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Seanad Éireann debate -
Wednesday, 21 Dec 1960

Vol. 53 No. 7

Health (Fluoridation of Water Supplies) Bill, 1959—Committee and Final Stages.

Before we take up consideration of the Committee Stage of this Bill, I should like to indicate to the House that I have ruled that amendments Nos. 2, 4, 5 and 6, standing in the name of Senator Sheehy Skeffington, are out of order, on the ground that they are not relevant to the subject matter of the Bill as read a Second Time. The Senator has been notified accordingly.

I submit to your ruling, of course, Sir, but might I advert to the fact that in the Long Title of the Bill the words "...and to provide for certain other matters connected with the matter aforesaid" appear. It seems to me that the subject matter of the amendments would come under those words.

I can assure the Senator the matter has been fully considered.

Section 1 agreed to.
SECTION 2.

I move amendment No. 1:

In subsection (1), line 24, to delete "shall" and substitute "may".

Would it not be possible to take amendments Nos. 1 and 3 together?

The same principle is involved.

Amendment No 3 is consequential on amendment No. 1.

Subsection (1) of Section 2 reads:

Subject to and in accordance with this Act and regulations made under subsection (3) of this section, a health authority shall arrange for the fluoridation of water supplied to the public by sanitary authorities through pipes.

The purpose of my amendment is to change the word "shall" to "may". The subsection would then read: "...a health authority may arrange for the fluoridation of water...", in other words it would give the health authority the right but not make it mandatory upon them to carry out these matters. Since we are discussing my other amendment, I might mention now that subsection (2) at present reads:

The Minister may, in relation to a particular health authority, fix a date before which they shall, in relation to a particular public water supply, arrange for the fluoridation of water derived therefrom.

Again, it seems to me that if we accept the notion that this should be premissive rather than mandatory, we would have to change that subsection also.

I feel very strongly that this Bill would be less objectionable to a wide section of the people if the Minister were prepared to leave it to the local authorities to decide, taking all the local factors into consideration, whether or not they wanted locally to introduce fluoridation of water. I want to make the point that, if it is allowed to be permissive, a local authority might well decide that instead of adopting this method of fluoridation, they preferred to adopt an alternative method, of which there are several. One method, of course, would be the method I mentioned on Second Stage, the free distribution of fluoride tablets to children under 14 years of age.

It might well be—and this is a capital factor in my conviction that the word should be "may" rather than "shall"—that we should spread the results of beneficial fluoridation, that is to say, the arresting of the incidence of caries in teeth, far more widely to the people concerned, that is to say, the children of the country, by such an alternative method to the fluoridation of the drinking water.

I made the point that piped water, in fact, reaches less than half the dwellings of the country. I cited the figures before on Second Stage and I shall not cite them again. Less than half of the whole of the Republic have piped water supplies and only about one-tenth of the dwellings in Connaught have such supplies. Therefore, the single method which is mandatory if we maintain the word "shall" will, even from the Minister's point of view, be singularly ineffectual over a large section of the population for whom the Bill has been devised, that is, the children in areas not having piped water. The Minister does not claim, and nobody claims, that fluoridation will do any good to adults. The most he claims in the case of adults is that it will not do any harm.

In fact, if this remains the sole method, and if the Minister is given the right in this Bill to say they shall do it in this way, that precludes the local authorities from adopting an alternative method, because, of course, it could be highly dangerous to adopt an alternative method and distribute fluoride tablets in an area where the water supply is to be fluoridated in a short time because it might be possible that overdoses would be taken in that way.

If, on the other hand, it were left to the local authorities, and if they decided they preferred to try another method, it would seem to me that that would have a great advantage, because it would reach as many as 90 per cent. of the children under 14 years of age, whereas under the Minister's method, the sole method in the Bill as at present framed, less than 50 per cent. of the children will be reached. It would have an added advantage also, in that it would not reach the rest of the popualtion for whom no benefit is claimed. It seems to me, therefore, that a very strong case could be made for leaving it to the discretion of the local authority in question.

I would put it to the Minister, furthermore, that there is no country in the world which has granted to the central Government the right to make it mandatory upon any local authority to introduce fluoridation of the drinking water. I am open to correction on that but I have been unable to find on record any country where the central Government has claimed the right, if they feel like it, to tell every local authority they must introduce fluoridation of drinking water for their area. Yet that is the principle for which the Minister, if he resists this amendment, will be fighting.

The Minister is asking for the power to tell every authority in the Republic that they must introduce fluoridation of drinking water for their population no matter what the local sentiment or situation may be or what the local representatives may feel. It has been said here and in the Dáil that we have plenty of local representatives in both Houses—that we have county councillors, city councillors, and so on. That is quite true. I suggest a matter like this is one for local decision. It is open to the Minister to put it as strongly as he likes to the local authority that great advantage will accrue from the introduction of some such scheme as this.

I should very much prefer and I believe that many members of this House would prefer, and I believe that great sections of the people would prefer, that the decision in relation to any given area should be left to the local representatives of that area. I do not want to delay the House. There is a lot of other business but I should like to put the point to the Minister and I believe it is strictly relevant to this amendment that there may be, in certain areas, practical difficulties which would be known primarily to the local authorities and not so well known to the Minister for Health.

I quoted on the Second Stage from the New York Commissioner of the Department of Water Supply, Gas and Electricity. In commenting on what I said rather than in refuting, because I do not think he did refute it, the Minister made play with the fact that this man, Mr. Arthur C. Ford, was an engineer. He did not question his qualifications as an engineer but he did question his qualifications to talk about the health effect of fluoridation.

Now, as an engineer, Mr. Ford said:

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 is in the New York system is formidable. None of those who have made statements to the countrary have ever had the experience nor do they possess knowledge of what the exact result would be.

My point is that as in New York so too in some of our own towns and even villages. There may be local problems of pipes and pressures and gradients which would be known better to the local authorities, as I suggest those local problems were known better to this Commissioner of the Department of Water Supply, Gas and Electricity in New York than they would be known to a central Government either in Dublin or Washington, D.C.

I would point out that while in the United States certain towns have adopted fluoridation, large numbers have refused to do so for local reasons, for reasons they regarded as sufficient, and, furthermore, large numbers of towns, having tried it, have dropped it. None of that remains possible under the present Bill, if we give the Minister the power to say to every local authority: "You must" and "ye shall". Therefore, I feel that the whole atmosphere of the situation might be far better if the Minister would accept the amendment and agree that it should be permissive and not mandatory.

I support Senator Sheehy Skeffington's amendment. We are all agreed that the fluorine will be good for children up to the age of 14. We have been assured on that point by the experts and I think we are all convinced. What we are not sure of is this: is this distribution through the water supply the best and most economic method of distribution? I think Senator Sheehy Skeffington has made it very clear that that is gravely open to doubt. Besides what he said, I should like to mention another difficulty. How are we to be sure that children will drink just so much water from the local supply as to get the right amount of fluorine? Some drink a good deal more water than others. The amount of intake of water by children in various families might be in the ratio of three to one. There is a grave risk of under-dosing or over-dosing there.

As Senator Sheehy Skeffington made very clear indeed, there is a possibility that adults will ultimately be harmed by this intake of fluorine. The sinister fact is that we will not know about that perhaps for 20 or 30 years. Then the first remedy will be: "stop taking fluorine." You cannot apparently get rid of what is taken in. If you have reached the point of poisoning at that time, it would seem that nothing, at the moment, can be done about it.

Apparently distribution through tablets would be a great deal cheaper for the Exchequer. Senator Sheehy Skeffington quoted good authority to the effect that it would cost about one-fifth of what it will cost to distribute through the water supply.

This is mere hearsay, but still I think I should quote it. I have heard that originally the Minister's and the Government's intention was to make this legislation permissive. In other words, that the original intention was to have a "may" instead of a "shall". Perhaps I was misinformed on that.

You certainly were.

Thank you. In that case I shall not continue on those lines but I was so told by certain people——

By whom? I do not know who told the Senator but no one had a right to misinform him as to my attitude in relation to this matter.

Thank you, but they did, whether they had a right or not. The Minister has now had the opportunity of dealing with this misstatement and both he and I, I am sure, welcome that opportunity.

I am sorry the Senator cast doubts upon the loyalty of my officers.

I did nothing of the kind. There are some 3,000,000 persons in this country. It could have been any of this approximate 3,000,000 persons who can speak, since I suppose we must allow for infants.

I must protest against the Senator's ascribing to me a position which I did not take up at any time. I do not know what Tom, Dick or Harry might have misinformed the Senator in relation to this matter but I am perfectly certain not officer of my Department did, because they knew my view.

The Minister is perfectly correct. No officer of his Department informed or misinformed me in this way. I do not think there is any reason to be perturbed about this.

I am. If the Senator were speaking upon any firm basis of authority I could only believe that some person in my Department misinformed him as to my attitude. If the Senator is making the statement here on what he has been told by some Tom, Dick or Harry I have no control over that except that I regret very much that the Senator did not verify the source before he used that argument in the House.

It would be impossible because at that time the information was confidential and I presume——

I must protest again. I trust the Senator will forbear and give way to me. I am raising a point of order. The Senator has now said that the information which he has was confidential. Now, that means as a matter of confidence between myself and my officers. The Senator has said the information which he got was confidential.

I think every member of the Seanad must have heard Senator Stanford say that.

Yes, I said that.

A matter of confidence in relation to proposed legislation can reside only between the Minister and his advisers. I do not got out around the town talking about what I may do in regard to legislation, nor do I believe that any of my advisers do so, either. I believe that the Senator should, in fairness to me and my officers, who have my confidence, withdraw that adjective and say that he is speaking now——

That is a long point of order.

——not from the point of view of any authoritative expression of opinion but from what he has heard from some Tom, Dick or Harry whom I do not know.

I think the Senator should accept the Minister's assurance on the matter.

I certainly accept the Minister's assurance that I was misinformed. As to the person he calls Tom, Dick or Harry, he was a citizen of the Republic.

He is not in my confidence or the confidence of my advisers.

In relation to what I stated or intended to say, I did not complete the sentence for obvious reasons. It was a matter of confidence between the Minister and his advisers.

If the Senator will permit me——

The Minister——

Senator L'Estrange will allow the Minister to speak.

