Dáil Éireann díospóireacht -
Wednesday, 9 Nov 1960

Vol. 184 No. 5

Committee on Finance. - Health (Fluoridation of Water Supplies) Bill, 1959—Committee Stage.

SECTION 1.

Mr. MacEntee

I move amendment No. 1:—

1. To delete the definition of "health authority" and substitute the following definition:

"‘health authority' has the meaning assigned to it by virtue of the Health Act, 1947, and the Health Authorities Act, 1960."

This is merely to extend the definition of "health authority" to cover the new health authorities which have been set up in Dublin, Cork, Limerick and Waterford. The Bill constituting these authorities was introduced and passed, in fact, after this Bill as printed had been introduced.

Amendment agreed to.

Section 1, as amended, agreed to.

SECTION 2.

Mr. M.J. O'Higgins

May I move amendment No. 2 for Deputy Ritchie Ryan?

An Leas-Cheann Comhairle

I was about to inform Deputy Ryan that the amendment has been ruled out of order. The Deputy has been informed accordingly.

Amendment No. 2 not moved.

Mr. M.J. O'Higgins

I move amendment No. 3:

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

Mr. MacEntee

I think the same principle is involved in amendments Nos. 3, 5, 7 and 8 and I would assume, if I may, that amendments Nos. 7 and 8 would be determined by the decision on amendments Nos. 3 and 5.

Mr. M.J. O'Higgins

I do not follow that.

Mr. MacEntee

It is whether the Bill will be permissive or mandatory and it is the same principle.

An Leas-Cheann Comhairle

Nos. 3, 5, 7 and 8 may be discussed together and separate decisions taken on Nos. 3, 5 and 7 if required.

Mr. M.J. O'Higgins

This amendment is designed for the purpose of putting this Bill into the character in which it was recommended by the Fluorine Consultative Council. There was some discussion on this aspect of the matter on the Second Stage of the Bill. The Consultative Council which was set up to examine this question made a report to the Minister and the introduction of this Bill is the result of that report and the result of the Minister's acceptance of the report of the Consultative Council.

The Minister in introducing the Bill gave a lengthy and detailed account of the considerations which weighed with him and I think he made it quite clear to the House that he was introducing this Bill because the Consultative Council had recommended that legislation should be introduced. I and other Deputies on this side of the House disagreed that the Minister was, in fact, carrying out the recommendations of the Consultative Council and we pointed out to the Minister that in paragraph 41 of their report the Council were recommending that enabling legislation should be introduced and not a Bill of a mandatory character such as this Bill is as it stands. Paragraph 41 reads:

The Council is in doubt as to whether local authorities have the necessary statutory authority to add fluoride to public water supplies. It recommends the introduction of any legislation which may be necessary to enable local authorities to discharge this function.

The amendments which are down in my name suggest that the Minister should carry out that recommendation of the Council and should make this Bill a permissive rather than a mandatory measure. The Bill as it stands will, when it is passed by the Oireachtas and when the regulations which the Minister is required to make under it have been made, require local authorities to add fluorine to water whether they want to do it or not. It will force this scheme down the necks of the local authorities and down the throats of the people who drink water supplied by the local authorities.

We indicated to the Minister on the Second Reading of the Bill that because of the weightly considerations involved, because of the weight of the Fluorine Consultative Council's report, that we were prepared to accept the Bill, even though many of us on these benches, and I daresay on the Fianna Fáil benches as well, are not enamoured of the idea of tampering with water supplies for this purpose, if the Minister on his part would meet us by making the Bill permissive rather than mandatory. It is to that end that these amendments have been put down.

Mr. MacEntee

I think the principle to which these amendments seek to give effect was argued at length on the Second Reading of the Bill and I would suggest that we should accept the decision of the House on the Second Reading as covering these amendments. However, if that is not acceded to I would like to say that in my view Deputy O'Higgins has misinterpreted the purport of paragraph 41 of the Consultative Council's report, because what the Council does say is this:

The Council is in doubt as to whether local authorities have the necessary statutory authority to add fluoride to public water supplies.

That does not say that local authorities are to be given permission to do so if they so desire. It merely says that, whether they want to do so or not, as the law stands at the moment they may not have the authority to do so. They may not have the authority to instal the plant; they may not have the authority to expend money on the plant or to incur the expense of operating it. That is the real significance of the first part of paragraph 41.

