Dáil Éireann debate -
Thursday, 17 Nov 1960

Vol. 184 No. 8

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

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

Mr. Desmond

When speaking on this last night, the Minister again adopted an attitude which, in my opinion, is of no help either to those in favour of the Bill or those opposing it. It is strange that the Minister should on this section again take advantage of attacking people outside just because they hold different views from his and just because they may write letters to the daily newspapers with which the Minister does not agree. He finds it more suitable to spend his time here attacking those individuals and groups. I believe it is far more important for the Minister to try to put up his own case and stand by that, rather than adopt his usual tactics of attacking and abusing everyone who does not agree with him.

I have little to say on this section. We have discussed it for a long time. In the end, we realise that the Minister, because he has the advantage of being able to steamroll this through the House, will get his way in spite of the fact that the case he put up contains many defects. The Minister should be far more capable of dealing with the matter in a gentlemanly manner, particularly when it is of such importance to the people of the country.

I personally agree with subsection (4) of the section. We find it stated that "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," etc. Still, we cannot get away from the fact that that provision, which is essential, must demonstrate to the Minister how weak his case is all the way through.

I tried to direct my remarks to the position as it will affect the people in rural areas. Should it happen, certainly without any support from me, that the people in these areas should decide they will not agree to their school—going children submitting to these tests, what does the Minister hope to secure out of a survey? If the survey is to be carried out successfully, surely it should be based on reasons which in themselves will show whether or not there is justifiable reason for the Minister adopting the attitude he has adopted in connection with this aspect of the matter? I believe that such a survey cannot succeed for the very simple reason— and the Minister himself must know this—that in a large number of rural areas, where these school children live, there is no such thing as a piped water supply. All the way through on this section the Minister has not enlightened the House, nor has he made any attempt to enlighten the House, as to what should happen in the areas where there is no such thing as a piped water supply.

I believe we are wasting the time of this House discussing a measure which cannot give to the people the results which the Minister may hope for himself. In dealing with any particular section of the Bill it seems hopeless to consider it from the point of view of fair criticism when we have a Minister attacking everyone who may differ from him and who, in a childlike political fashion, seems to find it suitable to praise those who are in favour of the matter and abuse those who do not agree, and also when we have a Minister who found it convenient last night to attack those sections of the community in America who, according to him, stampeded on the publication of a statement as to whether or not a certain individual in America was using fluoridated water.

What has it to do with us what they do in America? One thing they did not do was make it compulsory. My argument all the way through is that the administration in any country have not found it necessary to make this compulsory. Why then should the Minister abuse everyone who tries to adopt a fair line of criticism to show that the results anywhere else do not justify the Minister in his direct criticism of all concerned? It is a waste of time discussing even this section with a man who already knows the result of the vote in this House.

Mr. MacEntee

We have just listened to an excellent example of Satan reproving sin. I am being attacked by Deputy Desmond as being abusive. I think the House has seldom listened to a more unrestrained example of reckless misrepresentation and abuse than that to which we have just listened from the Deputy. I protested again in this House, as I am entitled to protest, against the manner in which a statement I made in the House had been bowdlerised by the gentlemen associated with the Pure Water Association. They wrote to the press and they said this: "The Pure Water Association wishes to draw attention to the following statement made by the Minister for Health on Thursday, 27th October, in reply to the Second Reading debate." Then they go on to quote what purports to be a statement of mine. It is a partial statement and, not only that, it is a distorted statement, because they add words which I did not say and they delete words which I did say. They presented the people with an incomplete and distorted statement of mine and am I not entitled to protest, Sir, when that sort of thing is done in the public press?

Is it abusive for me to point out here that my statement was truncated and altered by the members of the Pure Water Association? Was I abusive in so doing? Surely I am entitled to protect myself against the misrepresentative methods used against me. For doing that, I was attacked by Deputy Desmond. The Deputy may wish to blacken me in the eyes of the people for his own particular political purposes but he has no right under that smokescreen of abuse to try to conceal the truth from the people. That is what the Deputy is doing.

The Deputy is opposed to this measure. He is entitled to be opposed to it, if he so wishes. He spoke against the Bill on the Second Reading. This is a deliberative assembly in which we all have different views about matters which come before us and I do not object to the Deputy making a speech against the Bill. What I do object to is that misleading statements are quoted by those opposing the Bill. When these statements are characterised by me as being fallacious and misleading, I am charged with being abusive. I hope the Deputy will not again afford me the opportunity of taking exception to the manner in which he has approached this Bill.

He stated yesterday that I attacked the people in America who had been opposed to fluoridation. I did not attack them but I did quote what I think are authoritative words issued by the Government of the United States of America on this matter. I quoted what was put forward as the reason why there had been a slowing down of fluoridation in America. The House will remember that Deputy Ryan has occupied quite a considerable portion of its time on every Stage of this Bill and on every section of the Bill so far debated. In making his case against it, he emphasised that certain insignificant communities in America, having adopted fluoridation, have abandoned it.

Having referred to these few little insignificant communities, he spoke of 60 million people being opposed to it. In order to refute that statement, I quoted from an official publication of the United States of America in which the Secretary of State for Health, Education and Welfare, Mr. Arthur S. Flemming, said this—and I hope that if Deputy Desmond is receptive to argument and has not taken up the attitude which he has purely because of political bias, he will listen to what the Secretary of State has had to say:

Intensive reasearch over a quarter of a century shows conclusively that water containing a proper amount of fluoride reduces dental decay by about 65 per cent. Equally conclusive research has demonstrated that controlled fluoridation is completely safe, causing no bodily harm of any kind.

The point which those opposed to this measure must put to themselves is this: dental decay is rampant in this country; a survey in 1952 revealed that it could be said that 99 per cent. of our young people and adolescents have suffered in some way from dental caries. Here we have a measure which has been tried under strict control in America for 15 years, but on which there has been investigation and research for 70 years. About it, the Secretary of State for Health says that intensive research over a quarter of a century shows conclusively that water containing a proper amount of fluorine reduces dental decay by about 65 per cent.

I want to put this question to Deputy Desmond. He represents many workers in his constituency. Dental caries is not confined to any particular social or economic stratum of society. It is as common among the workers as among the better classes and it is rampant in both. The question I am now putting to Deputy Desmond and to those associated with him is whether he is prepared to continue his opposition to the introduction of a process in this country which will safeguard the children of the workers of his constituency by a 65 per cent. reduction in this horrible disease. That is the question he has now to put to himself. I am putting that question to him and do not let him get up here and say that in doing so, I am being abusive. I am putting the question to him straight and I am not whinging or whining about it as he was.

The Secretary of State for Health went on to say:

Equally conclusive research has demonstrated that controlled fluoridation is completely safe, causing no bodily harm of any kind.

The question arising here is whether that is going to be accepted for what it is worth as an authoritative statement issued by a recognised authority carrying with it responsibility for anything it may say, responsibility to the Congress and to the people of the United States. Are we to have this sort of thing dished out to us here all the time that the Dáil will be occupied in debating this measure? It is a question of authority against irresponsibility.

In the same publication, reference is made to the progress which fluoridation has made. It is admitted that, in the past two or three years, progress has been slowed down. I shall quote now from the second section of the official American document on fluoridation:

At first glance the acceptance of fluoridation during the last eight years appears satisfactory. A closer look, however, reveals that most of the gain has been made in the larger cities. Sixty-six per cent. of the nation's cities with populations of more than half a million and 32 per cent. of the cities with populations between 10,000 and 500,000 have fluoridation programmes. By contrast only 17 per cent. of those communities having populations of 2,500 to 10,000 and 5 per cent. of communities with populations of less than 2,500 have such programmes. Consequently, most of the people benefiting from this measure live in the large cities.