Senator Stanford has now said that this was a matter which was confidential between the Minister and his advisers. I did not disclose to Senator Stanford what my mind was on this matter and obviously the only other person who could have communicated anything to Senator Stanford was the other side of the equation—my advisers. I am afraid that Senator Stanford is accusing my advisers of having been guilty of a branch of confidence, which is a very serious matter. I think the Chair should ask Senator Stanford to substantiate that statement or else withdraw it without any reservation.

I think Senator Stanford should accept the Minister's assurance on the matter.

Senator Stanford has made a very grave allegation that someone in my confidence disclosed what he and I had been discussing and I do not believe that.

That is not my allegation. The Minister misunderstands me. I will attempt to make myself crystal clear for fear of a misunderstanding. When I said the matter was confidential, as I did say a few minutes ago, what I meant was that it was a matter of confidence between the Minister and his advisers. I, therefore, did not feel entitled to ask the Minister or his advisers what the proposals were. That is what I mean; that is what I always meant.

I am sorry. This matter must be cleared up once and for all. This imbroglio began with the statement made by Senator Stanford that he had information that in the beginning I was disposed to leave this matter of fluoridation to the local authorities to decide for themselves. He said he had been told that as a matter of confidence.

That is how it started. We will have the script and the matter will be raised elsewhere. It is not going to rest here. I can assure the Senator of that.

I understood that Senator Stanford had accepted the Minister's assurance on that matter.

No, Sir. He has come back and reiterated what I have already asked him to withdraw without any reservation whatsoever.

There is no question of my withdrawing. All the unpleasant suggestions in relation to what I said did not come from me. From the beginning, I have made it quite clear——

The Senator is not going to get away with that, whatever he may do in the House.

I got the information—perhaps, I did not say it as clearly as I should—neither from the Minister nor from any member of his Department. I never intended to suggest anything else.

Now that we have reached that stage, after long argument, I am glad to accept what the Senator has said. I am sorry that, for the sake of the calmness of this debate, he did not say that in the beginning.

He did not get an opportunity.

That is what I said. It may not have been as clear as I would have desired. That is exactly what I intended to say. I hope the Minister is satisfied with that assurance.

Since we have had a certain amount of perturbation, I should like to repeat that this method of distribution through the water supply is going to cost more and will carry graver risks. On these grounds, I would ask the Minister to consider very seriously accepting this amendment.

I, too, should like to support the amendment. I should also like to support Senator Sheehy Skeffington in his plea that the local authorities should be allowed to decide for themselves whether they will make arrangements to fluoridate water. I think this should be a matter for local discussion so that people who have doubts could raise the matter again with their local councillors and have a decision taken at local level.

I can visualise the parents of a delicate child who already has to have a large number of injections of drugs of various kinds feeling real distress at the danger to such a child of an additional intake of an unknown quantity of what is practically an unknown substance.

I understand that we are discussing amendments Nos. 1 and 3 and that we are debarred from discussing the other amendments. These amendments deal with the substitution of "pharmaceutically prepared tablets" for the use of fluorine in piped water. We cannot, I take it, have any discussion on that but if we had, I would strongly advise the Minister not to adopt that suggestion because it would be very dangerous. We would be taking a very dangerous step. We would be taking a leap in the dark because, as far as the use of the tablets referred to in the amendment is concerned, we have no expert medical opinion to guide us. Even though it may be justifiable sometimes to take a leap in the dark about many things, it would certainly not be justifiable in connection with the health of the people. The health of the people is something with which we cannot take chances.

There has been a lot of debate about using the words "may" and "shall" and we all see that the idea of substituting "may" for "shall" is an attempt to frustrate the whole purpose of the Bill. We have been talking about dental caries and everybody knows that the incidence of it is widespread throughout the country. If legislation is to be enacted here to deal with that very important and very acute problem, such legislation must be based on reality; it must be or should be the intention of the Oireachtas as well as the intention of the Minister to make sure that the provisions of the legislation we enact will be carried out. Senators talk about having the application of the principles of this Bill permissive for the local authorities. If that argument were carried to its logical conclusion, should not all the legislation dealing with the health of the people be left to the free will of the local authorities? As I have said, this is a nation-wide problem and it must be dealt with on a nation-wide basis. Either we are in earnest about this or we are not. If we are in earnest, we must make sure that the provisions of the measure now before us will be carried out uniformly.

I do not claim to be an expert on this matter; in fact very few of us could claim to be experts, but all we can do is bring whatever common sense we have to bear on it. I think it is common sense to say that if we are dealing with a national problem, that problem must be dealt with on a national basis.

By some method that will reach all the country.

I am against this amendment. I cannot see any reason for making any difference between public representatives of a health district who are sent to these Houses deciding this issue and say 13 out of 25 members of a health authority deciding that water shall be fluoridated. I cannot see that the onus should be put on the local authority to do work which public representatives were sent here to do. Senator Miss Davidson quoted a specific case, of a delicate child, but a health authority could not take individual cases into account. This is rather a case of passing the decision on to a local authority and I think the public representatives here are better qualified to make the decision.

In my view, the best argument in favour of the amendment has not been made. In saying that, I am not to be taken as expressing support for the amendment. I take the view that the only real case that can be made for the amendment is that a proper survey would not be carried out by the Government or the Department of Health to ensure that fluorides would not be added to water where already you had a reasonably high content. I remember when this matter first became public I was informed by a dental authority that in certain areas in Connaught—the area referred to by Senator Sheehy Skeffington—particularly around Maam in Galway, that there is quite a high content of fluorine in water. I am not a technician and I am not able to prove that that is so but I am informed that is so by a dental authority whom I regard as a reliable authority.

Surely the Minister will be in a position to guarantee to this House that a local authority will not be asked or compelled by the Department of Health to fluoridate water without taking the reasonable precautions of ensuring that it is necessary—in other words, that in the opinion of the expert who will be able to decide this matter it is necessary to add the fluorine. I am sure that the Minister will be able to guarantee that. If that were not to be done, that would be the only strong case for the amendment. It would be ridiculous to expect local authorities to go to the expense and trouble of employing scientists to decide this issue. That is the function of the Department of Health and should be left to the Department.

I must join issue with Senator Sheehy Skeffington on the question of piped water. There will have to be some definition of piped water. The Senator stated that only one in 20— I take it he meant dwelling houses— has piped water.

One in ten is what I said.

My feeling is that when the Senator made that statement he had no regard to the figures for people using water which was piped by the local sanitary authorities and no regard to the fact that many people in Galway and elsewhere in the farming community have over the years, through the medium of grants given by the Department of Local Government, provided themselves with water on tap. If there is to be a distinction between piped water and water on tap we would have to have the matter defined.

On a point of clarification, my figures are from the Statistical Abstract which gives 112,400 dwellings in Connaught and 14,000 of those have piped water supplies.

That is on the last complete census.

It is a misleading figure because so many people have provided water on tap, which can be regarded as piped water.

They will not be affected by this scheme.

It is unfair to suggest that the standard is so low in Connaught that so few people have water on tap. I argue that it is a misleading figure. I am sure that Senator would be happy to know that it is a mistake.

I am sure they have much better water.

The people who have private tapped water supplies are compelled to use the very old and reliable method of drawing water from a good spring well and the fluorine content of such water is much higher than is normally present in piped water supplied by a sanitary authority.

How many parts per million?

I should like to agree with my colleagues, Senator Sheehy Skeffington and Senator Stanford about the basis of administering this fluorine and about the substitution of the word "may" for the word "shall" in the Bill, but I am afraid I am forced by what we know about it in other circumstances to disagree with them most definitely.

We have, I take it, in this House last week decided that this addition of fluorine to water was a means by which we could deal with the very serious problem of dental caries, or at least, could make a start in dealing with it. Nobody disputes the evidence that fluorine is a help towards the production of healthy teeth. We know we can distribute it to round about 50 per cent. of the children by putting it into the piped water. I agree that it is a great pity that we cannot distribute it to a higher percentage; in other words, it is a pity we have not got a municipally-supplied source of piped water in a higher percentage of houses, but, as the Minister has told us, he hopes that figure will increase.

On the other hand, there is no doubt that we can do it. We are not faced with the difficulties which Commissioner Ford faced in New York. I understand from Senator Sheehy Skeffington's quotation that his real problem was to ensure a uniform distribution of this material in 5,000 miles of water supply. No town in Ireland has 5,000 miles of water supply so Commissioner Ford's difficulty does not arise here. We can do it in all our relatively small water supplies in this country and I think we can do it, as the Minister's commission on fluoridation pointed out, quite easily. There is no problem there.

Senator Stanford's difficulty about over-dosage is not likely to arise, either. A factor of perhaps three might be the outside limit between the intake of water by a child from one time to another, say winter to summer, or from one child to another, but, if we are dealing with tablets, a youngster can get hold of a bottle of these things from the cupboard and there could be a factor of 20 or even 30; he might take 50 in a handful instead of one. This is a very toxic material and this method of distribution is, therefore, highly dangerous.

Senator Sheehy Skeffington felt that if we use this method of distribution, we can reach 90 per cent. of our children. Perhaps we can, but what is one's experience in this matter? Between 1943 and 1948, I carried out a number of surveys on the distribution of vitamin D in the form of cod liver oil and preparations of it in Dublin. This material is distributed free to children through the child welfare centres here. A considerable propaganda is exercised to induce the mothers to make use of this free material and it is pointed out to them that it is greatly in the interests of their children's health. Over that six years' period, the uptake of that material by the children for whom it was intended varied from 15 per cent. to 50. The highest figure, in fact, was 49; the average was under 30. So that, under 30 per cent. of the children for whom this material was being made available actually benefited from it.

I did not know whether perhaps children or their mothers might be somewhat different now and this morning I rang up the child welfare centre. I got the senior doctor in charge of it and she told me that conditions were in fact exactly the same. The mothers come there. Some of them do not take the material. Most of them do. But, when they are asked subsequently what they did with it they say they gave it to the older children, take it themselves, give it to aunts and uncles. Almost everybody gets it rather than the child for whom it was intended.

