deliberately-misled the House but somebody fed him this canard about the President of the United States and he, like a number of other innocent people, had fallen for it. He said that President Eisenhower was not allowed to drink fluoridated water and, during the debate on the last amendment, we heard Deputy Ryan describe the terrible things which happen to people who do drink fluoridated water. Since he has relied upon the alleged prohibition imposed upon President Eisenhower in relation to fluoridated water by his physician, I propose to put on the records of the House what the President's own physician has to say on this matter. I am doing so, not because of anything that was said during the course of the debate on Second Reading, but in rebuttal of some of the statements which were made by Deputy Ryan when speaking on the last amendment.

This is a statement which was issued from the White House, in a letter from President Eisenhower's personal physician, Dr. Howard Mac C. Snyder, to Dr. Charlotte Brown, Director of Health, New Canaan, Connecticut, dated April 9th. It reads:

Dear Dr. Brown, I have never seen a case of illness which could be attributed to fluoridation of a community's water supply. I have no reason not to endorse a health policy that is advocated by the American Medical Association and the United States Public Health Service Sincerely yours, Howard Mac C. Snyder.

So, whatever the Water Commissioner, if that is his title, of New York City had to say about the proposal to fluoridate that city's water supply, in that connection he was speaking as a layman. I understand he is not a doctor.

Mr. Ryan

Like the Minister.

I am not a doctor. I do not profess to be a doctor but I am guided by highly qualified advisers on this matter.

Mr. Ryan

So is he.

And by the advice of several commissions, by the advice of the experts of the World Health Organisation——

Mr. Ryan

No, no. That is not fair. The World Health Organisation gave no decision on the matter. That will be found in the records in the Library.

The Deputy was once an ornament of, or perhaps I should say a very active element in, the Literary and Historical Society in U.C.D. This is not the Literary and Historical Society. We cannot deal with this and make petty debating points. It is quite true that the World Health Organisation in relation to the Report of the Expert Committee on the proposal to fluoridate water had the usual caveat which appears in every one of its publications saying that the Organisation as a whole did not necessarily accept responsibility for the Report, but the Organisation as a whole embraces every State in the world.

What the Governing Committee of the Organisation did was to appoint an Expert Committee and, having considered their Report, to publish that Report on its responsibility as making a general recommendation in relation to this problem. The authority for its publication is stated on the first page of the Report, if my recollection is correct. I want to come back to the statement made by the President's personal physician.

Mr. Ryan

On a point of order, the Minister's amendment seeks to have a certain amount of statistical information collected in regard to dental caries. It does not provide for the matter about which the Minister is now talking, that is, statistical information in regard to the effects of fluorine on the medical health of the community. Therefore, I suggest the Minister's remarks are obviously out of order.

I am suggesting I am perfectly in order on this.

We should have a ruling on this. I want to calm the Minister for a minute. I am quite prepared to accept his statement, which he has already put on record in the Committee discussion, with regard to the President of the United States, but my point of order is that it is not relevant to the discussion on every amendment. Surely, it is not relevant for the Minister to use every amendment put down to this Bill for the purpose of replying to points raised on the Second Reading discussion of the Bill? If the Minister wants to prolong the discussion, well and good.

I agree that it is not quite relevant.

How can it not be relevant having regard to the fact that on the——

It would be more relevant on the section as amended.

The purpose of this amendment is to establish certain facts as to the problems of certain conditions and also to establish the significant fact that, in general, the prevalence of these conditions is very largely influenced by the absence of fluorine in the water.

Mr. Ryan

That is not doubted. We have never contended otherwise.

I am quite willing to accept the suggestion that the amendment should be agreed on and then proceed to the section.

Does the Minister expect us to pass on without Comment?

You can comment on the section.

Is the amendment agreed?

I propose to make some comment on it.

All right.

In the first place, I should like to tell the Minister we have no objection to this amendment. We believe it to be a very sensible amendment for the Minister to introduce, and I am very glad he has done so. I am very glad he has had the courage to point out that whereas Section 6 of the Bill was permissive, he is now making the provision contained in this amendment mandatory on the Minister. I am sorry that the Minister did not refer to the——

I am sorry. All the wisdom the Deputy is offering is not going astray. It is going in through half an ear.