It is very relevant in connection with that quotation to remind the House of what I had to say about some of the towns which Deputy Ryan alleged yesterday had abandoned the process of fluoridation, having accepted it. From the list of 76 towns solemnly trotted out as arguments to influence Dáil Éireann in considering this measure, we find that in Knoxville, Iowa, 356 people voted for fluoridation and 868 voted against it in a referendum. In Genesco, Illinois, the figures were 988 against and 422 for; in Greensboro, North Carolina, the figures were 5,545 against and 4,326 for; in Rhinelander, Wisconsin, there were 1,550 against and 1,117 for. The "for" and "against" in those communities do not count for very much because they are some of the backward communities, the fundamentalist communities in America. They are communities in which they know nothing; they are the communities in which the Ku Klux Klan are a force in America; and they are the communities Deputy Ryan asks us to weigh against the 66 per cent. of the cities of the nation with populations of more than half a million, and 31 per cent. of the cities with populations of between 10,000 and 500,000. We are asked to put them against the communities that have resources and knowledge and have had this matter fully investigated. We are asked to allow their record to be buried under this mass of infinitesimal communities which the Deputy has trotted out.

I want to get back to Deputy Desmond. Deputy Desmond accuses me of having attacked the Pure Water Association yesterday. I have shown that my remarks yesterday in relation to that association were directed to the fact that they had wilfully and deliberately truncated my speech and interfered with my statements in this House in order to mislead. That is what I said. The Pure Water Association has this to say about the report issued by the World Health Organisation:

...the Minister made it clear that he was relying for the accuracy of this statement on a single sentence culled from an "expert" report issued by the W.H.O. in 1958.

First of all, that is not true, because, in opening the debate on the Second Reading of this Bill, I cited and quoted extensively from the reports of commissions of inquiry set up by sovereign States to investigate this problem, so that I was not relying merely upon the report of the Expert Committee appointed by the World Health Organisation.

Deputy Desmond, who is anxious to protect people from abuse and misrepresentation, might direct his mind to the next quotation. I am quoting now from a letter which was deliberately written by the Pure Water Association:

The sentence in question is extremely misleading—indeed it might almost be characterised as dishonest —and it is completely undocumented.

What is that? Is it an attack upon the World Health Organisation? That expert committee is charged with misleading the people, the world, those who are concerned—yes, the Deputy may smile, but it does happen to be the people of the world—with the health of the world communities. It is engaged in fighting disease in Africa, Asia and Europe. It is not a matter to be taken lightly that the Pure Water Association should make a charge against that Organisation to which we contribute very heavily and which has, I am glad to say, readily availed of the highly expert advice, help and assistance which we have been able to give them. My Chief Medical Adviser has just returned from a most important assignment in Indonesia where he endeavoured to establish a health service more or less on the lines of the service we have. His efforts have been the subject of very complimentary letters to me.

The fact that the World Health Organisation has been attacked in this way is not a matter which can be taken lightly by any responsible public man. Therefore, when the World Health Organisation is charged by those who are opposing this Bill with misleading the public and with making statements which are tantamount to being dishonest and completely undocumented, we are entitled to challenge the bona fides and the credibility of the people who make those charges. I have already challenged their representative in this House. I have already shown the extent to which Deputy Ryan will endeavour to mislead this House. I know, of course, that he is merely the mouthpiece of those people and that what he says is supplied to him by them.

It has been said, and it was said by Deputy Desmond, that there is no proof that this process will be of any value. I hope I am not misrepresenting the Deputy; I do not want to. The Deputy apparently takes the view that fluoridation will not do what its advocates claim for it. He apparently takes the view that it will not restrict and limit the incidence of dental caries in the community to the extent that I said, namely, that two children out of three have a reasonable chance of growing up at least to their early years at school without being affected by the process in their permanent teeth. If he takes that view, I take it that it is because he has been impressed by the statements made here and by people outside this House that there has been no sufficient control over the experiments which have been carried out and that the reduction in the incidence of dental caries cannot be explained by the presence of fluorine in the water or by the ingestion of fluorine by individual children.

Just this morning, I received a quotation from the Swedish International Press Bureau dated 12th November and headed Science and Techniques. It says that fluorine in drinking water may give 60 per cent. less caries. It is from Stockholm, and it reads:

The experiments to find out the effect of fluorine added to the drinking water as a means against caries, which have been going on in the city of Norrköping since 1952, are now nearly concluded and have given very promising results, according to an article in the Stockholm daily Svenska Dagbladet. The investigations are claimed to be the most extensive of this kind carried out in the world, and the findings will be presented to the congress of the European organisation for fluorine and caries research in London in July, 1961.

While the field work has been carried on by dental and medical authorities in Norrköping, the scientific work on the material has been conducted at the Royal School of Dentistry in Malmö by Professors Sven Sellman and Arvid Syrrist. One point of interest has been whether the need for dental care of children can be reduced. At present about 60 per cent. of all Swedish children in the ages of 7-14 receive dental care from the Public Dental Service. About 80 per cent. of all 7-year-olds suffer from caries according to the journals of the Dental Service.

In the Norrköping experiments 500 children have been given fluorine in their drinking water without their knowledge, both at school and at home. They have been compared as to caries frequency with another group of 500 who have received no fluorine at all. Other smaller groups have been given fluorine in the drinking water either at home or at school.

In the centre of interest has been a group of children who were born in 1952 and since then until they started school in 1959 were given drinking water with fluorine added. The amount of fluorine added has been 1 mg. to 1 litre of water. Already in 1955—three years after the start of experiments—a 20-30 per cent. decrease of the caries frequency was noted among "fluorine drinking" children. It is, however, estimated that the figure will increase to some 60 per cent. after a prolonged treatment.

I hope the Deputy who is concerned to oppose this measure because he does not believe that fluoridation will safeguard the teeth of our children will study that highly-controlled scientific experiment. He will see that people who drink water to which fluorine has been added are much less liable to dental caries than those who drink water to which it has not been added.

I think that when he has studied that experiment he will modify, if he cannot change his mind in the light of the facts presented to him, his opposition to this Bill, and that he will not oppose it merely because it is introduced by the person who now happens to be Minister for Health. The Deputy, in this House and on other occasions, has said that however good a measure might be, so long as I was associated with it he was prepared to oppose it.

Mr. Desmond

I never said it.

Mr. MacEntee

Oh, no—not just so succinctly. The Deputy has harked back to 1/-, if he remembers it, on a number of occasions and has given that as his ground for opposing any measure with which I am associated. We heard a great deal from Deputy Ryan yesterday and we have heard on several occasions about the Holy Father's allocution. There, again, we have a fair example of selective quotations. The Deputy, in the role of the Devil, sanctimoniously quoted Holy Writ.

Mr. Ryan

On a point of order, surely this is just a new low level even for the Minister for Health which should not be tolerated by the Chair? It is surely not normal for any person in this House to call another person a devil, as the Minister has.

Mr. MacEntee

The Deputy appears to lack knowledge of the ordinary wisdom of the people, which has been crystallised in the——

Mr. Ryan

The Minister is throwing dirt from the bottom of the barrel.

Mr. MacEntee

If Deputy Ryan wants to sprout horns and a tail he is quite at liberty to do so. I did not say he is the Devil or Satan. I said he had adopted a role and was playing a part. I shall repeat what I said. I said that Deputy Ryan, in the role of Satan, sanctimoniously quoted from an allocution of the late Holy Father, Pius XII, delivered to the First International Congress on Histopathology of the Nervous System on 14th September, 1952. I take it that that is the source.

Let us see the position. What was the Holy Father talking about on that occasion? He was not talking about fluoridation. He was not talking about a process that had been in operation. He was not talking about the artificial fluoridation of water. He was not talking about naturally fluoridated waters, either; that goes without saying. He was not talking about a phenomenon that had been studied for over 70 years, the scientifically ascertained fact that the presence of the minute quantity of fluorine in water greatly reduces the incidence of dental decay in children's teeth. He was not talking about the artificial fluoridation of water, a process which has been in operation in major States and major cities of America, some of them for 15 years. Not at all.

He was talking about something quite different. He was talking to this First International Congress of the Histopathology of the Nervous System and he opened his address with these words:—

This First International Congress of histopathology of the nervous system succeeded in mastering a subject truly vast. It was deemed necessary by the exposition and demonstration of thorough investigation to place in an exact perspective the causes and first beginnings of the diseases of the nervous system proper and of the diseases described as psychic. Furthermore, a report has been presented and an exchange of views organised on the subject of the known facts and of the recent discoveries in the lesions of the brain and other organs lesions which are the causes of nervous diseases as they are of mental diseases.