The Council in its report logically goes on to recommend: "the introduction of any legislation which may be necessary to enable local authorities to discharge this function." This Bill gives effect to that recommendation because it does enable the local authorities to discharge that function when they are required by the Minister for Health to do so.

Again, paragraph 41 is to be construed in conjunction with paragraph 38. Paragraph 38 reads:

Having considered all the information available to it on the relationship between fluorine and dental decay the Council is satisfied that an increased intake of fluorine will reduce the incidence of dental caries and that it is desirable to provide for such an increased intake. The Council is further satisfied that the increased intake of fluorine can best be provided by the fluoridation of public water supplies to the level of 1.0 part per million F. In so recommending the Council is aware that not quite 50% of the community would thereby benefit at present even if all public piped water supplies in the country were fluoridated but the percentage will increase according as public piped water supplies are extended.

There is a specific recommendation that the piped public water supplies should be fluoridated. What would be the use of making that recommendation to the Minister if he did not take steps to make it effective? The Consultative Council which was appointed by my predecessor to advise him on this matter gave a great deal of thought and consideration to the information which was available to them from a great number of sources. Having studied this, they came forward with that recommendation.

Surely they did not assume that their recommendation would be rendered nugatory by the action of an association and of people who are opposed to the general principle of fluoridation, who would be able to go around every local authority with the sort of misrepresentation that we listened to last day from Deputy Ryan——

Mr. Ryan

Wait until I deal with the Minister.

Mr. MacEntee

——and persuade them to disregard the recommendations, not only of this committee but of every other authoritative body that has been set up to investigate the problem?

Mr. M.J. O'Higgins

Nonsense.

An Leas-Cheann Comhairle

Order.

Mr. MacEntee

These bodies ranged from the committee of experts which was set up by the World Health Organisation, to the body which was set up by the New Zealand Government and the Council which was set up by my predecessor. These were all bodies competent to investigate the matter. They heard evidence at great length. They sat for months. In many cases their inquiries extended over years and, as a result of the painstaking investigations which they carried out, they recommended that for the prevention of dental caries among the young the level of fluorine in piped water supplies should be brought up to that of one part per million parts of water.

As I say, that recommendation was based upon exhaustive investigations by competent people. As a result of the study of the reports of such bodies and of the evidence which the Council themselves heard on the matter, they made this recommendation. In making it, surely they did not want to have this proposal, which they regarded as of great importance from the point of view of the general health of the community, to be made the shuttlecock at a half hour's meeting or even a whole night's meeting of a local authority, where the sort of arguments we listened to from Deputy Ryan on the Second Stage would be passed back and forward with no person really understanding, indeed with the majority of people not understanding, what all the bother was about?

If we were to accept that interpretation of what the Council had in mind when they made this recommendation it would, I think, be a reflection upon the competency of the Council to investigate a matter of this sort because, on the grounds upon which this is sought to be left to the decision of every local authority in the country, we would not have appointed the Council at all. The Minister for Health could have asked that every local authority would consider this matter at a particular meeting on a particular night and devote an hour, an hour and a half, or two hours to a study of the whole thing and that it would stand or fall by the decision then taken, having listened to people like Deputy Ryan who make these flamboyant, completely irresponsible speeches.

Mr. Ryan

Be good. Do not play to the Gallery.

Mr. MacEntee

As I said, it would be a reflection on the Council to leave a decision as to whether or not their recommendations were to be made effective to a short meeting at which, perhaps, there would be a mass of misrepresentation. Members of a local authority are elected for quite a different purpose—I should not say "for quite a different purpose", but on quite a different basis, as good citizens knowing how public affairs should be run and administered but, in the mass, knowing very little about abstruse scientific problems. This is a highly scientific and complicated problem and the proposal now before the House is that, in effect, we should declare that this Fluorine Consultative Council did not know what they were talking about and, though they made this recommendation, that the final word must rest with the county council or health authority acting for its own particular area.