I shall wait for the Minister to finish. I would prefer his whole ear. If the Minister has something urgent to discuss with the Parliamentary Secretary I have no objection to waiting. I am sorry that in speaking to this amendment the Minister did not refer to the fact that there had been a blunder made by him or his Department in preparing the White Paper published with this Bill. The Minister will recall that paragraph 39 of the Consultative Council's Report recommended that these statistics should be compiled and the surveys made before any public water supply was fluoridated. That was a definite recommendation made by the Consultative Council.

The Minister published a White Paper claiming that the contents of Section 6 of the Bill were deliberately put into the Bill for the purpose of complying with that recommendation of the Consultative Council. Paragraph 39 of the Council's Report reads as follows:

Before any public water supply is fluoridated, the Council considers that steps should be taken to assess the incidence of dental caries in children resident in the area served by that water supply. The Council also considers that, subsequent to fluoridation, steps should be taken to permit a proper evaluation of the results.

Paragraph 4 of the White Paper, which deals with Section 6 of the Bill, says:

It is particularly with a view to implementing the recommendation in Paragraph 39, cited above, of the Consultative Council's Report that provision is being made by Section 6 of the Bill for a survey of dental caries. These surveys will be carried out by Health Authorities as and when required by the Minister for Health and should be of considerable value in enabling statistical material on the benefits of fluoridation to be prepared.

In other words, it is quite clear from the White Paper that the surveys and statistics which the Minister contemplated in Section 6 of the Bill were to be carried out and compiled after the water had been fluoridated, whereas Paragraph 39 of the Council's Report gave a definite recommendation to the Minister that these surveys should be made and the statistics compiled before any water was fluoridated.

The amendment which the Minister is now introducing is an amendment which does comply with the recommendation of the Consultative Council's Report and I would have thought that the Minister would simply get up here, move the amendment, and say he is moving it to comply with Paragraph 39 of the Council's Report, and recommend it to the House on that basis. Certainly, I am prepared to accept it on that basis as a worthwhile amendment and I am glad the Minister introduced it.

There are one or two small points in connection with it which I should like the Minister to clarify. In subsection (5) the Minister in his amendment provides that:

Any information in relation to dental caries in individuals which is obtained in the course of a survey under subsection (4) of this section shall be treated in a confidential manner.

I think that is right, that it must be treated in a confidential manner. However, I should like the Minister's assurance that the phrase "confidential manner" will be interpreted in a very strict sense because provision is made in subsection (4) (b) that a report of any survey made will be made available to each House of the Oireachtas. I take it that it is implicit in subsection (5) that no details of individual cases which in any way could be identified would be contained in a report under subsection (4) (b)? I am sure that is the Minister's intention and I simply want to get it from him for record purposes in connection with the future interpretation of this section when it goes into the Bill.

I want to say to Deputy O'Higgins that what he has said to be implicit in the section is, in fact, explicit.

I know that there is the question of identity earlier.

"...shall not include any information in respect of any identifiable pupil." That is in subsection (4) at the end of the last line.

Yes, I saw that.

Subsection (5) provides that any information in relation to dental caries in individuals shall be treated in a confidential manner. I do not think there is any question of anything being implicit in these provisions: I think they are explicit and that was the specific intention.

I accept that.

Mr. Ryan

I feel that the Minister's amendment does not go half far enough as far as his examination is concerned. The Minister is concerned with the survey and reports of dental caries and with a series of analyses of the quantities of fluorine in water but he makes no provision for any examination of the general health of the people in an area. His examination is confined to pupils attending full time day schools and I think this clearly proves what we are arguing in regard to this Bill, that fluoridated water is of no benefit whatever to adults. Before the Minister is to act on this survey, the survey ought to be complete and should examine the general health condition of a complete community and decide on the balance whether or not, in view of the general health of the community, it is a justifable risk to take to expose the larger section of the community to a toxic substance, fluoridated water, when the only beneficial effect is to postpone the onset of dental caries for a couple of years in relation to pupils attending full time day schools.

I am not sure what is to happen if the majority of the schools or the majority of parents object to this examination. It would appear then that decisions might be taken by the Minister arising out of an investigation of one school in an area which might have 20 schools because subsection (6) provides that where one or more schools refuse to have this examination the survey shall be made by reference to the pupils attending other full-time day schools in the area or the areas. It is well known that incomplete statistics can tell greater lies than no statistics at all——

Hear, hear. The Deputy is an expert at that.