Further on, having expatiated on that and expressed the full implications of what was being done, he went on to say:—

For the moral justification of new processes, new experiments and methods of research three principles are invoked: (1) the interests of medical science; (2) the individual interests of the patients under treatment; (3) the common interest of the community, "the bonum commune".

We now state the question: these three interests—considered each one apart or at least all three together—have they an absolute value as the motive and justification of the medical treatment, or do they find their value only within determined frontiers? To this we shall try to give a short reply.

What is the reply? The reply concerns itself entirely with new techniques in the treatment of mental and nervous diseases. It was addressed to questions like leucotomy or those other surgical operations which, by altering the constitution, the structure of the body and, in particular, the brain, can change the personality of an individual. That Allocution had nothing whatsoever to do with the questions we are discussing here. Yet, it has been trotted out by Deputy Ryan trying to play upon the natural piety of the Irish people and upon their readiness to accept and obey the words of the Holy Father.

This is not the first occasion upon which this question was raised. It was raised before the Consultative Council and they had this matter considered in the proper quarter, where the full significance of the teaching of the Church in relation to matters of this sort was properly appreciated, and where the wisdom and the teachings of the Church were not going to be misapplied for the sake of scoring some sort of political triumph. Here is what the Council had to report on that matter. I shall read paragraph 37 again:—

The Council received representations to the effect that flouridation of public water supplies was unethical. The main grounds for objection were that it was mass medication, a usurpation of parental rights by the public authorities and an interference by the public authority with the integrity of the human body.

These are the three grounds of objection. These are the three grounds upon which people have endeavoured to raise this bogey of unethical procedure here. They were fairly studied by those who were consulted and as a result of the consultation this is what the Council says:—

These objections were carefully considered and advice was sought and received. The Council is satisfied that there is no ethical objection to the flouridation of public water supplies within the margin of safety recommended in this report.

I am sorry to have kept the House but it was necessary in order to ease the public mind that the arguments which have been used in this House against this proposal should be shown for what they are, hollow and empty, and where they appear to be most impressive, that they are impressive only because they suppress the truth like Deputy Ryan's statement about the President of the United States, like his statement about the 60,000,000 people in America who would not have flouridation, like his statements with his misleading quotations from the Holy Father. These are the things which influence honest, simple Deputies like Deputy Desmond to the extent that they give rein to their personal prejudices against the Minister for Health and try to make him stand against medical progress in this country.

In that connection I should like him to take to heart the words which Secretary Flemming adopted as his own—because they appear and are quoted by him in his statement—the words of the Secretary of the American Medical Association who described the opposition to flouridation in these terms:—

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. They bring all manner of irresponsible charges——

including the allegation which we have heard in this House on the Second Stage of the Bill from Deputy Ryan—

including the allegation that fluoridation is promoted for commercial profits by those who manufacture the chemicals and machinery and that irresponsible scientists and public officials have been ‘bought'. The ridiculousness of such a charge evaporates into thin air when one merely looks at the official and professional bodies that have endorsed fluoridation.

I hope Deputy Desmond will read that statement and will ponder it and then see if he can in conscience continue to support Deputy Ryan in his vexatious opposition to this measure.

Mr. Dillon

The modest purpose of the Opposition in regard to this section is that a decision to fluoridate a water supply should be left to the local authority, rather than that the Minister should be invested with the power to direct an authority to fluoridate its local water supply, and many I suggest that the very passion that has been generated on both sides of the House is one of the very strongest possible arguments for leaving it to be determined by the local authority? If we charge the Minister for Health for the time being with the duty of making a coercive order which may tear a parish into two feuding groups, using as violent language as has been used on both sides of the issue in this House, can anyone imagine that we are conferring any benefit on the community which we thus tear into two feuding, raging factions? I cannot think it is so. I can well imagine if I were a member of Carrickmacross urban district council or Clones district council and was in favour of fluoridating the water supply but found that 45 per cent. of my neighbours in that area were passionately opposed, and that my best arguments could not persuade them that it was a desirable course to pursue, I would advise the majority of 50 per cent. of the community, for peace sake, not to thrust this new procedure down the throats of the 45 per cent. of our neighbours who were passionately opposed to it.

The Minister today, in what I think was an extravagant moment, chose to describe Rhinelander, Wisconsin, as a Ku Klux Klan town. That sort of language is fantastic. These relatively small communities in the United States of America to which he has referred are just like the small communities in our own country, like Carrickmacross, Ballinasloe, Clonmel, or any of our smaller cities and towns and, though they are small, that fact in itself seems to me to argue most powerfully for this House refraining from extreme intervention in their domestic affairs, possibly with the best intention of conferring some benefit upon them but with the inevitable end result of bringing dissension, ill-will and ructions into a peaceful community, out of all proportion to the public benefit conferred by the process envisaged in the Bill. I think we are in a rational Parliament, and to hear the Minister for Health describe a bad tooth as a dreadful disease reveals a lack of detachment and objectivity on his part which causes me some concern.

I have heard it argued by excellent authorities that the ultimate destiny of a child's or, indeed, an adult's teeth, is determined long before he is born. The character of a human creature's teeth is largely determined en ventre sa mere—it is very largely the diet of his mother and the care with which here pre-natal clinics have been carried out that ultimately and irrevocably condition her offspring's teeth, but I do not believe that we in this House are qualified to conduct an inquiry into the whole question of the genesis and incidence of dental caries, and I think there is a great danger in passionate arguments about these matters, producing what appear to be authoritative opinions carefully selected to support the case one is concerned to make.

I remember not many years ago— certainly within the past ten years— there was a powerful and raucous school of thought prepared to convince us all that cortisone was a panacea for almost all human ills. Every arthritic and rheumatic person was to leap out of his bed and chase around Phoenix Park if he got cortisone. Almost any obscure medical condition that defied diagnosis was subjected to a course of cortisone treatment. Indeed, I remember a very dear friend of mine who got it and died, and it was only discovered after it was in use for some time that the limitations and advantages of cortisone were very great and that, while it did confer some striking benefits, it had considerable handicaps which have since very seriously circumscribed its use in medical treatment, but the Minister for Health argues strongly that in regard to fluoridation experiments, they have continued for 70 years. That is news to me. As far as I know, this business of artificially increasing the fluorine content of water was only initiated relatively shortly before the last World War, though I may be wrong.

Mr. MacEntee

I said the researches and investigations into the properties of naturally fluoridated water.

Mr. Dillon

Of course, "naturally", but this is a question of "artificially".

Mr. MacEntee

Empirical experiments before the general adoption.

Mr. Dillon

I think there were experiments made on the fluoridation of water in America and Canada before the first World War, and I have been watching this matter with interest. What I want to emphasise is this: I am not prepared to argue for or against fluoridation. I think there is a powerful case to be made in favour of it but I am constrained to listen with patience and respect to the passionately held views against it. All I am arguing for is that we should not take it upon ourselves in Dáil Éireann to direct a rural community that has its own local authority to fluoridate water without any regard to the feelings of the people for whom it is charged with the responsibility of providing a public water supply. Now, if the Minister had accepted that principle on the First Stage of the Bill, there would have been no serious opposition to his proposal.

The Minister waxes very eloquent about Deputy Ryan consulting persons outside this House, listening to representations from persons outside this House in regard to this Bill, and bringing such views to the attention of the House. I should like to ask the Minister what useful purpose does a Deputy serve if he does not bring the views of his constituents to the attention of the House and, if he finds himself in sympathy with the views of the constituents who approach him, has he not a public duty to bring them forcefully to the attention of Deputies?

I recently addressed a letter to every vocational body in this country whose name and description I could find, asking them to furnish me, as Leader of the Fine Gael Party, with their observations on any impending legislation so that legislation in this House might be more intelligently discussed. The Government, having as much information as they want, and having the organisation to get it, bring their measures before this House. The Opposition Parties do their best to examine and constructively to discuss them but it appears to me the Opposition Parties would be greatly sustained in the discharge of that duty if persons who believe that pending legislation will affect their interests would inform them of their views so that they could be brought before Dáil Éireann, argued out here and expounded by those who had sympathy with the views of the interested parties who had submissions to make.