Let us see what qualifications the Consultative Council had to advise the Government and the Minister on this. The members of the Council consisted of the City Engineer of Dublin, the Assistant Chief Engineering Adviser of the Department of Local Government, the Lecturer in Dental Surgery of the Royal College of Surgeons in Ireland, the Deputy City Medical Officer of Health for Dublin, a principal officer from the Department of Health, Dr. J.A. Drum, research chemist, who has conducted investigations into fluorine in water supplies in Ireland under the auspices of the Medical Research Council; the Professor of Dental Surgery, University College, Dublin; Mr. M.G. Durcan, member of the Pharmaceutical Society who happened to be a member of Ballina Urban District Council; the Lecturer in Dental Pathology, University College, Cork; the Lecturer in Dental Surgery in Trinity College, Dublin; the chairman of the Westmeath County Council, the Senior Geologist, Geological Survey Office of the Department of Industry and Commerce; the Dental Adviser of the Department of Health, the Waterford City Medical Officer, the Dublin Assistant City and County Manager, the Superintending Senior Research Officer, Veterinary Research Laboratory of the Department of Agriculture, a senior medical inspector of the Department of Health, and an officer of the Department of Health appointed as secretary to the Council.

These people, at least, came to their work fortified with prior knowledge of what had been done elsewhere, knowledge of the problem that had to be dealt with and, of course, with the professional qualifications to consider it. As a matter of fact some of them, as I have mentioned, were members of local authorities—the chairman of Westmeath County Council and a member of Ballina Urban Council who, I assume, were put on the Council because they would be able to represent to its professional members the difficulties which might have to be overcome.

Mr. M.J. O'Higgins

We are not disputing their qualifications.

Mr. MacEntee

The decision of the Council was that piped water supplies should be fluoridated and, with the exception of that small minority of persons who had administrative experience or who had experience as members of local authorities, the great majority of the Council appointed by my predecessor had professional qualifications enabling them to investigate this matter and come to a conclusion on it.

Mr. M.J. O'Higgins

They were excellent appointments. We are agreed on that.

Mr. MacEntee

And the recommendations were equally excellent. I gather we are agreed on that. The only question remaining is whether these excellent recommendations of theirs are to be made effective or whether the whole thing is to be thrown into the melting pot and disposed of at a meeting of voluntary servants of the public who represent the people in their area but who are not chosen to determine and decide upon an issue of this sort. It is a question of whether we are going to allow this recommendation, which all of us who studied this matter know is of great importance from the point of view of the dental health and, aye, the general health of the community, whether we are going to leave that recommendation to the mercy of a decision, perhaps a snap decision, by a local authority.

I suggest that is merely a way of getting out of our responsibilities. This Council was set up by the Minister for Health to consider a problem vital to the health of the community. They having reported, if the Minister feels he is bound to accept their recommendation to fluoridate the piped public water supplies, then, in my opinion, he is bound to come here and ask the Oireachtas to give to him the authority to make that recommendation effective. It will not be made effective if we ourselves decide that the Bill will be permissive and not mandatory upon the local authority. For that reason I would ask the House to reject these amendments.

Mr. M.J. O'Higgins

I should like to know who are these ignorant councillors to which the Minister refers. Do Deputy Séan Brady, Deputy Phil Brady and Deputy P.J. Burke suddenly become endowed with all sorts of knowledge because they happen to sit here instead of sitting in the local authority to which they were also elected? I see sitting behind the Minister six or seven members of local authorities. Is the Minister going to call these men, on whose assistance he is relying now to make this Bill mandatory, is he going to call them a lot of ignoramuses——

Mr. MacEntee

I never said that.

Mr. M.J. O'Higgins

——who are not capable of discussing this or taking a decision if they consider it at local authority or health authority level? We have Deputy Phil Brady, Deputy Brennan from Wicklow, Deputy P.J. Burke, Deputy Gogan, Deputy Healy and Deputy Davern, all members of local authorities. Are these men not capable of coming to a decision at their own local authorities? Are they not capable of hearing the arguments for and against fluoridation of water in their local authorities and making up their minds about it? Are they not capable, as members of local authorities presumably in touch with those they represent, of ascertaining the views and feelings of the people they represent; and with those views and feelings are they not capable of coming to a decision on what the Minister describes as a highly complicated question?