Mr. Ryan

I am only an apprentice to the Minister. I can never be as well qualified as he is and I am not accepting the title that he seeks to bestow on me. The fact is that we could have in one school, or in a number of schools, children who would have particular dietary habits whereas, in the schools which refuse to have this examination, there could be children with totally different dietary habits. The result would be that your statistics would be distorted in relation to the amount of dental caries. It is known for instance that the Eskimos, eating only the diet which their ancestors have consumed for years, have no dental caries, but as soon as they allow themselves to be contaminated by civilisation, by modern eating habits, dental caries have set in rather rapidly.

On a point of order—the real question at issue in this amendment is not whether a survey shall be made or not. Section 6 as it stands provides that such a survey may be made and what this amendment does propose is that before any regulations are made the survey must be carried out. Deputy Ryan is now going far beyond that specific question. He is discussing the Eskimos, he has been referring to statistical errors and, in general, he has been traversing all the ground he has gone over so often in the House.

I take it that the Minister was talking with his tongue in his cheek when raising the point of order.

Mr. Ryan

The only difference between the Eskimos and President Eisenhower is that there are several Eskimos and only one President Eisenhower and, if one individual's state of health is relevant, it is surely relevant for me to point out that in certain communities there are different reports in regard to dental caries. I am pointing out that the survey for which the Minister seeks power would be utterly unreliable unless all the schools and all the children will be submitted to investigation.

I have already asked the Chair to rule on a point of Order. Before your predecessor vacated it, Sir, he did not rule. The purpose of this amendment is to ensure that before any regulations are made the Minister has to carry out surveys. In the section as it stands it was not made mandatory upon the Minister to carry out these surveys in advance of any regulations and I suggest that the only question to which the Deputy is entitled to address himself now is whether the survey should be made before the regulations or not.

That seems to be the specific intention of the proposed subsections.

If the Minister had stated that at the beginning his introductory speech would have been very much briefer.

Mr. Ryan

I understood that when it was relevant to discuss what one doctor said about the health of President Eisenhower, as the Minister did at great length——

But I was ruled out of order on that.

Mr. Ryan

The Minister is making a general confession which is good for the soul. The Minister for Health admits being out of order. Now, we might get somewhere in relation to the remainder of the Bill if the Minister is still in the same penitent state of mind. We shall discuss the point the Minister wants to discuss, whether or not it should be mandatory on him to carry out these investigations first. I say it does not matter a hoot whether he does or not because there is provision in the amendment he is making that if the reports provide statistics that indicate that it is not necessary to fluoridate the water, the Minister may still go ahead and do it. He is not bound in any way by this report so that it seems ludicrous that he should bother making it in the first case. The fact that he has rejected a wealth of expert opinion from all over the world shows that he is capable of ignoring any report made as a result of the survey he seeks to have made here. The result is worthless unless it is a complete survey.

Acting-Chairman

That has been ruled on already as being outside the purpose of the proposed sub-sections. It may be dealt with on the section, as amended, when I propose that question.

Mr. Ryan

It is ridiculous that we should enable the Minister to spend money on something that is going to produce a report on which he is not bound to act.

Acting-Chairman

It appears to me that the circumstances of the report are not an issue at the moment.

Mr. Ryan

I think that it is foolish that we should make this matter mandatory on the Minister. The Minister sought to go against the recommendation of the Council and to put in a permissive clause. Now he is putting in a mandatory clause which is worthless. The money which he wants to spend on carrying out this limited survey would be better spent on educating the people in ordinary hygiene. It is wrong to make this clause mandatory. If it were a permissive clause I would hope that we would not waste money and time in getting reports which would be abortive or useless. No useful purpose would be served by getting these reports.

Acting-Chairman

This seems to be going further and further from the amendment.

As I understand it the purpose of this amendment is to ensure that a survey will be made of all school children before any regulations will be made. Is the Minister stating now that he will accept the report that will come to hand from that survey? I presume that he will accept the result of the survey if he is going to insist on making it.

I am making the survey in order that the House will be in full possession of all the information. Two reports will be presented to the House so that the House will be in full possession of the facts and be able to discuss the regulation if a regulation is made.

And the regulation of the Minister can be held up if the House so desires?

I would say that the regulation will give to the House an opportunity of discussing whether the regulation should be adopted.

Is it not necessary, if that is the Minister's intention, further to amend this to provide that the House may annul a regulation?

That is provided for in another section of the Bill.