I think the Minister does the House no service if he suggests that a Deputy in any way betrays his trust by bringing the views of his constituents to the attention of this House, and by doing it with emphasis if he finds himself in substantial sympathy with those views. One fact emerges from this whole Bill, and that is that, on the subject of fluoridation, there can be as passionate views held, for and against, as we have heard from the Minister and Deputy Ryan. I ask reasonable Deputies here in the face of that fact without going any further into the determination of the merits of the arguments put forward, pro and con, does not that fact of this profound and passionately felt difference argue powerfully for the proposal that we should leave this matter to the local authorities concerned?

I suggest to Deputies that if the Minister for Health becomes convinced tomorrow that on the evidence of the surveys conducted in Ballinasloe, Clonmel and Carrickmacross, he has authority to make an Order for fluoridation and the local authorities say to him: "Listen; a majority of the people here agree with you that fluoridation would reduce the incidence of dental caries in the children, but they also know that it will create dissension and ill-will out of all proportion to the benefits you hope to confer; we, therefore, having weighed up all aspects of this question, would prefer to provide additional dental care for the children of the parish and at least for the present to eschew fluoridation," does this House consider it desirable that the Minister would have not only the right but the duty to say: "Without any regard to what your views may be, this is good for you and you must do it?"

I think that is a mistaken view. I have a good deal of sympathy with the Minister's view on the merits of fluoridation, but I think he has become so obsessed with it that he is allowing himself to be carried away. It is indicative of the state of mind he gets into when he rises up and passionately says of Deputy Ryan that he is casting himself in the role of Satan quoting Holy Writ. I differ from Deputy Ryan in thinking that is disorderly.

Mr. Ryan

It is.

Mr. Dillon

I do not think it really is. I often called a man worse things than that, but I find it very unbecoming in the Tánaiste and Minister for Health. If everybody who gets up here and speaks his mind is to be described by the Minister as the devil quoting Holy Writ, it is very offensive and it certainly does not help in the dispassionate consideration of legislation. I do not think it was meant to help in that direction. It was meant to indicate to any other person who intended to intervene against the Minister that the Minister was quite capable of getting rough and that, if he got rough, by the time he had finished with him he would have wrecked his reputation. Well, now, pipe down, because that cuts no ice on this side of the House.

If we wanted to tear the Minister to pieces we could scatter them to the four corners of Heaven and not leave a rag on the Minister's back when we were finished with him. I do not think that is necessary in the discussion of fluoridation of water. But the possibility that a man of the Minister's long experience in public life could find himself boiling up into the passionate indignation he displayed at half-past ten this morning suggests to me most strongly that it is folly on the part of this House not only to give the Minister the right but to impose upon him, or any successor of his, the duty of going to a small rural community or any other organised community where there is deep division, marked by the same passion as the Minister himself showed this morning, and directing them to adopt this procedure because he thinks it is good for them, without any regard to the depth of feeling that may influence a minority in that community who are opposed to this procedure.

I urge on the Minister to bear this in mind. Those of any community who want fluoridation have always the comforting knowledge that, if a local authority will not provide it, they can go down to the chemist, buy fluoride tablets and arrange for their children to have them. Their depth of feeling, no matter how reasonable, cannot correspond to any degree with the depth of feeling of somebody who to us may appear utterly unreasonable but who passionately feels that his children ought not to be forced to consume artificially added fluorine in the water. The person who feels that finds himself in the position that he cannot avoid the consequences of the Order.

We ought to stop and think for a moment. People are, perhaps, inclined to be a bit irrational in a matter of that kind. I agree with the Minister that sometimes, after having used all possible forbearance, the public interest demands that you say to them: "In the last analysis we shall have to override your feelings. We have done everything we can to explain to you that no evil can eventuate from this and we have failed to convince you, but the public interest demands that we override you in this matter." But we ought to have regard to their feelings. Unless there is some supreme interest involved, we ought to be very slow to disregard them altogether.

As I said on the Second Stage, no ethical question is here involved. If there was a question of pure ethics involved, then we would have to argue not only against this House having the right to impose fluoridation but any town council or body representative of a community, however small and closely knit together, having that right. But I do not think there is an ethical question involved. I think it is a social question. In that regard I was a bit shocked by the Minister's contemptuous reference to the communities referred to by Deputy Ryan. I agree they are small communities, but they are the kind of communities we have in Ireland. We have only about four or five big cities here.

Ninety-five per cent. of the public water supplies in Ireland are in communities such as the Minister described contemptuously as "backward, Ku Klux Klan towns in America". I think the Minister is as familiar as I am with Iowa and Wisconsin. I think that, on reflection, he will agree with me that to describe the rural communities there as "Ku Klux Klan towns of America" is offensive and contemptuous.

I do not believe the Ku Klux Klan was ever heard of in the State of Iowa or in the State of Wisconsin.

La Follette must turn in his grave to hear his constituents described as Ku Klux Klan—and by the Tánaiste who ought to know better—but, apart from the offensive animadversions on these communities to which Deputy Ryan referred, am I not right in saying that more than 90 per cent. of the public water supplies in this country are in an exactly similar condition? Am I right or wrong in saying that in a community of that kind good feeling and neighbourly forbearance and goodwill will in many cases be more important than the benefits which it is claimed fluoridation of water supplies will provide?

It is for these communities themselves to determine that issue. I think the Minister would be right if he brought in a Bill to make it possible for these communities to do that for themselves, if they thought it necessary. I think he would have been right to bring in a Bill to remove any doubt that might have existed as to whether that power was already there or not. I think he is going that much too far in seeking to centre the power in his own office and I believe if he did forbear from that extremity—and it is very important that the House should remember that our own Commission never advocated it; the body we set up, and which the Minister has quoted, to examine the whole question of fluoridation of water never went beyond the proposal that they thought the Minister should make it possible for any local authority who wished to introduce this into their own community to do so——

Mr. MacEntee

That is not so. I dealt with that when the Deputy was not here.

Mr. Dillon

I have studied it and, in my judgment, that is as far as they were prepared to go. Certainly, that is as far as the report goes. I think they were right: I think the Minister determined that he would cut the Gordian knot and go the step further. That decision has evoked extremes of opposition to the whole concept which has produced from him corresponding violence of language in defence of this procedure which would operate to alienate my sympathetic mind.

I think the truth lies between the two extreme positions that have been taken up in this House and I suggest to the Minister that a great deal of the misunderstanding and the violence of feeling could still be averted if, even at this stage, he determined as a first step to convert this into a permissive Bill. There is nothing to prevent us from returning to this matter in five or ten years if the permissive procedure yields no fruit and reconsidering the whole position, but it would be a step forward in the direction of the recommendations of the Commission, if a permissive Bill were enacted now. To go beyond that now, I think, in view of the strength of feeling that undoubtedly exists, albeit in the minds of a minority, is unwise.

I think the position is that you have an informed minority on one side strongly in favour of the recommendations of the Commission and an informed minority on the extreme other side passionately opposed, and a large amorphous body of citizens in the middle who really do not know anything about it and who probably do not much care. In that situation, it would be wiser to have a permissive Bill at this stage and to see how far forward we could get and the Minister might have made more progress and might have carried conviction to more people than he anticipates now. If fluoridation proved to be a success in a wide area of the country, the growing volume of support for it would have inevitable consequences. If, on the other hand, we had the experience recorded by Deputy Ryan of certain areas where the communities tried it and have withdrawn from it, that would indicate certain lessons also. I do not want to argue against it but there is no use closing our eyes to the fact that even accepting the Minister's case of the dramatic improvement in the incidence of dental caries which he claims—and which I am not prepared to deny—follows from fluoridation of water, there is the propagation of mottled teeth.