It is difficult at times to make a child take these medicines. The mothers want to take the things home anyway and they take it. By this method of distribution, the uptake is slightly under 30 per cent. and in local authorities in England, where we made this inquiry long ago, they consider they were doing very well if they got an uptake of over 50 per cent. for the vitamin tablets they were prepared to distribute. So I think Senator Sheehy Skeffington's figure of 90 per cent. is one that could be reached but I would be prepared to put a very large but that it will be perhaps one-third of that at the very most and that is in a town like Dublin where it is easy to reach people by propaganda.

That is the principal difficulty I see here. We have dealt with this matter. We have sifted the evidence. The Minister's commission have sifted the evidence. The Minister's officials have sifted what the commission gave to them. We have thought about it and talked about it and I am quite certain now that it is our duty, in the interests of the children of the country and in the interests of the health of the people, the adults these children will grow up to be, to take this measure now and give the Minister the authority to direct local authorities to put this material into the water supply and deal with it once and for all.

First of all, I should express my regret to you, Sir, and to the Seanad for the heat with which I intervened when Senator Stanford said that he had confidential information that I had changed my mind in this matter. If I had changed my mind in this matter, I should not be ashamed of it. That merely implied that I was open to reason and use my reason and consider arguments objectively; but, I did not change my mind, for the reason that I did not start with a mind which was made up and fixed. I started in the belief that there were two points of view to be considered: first of all, whether we should impose this as an obligation upon local authorities or whether we should give them permission to fluoridate water if they considered it wise to do so, but I did not, certainly, come to any decision that the matter should be left purely to their discretion because if I were to do that, I should be abdicating my own responsibilities as Minister for Health and, in the terms of ex-President Truman, I should be passing the buck to a subordinate authority to take the rap if anything went wrong.

Which is frequently done.

It is not my practice to do it and I think I can say that quite frankly without throwing any bouquets at myself.

A lot of heat, perhaps, has been engendered on my part in relation to this matter because I regard the fluoridation of our public water supplies as being a very important step from the point of view of improving the health of future generations of our children.

I am a layman but I have at my disposal the advice of very highly qualified persons. I listen to what they say; I do a little reading on my own behalf and then I make the decision for myself. I am convinced that if we can improve the dental health of our children that we are going to improve the general health of the community as a whole. Therefore, speaking as Minister for Health, I say this is not a matter to be disposed of lightly or to be obscured by the use of mere debating points. If I exhibited a little heat some time ago it was merely for this reason, that I have a very high opinion of the intellectual capacity of the two Senators who are associating themselves with this amendment and that I hated to see these great gifts abused in a way which would indicate that they had adopted the tactics of the Pure Water Association.

I regard what we are now proposing in this Bill as something which is of great importance to the future health of this community, particularly to the generation which is now growing up, to the children of the present generation and to those who come after them. I cannot see what substance there is in the argument that because everybody cannot have the benefit of what is proposed in the Bill, then nobody should have it. Surely, even for Senator Sheehy Skeffington, that is carrying egalitarianism beyond the limit of absurdity. I think we are bound as far as we can to give to those who can avail of this great protective measure because they have these facilities in relation to water supply which is brought to their door and into their houses, the benefit of what we can do to preserve the dental health of their children, to ensure their children will get as good dental health as may be, and to strive, as we are striving, to ensure that those sections of the community who do not enjoy these amenities will do so in due course.

As I said when I was speaking here on the last occasion, when I was Minister for Local Government and Public Health we set up a commission to consider that very matter, but unfortunately the commission, for some reason or other, was disbanded. My colleague, the Minister for Local Government, has recently taken up that matter again and is offering to local authorities, and not merely to local authorities but to residents in rural areas, very substantial incentives to ensure they will have piped water supplies.

Thought you ruled out of order certain amendments relating to the provision of fluorides by the distribution of tablets, the debate largely resolved itself into this, as to whether there is not a better alternative than that which is proposed in the Bill, and it has been argued here that we should provide for the free distribution of tablets. I do not think it is necessary for me to add anything to what Senator Jessop has said in relation to this matter. We shall all have to admit that on a matter of this kind he speaks with authority. What he has said is reinforced by the findings of all the commissions of the different countries which have considered this problem. Every one of them has rejected the distribution of tablets as being an adequate or even a desirable alternative—make no mistake about that—to that which is proposed in the Bill.

If the House wants to know the extremity to which the advocates of tablet distribution have been driven by the arguments which have been used against any such proposal, I can only quote what was said in the other House by a Deputy there who has been prominent in opposition to the proposals in this Bill. He said this:

People with more authority than I assert it is possible to make up these tablets with some other substance so that children taking more than one at a time will vomit up the poison.

The Deputy's suggestion is that children should be served with tablets which in the event of their taking more than one they would enjoy a régime of day in day out vomiting. The remedy surely is worse than the disease. Is it not a rather nauseating proposal that we are going to have our children throw up day in day out because they happen to have taken more than one of these tablets? When you consider, apart altogether from that, the extremes to which their mothers and their attendants would have to go in order to ensure they did not take an overdose of fluoride, which people have been told is a poisonous substance and which, we admit, when taken in excess is likely to be detrimental to the health of the individual, surely we are entitled to reject a proposal in relation to which there can be no definite, fixed or assured control.

The Minister is not entitled to criticise a Deputy.

I am not criticising a Deputy. I am criticising the argument he used.

We are not allowed to criticise any statement.

Even a T.D.'s statement is not like Holy Writ. His words are open to criticism even if his person is not.

We are not allowed to do it here.

The Senator takes advantage of it all the same.

Let us consider what is involved here. This is a relatively simple question when it is considered by serious, well-informed professionally qualified and expert persons. But once you get outside the category of persons who are qualified to consider and to come to a judgment upon this matter, then you are open to all sorts of misrepresentations. One of the reasons why I had to decide in the end whether we should make this mandatory on local authorities or whether the Bill would be merely a permissive piece of legislation, was this fact. After all, members of local authorities are voluntary servants of the public. They are unpaid; they have no allowances or expenses beyond their travelling expenses. They have no facilities at their disposal for investigation or for reading. If a statement is made by a person they must either take it at its face value or reject it out of hand. They have not available to them the literature which would be necessary, if they had the time to read it, to inform themselves well on a matter of this sort.

The Legislature is in quite a different position. Those who serve in it have certain allowances which will enable them, if necessary, to employ secretarial assistance and they are supposed to have a fair amount of time at their disposal. They absent themselves from their ordinary avocations to come here and there is a magnificent library with all the documents they require at their disposal if they want to study the question in order that they may come to a well-considered conclusion in regard to it. That is not the situation in relation to members of local authorities.

Furthermore, because the Minister for Health is after all the person responsible to the Legislature for what he may do, we are charged with responsibility for the health of the nation as a whole and the proposal in this Bill does touch the health of the nation as a whole.

It cannot provide a remedy for a certain addition which should be available at this stage to the nation as a whole but we all hope ultimately that it will be, and, to the extent to which we can at the moment make this prophylactic available to a very large section of the community the responsibility, I think, belongs to us to decide whether or not we shall make that remedy available.

If we abdicate from that position, abrogate our responsibilities and pass them on to somebody else, what sort of discussion are we going to have at every local authority or sanitary authority in the country which has control of a water supply? Will it be the sort of discussion we had in the Dáil and which we have had here, a discussion in which we had the expert opinion, if I may put it that way, of a member of the Seanad to guide the opinion of those Senators who were amenable to that? Not at all. What we would have in the local authorities would be something like this, something which I read the other evening in a Dublin newspaper under a banner headline across two columns: "Fluoridation—were the old methods best?" Here is one of the arguments which we would hear repeated time and again at every sanitary authority meeting where this matter came up for discussion:

It is really alarming to think that soon the water we drink will contain poison which is used for killing rats and which was used in German and Soviet concentration camps in the brain washing of prisoners.

Are we entitled, having regard to our responsibilities to the people for the health of the nation, to leave this question to be decided at a local authority meeting by an argument such as that, an argument which I may also say was used in Dáil Éireann against this Bill?

Then there is this other one:

A few American States that tried fluoridation of water soon gave it up because they discovered it hardened the arteries and damaged the heart and other organs.

Could we have the reference? The Minister quoted a Dublin paper—could we have the reference? Why should we miss these colourful arguments?

Certainly, although whether the editor of the Dublin evening paper concerned will thank Senator O'Donovan for extracting the information is another matter. It is from the Dublin Evening Mail of Saturday, December 10th. I was being merciful because I should hope that no sensible newspaper editor would print that sort of stuff——

Is it newspaper policy or "Letters to the Editor"?

It is "Letters to the Editor".

Then we cannot blame the newspaper.

Who said: "The Oath was an empty formula"?

I do not know what is happening to Senator L'Estrange. However, we had got to the stage at which we were told that fluoridation was going to harden the arteries, and damage the heart and other organs.

On a point of order, I think the Minister should give the reference, not only to the paper but should also state the signatory to the letter.

The Minister has given the reference.

It is a very comprehensive nom-de-plume because it is signed “Democrat”.

I thought it was "Mother of Ten"——

He should have said "Demagogue".

——who by the way would have been an authority on fluoridation.

I was saying that on the Second Stage of this Bill I put before the Seanad the considered findings of a number of authoritative committees and scientific investigations which had taken place in several countries. I think all of them without exception categorically declared that, as far as they could ascertain, there was no substance in the allegation that fluoridation of water to the extent of one part per million would in any way justify the arguments which were made as to the detrimental effects of fluoridation on the general health of the community.

Then we go on. I am not reading the whole of the letter; I am culling these gems from it. "Democrat" goes on to say: "Your correspondent, `Anxious Parent' "—that is very touching, is it not?—"asks how we can rid ourselves of these Ministers."

At the next election.

I should imagine that our friend is much more anxious to get a satisfactory solution to that question than as to whether or not we should fluoridate public water supplies. Then he goes on—and this is the question of the election—to say: "Vote for anything else and we can hope for pure water and purer air."

I hope I have cleared the air about what is likely to happen at a local authority meeting when this question of fluoridation comes up for discussion if, by any chance, the Oireachtas were misguided enough to accept these amendments.

Would the Minister say, if by any chance, that was a Progressive Democrat?

There might be a split in the Fine Gael Party.

I suppose the Seanad like myself is very anxious that we should not prolong these proceedings. I would ask then in the light of that letter not to have this question decided at every local authority level on the basis of arguments like that. I am asking the Seanad to reject these amendments and accept responsibility for this measure.