Mr. Ryan

There is another question. Am I to understand from the Minister's remarks that the purpose is to put the House in possession of the necessary information so that it will be able to criticise and, if necessary, annul the regulation made? If that be the intention, it is certainly not the result of his amendment. The amendment is to put the House into possession of certain information which is not in dispute, that is that the intake of fluorine will delay dental caries. I say that the Minister's amendment is worthless. It is a waste of time and money to have a survey carried out, the sole result of which will be to put the House into possession of information about dental caries but which will not give the House any information as to the result of the intake of fluorine on the people. Until we know the results of intake of fluorine on the system generally the proposed survey is worthless and, therefore, I am against the amendment.

Acting-Chairman

I do not consider that that is pertinent to the amendment. Is the amendment agreed to?

Mr. Ryan

No.

I suggest that Deputy Ryan be recorded as dissenting. I am accepting the amendment.

Amendment put and agreed to, Deputy Ryan dissenting.

Question proposed: "That Section 2, as amended, stand part of the Bill."

On the section, I wish to continue the remarks which I was making because it is very important that the tactics adopted by Deputy Ryan and those associated with him in opposing this Bill should be disposed of I was dealing with Deputy Ryan's statement, which has been repeated, that the President of the United States was forbidden by his doctor to drink fluoridated water. The President himself denied that and Said that he did drink Washington fluoridated water which he found as good as any other. Later the President's own personal physician wrote a letter to a colleague stating that he had never seen a case of illness which could be attributed to the fluoridation of a public water-supply. I hope that we shall not hear from Deputy Ryan any further reiteration of the falsehoods which he has used in this House.

On a point of order, is it in order for the Minister to accuse a Deputy of uttering a falsehood? I think that should be ruled on.

Acting Chairman

If he used the word "deliberate"——

I did not use it deliberately. I do not know whether Deputy Ryan was aware of the fact that it was a falsehood or if it were one of those statements supplied to him by that body which calls itself the Pure Water Association. What ever else that Association lays claim to, it is not the unadulterated truth.

This is scandalous.

In this morning's Irish Independent there is an example of the manner in which this unscrupulous campaign has been conducted by certain persons. On October 27th last, speaking on the Second Stage of the Bill, I said this:

Deputy Manley went on to say that we ought to be fully acquainted with the subject. This is a complex scientific subject; it is a problem which is widespread and on which there has been a great deal of scientific research. It is not something that has been suggested here for the first time nor has it been developed merely over the last 15 years. I shall show in due course that this problem has been the subject of numerous and close investigations for almost three-quarters of a century; but it is only in the past 15 years that the results of these investigations, experiments and researches have come to be applied in a controlled way.

In this morning's Independent there appeared a letter issued on behalf of the Pure Water Association which operated with a pickaxe upon the true content of the passage I quoted. The signatories to the letter stated, with interpolated brackets, that the artificial fluoridation of public water supplies is not something which has not been suggested here for the first time. You notice how my words have been doctored. They have not been fluoridated, but something has been added to them which suggests something different from what I did say. They have interpolated the words “artificial fluoridation of water supplies”. There is not a word in the passage I have read to the House about the artificial fluoridation of water supplies.

Mr. Ryan

That is what the Minister meant.

It is not what I meant. What I meant is what I said —that for almost three-quarters of a century there have been investigations but that it is only in the past 15 years that the results of these investigations have come to be applied in a controlled way—and that this extraordinary coincidence between the presence of minute traces of fluorine and the absence of dental decay has been under close investigation. That is what I said, but these purists in respect of liquid have represented me as saying something else in one of this morning's newspapers.

I cannot see any great difference.

What I did say is in the Official Reports of the Dáil, but it has been omitted in the bowdlerised version which has been published over the names of these people who are so concerned with morality. While they profess to be gravely concerned with the ethical aspect of this matter, they seem to have very little respect indeed for one of the Ten Commandments.

Mr. Ryan

Surely it is not in order for the Minister to accuse people who are outside this House with having no respect for the Ten Commandments?

I am making the charge and I am proving it. They have made an attack on me and I am answering them.

Mr. Ryan

There is another place——

There is, and I may do it there too. I am doing it here in order that the House may know the type of people who are filling Deputy Ryan with misleading statements, which he has been dishing out in this House, in this debate.

This is scandalous.

Acting-Chairman

I think we would proceed more expeditiously if we had fewer interruptions.

These people want to say that I was telling a falsehood when I made the statement I have just read out to the House. I said that though the matter had been closely investigated for almost three-quarters of a century, it was only in the past fifteen years that the results had come to be applied in a controlled way. Quite clearly the vital words in that statement of mine—that it had been under investigation but that it was only within fifteen years that the results had been applied in a controlled way—were twisted by these people. The gentlemen of the Pure Water Association, in order conveniently to doctor my statement, have cut out the vital words.