I am only trying to put the case. We must bear in mind that there is a cosmetic element in this matter. A girl's front teeth are a matter of grave cosmetic consequence and could be a matter of grave psychological importance to a growing child. Mottling of teeth can give rise to serious problems —I shall go no further. That is one qualification of the benefit which the Minister so emphatically describes in the matter of dental caries. I do not think all the truth of the story lies with the Minister or with the extreme opposition as expressed by Deputy Ryan; I believe a middle position more closely approximates the full truth. I would welcome an experimental period based on permissive legislation and then a review of the matter to see if further powers are required. I believe that if that course had been adopted at an earlier stage of this Bill, much of the immoderate language that has been employed on both sides would have been avoided and the real issues involved here could have been more dispassionately reviewed. It is not too late for the Minister to mend his hand: if he does so, I undertake in advance not to say: "When the devil is sick, the devil a saint would be." If I did say that, of course, I should be thinking of the general election.

Major de Valera

Following the last of the orators, my remarks may seem rather flat but perhaps a few flat remarks on this matter will help to bring the issue to a conclusion. Is fluoridation of water compulsory medication? Is that the only way we can look at it? A very minute quantity of a salt will be added to the water. I should like to put this counter argument: may it not very well be, on all the evidence, that most of our water supplies are deficient from the point of view of the human element and that putting in fluorine is actually supplying a deficiency? If you had to argue on the fundamentals of compulsory medication, it could be countered by the simple argument that you are merely supplying something to meet a deficiency.

We have had, for instance, in the field of agriculture, cases where certain animals in certain quarters and on certain pastures were found to be suffering from certain defects. It was found that the supply of some element —sometimes traces—remedied the deficiency. Surely in these cases what you had was a deficiency in the environment? May it not well be that all this prevalence of dental caries in the human can be ascribed to a deficiency in the local water supply? I only mention this particular approach; I do not want to pursue the matter. I simply want to point out that it is very easy to pontificate and advocate forceful medication. I wonder have the people who have done so considered that what is being done here is to supply a natural deficiency?

Indignation has been expressed in regard to this extremely small quantity of a salt which occurs in natural water. Water in which this salt occurs has been found to be beneficial when consumed. This is merely the adding of the salt. Probably in most samples of water, you will get extremely minute traces of fluoride anyway, because, as anybody who has taken the trouble of even reading a little elementary literature on the matter will know, there is no such thing as chemically pure water. All water supplies have dissolved in them various salts in various concentrations and have present in them also other substances—possibly salts—some of which are helpful and others harmful.

I think we would all agree that the function of a local authority is, first of all, to see that the level of harmful substances is kept down. The addition of this relatively small quantity of salt which occurs in natural water used freely by humans elsewhere does not seem to me to raise any great moral or practical problems. The problem is simply whether it is beneficial or harmful. On the question of its being beneficial, the Minister has amply put a case, and that, so far as dental caries is concerned, has not been controverted.

I disagree with Deputy Dillon. Dental caries, although it is not an immediate and killing disease, is a serious disease in the community. It is a serious disability and has had serious repercussions on the health of individuals. If that disease can be eradicated, there is a very substantial contribution made to the improvement, not only of the health of the individual but of the health of the community. Therefore, the beneficial effect that can accrue from the addition of this small quantity of fluorine in whatever form it is added—it will be in the water in the form of a fluoride—will achieve this object and can be commended on these grounds. I do not think anybody can controvert that fact.

The next question to be asked is: what are the disadvantages? Having countered the argument by asking if it might not be the supplying of a deficiency, which everybody would argue would be a very legitimate thing to do, we have to ask if any harm accrues from the doing of this, apart from the mottling of the teeth. That is a matter which I am sure the Minister will consider and I freely concede it is a point to be considered.

So far as I know, there has been no evidence advanced anywhere that any deleterious effects can follow from the addition of fluorine to water. It is not like the cortisone to which Deputy Dillon referred. This is a matter of practical experience for a sufficiently long time to enable us to judge the effects and so far as I know, no allegation can be substantiated. In fact, no serious allegation is made that any positive, harmful effects will result from the addition of fluorine to water.

Let me ask this question. Does the House think that Deputy Ryan, after his diligent digging up of cases in America, would have failed to produce here the charge and the allegation, if not the substantiation of it, that it was a serious threat to health? Does the House think that he would have forborne to bring that here if he had the material available to make that charge? I think that it is a very significant fact. The fact that he was driven back to the type of argument he made is sufficient justification for me, if we had no other justification, for asserting that it is, as far as can be humanly ascertained, a perfectly safe matter to add this substance to the water supplies and that, being perfectly safe, we also know that it is positively beneficial. Surely, that must dispose of a large part of the arguments made against this proposal?

Before I deal with what is really the substance of this section, I should like to make one other remark. The amount of discussion that has taken place about this measure would seem to suggest to people who have no further information that we were, for the first time, embarking upon some horrible programme of doctoring water supplies. The public should be informed at this stage and should know that all water supplies for modern communities handled by local authorities have to be doctored to make sure they are safe and proper for the community.

They are doctored in several ways. The filtration process is in itself a doctoring, if one looks at it carefully. Adding chlorine to disinfect the water, because that is what it is, is doctoring. Water supplies have even been doctored in the interests of the pipes and nobody has said a word about it. There have been instances where really soft, natural water supplies were so soft that engineering problems in regard to the pipes ensued and hardening substances had to be added —substances for the addition of which much less case could be made from the human point of view than is made for the addition of fluorine.

It is necessary to say all these things to dispel the fog of apprehension caused by these indiscriminate allegations—that silly little trick of referring to a substance as a poison which has been used here. Deputy Ryan kept referring to this as a poison.

Mr. Rooney

It is a poison.

Major de Valera

Yes, and so is chlorine a poison and we put it in the water. So is the common salt which we use at the table a poison, if you take enough of it. The fact is that using terms in this manner is a disservice to the community and creates unnecessary apprehensions. It is to be deprecated in a responsible body such as this. I was taken to task by a Deputy for saying that I relied on the technical experts and on the same evidence as the Minister advanced here. I do not for a moment dispute that we should use our common sense in relying on expert evidence. Let us rely on common sense. I would say to those relying on common sense and digging into the expert field to go diligently into the subject and not talk through their hats about something of which they know nothing. That is what has happened in the case of a number of the allegations in this debate. If Deputies—and the people to whom I refer have enough education—would study the technical problem and be more responsible, they would do a greater service to the community.

I do deprecate this arousing of public apprehension when it is unnecessary. I would equally deprecate making the opposite case beyond what is warranted. Therefore I shall not pursue the technical implications of this. Let me repeat that, throughout this long debate, it has been admitted that the addition of fluorine to water is beneficial and it has not been seriously alleged that, beyond the mottling of teeth, which is a serious point to be considered, there is any allegation, let alone argument, that any harmful effect can follow.

On the ethical argument, one point will cancel out another leaving us at the end where we were at the start. On the substance of this section, could there be any greater justification of the course the Minister is adopting than the performance which has taken place in this House on this measure? Let me express a personal point of view; my own instincts would be to leave this matter an optional one as far as possible. Let us face the practical implications of that. What is the essential difference between our deciding it for the whole community and leaving it to the local authorities to decide for parts of the community? Will it not equally be compulsory medication if the local authority decides to do it? I fail to follow the logic of that argument at all.

It is merely avoiding the issue. You do not solve your first problem by passing the buck to the local authority to argue the issue. Let us face our problems here. The very things that have happened in this House are the justification of what the Minister has done. Take the long list to which Deputy Ryan referred. In no case has he been able to give us the reasons why these groups which he mentioned departed from fluoridation. There is no suggestion that any of these groups abandoned fluoridation of water because of any damage done to health; rather would it appear that it was perhaps because of some engineering consideration, because one of the reasons Deputy Ryan gave us was that of damage to water cocks.

It may have been a financial reason, it may have been an engineering reason. More than likely it was a local political reason—one group against another. Do you not know very well what would happen here if the matter were left optional? What would happen is that perhaps a Fianna Fáil councillor would propose fluoridation and the Fine Gael councillor would get up and oppose it or vice versa. Once the responsibility of decision was placed on the local authorities you would have the same situation as we have here. One Party might favour it and another Party would oppose it. The whole lot, the pure water people and the impure water people, would descend on the council, as they have done here, and the net result would probably be to leave it to the county engineer.