I have listened to other Senators and to the Minister speaking on this amendment and I should like to deal with the few points that were made. Senator Kissane supported the Minister's right to say "ye shall" rather than "ye may" on the ground that a matter like this is so important that we must apply it throughout the whole country. The Senator, apparently, is unaware that this Bill cannot possibly do that because it is a Bill for the fluoridation of water supplies and will be concerned with piped water alone and it has been amply demonstrated that the number of dwellings to be reached by this Bill will certainly be less than half the dwellings in the country. Yet the proposal is being supported by Senator Ó Ciosáin on the grounds that it is one which must be universally applied. The answer to that is: "You cannot," and this Bill will not do it. If there were an alternative method allowed—there are various alternatives besides the tablets—that could be applied to all children, whether or not they had piped water, then, clearly, Senator Ó Ciosáin would support that. I am a little surprised that he is not however prepared apparently to allow the authorities to have any alternative.

He also said that no doctor, no medical opinion, had ever been quoted to support other methods. That is not so. I have before me the Swedish Report. We dealt with some of that the other day. I have already quoted some of what Dr. Strälfors said and, in reply, the Minister quoted the following:

These data demonstrate that Strälfors' criticism of investigations supporting the safety and caries preventive effect of water fluoridation is exaggerated...

The Committee do not say that what Dr. Strälfors says is untrue; they say it is exaggerated.

... while on the other hand a notable lack of criticism appears in his quotations of papers produced against the fluoridation of drinking water. Some of Strälfors' statements are found to be purely speculative.

That was quoted by the Minister as a resounding reply to Strälfors.

I suggest to the Minister, before continuing the quotation, that a great deal of his own speech in defence of the fluoridation of water is purely speculative, for the reason that no community has had a regularly controlled supply of fluoridated water, and neither has there been a regularly controlled analysis of the state of health of the population, over a period of 40 or 50 years, or 60 or 70 years, of intake, and when he suggests, therefore, that an adult can go on for 60 or 70 years after the age of 14 years— when the fluorides cease to be of any benefit—absorbing this fluoride, which is cumulative in effect, and that it will not do him any harm, again the Minister just does not know. There has been no investigation. There is no proof. It has not been demonstrated, and those who say that it cannot do any harm—this long-term absorption of a cumulative, toxic substance—are purely speculative in their opinion. Mark you, they may be right; but they may be wrong, too. Their statements are certainly not proven.

As I suggested the other day, there are things which are now recognised as being dangerously cumulative in their effect, such as radiation. Twenty or thirty years ago, the experts and the doctors were not sufficiently afraid of radiation. I will put it that way. We were told by the Minister's Committee Report the other day that the effects of radiation are "cumulative and irreparable". Those are frightening words. In that case it is no longer something speculative; it has been proved. I would be very loath similarly to have the cumulative effects of the absorption of fluoride over a long period of time to be proved to cease to be speculative, by means of compelling the entire adult population where there are piped water supplies to absorb fluorine, only to discover 50 or 60 years later that the effects are not only cumulative but irreparable.

The Minister did not point out furthermore, that Dr. Strälfors had replied to his critics:

"On March 4th he submitted an answer. He maintained (1) that fluorine is a strongly poisonous substance; (2) that drinking water containing fluorine has been found to produce toxic effects in man; (3) the conventional safety margin for water fluoridation does not give any guarantee against harmful effects due to the great individual variations in water consumption and sensitivity to fluorine; and (4) that topical applications of fluorides is a good substitute for water fluoridation."

That means local application to the teeth of children, and so on.

Further on in the report—I do not want to weary the Seanad—there is a statement by——

May I suggest that this seems more like a Second Reading speech than a speech in relation to the amendment? All that ground has been covered before.

I was answering the point made by Senator Ó Ciosáin that no doctor has ever suggested other methods. I have quoted one. There are others in the report. I shall not quote them.

I did not mention the word "doctor".

If I recollect rightly, I think the words were "no doctor".

I did not mention the word "doctor".

I accept the Senator's correction. However, the record will show I think that that was the import of his remark. Senator Cole said he did not see any difference in local representatives deciding here, and local representatives deciding locally.

I did not mean local representatives deciding here. I said there was no difference as between this House making a decision and a local body making a similar decision in a county health district, but this House should make the decision. As far as Senator Sheehy Skeffington's argument was concerned, I felt he was merely passing the decision on to the local authorities. I did not suggest the local authorities should make the decision in this House.

I understood that, but I should like to put it to Senator Cole now, and to the House that it might be possible for bodies such as the Oireachtas to consider that the principle was sound and a good thing generally for the country, but it might still be preferable to allow local authorities to decide whether or not they would apply that sound principle locally, in the light of their own local circumstances. I do not think there is anything incompatible in that, and I should prefer to have it left to the local authorities to make the final decision.

Senator O'Reilly, I think, misunderstood my point about piped water. I am glad he did, because it enables me to say that, when I quoted the statistics for the whole country, for Leinster, Munster, Connaught, and the three counties of Ulster in the Republic, and showed from the latest available figures that only a small proportion of dwellings in various parts had got piped water, I did not mean to cast an aspersion on anybody. I merely meant to show that this Bill could not affect, and would not affect, that large proportion who have no piped water. I am quite certain that drinking water privately-piped or procured from a well is every bit as good as and probably very much better than, water on tap. The fact remains, however, that it is only water on tap which will be affected by this Bill. Therefore, no matter how good it is, if it is privately-piped water, it will not be affected by this Bill, and those children will not be reached.

The Senator also said that in some of these local water supplies there is a bigger content of fluorine than there will be in piped water supplies as a result of this measure. He did not quote any figures in support of that, but, if that is so, the children from these areas who attend schools in which there is piped water will be getting a double, or treble, dose of fluorine.

Senator Jessop disagreed on general grounds—I hope I am not misinterpreting him—that if one leaves this to the local bodies, there is some kind of fear that the local bodies will not want to fluoridate the water supplies, and it should not, therefore, be left to them to decide. One can sympathise with that, but I feel that that is a risk, if you like, which must be taken. After all, freedom must be granted to local authorities to choose and decide on alternative methods, if they want to. His argument about the uptake of cod liver oil when distributed free is certainly a very powerful one. I would grant him that. It is relevant here. It is a deplorable thing when you find it is made available and is not taken up. He says the uptake in Dublin is not more than 30 per cent. I would say in regard to the distribution of fluoride tablets, or other topical applications of fluoride that might be conceived as an alternative, that it ought to be possible for the dental services, if properly organised—unless we are trying to get this on the cheap—to see to it that the intake is balanced and universal, as it would not be, in fact, merely in the case of infants, but would apply to children up to the age of 14.

The Minister dealt very well, I thought, with an anonymous letter in the Evening Mail. I was a little disappointed he did not deal as well with more serious arguments made here in the House. I am always suspicious when, in answering arguments, anybody, be he Minister or not, decides that he would prefer to deal with arguments which were not put. Why is that? Why does the Minister in this House prefer to deal with arguments which were not put except in an anonymous letter in the Evening Mail? He did not quote the very good editorial on fluoridation in the same issue, or perhaps it was last night's issue. However, he quotes this anonymous letter with its exaggerated arguments. It is easier to deal with exaggerated argument than with the arguments put before him in the House.

He made a comparison and drew a parallel which was, I think, unfair. He apologised for growing heated, out of a misunderstanding, I think. He said he resented what resembled "the tactics of the Pure Water Association." I feel he is wronging those people. I submit that they have been merely arguing a case. I do not go all the way with them, but I think they have argued it fairly. I am afraid the thing the Minister finds irritating with them is that they argue it well. The Americans have a definition for propaganda which says it is the other side so well put that it makes you mad. I am afraid that is the basis of the Minister's not very fair reference to them.

In dealing the other day with the effects of an over absorption of fluorides, which the Minister in the Dáil mentioned as a possibility in certain cases—although he denied the possibility at the level of intake he hopes will be implemented here—I quoted the case where osteosclerosis and mottling of the teeth occurred in ten per cent. of children. I quoted a passage dealing with osteosclerosis and what it meant. The Minister's reply to that was that I had made his flesh creep. I do not think that is a very good reply.

In fact, of course, what osteosclerosis does is something that might well be more important and more disastrous for politicians like ourselves. It does not produce creeping of the flesh but produces stiffening of the back bone. In party politicians particularly that might be disastrous. Now the Minister is not noted as being a supine person. On the contrary, he has plenty of backbone. But one can have too much of a good thing, and osteosclerosis does produce, over the years, precisely that. It may be funny until you get it. When I quoted this as one of the extreme effects, without making any exaggerated claims, all the Minister did was to make a joke and say I was making his flesh creep. I do not think that is satisfactory, when we are dealing with fluoride absorption that will be compulsory. The Minister has stated quite clearly that he wants this to be compulsory, that he always wanted it to be compulsory and that he never had any hesitation——

I did not say so. I said that was my conclusion—that it ought to be compulsory.

I am sorry. When I say he always said it was compulsory, I understood him to deny Senator Stanford's statement that he was at one time in doubt about it.

Therefore, I must assume he always wanted it. Is the Minister now telling me that this is a recent view, and that there was a time when he would have preferred it not to be compulsory? If that is so, I must presume that the Minister was merely shadow-boxing just now. I believe that the Minister wants it to be compulsory, that he wants to have the power to make it compulsory and that that has always been his view. He said that if he did not take this power, it would be abdicating his own responsibility in relation to the health of the children.

I would suggest that the dental health of the children has been long neglected and that those responsible have been in large measure abdicating their responsibility by the failure of successive Ministers for Health to institute an adequate and comprehensive dental service for school children. Therefore, I would reject this as an overriding argument, that the Minister says he does not want to abdicate his responsibility. I say to him, and I say it with respect, that that responsibility will continue to be abdicated so long as there is not an adequate dental service for all children, as well as putting fluorides into the piped water of some.

I asked the Minister a number of questions. I asked him could he quote another country, one country, where power had been given to the central Government to lay it down that when the Government wanted it, the local authority would have to have fluoridation of water. The Minister preferred to return to the anonymous letter in the Evening Mail, but he did not answer my question. I suggest that the reason he did not answer it —though possibly he forgot about it —is because there is no other country where this power has been asked for and granted. I would challenge the Minister, if he would like to intervene when I sit down, to mention one country where that authority has been asked for and given. In other words, the Minister says that if he did not get this full power, he would be abdicating his responsibilities, and at the same time he must recognise, if that is the case, all Ministers for Health in the world, except ours, have abdicated their responsibilities in this regard, even where they have introduced fluoridation of water in some areas.