I have shown how they misled Deputy Ryan in relation to the advice given to President Elsenhower by his personal physician. I now show how they take words out of their context, how they truncate statements in order to try to convince other people of the falsehood of which they themselves are guilty by suppression and suggestion.

Deputy Ryan, again to-day as he did on the last occasion, spoke about the civic authorities in America who, having decided to fluoridate their water, afterwards reversed that decision, and he occupied the time of this House at great length last Wednesday by reciting some 76 municipalities in America who had decided to cease fluoridating their water supplies.

Artificially. That was a remarkable list. You know, it is worth studying. Subjects such as this must be discussed in an assembly like this where people have time to discuss them without heat, and when authorities are cited they must be authoritative. We find that in that list the municipalities—I am not discussing their size or their importance but their responsibility—had been adopting fluoridation one week and abandoning it the next. Whether it was the adoption of the measure or its abandonment in less than a week that was the worst I do not know. What I do say is that the fact that a municipality—I am dignifying some of these bodies when I apply that title to them; I am enhancing their status far beyond what in fact it is—which can in one week adopt what Deputy Ryan and those associated with him think a very momentous and, according to them, injurious procedure, should the following week abandon it, certainly shows a degree of irresponsibility which renders any action of theirs worthless as evidence for or against the fluoridation process.

This is a process the effects of which will be fully tested after a period of years when we have manifested in this country, as there has been manifested everywhere else where it has been tried, a marked decline in the incidence of dental caries. That decline does not take place overnight. I am not saying that fluoridation will have the same sort of effect as an antibiotic drug would have but it is a preventive process which, if applied, will over the years show a marked decline in the incidence of dental caries. That is an established scientific fact. Not even Deputy Ryan has ventured to deny that. On the contrary, he has admitted that it at least retards dental decay.

Mr. Ryan

Delays, not prevents.

He has now being trying to ring the changes upon a word.

Mr. Ryan

Not at all.

He said, "We do not deny now that the presence of a trace of fluorine in water will prevent dental decay in the vast majority of cases."

Mr. Ryan

For a couple of years.

We do not say that it will do it universally but Deputy Ryan says it will not prevent dental decay but it will delay it. He has been compelled to make that admission because of the facts which have been proven wherever this process has been adopted, that is to say, that over the years there has been a reduction in the incidence of dental caries in every community where the process is in use. That is what he has been compelled to admit.

Mr. Ryan

I never denied it.

Therefore, as I was saying, the evidence of the attitude towards the proposal of communities who have not tried out this process over a term of years is worthless and, if you go through the list of 76 which Deputy Ryan at great length put before the House last week, you will find that a very large proportion of them indeed did not complete this experiment, the reason being, of course, that they were worked upon by those who said, "Elsenhower's physician has forbidden him to drink the Washington water." That is how these reversals of policy were secured. Everybody knows that. There is ample evidence in official documents proving it.

Mr. Ryan

The Minister should be careful. I said there were 2,500 communities. I shall finish the list if he is not careful.

Here is a document issued by the United States Department of Health, Education and Welfare. It is entitled "Fluoridation." It contains a statement, by the Secretary of State for Health, Education and Welfare, Arthur S. Flemming. Referring to the fact that there had been— and I am not denying it—some decline in the rate at which American public authorities were adopting the fluoridation process and in some instances, indeed, as Deputy Ryan has said, were abandoning it, the Secretary of State for Health, Education and Welfare said:

Intensive research over a quarter of a century shows conclusively that water containing a proper amount of fluoride reduces dental decay by about 65 per cent.

(2) Equally conclusive research has demonstrated that controlled fluoridation is completely safe, causing no bodily harm.

Having pointed out both these facts, the Secretary of State—President Eisenhower's Secretary of State—said:

I have inquired into why, in the light of all these factors, the extension of fluoridation has been lagging in the last two years. I have come to the conclusion that it amounts basically to this: the opponents of fluoridation are a militant minority; the proponents of fluoridation, as is so frequently the case with proponents of new health measures, are an unmilitant majority.

Then the Secretary of the American Medical Association is quoted by Secretary Flemming, as follows:—

In addition to the sincere opposition which merits respect, there is the usual hue and cry from those who take every opportunity to discredit medical science and legitimate public health progress. We find in the antifluoridation camp the anti-vaccinationists, the anti-vivi-sectionists, the cults and quacks of all descriptions, in short, everyone who has a grudge against legitimate scientific progress.