Let us be realistic in this. It is good that the matter should be thrashed out here. I am not objecting to anyone making his case. I am not objecting to Deputy Ryan making his case. He could have made it more moderately and I think he damaged his case by going as far as he did. I agree with the Leader of the Opposition that the matter should be argued out and examined in every way but I want to finish now. I said in the beginning that I would be brief and I am afraid that I have not honoured my word in that regard.

On the section, having disposed of the other matter, you are faced either with dropping the measure altogether, or perhaps making it an enabling measure or of doing what the Minister did. I think it would be impractical to do otherwise than he has done and that we have no choice except to drop the Bill as a whole or to go ahead.

Mr. M.J. O'Higgins

I think the Minister for Health has had a bad effect on Deputy de Valera.

Mr. MacEntee

The Deputy was not here.

Mr. M.J. O'Higgins

I was here yesterday evening when the Minister worked himself into a frenzy about this section and apparently Deputy de Valera feels that the appropriate thing in relation to this Bill is to work himself up into a frenzy also. That is what his contribution to the section amounted to.

Mr. Loughman

Nonsense.

Major de Valera

It must be the infectious atmosphere created by Deputy Dillon.

Mr. M.J. O'Higgins

He started off by countering the ethical argument which was made. That argument is that people should not be treated like animals and subjected to mass medication against their wills, to direction by bureaucratic authority as to what medicine they will take and what medicine they will not take. Deputy de Valera says that the human animal may suffer from deficiencies, just as any other animal, and that tests have been carried out which disclosed deficiencies in certain pastures and that by making up that deficiency the bullock or the horse is improved, thrives and fattens. He argues that if that can be done for the four footed animal it can be done for the human animal. That is the very justification for the ethical argument against this measure, which is that human beings should not be treated like animals.

Deputy de Valera's second point is that there is no concrete evidence to show that there are any harmful effects at all from fluoridation. Does Deputy de Valera realise that one of the points argued in connection with this measure is the fact that there have been no statistics, no evaluation of the results to find out if there can be harmful effects, apart from the effect on teeth? It is conceded that fluoridation can have a harmful effect in so far as the mottling of teeth is concerned. It is also conceded that it may make them brittle. That is one of the points advanced but apart from that is the question of general health and whether it has a harmful effect on people suffering from the kind of diseases mentioned here during the Second Reading Debate.

As far as I am aware no tests have been made, no survey has been made, no statistics have been compiled and that is one of the reasons why we argue so strongly against this measure. In a later amendment it is suggested that that kind of survey should be made.

Major de Valera

Surely the evidence of all the responsible bodies mentioned by the Minister is something to be assessed?

Mr. M.J. O'Higgins

I shall go a long way with the Minister and the Deputy if either of them can give me a positive assurance that a survey has been made which demonstrates that it has no harmful effect on the general health of people or on the health of people suffering from kidney trouble or rheumatoid diseases.

Major de Valera

The Deputy misunderstands me. I said it was significant that no one has advanced that argument.

Mr. M.J. O'Higgins

Deputy de Valera said that but he said it without having fully informed himself of the facts. A great number of people have expressed fears that it is harmful. There is no doubt at all about that. I shall not waste the time of the House with quotations. I could do so, because I have many quotations here in front of me. That case has been made, and those fears have been expressed. I should be satisfied to accept that they are not justified if the Minister, or anyone else, assures me that proper tests have been made which prove that the fears are not justified. My complaint is that, so far as I know—and I have asked the Minister to give me the information if he has it—no tests and no specific survey have been made on the question of whether it could be harmful or have an adverse effect, apart from the question of teeth.

I have dealt now with two of Deputy de Valera's points. His third and main point is about as relevant to this discussion as a wasps' nest. Deputy de Valera assures us in all solemnity that there is nothing to be afraid of because chlorine has already been added to water.

Major de Valera

More than chlorine.

Mr. M.J. O'Higgins

Yes, but he did acknowledge—and I was sorry that he did not pursue the point and clarify it—that chlorine and other substances which are added to water are added for the purpose, as he says, of disinfecting, and as I say, of purifying water and killing any bugs which might be harmful to the people who drink it.

There is a very big difference between adding a substance to water for the purpose, on the one hand, of purifying it, for the purpose of making it as Deputy de Valera himself said, safe and proper for communities to drink, and, on the other hand, adding a substance to water which is not designed for the purpose of purifying the water and rendering it safe for communities to drink but for the specific purpose of medicating the water supply——

Mr. MacEntee

It is not medication.

Mr. M.J. O'Higgins

——so that people who drink it will have to take medicine, whether they want it or not.

Mr. MacEntee

The Deputy is getting away with it. It is not medication. It is a prophylactic just as chlorine is.

Mr. M.J. O'Higgins

I do not think the Minister is serious in that argument. It is designed to——

Mr. MacEntee

To prevent disease. Like chlorine, it is designed to prevent disease.

Mr. M.J. O'Higgins

It is designed to delay for a couple of years the onset of dental caries.

Mr. MacEntee

The Deputy has enough intelligence to argue honestly on this matter. He should not be demoralised by Deputy Ryan's arguments.

Mr. M.J. O'Higgins

The Deputy has enough intelligence to know when he is in order and when the Minister is out of order. The Minister has conceded already in this discussion that the addition of fluorine will have the effect of delaying dental caries. Nowhere that I know of has the argument been made that it is a cure for dental caries.

Mr. MacEntee

No one said it is a cure; it is a preventive.

Mr. M.J. O'Higgins

It is a preventive for a period.

Major de Valera

What is the difference between adding fluorine and adding calcium and magnesium to prevent corrosion in pipes? That has been done.

Mr. M.J. O'Higgins

I may have a high opinion of myself, but I cannot deal with both the Minister and the Deputy at the same time, so I shall deal with the Minister for the moment. The Minister has now reduced himself to fencing with words. The fact of the matter is—and it does not matter very much what words are used—that fluorine is to be added to the water supply with the definite intent and purpose that it will have an effect on people's teeth, and for no other purpose.

Mr. MacEntee

It will prevent other things having an effect on people's teeth. It will prevent jams and jellies from having a deleterious effect.

Mr. M.J. O'Higgins

I do not know whether or not there is any significance in the fact that the Minister singles out jams and jellies.

Mr. MacEntee

Deputy Ryan was weeping about the jam and jelly manufacturers.

Major de Valera

We are proving the futility of that argument.

Mr. M.J. O'Higgins

I am satisfied the Minister understands the purpose for which fluroine is to be added to water, but whether he has made that clear to Deputy de Valera, I am not so sure. It is not for the same purpose as chlorine is added to water. As Deputy de Valera said, chlorine is added for the purpose of making water safe and proper for communities.

I am glad Deputy de Valera had the courage, in the face of the Minister's remarks on this Bill, to say that his own personal preference would be an optional Bill. It is a pity Deputy de Valera did not interest himself in this matter at an earlier stage, because I feel that if he and some of his colleagues who think like him had discussions with the Minister in the calm of the Fianna Fáil Party room, we might have had a better Bill and one which would not give rise to the controversy to which this Bill has given rise.

Mr. Loughman

I fully agree with Deputy de Valera when he says that, with the example of what has happened here, it would be disastrous if the Minister were to allow this measure to go through the House without making it mandatory. If an assembly of the selected representatives of the people take so long to decide on this measure, we can well imagine what would happen in the various councils when this matter came under discussion. As Deputy de Valera says, one person would oppose another simply because someone else had proposed it. People would also oppose it without the slightest knowledge of what is involved.

I was rather puzzled by Deputy O'Higgins trying to split hairs so far as chlorine is concerned. He almost suggested its purpose was not to prevent disease, which of course it is. We introduce chlorine into water to ensure that people can drink it without danger to their health. I cannot see any difference between that and introducing this very small quantity of fluorine for the same purpose. I might mention at this point that I made a calculation to find out what that quantity is, because people are sometimes impressed by figures. As I recollect, it means one grain of fluorine to 12½ gallons of water. That is actually the quantity I make out is in it. I am using the 480-grain measure for the ounce and it would be roughly one grain in 12½ gallons of water.