The second question I asked the Minister was: does he attach any importance to the view of the engineer in relation to the capacity of his services to ensure uniformity in the intake of these fluorides? Senator Jessop answered that to some extent by saying that the complexities would not be so great here. I grant that. There are not 5,000 miles of piping here, but the problem remains. I would suggest that if you want to make sure that everybody gets at least the requisite minimum, some will be getting more than the maximum and you will have, perhaps, something like ten per cent. of the children getting mottled teeth and a certain incidence of osteosclerosis.

The third question I put to the Minister, to which he did not find time to make an answer, was: what is his objection to allowing local health authorities, if they want to, to try out other methods and to investigate them? The Minister said jokingly, in relation to my own attitude, that as far as he could see—I hope I am not misinterpreting him—my view was: if everybody cannot have it, then nobody shall. He suggested that I was carrying egalitarianism too far. I suggest that the Minister's attitude is: if we cannot reach with fluoridation the children in half the country, we will compensate for this by forcing it on all the adults in the other half. I do not think that that makes for a more intelligent approach. Yet, that is what is underlying this Bill. He talked about "half". I could make the point that this proposal will not, in fact, reach half the country.

I conclude by putting a further question. Does the Minister intend at once, as soon as he reaches a decision—I do not mean at once as soon as the Bill is passed; the Minister cannot do that because there are safeguards in the Bill—once he has decided to implement the Bill, to have fluoridation of all piped water? Does he intend to make it mandatory on all local authorities at once? If not, why not? If he is convinced that we must quickly be able to put this into the piped water in order that the children shall not be deprived of it any longer, the logical thing is to say: "Yes, as soon as the preliminary surveys and so on are done, I intend to make it mandatory on each local health authority to put it in the piped water." I should like the Minister to answer that question. Possibly that implication is not to be read into his argument that we must give it to all of those for whom it is possible to make it available.

I shall conclude by pressing this amendment which would have the effect of leaving the matter to local decision, to the choice of an alternative method, and would enable the Bill to be implemented at local level, as a permissive measure, rather than as a mandatory measure.

The grave question before us now is: are we prepared to take the risk of buying the health of the children at the cost of possible damage to the health of the adults? Experts have spoken this evening and we are very grateful to them. But experts—and I am open to challenge on this—are not prepared to say: "I guarantee that 30 or 40 years of fluoridation of water will have no deleterious effect on the health of adults." They will not do that. It is in the nature of experts that they do not predict for the future but give only the likelihood.

Senator Sheehy Skeffington quoted with great effect where the experts let us down in this country and throughout the world in the matter of using X-rays for the fitting of shoes. We all know, and I know from my personal acquaintances, that they had the most disastrous results, though they seemed harmless at the time. For that reason, I support this amendment, and I would ask the Minister even at this eleventh hour to reconsider it. Are we to buy the health of the children at the cost of the health of adults?

What makes it more serious is the fact that it is the youngest members of the household who are most likely to suffer and it is the youngest people in the country who are most likely to suffer. We who are around 50 years of age will receive this fluoridated water for the next 20 years perhaps, but those who are 20 or 30 years of age will receive it for perhaps 50 or 60 years. They are the people I am principally worried about this evening, and for that reason I support the amendment.

I should like to make a brief reply to Senator Sheehy Skeffington. The position of an expert is that he may speak with certitude only on matters of which he has direct knowledge. Obviously, he cannot have direct knowledge of something that will extend over 40 or 50 years in the future. We know that people have lived in districts where the natural water contains from four to eight parts per million of fluorine. Generations and generations have lived in those districts without suffering from anything more than superficial changes in the enamel of their teeth in a certain small percentage of the population.

That change is not a damage to health. It is part and parcel of the hardening process of the teeth. Teeth become coloured when there is too much fluorine in the intake. The more serious changes such as hardening of the bones, osteosclerosis, and so on, have not occurred in places where there has been a high intake of natural fluorine. If that has been happening in those districts over the centuries and over the ages—it is extremely unlikely that one part per million will produce any real change in the future, but obviously I cannot assure Senator Sheehy Skeffington and Senator Stanford that it is absolutely impossible.

The analogy of the X-rays is not satisfactory. It is only about 60 years since X-rays were discovered and for many years there was no question of utilising them except in hospitals. The business of using X-rays for fitting shoes was introduced only about 30 years ago. We did not then know the changes which might arise from the scattering of X-rays through faulty apparatus. That matter was investigated over the period from 1940 to 1950 and it was then found that the damage that might arise could possibly be serious. That experience cannot be compared with the experience of people living in areas where the natural content of fluorine has always been four or five times as great as the Minister proposes in this Bill. That comparison has been made, but I do not think it should lead us to conclude that we are submitting people to something very dangerous if we put one part fluorine per million into water supplies.

This debate has raised an alarming principle. In the matter of fluoridation, we have had reports from experts and apparently the vast majority of those experts are in favour of fluoridation. About 98 or 99 per cent. think it would be harmless to adults and good for the children. In the Dáil and Seanad, we have expert information available to us, and we take the view, that because we have more information than any other body in the country, whether local health authority or otherwise, have at their disposal, we are, therefore, in a better position to make a decision than any of these less well-informed bodies. Consequently, we make the measure mandatory on those bodies.

Let us follow that through to its logical conclusion. Is there any single item affecting the health of the people, the education of the people or anything affecting their wellbeing on which we have not got more expert knowledge available to us, more time to study it, than any of the subsidiary bodies, local corporations or county councils? Consequently, if we are to be logical in the views expressed here, we should make each and every Act mandatory on the people. In other words, if we are logical, we should widen out into an absolute centralised dictatorship, a dictatorship that says that because it knows more than the local council, it has the right to impose its will on that local council.

If the local council were to follow that attitude logically, it should say that as it knows far more than the individual parent knows about children, it consequently has the right to impose its will on the parent. In short, we are heading into very dangerous ground. I think it is not worth it in the present case. If the Minister read other letters, he may have read in yesterday's Irish Independent a letter by an eminent authority in this country, Professor Dr. Saunders, who for 40 years has been the chief medical officer in Cork city. In that letter, he discussed the question of dental decay and came to the conclusion, from his lifetime of experience, that by far the greatest single factor causing dental decay was the eating of sweets by children.

What did the final paragraph of the letter say?

How can any measure be fully effective in the reduction of dental decay while other factors remain? Consequently, I feel it is desirable that such measures should be permissive and should not violate a fundamental principle of our Constitution and our State. The central authority should not arrogate to itself the right to control the lesser authorities. If we follow that through, we will have more and more of this mandatory legislation and we will finally wind up where it will be a case of the Dáil; or Seanad—I should say the Dáil; the Seanad does not really count as it can be over-ridden—alone deciding. That means the Minister alone decides. Is that what we want? I am strongly in favour of the amendment.

I think that, in fairness to Dr. Saunders, the Senator might have quoted the whole of his letter. Dr. Saunders spoke up strongly in favour of fluoridation. Of course, he stated that, as an extra element, sweets were also in part responsible. He did not ascribe the decay of teeth in whole to sweets but he supported very strongly the fluoridation of water.

I am surprised that a representative in this House of the National University of Ireland should have used an argument in this debate which, if carried to its logical conclusion, would mean that we should abolish all representative assemblies in this country and that the country should be ruled by village and urban mob law. After all, the Dáil does represent the people of Ireland and the Seanad represents them, too.

They did in 1922.

I do not know what has happened to Senator L'Estrange.

He has not got his tranquillisers and he wants them.

An Leas-Chathaoirleach

I have just called him to order.

After all, the Dáil does represent the people of Ireland——

——on the free franchise of the people. The Seanad represents the people, too, at another remove. This is not a local question. What we are concerned with here is the health of the future generations of all the Irish people. If the Dáil cannot determine to decide this national question, what authority has a local council to decide it? If it is to be decided by a majority vote, then the majority are going to impose on every household in its community its decision that every child will ingest fluoridated water. If there is objection taken to the Dáil against doing that on the ground of broad principle, that it interferes with parental authority, surely you must find it equally objectionable in the case of a subordinate assembly or a subordinate authority, which has not even the power to legislate but only the power to administer, that they should take a decision which would impose this disability, as the Senator would seem to regard it, upon every household within their administrative area. If you carry that to its logical conclusion, then you must say it is wrong, if you say it is wrong in the case of the Oireachtas. It means that every household is to determine whether or not its members will be supplied with fluoridated water or with water unfluoridated, without an adequate content of fluorine. What will that mean?

Are we going to have to maintain two public water supplies for those who are prepared to accept the findings of qualified and informed persons in this regard as to the effects of fluorine upon dental health and those who reject all that and say we must have the water as it comes from its virgin source? We must ingest it with all the bacteria which water would contain if it were not chlorinated, with all the possibilities of infectious disease which would be present if it were not chlorinated and with all the other organisms and all the foreign matter that might be there if it were not chlorinated.

The best of principles can be carried to the point at which it is quite absurd to apply them and, as the Senator is a mathematician, he ought to know where that would lead us. As practical men entrusted with the government of the country, we have the responsibility of ensuring that the people will enjoy a high and comfortable standard of living and will have made available to them the advantages of all the progress which has been made in relation to matters of health and, indeed, in relation to a great number of other things as well. I think that, as a responsible body, we are not entitled to wash our hands or take up a Pilate-like attitude and say we are not going to take responsibility for coming to a decision on this matter.

Senator Quinlan, who referred to this matter, spoke on education. Neither in relation to primary, secondary nor university education do we allow parents to decide what the curricula in our various educational institutions will be. They are prescribed. They are prescribed in relation to primary—and secondary education at another level—education by the Minister for Education. In university education, they are prescribed by professional bodies as well as by the university authorities. I do not see that that is an unwarranted interference with parental authority. We accept that in relation to these broad matters there has to be a rule of law. If we live in an organised community, something has to be done to ensure that life will be conducted in an orderly fashion.