It is these people, operating upon these volatile and irresponsible American communities whom Deputy Ryan cited to us, who have succeeded in the United States of America in slowing down the adoption of fluoridation.

To consider another aspect of this long and apparently impressive list which Deputy Ryan cited to us, consider some of the communities that he asks this Dáil to be influenced by. Take Knoxville, Iowa,: in a referendum there were 868 against fluoridation and 356 for. In Genesco, Illinois, there were 988 against and 422 for. In Greensboro there were 5,545 against and 4,326 for. In Wichita Falls, Texas, there were 1,800 against and 1,400 for. In Rhinelander, Wisconsin, there were 1,500 against and 1,117 for. He quoted 76 communities and in that list it would appear that the largest number of people who voted at a referendum on this question was in San Diego—and there 46,000 voted against and 41,000 for fluoridation.

Having read that list of 76 obscure and, in some instances, minute communities, Deputy Ryan told the House that 60 million American people were against fluoridation. I am perfectly certain that he quoted those that he thought were most impressive, and this enormous, terrifying opposition of 60 million people was based upon what? Upon 868 in Knoxville, 988 in Genesco, 5,545 in Greensboro, and 1,550 in Rhinelander and, to throw it in for good measure, 46,000 in San Diego. The Deputy will have to multiply a long time before he makes 60 million out of that. As against that tawdry list of little communities you have the official pronouncement of the Secretary of Health in the United States of America. Does he count for nothing? He at any rate represents the whole of America, and not Knoxville with its 868 or Genesco with its 988. If we are going to have this matter discussed let it be discussed on an intelligent basis.

The reason I am asking the Dáil to give the Minister for Health, whoever he may be, powers to make it mandatory upon local authorities to fluoridate the water if the Minister makes a regulation which is applicable to their area, is to prevent the sort of thing that has happened in America where, as Secretary of Health Flemming has stated: "...there is the usual hue and cry from those who take every opportunity to discredit medical science and legitimate public health progress."

Under the Section as now amended the position will be this: that the Minister for Health, if he proposes to make a regulation, will have a survey carried out in a representative sample of day schools, which permit such a survey to be made of the pupils, in order to ascertain in that administrative area what is the incidence of dental caries. There will also be made an analysis of the public water supply of that district and then, with full information as to the manner in which the survey was made, the numbers classified by age and otherwise of the pupils to whom it relates, the Minister will make a regulation, if he thinks he is justified in doing so, and the regulation will be laid upon the Table of the House. If the proposal that the water supply in Dublin city and county, embracing three-quarters of a million people, should be fluoridated meets with any opposition, those who oppose it like Deputy Ryan and others can put down a motion to have the regulation annulled and we can have the matter discussed here in a rational and reasonable way and not in the manner in which——

Mr. Ryan

The Minister is doing it.

——the debate upon this Bill has been conducted so far by Deputy Richard Ryan.

I do not propose to take up the time of the House at any length. However, I am surprised that the Minister should regard it as necessary for him to intervene on the Section and to whip himself into a frenzy because of a letter which appeared in the Irish Independent this morning. Half of his contribution was devoted to castigating the Association responsible for the letter; the other half of his contribution was devoted to condemning as irresponsible a number of communities in America. I do not believe that what the communities in America did falls within the Minister's jurisdiction to describe as responsible or irresponsible. I merely wish to dissociate myself completely from what I believe to be the unfair remarks made by the Minister in connection with the Pure Water Association. I do not accuse the Minister of being deliberately unfair. He thinks he has been wronged by being misquoted and feels strongly about it. I want to dissociate myself from the Minister's remarks. I have met some of these people; I believe them to be absolutely honest and sincere and to entertain serious and genuine feelings in regard to the action which the Minister is taking.

The Deputy has an all-embracing charity.

It may be, but I have met them; that is my view and I want to put it on record in the House. I think, in view of the remarks the Minister has made, that in fairness to them, I should do as much.

When the Minister approaches this subject from such an extraordinary angle he has no right to complain about others taking a different line from his. The Minister's approach to those who oppose him is a far more serious matter for consideration than any problem in connection with the section. On the section itself, it is obvious, even at this stage, that the Minister has avoided completely the biggest problem of all. He speaks about the rights of those in day schools in regard to undergoing this check, but he completely avoids the main issue.

Progress reported; Committee to sit again.
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