As I said on another stage of the Bill, I think there is fluorine in water in many places and I rather think that in these cases the amount of dental decay is very much less than elsewhere. I am altogether in favour of compulsion, so far as this measure is concerned. I have not heard any ordinary member of the general public—not one solitary person—protest against this measure, notwithstanding all the talk about it here. I meet as many of the ordinary people as most Deputies, living in the heart of the country and in a big town. Not one solitary member of the ordinary general public has protested to me against this measure.

Mr. Rooney

Would the Deputy's town swallow this?

Mr. Loughman

They have no objection to it.

Mr. Rooney

We shall see whether or not they will.

Mr. Loughman

You may be able to stir up an agitation—it is the easiest thing in the world—but, so far, the council in my town has made no move whatsoever against it. There is a majority there against Fianna Fáil and if the matter is put to them—unless the Labour representatives divide on it —it may be carried.

I listened to Deputy Dillon make some kind of comparison with cortisone as if cortisone were an article which was established over the years, which had never changed, or anything else. I remember when cortisone first became available to the general public. I had occasion to order quite a quantity of it in a hospital with which I was connected. Quite suddenly, it was changed and I was left with £50 worth of it on the shelves in that hospital. It took me years to get rid of it simply because the doctors would not use the old stuff. After another couple of years, there was another change and I was left then with a lesser quantity.

However, to talk about cortisone in the same breath as fluorine is the most fantastic argument that could possibly be used. Deputy M.J. O'Higgins said there was nothing to show there was no harmful effect. Just before the Deputy came in, the Minister read a statement which said quite positively that one of the peculiar things about it was that there was absolutely no dangerous effect from the use——

Mr. MacEntee

That statement was an official publication of the Government of America issued by the Secretary of State for Health in America. That is what I quoted from.

Mr. Loughman

It stated there was no danger whatsoever to the public. What amazes me is that we have been talking about this matter for several days. We have had the same argument day after day.

Mr. M.J. O'Higgins

It is all the Minister's fault. He opened the discussion on this section. It would have been through yesterday.

Mr. Loughman

I have heard the Minister subjected to terrific abuse here. His reply has always been very mild. I listened to Deputy Ryan accuse him of attempting to put poison into the drinking water of the people. Surely nothing more vicious than that can be said in this House? I have come in contact with children and their teeth, to a much greater extent, I suppose, than most Deputies. It is shocking when a mother brings in her child with a bad tooth which is causing it terrific pain and torture. It is shocking to see these children crying and bawling. Either the dentist takes out such teeth or we try to give the children something in the form of various little tablets to ease the pain. I should think the Minister would be thanked by the people for introducing a measure which can guarantee to 65 per cent. of young people that they will not suffer from such dental decay in the future.

Mr. Rooney

I am surprised by Deputy Loughman's contribution. He knows very well that any people who consider that the teeth of their children require fluorine can obtain it in tablet form.

Mr. Loughman

Nonsense.

Mr. Rooney

They can add it to the 12½ gallons of water he mentioned. The Minister is trying to make this a compulsory Bill. The first question I would ask is: how many nations have taken action such as the Minister proposes? If he were following the majority of the nations, he might have a case. The number of nations which have made this mandatory is very small.

The Minister's attitude is completely unreasonable. He has not convinced the House by any of his arguments that we should make this proposal mandatory. We of Fine Gael have agreed to an arrangement whereby a permissive Bill would be put into effect so that the various communities could make their decisions just as happened in various towns in America, as the Minister himself read out last evening.

I think it is just a case of stubbornness. Deputy Loughman tried to play on the point that Deputy Ryan mentioned that this is a poisonous substance. It is; it is deadly poison. Naturally, with small doses, the effect is not as great as if a large dose of this deadly substance were administered. It is only right to describe this as a coercion Bill. It calls for the compulsory fluoridation of drinking water. It does not give the local authorities who administer these water schemes the option of adding the fluorine to the water.

Some people have mentioned that small doses are already available in supplies of water in certain places. That is only an opinion and an argument put forward here in support of making the Bill mandatory. Would the Minister not be prepared to leave this matter to a free vote of his Party? If he did so, he could not come here and say he has full support in making the consumers of piped water supplies swallow this dose of fluorine in the water.

There has been no public clamour for the Bill. If we had not raised our voices here, it might have amounted to deceiving the public in giving them this dose. That is the only way one can describe it. Why not suspend this Bill until the general election and make it a national issue? Why not get a decision from the people as a whole? Even in that case, a large number of electors will not be affected one way or another. Why not let us have a decision from the community as a whole if the Minister will not leave it to decision by the various local authorities?

The Minister read out figures concerning decisions reached in various towns where fluoridation was abandoned. It was remarkable to note the way in which only a few of those decisions came to a close vote. The Minister mentioned a large community; I think there were 45,000 against and almost the same number for. But that was only one example where the issue was fairly close. In all other cases, the proposal to abandon fluoridation was carried by a majority. When we find progressive nations like the United States and Great Britain not daring to put through a mandatory Bill, why should we try to set a headline for the rest of the world in a matter such as this? The problem has been considered for a long time in both the United States and Britain and both have decided against compulsion.

Why should the Minister make fluoridation compulsory here? In many countries, it was a 50/50 issue. It was not defeated in the majority of communities. We can boast of having the purest and cleanest water it is possible to supply. Why tamper with it, beyond disinfecting it? Deputy de Valera tried to make the point that fluorine is a disinfectant. Chlorine is a disinfectant; fluorine is not. The consumption of fluoridated water, apart from benefiting the teeth, and that to a questionable degree, affects the human constitution. In particular, it is supposed to affect the kidneys very adversely.

We are in favour of permissive legislation. I think we are very reasonable in that. Permissive legislation will enable local authorities to decide the issue for themselves. In Great Britain, local authorities attempted to add fluorine to water. Some were successful; others were put out of office by the people they represented. The Minister will use his majority here to put this Bill through and every public authority will be compelled to add fluorine to water. The inevitable result of this measure will be to cause contention in the local authorities themselves, and they will be much nearer to the communities affected.

The date on which fluoridation will commence will be another cause of contention. Some local authorities may wish to postpone fluoridation; some may not wish to implement it. If the Minister is not prepared to make this an issue in the next election, would he not consider having a referendum now? He should at least try to get a decision from the people, instead of using his majority here. If he made the provision permissive, fluoridation could be put on trial for a year, or a number of years. County councils which wished to add fluorine could continue to do so, so long as the community were satisfied. Surely the Minister could devise a scheme to make fluorine tablets available free to those who require them.

Mr. MacEntee

I think the Deputy is now speaking to an amendment which was ruled out of order. He cannot, therefore, be in order in raising it at this stage.

An Leas-Cheann Comhairle

Section 2, as amended, deals with the arrangement by health authorities for the fluoridation of water.

Mr. Rooney

That is so. I have been discussing the matter with local authorities and if the provision is mandatory——

Mr. MacEntee

It is on the question of tablets. That was disposed of and the amendment to permit the supply of these tablets was ruled out of order.

Mr. Rooney

The point I am making is that fluoridation will impose a charge on the rates and the cost of it will be much greater than the cost of supplying tablets to those who require them. When fluoridation has been rejected by so many communities, there seems to be no sound reason why we should make it compulsory here. The Minister has put forward here only those who support his own case. He has not made a general case to convince us that his attitude in making this a mandatory Bill is justified. I urge the Minister to think again. He still has time to withdraw the Bill. He still has time to permit the matter to be discussed by the local authorities and to get their decisions before he goes any further.

Question put and agreed to.

Section 3 agreed to.

Amendments Nos. 7 and 8 not moved.

Sections 4 and 5 agreed to.

SECTION 6.

Mr. M.J. O'Higgins

I move amendment No. 9:—

In subsection (1), line 7, before "in" to insert "or of the effect of fluoridated water upon people's health."

When speaking on Section 2, I mentioned that there was a later amendment tabled for the purpose of seeking the kind of review and testing the compilation of statistics which would prove a guide to the House and health authorities generally as to whether or not the increased intake of fluorine would have a harmful effect upon health. This amendment is designed for the purpose of having that kind of survey made.