Senator Sheehy Skeffington came back to his four miners in their pitiful plight. He said I had said it made my flesh creep. It did—for the reason the Senator knew very well, namely, that the example he was citing was not apposite in this discussion, that where we were talking about a measure designed to ensure that an infinitesimal but necessary portion of a mineral would be ingested by the community as a whole to the extent of one part of fluoride to one million parts of water he was citing an example of what might happen if you were working in an atmosphere where, with every breath you drew, you would be ingesting an infinitesimal fraction of fluoride. Is that not the condition in which these four miners were working, that, with every breath, they were inhaling fluoride?

That is very far removed from the position in which when children were taking a normal intake of water—I do not know what the normal intake of fluid might be per diem—one millionth part would represent the fluoride which they would ingest. I think I was quite right to say that when I heard that sort of argument addressed to an assembly like this it made my flesh creep. I am glad to say that my backbone might be inflexible but it certainly would have made me bend in two if I thought of the very horror that an argument of that sort would have in effect upon my mental processes.

We have heard a lot about Mr. Ford and about his 5,000 miles of piped water supplies. The argument again used by Senator Sheehy Skeffington was that there was no assurance that somewhere or other in these 5,000 miles of water supplies there would not be injected an excess of fluorine and that therefore the whole process was not safe. I have here a statement presented by the Executive Assistant Secretary of the American Waterworks Association at a New York City council hearing on fluoridation on 26th January, 1956. This is what the Executive Assistant Secretary, who presumably was speaking with the authority of the members of the Waterworks Association of the United States, had to say in regard to the point raised by Mr. Commissioner Ford:

It is of interest to note that no serious control problems have arisen to-day at any of the towns that are fluoridating. Those towns run the gamut in size from communities with less than 1,000 people to towns as large as Philadelphia, Washington, Baltimore, St. Louis, etc. This record, in my opinion, furnishes conclusive proof of the quality and dependability of the feeding equipment, the accuracy of the control tests and the conscientiousness and high qualifications of the operating personnel. The water industry has had a continuous need for quality control of product for many years to produce a bacteriologically safe supply. Thus the application and control of fluoridation presents no unusual problem, but can be taken in its stride.

As between the two persons, Mr. Commissioner Ford and Mr. Faust, who was speaking as a representative of the Waterworks Association of America, I think we are quite justified in accepting Mr. Faust's considered finding on this matter, a finding based upon experience.

Senator Sheehy Skeffington referred at some length to what the Swedish Royal Medical Board had to say about Dr. Stralfors. I do not want to prolong that controversy but I should like to quote this passage from that report because it has reference to the point made by Senator Sheehy Skeffington and Senator Stanford that fluoridation by the distribution of tablets is an acceptable alternative to the proposal in the Bill. This is what the Royal Swedish Medical Board had to say on that point, as reported on page 13:

The Committee consider—also unanimously—that at present they cannot recommend a generalised administration of prophylatic doses of fluoride with vehicles other than water. On prescription by a physician or dentist, fluoride as tablets may be given in individual cases.

Are we to have a dentist prescribe for every child in Ireland whose parents consider it would be well for them to take tablets as a vehicle for ingesting fluorine? That is a practical question which everybody can ask himself. Do you think it would be practicable to do that? Do you think it would be advisable to do it, having regard again to the fact that we have been told fluoride is a poison? It is, when taken in excessive doses. If you distribute tablets ad lib., as you would have to, to every person who applies for them, would you be able to control the intake of the tablets? We know that children are likely, if they see anything resembling a sweet, even in form, to take it and eat it or suck it. Certainly, children are likely to take it and assimilate it and perhaps produce a very dangerous condition.

Whatever we may say about using water as a vehicle for fluoride, we have the evidence of every commission that sat upon this matter, that the intake of fluorine can be controlled within reasonable and necessary limits if the vehicle used for its administration is water. We cannot be certain of that in the case of tablets. This Swedish Commission, to which Senator Sheehy Skeffington has appealed on two or three occasions, has said that the tablets should be given only on prescription by a physician or dentist. I think that that, in practical terms, indicates that the administration by tablet is not a reasonable alternative to what is proposed in the Bill.

The Board goes further and has this to say:

With regard to fluoridation of public water-supplies, that is, bringing the concentration of fluoride in drinking water to approximately one mg. per liter, it has been found that this measure will reduce the incidence of dental caries by about 50 per cent. in children and young persons, who have consumed such water all their lives.

In children who have been drinking fluoridated water for only part of their lives, the caries incidence will be reduced roughly in proportion to the period of ingestion.

We come now to a point made by Senator Stanford. He suggested that, after all, he was more concerned with the health of the middle aged and aged people and, I think, took somewhat lightly the health of the younger generation. I am in this position, that I think the future of our country depends on our younger generation and if there was a choice between myself and the younger generation, or even between Senator Stanford and my grandchildren, I would sacrifice Senator Stanford for the sake of my grandchildren. I think that is the attitude that we mature persons should take towards the younger generations. We should give them the chance which we had not got, of having a whole set of teeth when they reach middle age. At any rate, on the point raised by Senator Stanford I think perhaps it is too late for anything which we may do as a result of this Bill to confer very great benefits upon us, but after all we have some middle-aged people still in the country.

This is what the Swedish Board had to say in that regard:

The protection of the teeth offered by fluoride seems to be effective still in middle aged persons...

—and they go on to make this reservation:

...judging from a small number of investigations.

On the other questions about the stiffening of the spine, the hardening of the arteries, the destruction of the kidneys and all the other things that the opponents of fluoridation offered as arguments against the proposals in this Bill, the Board had this to say:

In countries that are comparable with Sweden no evidence has been found that the consumption of fluoride is harmful to health, not even in areas in which the water has a natural content of fluoride that is 10 times as high as that used at artificial fluoridation.

They go further and say:

In the opinion of the Board the inquiry carried out has shown that fluoridation of public water-supplies does not involve any demonstrable health hazards even on prolonged consumption of the water. Being convinced that fluoridation of drinking water is an effective means of preventing caries in children and young persons, the Board maintains that communities which desire to start fluoridation of their domestic water-supplies should be authorised to do so under the necessary technical control.

Finally, to conclude the discussion about alternative means for fluoridating water the Board winds up by saying:

The Board, believing that at present neither topical application of fluoride nor administration with the aforementioned alternative vehicles can replace water fluoridation, will later consider plans for close investigations of these caries-preventive methods.

Despite what Senator Quinlan has said we are entitled to use our reason and right judgment here on this matter, as an assembly of the Oireachtas which represents the nation as a whole, and whose members are chosen in order that they may fulfil the duty of acting for the nation as a whole. I think there should be no question that we should take the responsibility ourselves of deciding public water supplies will be fluoridated where it is thought necessary.

The Minister has further aggravated my fears in this matter. At the outset I had better make it clear that I am in favour of fluoridation on a limited scale. I believe the arguments for it are quite reasonable but I think we should proceed rather slowly. If the Minister wishes to make Cork City his first guinea pig in this matter I will give him any help I can.

Is the Senator prepared to act the guinea pig?

I am. I think the Minister's whole attitude shows how far we have travelled in this country towards a centralised bureaucracy, a bureaucracy which because it can be supposed to have a better knowledge of the facts and better advice available to it then the other subsidiary bodies within the country simply regards the subsidiary bodies as unnecessary and to be over-ridden. We have constituted health authorities and now the Minister says in effect that he cannot issue a pamphlet to those health authorities giving the reasons why fluoridation should be introduced; that he cannot rely on the leading citizens in those districts to study those pamphlets and to reach a right and proper conclusion. I think we are travelling very far if we take that attitude. We want to go back again and study carefully the principles of subsidiary function which is the keystone of the social and democratic structure in any modern democratic community. That means that the greater body, in this case the Oireachtas, should not arrogate to itself power to do what lesser bodies can do. If we cannot trust lesser bodies to make a simple decision like this—to say "We are agreed for the sake of our children to fluoridate the water supplies"—then what kind of decision can we ask from those local bodies?

Then the Minister went on to quote, gaily, centralised education. Here I might point out what is really wrong with our educational system and that is that the young boy or girl in the heart of the country who is preparing to live on the land has to follow exactly the same curriculum as the young boy or girl in the city who is preparing for an industrial career——

Is the Senator speaking as an expert on this?

I am giving my views on that.

A few minutes ago the Senator ridiculed all experts. What are we to believe?

Apparently the Leader of the House does not want to get business done today.

I am not going to be blackmailed by anybody saying that I do not want to get business done. I am prepared to sit here until Christmas morning to get the business done.

In regard to this centralised education which the Minister is advocating as a corollary to his health services he might be surprised to know how we operate in the universities. We have not got a centralised curriculum imposed on us by the Senate or anybody else. The individual colleges act individually. The individual professors have the responsibility of drawing up the curriculum that suits their set-up, that will provide the best framework for developing their students in the subject in the period that is allotted to that subject.

An Leas-Chathaoirleach

I think that is sufficient answer. I think the Senator has dealt sufficiently with the Minister's remarks about education.

May I say this to the Minister. You have permissive bodies; you have the faculty, the academic council and the Senate—all bodies that review—but it comes from the ground up. That is the principle we are fighting for here. I am afraid I shall have again to support strongly this amendment because I believe a great constitutional point is involved. It is just simply this stand against centralised bureaucracy which threatens to extinguish all our local bodies in this country.

I shall try to have the last word in this matter.

A super-optimist.

I know it is very ungracious of me to try to snatch the last word from Senator Sheehy Skeffington, Senator Stanford, Senator O'Quigley, the Minister——

I have not spoken at all.

——and from Senator Quinlan. It is ungracious of me to try to do that because the last word is a very powerful weapon. The womenfolk regard it as their prerogative. I say to those people who fear fluoridation—drink milk. The Bord Bainne Bill has to come before this House and those of us who are interested in agriculture thought the Bill would come before the House this afternoon. We are now beginning to worry on that score. If people are really worried about the poisonous effect of fluorine which, apparently, accumulates and ultimately does terrific damage to people in their later years, I would suggest that they should drink milk because if a cow does drink water that has been treated with fluorine none of the fluorine is excreted in the milk. Most cows will drink water which has not been fluoridated. The opinion of the experts seems to be that fluorine is cumulative and therefore dangerous but even if the cows drink fluoridated water the fluorine will not be transmitted in the milk.

In the interests of the agricultural community and in the interests of people who are fearful about the damage that may be done as a result of drinking fluoridated water, I would suggest that the only safe thing for them to do is to drink milk.

I do not want to take the last word from Senator O'Reilly and do not want to appear to defend bureaucracy but I should like to add a remark to Senator Quinlan's reference to the dangers of centralised bureaucracy. We in this House come in contact with the operations of this machine on occasions like this and sometimes they look pretty terrifying but there are many other occasions similar to this when issues arise and we do not bother about them at all. One such issue came to my personal knowledge ten or 15 years ago when it was a question of putting iodine into salt in order to cope with a deficiency of iodine in southern Tipperary. The Research Council had noted that there was a great incidence of goitre in this area. They had determined that that was due to a deficiency of iodine in the soil; it had been washed down from the Galtees into the sea, over the edges. In those circumstances the practice in other countries has been to put iodine into salt and many Governments have taken the step of putting iodine into salt so that people may get the necessary mineral for their glands to work on.

In this case we were undecided as to whether this iodine should be put in from a central direction given by the Department of Health. The Research Council considered this and, in conjunction with the Minister's officers, we eventually came to the conclusion that locally we would advise people to have iodine in their salt and the manufactures of table salt would be requested to put it in, that they would have the propaganda exercised to try to persuade people to take iodised salt rather than non-iodised salt. It may be suggested that that is the same thing as we are dealing with here but the conditions are quite different. The goitre was just a local condition; it does not occur generally in Ireland. Furthermore, it was not a dangerous condition; it was a disfiguring one. The question of treating dental caries by putting fluorine into water is a different matter. Dental caries is not a local condition. It occurs everywhere in Ireland. It is, I believe, a condition that is dangerous.

I should like to say a few words, possibly in conclusion. At any rate, I should like to comment on some of the things that have been said since I spoke. I thought I was concluding before, but there were further points made. I shall try not to be long.

Senator O'Reilly has made a moving appeal to us to get on the milk wagon, but I should like to see the survey upon which he bases his view that none of the fluoridated water gets into the milk. I think he has misunderstood the word "cumulative" which merely means that some of the fluorine remains, not necessarily all. I would warn him that he may be endangering his health if he drinks too much milk. I do not know whether he is prone to run that danger but, if he is, he should be careful and not drink it too lightly in an area where the cows are getting piped water.

Perhaps the Senator would explain what he understands by the word "cumulative."

An Leas-Chathaoirleach

I think it would be better if the Senator got back to the water wagon.

In point of fact, it should be realised by the Seanad that "cumulative effect" simply means that some of the fluorine remains forever and does, I understand, lodge in bones and teeth. The whole point of the Bill is lost unless it is cumulative to some extent. It would not lodge in teeth unless it were cumulative. That does not mean that it all resides, merely some.

In answer to a point raised by Senator Stanford, the Minister said that on the whole, if he had to choose between the health of adults and children he would come down on the side of the children and would sacrifice even such adults as Senator Stanford and himself, but I think there is a fallacy in the Minister's argument, because he is assuming that no children ever grow up. I am prepared to admit that in this country there are people who never seem to grow up, and who merely get taller, but if children are benefited in the early years, they later become adults, for as long as they survive. I can assure the Minister that they do eventually become adults, and, therefore, these are the very adults that he is prepared to sacrifice. I am afraid he is working on an illogical argument, for these adults will go on absorbing fluoride for long years after they have ceased to be in the benefiting age-group.

In referring to osteosclerosis the Minister was rather facetious. This time it is not the flesh that crept; it was the hair that was raised. He said it was hair-raising this time. I made it quite clear, in referring to osteosclerosis, that I was referring to an extreme case, but I shall quote the Minister again. This is what he said in the Dáil, and this is relevant to what Senator Jessop says too:

The Cameron survey, a ten years' study of 168 individuals, demonstrated that there was no adverse health effects found with eight parts per one million in the drinking water, although tooth mottling and a low incidence of osteosclerosis were found.

It is all very well to say, as Senator Jessop said, that tooth mottling is a slight disfigurement, which harms beauty but not health. You cannot say that even, I suggest, about a low incidence of osteosclerosis.

In relation to what?

All that the Minister can answer in reply to it— and I grant him the validity of the answer to some extent—is that it is eight parts in one million and that he is asking for only one part in one million, and he is saying that you cannot possibly have anything like the effect with one part; but I am not satisfied that the cumulative effect over 60 or 70 years has been demonstrated to be quite harmless; and no doctor or expert is prepared to say that it is, although they may explain to us years later that they did not quite realise it at the time, and that now it is "cumulative and irreparable".

We cannot brush aside the possibility of osteosclerosis being imposed cumulatively in people who absorb fluoridated water over long periods of years. That is why it appeals to me so much more to allow local authorities to have an alternative, which would be to give it to children in tablet form up to the age of 14 and then stop, because that is the age at which the effect is claimed to be maximum. Therefore, the danger of cumulative effect just would not arise. The Minister quoted this from page 13 of the Swedish report:

The committee consider—also unanimously—that at present...

"At present", he did not pause on those words but I do.

... they cannot recommend a generalised administration of prophylactic doses of fluoride with vehicles other than water.

I am not appealing necessarily for generalised administration; I am appealing for the right of an individual local authority to choose an alternative method.

The committee go on to say something which the Minister did not quote:

The proposal concerning the right to carry out fluoridation of drinking water is not seconded by one member of the committee and two of the scientific advisers. Their arguments against artificial fluoridation are the possibility of ill-effects of a toxic or allergic nature, the compulsory character of the scheme, and the expensiveness of the method in that only a small part of the fluoride added to the water is ingested with food and drink.

That seems to me to be relevant to the question as to whether we should insist that the local authority shall adopt one method or whether we allow them to adopt others. The Minister has made a lot of play with the Swedish report, and he is quite justified in saying that they recommended certain things. We should not forget, however, that the Swedish Parliament rejected the recommendations. Is that not relevant? The Swedish committee of experts made certain recommendations, with a reservation by some members and some scientific advisers. The Swedish Parliament went into the question, considered their recommendations, and rejected them, decided not to act upon them. The Minister uses this report at great length to persuade the Irish Parliament to know better, and to accept the recommendations which the Swedish Parliament did not accept from their own experts.

I asked the Minister four questions but he answered only one of them. He answered the question about the possible difficulty of establishing uniformity of absorption through the public piped water system; though he admitted that he did not know what the per diem intake of water per child might be—he did not apparently reach any figure for that per child—he is satisfied that uniformity can be obtained.

However, he did not answer the question I put to him as to whether he would object to other methods being used by local authorities before he insisted that fluoridation of water take place. Is he prepared to hold back, as it were, in relation to certain local authorities in order to give them an opportunity of trying other methods; and would he object to other local authorities, in non-piped water areas, trying other methods? He did not answer that question.

He did not answer the question as to whether he intends to implement this Bill for all local authorities with piped water together, or do it one by one.

Finally, he did not quote for me, as I asked, any Minister for Health in the world who had the power to make it mandatory upon all local authorities to have fluoridation of water. Consequently, I feel the Minister has not fully answered the case against permissive as opposed to mandatory legislation.

An Leas-Chathaoirleach

Is the Senator pressing the amendment?

I am still hoping for an answer to those last questions.

I shall proceed to implement this in an orderly way. I shall not cause confusion by asking every local authority in Ireland to fluoridate at the same time and if the Senator will read the Bill, he will see why. First of all, I have to conduct an investigation to see the extent of dental caries in every area and I have also to have the water supplies analysed in order to see to what extent they are deficient in fluoride. As these investigations will not be completed simultaneously and will probably not be undertaken simultaneously, I can deal with each area only when I have the data relating to that area before, me; then I shall decide whether or not it is necessary to fluoridate and the extent to which it is necessary to fluoridate the public water supply in that area.

Secondly, in relation to the question as to whether the Parliament of any other country than ours has accepted responsibility for empowering a Minister to secure that the public piped water supply will be fluoridated, I am not aware of any, but then if other countries do not carry their responsibilities, that is no justification for our failing to accept them and if it happened that for one reason or another the Swedish Parliament failed to live up to these responsibilities, I hope the Irish Parliament will live up to them.

Everybody is out of step except us.

Precisely, and, as you know, somewhere, sometime by some person, a beginning must be made.

I want to assure Senator Sheehy Skeffington that the number of cows drinking tap water supplied by a local authority are so few as in no way to affect the position. I certainly do not agree with his definition of "cumulative". If he is able to convince me that his interpretation is more correct than mine, then I shall bow to a superior mind, but in the meantime I shall stick to my own definition of "cumulative". In any event, the fact remains that the majority of cows drink from rivers and streams and there is no danger the Minister will go so far as to add fluorine to rivers and streams. I still believe the mover of the amendment ought to do what I suggested earlier, get his friends to drink more milk.

I am not, as suggested by Senator O'Reilly, frightened about fluoridation but I am alarmed at the spread of centralised bureaucracy or State socialism in this country and the Minister's statement that we are to be the first country to make fluoridation mandatory is a further cause for alarm.

On that assumption, I think the Senator ought to bring in a motion suggesting that the local authorities should discontinue their present practice of providing public water supplies and let each man draw water from his own well; then we will have no socialism.

Question—"That the word proposed to be deleted stand"—put.
The Seanad divided: Tá, 24; Níl, 12.

  • Brady, Seán.
  • Brennan, John J.
  • Carter, Frank.
  • Cole, John C.
  • Colley, Harry.
  • Connolly O'Brien, Nora.
  • Crowley, Tadhg.
  • Hayes, Seán.
  • Hogan, Daniel.
  • Jessop, W.J.E.
  • Lahiffe, Robert.
  • Lenihan, Brian.
  • Ó Ciosáin, Éamon.
  • Ó Donnabháin, Seán.
  • O'Dwyer, Martin.
  • Ó Grádaigh, Seán.
  • Ó Maoláin, Tomás.
  • O'Reilly, Patrick.
  • Ó Siochfhradha, Pádraig.
  • O'Sullivan, Ted.
  • Ruane, Thomas.
  • Ryan, Eoin.
  • Walsh, Laurence J.
  • Walsh, Louis.