As it stands, Section 6 imposes a duty on health authorities whenever required by the Minister, by a particular date which the Minister may specify, to make such estimates as may be directed by the Minister of the incidence of dental caries in their functional area or in a specified part of their functional area, either in respect to all persons therein or with respect to a specified class of such persons, and to furnish to the Minister particulars of such estimates as soon as may be after it is made. This amendment suggests that in line 7 of the section, before the word "in", that is, after the words "dental caries", there should be added the phrase "or of the effect of fluoridated water upon people's health," so that, if accepted by the Minister, the subsection will read:

It shall be the duty of each health authority, whenever and so often as the Minister so requires, to make, before such date as the Minister may specify, such estimate as may be directed by the Minister of the incidence of dental caries or of the effect of fluoridated water upon people's health in their functional area...

I ask the Minister to accept this amendment which certainly is not being moved in any obstructionist spirit or frivolous manner. I have said earlier, and I believe I am right, that as far as I know, no tests have been made which are capable of demonstrating in a positive way that an increased intake of fluorine will not be harmful to general health, or harmful to classes and categories of people who are afflicted with a particular type of disease.

Deputy Esmonde and other speakers referred on Second Reading to suggestions that the addition of fluorine may be harmful to people with certain conditions, and I believe that it should be possible for the Minister's Department to make arrangements to put the suggestion contained in this amendment into effect without in any way cutting across the principle of the Bill, without in any way interfering with the administration of the Bill, which is in the form the Minister wanted it.

I do not want to open discussion again on whether the whole question of adding fluorine to water can be regarded as something that is settled, or something that is still in an experimental stage, but I have said that it is not settled practice anywhere in the world, that it is still the subject of lively controversy in every continent and country in which it is considered, and that some communities which did adopt the practice have since discontinued it.

Deputy de Valera on Section 2 asked, reasonably enough, why they had discontinued the practice, whether it was on medical grounds or because of the expense involved? Quite frankly, I do not know the answers to those questions. The Minister may know the answers. He may have made inquiries to establish the reasons why a long list of communities discontinued the practice of fluoridating their water supplies, and it would certainly be relevant, both to the Bill and to the amendment, to know to what extent these communities were influenced by medical fears or by medical conclusions as to the effect of fluorine on general health and on the health of those with particular medical conditions. That is an investigation which should be made.

If communities abroad that have already been concerned in this question can help the Minister with information then I think that information should be sought and obtained but, irrespective of whether it can help or not, I believe he should take powers under the Bill to require a survey to be made of the type suggested in the amendment. If he is serious about implementing the Bill, if he is serious in the faith he professes in the fluoridation scheme, I believe acceptance of the amendment would be helpful to him and the public. If he does not like the particular wording of the amendment, let him write his own provision into the Bill, giving a similar effect.

Mr. MacEntee

This amendment is unnecessary. Naturally, the Minister for Health will be very concerned to keep under observation any area where a fluoridated water supply has been introduced if only for the purpose of easing the public mind. The difficulty about the amendment is that it carries the implication that fluoridated water will have some detrimental effect on people's health in addition to the benefit which it will confer by way of resistance to dental decay, especially among children. I have already dealt fully with these allegations.

Provision is already made in the Bill, under Section 6, as amended, for the carrying out of surveys of dental caries, which surveys will be made before any regulations made by the Minister can become effective, and the section enables the Minister to continue to require local authorities to make similar surveys so often as he requires. It is not necessary to make it mandatory on local authorities to go further than that. From the beginning, as I said, the Minister will be concerned to keep the public mind at ease and to keep the general health of the communities who have the benefit of a fluoridated water supply under close observation. But if, notwithstanding the reassurance which we can obtain from experience elsewhere, a question did arise at some time in the future as to the possible association between, say, fluoridated water and some ailment or disease, the appropriate body which the Minister might arrange to carry out a study of that condition would be the Medical Research Council, not the local authority, which would be equipped for the task and could engage the necessary expert personnel.

The Deputy who put down the amendment, and Deputy O'Higgins, who spoke to it, have forgotten that the general health of the community is kept under continuous notice by the Minister for Health, in the first instance, by his Department, by the city and county medical officers of health and, most of all, by the medical profession generally. Therefore, if it did happen that there was a particular association between an ailment or a disease and a fluoridated water supply, that would immediately come under the attention of the Minister, and he could not possibly refrain from doing what the amendment asks.

We should consider the necessity for it, and I am taking advantage of the amendment to try and repeat again something I have already said at length. This time I am going to quote the words of the British Ministry of Health in their Report for 1955. It is known, of course, that the U.K. Government sent a Special Mission to the United States in the year 1952 to study this matter. As a result of that study and investigation the British Ministry of Health in their report for 1955 made the following comments:

In the light of the reports on the North American studies and of other evidence that water containing one part in one million of fluoride has no ill effects, it has become evident that some of the medical examinations that were envisaged by the U.K. Mission are not necessary. Research will, of course, continue so that more may be known of the mechanism by which fluoridation achieves such a beneficial reduction in dental decay; but this will be an effort of pure research, not a measure taken because of any likelihood of danger.

I am repeating that because I want to give to the people whose fears may have been needlessly aroused in relation to this matter the reassurance contained in that Report. It happens that I can carry the matter a little further. In the course of the intensive study of the effects of fluoridation carried out in the United States, and to which I have referred, one significant research project was undertaken. It was the study of the health experience of the adult populations in two adjoining towns in Texas. What differentiated these two towns was the character of their water supplies. One of them was a town called Bartlett, a small town. A small town is, perhaps, a better subject for research investigation than a large city because the number of variables, although still very great, are much less when dealing with populations of 1,000 or 2,000 than with a population of 500,000. In this town of Bartlett, which had a population of something over 1,600, the water supply had a natural fluoride content of eight parts per million— eight times that which is laid down as the maximum in the Bill.

Then there was the adjoining town of Cameron, with a population of over 5,000, where the fluoride content was 0.4 parts per million. That is like something we have in some parts in Ireland, although in our case I think the highest content is 0.3, that is, three-tenths of one part per million. The exhaustive investigation started in 1943 covered something over 270 people who had resided in these towns continuously for 15 years. They were submitted during this investigation to medical, dental X-ray and laboratory examinations. These individuals had the same method of life except they were drinking two different types of water—one a naturally heavily fluoridated water and the other water which was deficient in what was regarded as the optimum fluoride content.

A search was made for evidence of arthritis, raised blood pressure, cataract, decreased acuity of hearing, occurrence of fractures, stones in the urinary and bile tracts, goitre and abnormalities of the heart and blood vessels. The laboratory studies included examination of blood and urine. The examinations were repeated ten years later on a smaller number of people because, naturally, some of the original subjects had left the town. However, apart from mottled enamel it was found there were no clinically significant physiological or functional effects resulting from prolonged ingestion of water containing excessive fluorine, the excess being in the town whose inhabitants were drinking water containing eight parts fluoride per million.

Mr. M.J. O'Higgins

I did not catch where the experiments were carried out.

Mr. MacEntee

In America, starting in 1943. I mention that just to show that wherever it has been possible to carry out experiments with comparable populations there has not been adduced, a single instance of the general health of the people being affected by drinking fluoridated water, even where the fluoride content was by our standards greatly excessive. The only difference in the cases of these two populations was that the population drinking the naturally heavily fluoridated water suffered mottling of the teeth. I may say that if one were to consider these towns to find the most pertinent factor which might have given rise to the abandonment of fluoridation wherever it had been carried out, it probably was the cosmetic effect of drinking an excessively fluoridated water supply—and it was probably the ladies' vote that determined that.

I am not accepting this amendment. In any event I cannot accept it in the form in which it stands, but between now and the Report Stage I shall try some way of ensuring that this question of the effect of fluoridation on the general health of the people will be kept under continuous survey.

Mr. M.J. O'Higgins

In view of the Minister's undertaking to examine the matter between now and the Report Stage, I shall not press the amendment.

Amendment, by leave, withdrawn.

Sections 6 and 7 agreed to.

NEW SECTION.

Mr. Ryan

I move amendment No. 10:

10. Before Section 8 to insert the following new section:—

"No regulation made by the Minister under this Act shall come into operation unless and until it has been laid before each House of the Oireachtas, and approved by a resolution of each such House."

Progress reported: Committee to sit again.