Níl

  • Carton, Victor.
  • Crowe, Patrick.
  • Davidson, Mary F.
  • Donegan, Patrick.
  • O'Quigley, John B.
  • O'Sullivan, John L.
  • Prendergast, Micheál A.
  • Quinlan, Patrick M.
  • Sheehy Skeffington, Owen L.
  • Sheridan, John D.
  • Stanford, William B.
  • Tunney, James.
Tellers:—Tá: Senators Carter and Seán Ó Donnabháin; Níl: Senators Sheehy Skeffington and Miss Davidson.
Question declared carried.
Amendment No. 3 not moved.
Question proposed: "That Section 2 stand part of the Bill."

There is just a matter of drafting that I want to raise with the Minister. In subsection (1) there is a reference to regulations under which a health authority is bound to arrange for the fluoridation of water supplied to the public through pipes. That is the first reference to water in the section. In subsection (2) the reference is to "a public water supply" and in subsection (3) (a) there is a reference to "a water supply".

It appears to me that there should be a definition to the effect that a water supply to the public by a sanitary authority through pipes shall be referred to as a "public water supply" and that cognate phrases shall be construed accordingly. I do not think the section as drafted is correct. As I understand the position, a sanitary authority can bore a well and erect a pump, thereby supplying water for the use of the public. That is a public water supply. There is nothing in this section, or anywhere in the Bill, which says that a public water supply means a water supply by a sanitary authority through pipes. Consequently, I think the section is defective.

I appreciate it is a bit unfair to ask the Minister to comment on the matter now but I think the section is one in which a definition will have to be incorporated to make it quite clear that a public water supply for the purpose of this Bill means a supply of piped water made available by a sanitary authority. I do not expect the Minister to argue in defence of the section or against my contention at this stage. Had the matter occurred to me earlier, I should have put down an amendment for the purpose of clarifying the position. As the section stands, it does not matter whether or not the division is carried because I can see those who are interested in a pure water supply seeking injunctions in the courts to restrain the Minister and everyone else except in relation to water supplied to the public through pipes.

I do not think there is any defect in the section. I am, of course, a layman. I am not a lawyer. If the Senator will look at subsection (1) of Section 2, he will see there that the Minister is empowered to oblige a health authority to arrange for the fluoridation of water supplied to the public by the sanitary authority through pipes. That is to ensure that the water in the distribution system, so to speak, will be fluoridated.

Subsection (2) relates to the source of the water supply. There the Minister may fix a date before which a particular health authority shall arrange for the fluoridation of water derived from a particular reservoir or other source. Subsection (1) relates to the sanitary authority which, so to speak, distributes the water, and subsection (2) relates to the health authority which, for all practical purposes, except in the four county boroughs, is the sanitary authority; the Minister may prescribe a date within which the authority will arrange for the supply derived from a particular source to be fluoridated.

I do not think there is any defect in drafting. As I say, I am not a lawyer and the point has been sprung upon me. I have not had time to give due consideration to it. If, however, the Senator will consider it further, he will see that the two subsections relate to different identities. One is the piped distribution system and the other is the source of the supply. As well as that the subsections relate to two separate legal entities, the health authority, on the one hand, which may be the sanitary authority but operates under a different code and, on the other hand, the sanitary authority which is responsible for the distribution of the water.

I agree the point has been sprung upon the Minister and I do not want to put him in a difficulty. However, nothing that the Minister has said satisfies me because apparently "water supply" is used in different contexts and has different meanings. I think the meaning should be clearly defined in the Bill. If regard is had to Section 4, subsection (1), one finds the same commodity described in a different way again:

The Minister may, after consultation with the Minister for Local Government, make regulations under this subsection requiring sanitary authorities to perform, as agents for health authorities, such acts, in relation to the fluoridation of water.

That seems to me to be different from a public water supply. If we are to distinguish between water supplied from a reservoir and a supply of water through pipes, then I think the definition ought to be clear. At first reading it did not occur to me that a public water supply means what the Minister says it means, namely, water in a reservoir. A well is also a public water supply if it is sunk by a sanitary authority.

But the Minister can deal only with water which is supplied to the public by the sanitary authority through pipes. If it is for the good of the legal profession, could we not let it go?

Does the Senator mean that the words "through pipes" in subsection (1) of Section 2 should be dropped?

I shall leave the matter by saying that I regard the position as fluid.

Question put and agreed to.
SECTION 3.
Question proposed: "That Section 3 stand part of the Bill."

I suppose there must be a reason somewhere for this section. The present system with regard to the charging of rates by the various public authorities is such that, by and large, it covers the situation where a water supply feeds two areas under the control of two separate local authorities. For example, the county-at-large charge as distinct from the individual charge on a corporation or an urban council would deal with that. I do not like seeing the Minister have the decision as to who shall do the job and, therefore, pay for it. I cannot think of a situation in which it would be necessary. Perhaps the Minister could tell me where in this country it is necessary that he should decide who shall do the fluoridation and pay for it?

This subsection is necessary because there are one or two places where one sanitary authority is responsible for more than one health district. Take the case in Dublin. The Dublin water supply supplies the city and also serves Bray, Dún Laoghaire and parts of counties Dublin and Kildare. The section is required in order to fix the onus on that particular water supplier. There is a similar case in Longford where the Lanesboro' supply supplies a district in Roscommon.

That explains the matter.

Question put and agreed to.
Sections 4 and 5 agreed to.
SECTION 6.
Question proposed: "That Section 6 stand part of the Bill."

I very much approve of the amended form of subsection (1) of Section 6. The Minister was very well advised to make the amendment and he should get credit for being flexible on this occasion. The subsection says:

It shall be the duty of the Minister to arrange from time to time for such surveys as appear to him to be desirable to be made as respects the health, or any particular aspects of the health, of persons, or of particular classes of persons, in the functional area of a health authority in relation to whom regulations under section 2 of this Act are in force.

The point is that now it will be within the function of the health authority to discover, long-term perhaps, what are the effects upon different classes, different age groups with different sensitivity and absorbative capacity in relation to fluorine, after five, ten, 20 year and so on. This type of survey is now made possible and I should like to compliment the Minister on this subsection and to express the hope it will be very fully used for the protection of the community.

Question put and agreed to.
SECTION 7.
Question proposed: "That Section 7 stand part of the Bill."

As a member of two local authorities, I disapprove of the subsection whereby the Minister can require local authorities to carry out a survey. There is no subsection telling us the Minister will bear the entire cost of the survey. If the Minister requires a local authority to make a survey, I presume the cost of that survey will be borne in the usual manner, that is, 50 per cent. of the cost will be met by the Minister and 50 per cent. by the local rates. That is a charge on one section of the community, property owners, business men, those providing employment locally and householders. The Minister should tell us why, if he has taken power requiring local authorities to make a survey, he has made no provision to ensure that he will pay the entire cost of such surveys.

Might I suggest it would be wise to insert some suggestion as to how the Minister would like this survey to be done? There are a number of different ways in which a survey of dental caries can be carried out. Some of them give reliable results and some of them give results which are far from reliable. Some suggestion such as that in subsection (2) of Section 6, might be considered—that the survey should be made "through such other organisations or body as the Minister considers appropriate." I suggest there should be some reference like that to the manner of carrying out the survey.

I do not think it is necessary to provide that because, after all, the Minister will be concerned to ensure that, whatever survey is made, it will be one which can be relied upon. I think we would have to leave that to the discretion of the Minister. I am sure that, whoever he may be, the Minister will take the best advice available to him on that matter.

Is a continual survey not being carried out?

There is, under the school dental service, but the purpose is, before any regulation is made, to ensure that an authoritative survey will be made of the prevalence of dental caries and, under Section 7, to ensure that periodical surveys are made as the position may seem to demand.

If the statistics obtained following the introduction of the measure were compared with the statistics already collected, would that not give the answer?

The main purpose is to ensure that the position will be kept under more or less continuous observation. Naturally, a great deal of that can be done by the local authority officers in the course of their ordinary duty and will not be of the nature of a public survey which would call for special expense; but I have no doubt that, from time to time, the Minister, whoever he may be, for his own satisfaction and to satisfy the public, will have a survey made by a more independent body——

For which he will pay himself?

For which he may pay. I cannot bind my successors. In any event, I think the cost of the survey would not be such as to overburden any local authority. After all, it is the local people who would like to be satisfied in regard to a matter of this sort.

I am not satisfied at all. I know the cost of a housing survey in my area. I feel that a survey of the dental health of children could be a very expensive thing. I know the calls made on children in school to look after their teeth are few and far between. To have a survey made of all the children would be very expensive. I take the section to mean that the Minister will require the local authority to carry out the survey, and presumably the cost will be levied in the usual manner, namely, the Minister will put up 50 per cent. and the ratepayers the remaining 50 per cent. We are passing new legislation all the time and the ratepayers down the country and up here in town are being asked to bear more of the burden. We want to do more things but we ask the ratepayers to pay for them. We do not put a penny on cigarettes or 2d. on the pint because that might lose us votes. Only one voter in every five is a ratepayer.

Question put and agreed to.
Sections 8 to 10, inclusive, agreed to.
Title agreed to.
Bill reported without amendment.

An Leas-Chathaoirleach

Next Stage?

I wonder would the Minister agree to have another look at Section 2 and, for that reason, defer the next Stage until after Christmas? I notice this Bill was ordered to be printed on 7th December. It must have had a record quick passage.

Ordered to be printed as passed by Dáil Éireann.

It was not passed by Dáil Éireann until 16th or 17th December.

Bill received for final consideration.

Question proposed: "That the Bill do now pass."

In expressing my satisfaction that it appears now to be likely that this Bill will be passed, I should like to refer very briefly to the distinguished scientist to whose seat I have succeeded in this House—Professor Fearon. He was very interested in all aspects of nutrition but, in particular, was he interested in dental health. He was chairman of the committee which carried out the survey on the incidence of dental caries. I was secretary to the committee and I know at first hand therefore how interested he was. He was also interested in the distribution of fluorine in Irish water. Dr. Drum, whom the Minister mentioned in his speech, was in fact Professor Fearon's assistant and it was on Professor Fearon's suggestion and under his guidance that the survey was carried out. I think Professor Fearon would have been very pleased indeed to know the work he started was bearing such fruit tonight.

Question put and agreed to.
Business suspended at 6.15 p.m. and resumed at 7.30 p.m.
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