These men are not ignoramuses. I would hate to witness the scene at a Fianna Fáil meeting if the Minister for Health came along and made the kind of speech he has made here about members of local authorities. We have had another coming in to listen since the Minister sat down, so he should not make that kind of speech again. Deputy Loughman's particular local authority was one of the local authorities that considered this question and decided to recommend to the Minister that he should not proceed with this Bill. The local authorities are well able to consider this matter, under stand the pros and cons of the argument and give their recommendations to the Minister.

I do not want to deny the Minister any debating point he thinks he may have arising out of the Report of the Consultative Council. We disagree as to the meaning of the recemmendations in paragraph 41 of the Report. I do not mind whether the Minister is right or I am right. I say that the Council asked the Minister to bring in enabling legislation; the Minister says they did not, that they asked him to bring in mandatory legislation. I do not mind who is right. I think, quite apart from the particular wording or phrasing of any recommendation in the Consultative Council's Report, there are very weighty arguments which were put to the Minister across the floor of this House as to why he should not bring in a mandatory measure.

The Minister says that every competent authority who considered this matter decided in favour of fluoridation. I do not believe that is so. I think the Minister is making altogether too sweeping a statement when he says that. Surely it is known to the Minister—at least it should be known to him since the discussion on the Second Reading here—that there is a very definite controversy in practically every country in the world in which this question was considered. There are those who argue for it and those who argue against it. There is a difference of opinion among the medical authorities. The experts differ as to the value of a scheme of fluoridation of water, on the one hand, and the harmful effects which such a scheme might have, on the other. There is no doubt at all, despite a reference the Minister made on the Second Reading, that this whole thing is still at an experimental stage. Some of the communities which accepted the idea some years ago have since rejected it. They have had second thoughts on it. There are valid arguments against it.

In that situation where there are at least valid arguments—and the Minister cannot deny the validity and force of the arguments against the fluoridation of water—in that situation surely it is not right that the Minister should come here and say to those who disagree with his views regarding the value of fluoridation: "It does not matter whether you are right or wrong or how strongly you feel. I am going to have my way. I am going to get the Fianna Fáil Party to come into the division lobbies behind me and force this Bill on you whether you want it or not." That is what the Minister is doing, in face of the certain knowledge—because he has that now—that there are a great number of people in this country who honestly fear the effect of the measure the Minister is proposing, who fear it from the point of view of their own health and the health of their children and those under their charge, who want to honour their obligations in the matter of the dental care of their children without interference or dictation from the Minister or any other Deputy in the Fianna Fáil benches. That is what is at issue here. It does not matter what the precise wording of the Council's report is. Those arguments exist and they are genuine arguments. Those fears exist and they are genuine fears. The Minister is overriding that simply by bringing in a measure to compel local authorities to do this.

I do not want to delay discussion of this amendment but when the Minister says that every competent authority who has looked at that proposal favours it I think I am entitled to draw his attention to the fact that a body of people in America drawn from the medical and dental professions set up an independent board to evaluate the idea of adding fluorine to water in America and they published their findings. At the time this document was published there were about 1,500 people connected with the medical and dental professions in America who subscribed to the statement and to the findings which were published by that Committee.

I think it is worth while for the House to know briefly what these people thought of the scheme for adding fluorine to the water. I am quoting from the statement by the ad hoc medical-dental committee which was set up on the evaluation of fluoridation and which was published, I think, in February, 1957. They said:

We, the undersigned, are opposed to the fluoridation of public water supplies. As members of the medical, dental and related public health professions, we are as concerned as anyone over the prevalence of teeth decay, and as anxious that it be prevented; but each of us, for some or all of the reasons set forth here and discussed more fully in the appended memorandum believes that fluoridation of public water supplies is not a proper means of attempting such prevention.

1. Positive proofs of the safety of fluoridation are required. None has been offered.

2. The so-called therapeutic concentration of fluoride, arbitrarily established at 1 ppm, in drinking water, is in the toxic range.

3. Dental fluorosis, the first obvious symptom of chronic fluoride toxicity in children is an inevitable result of fluoridation. The evidence reveals that large numbers of the population may be afflicted, and with varying degrees of damage.

4. The determination of whether damage resulting from dental fluorosis is "objectionable" is a matter for the person whose teeth are affected, and not for the arbitrary assertion of public officials.

5. The conceivable rôle of fluoride as an insidious factor in chronic disease has been evaded by the proponents. A substantial amount of evidence indicates such a possibility. Properly planned long term studies are required to determine the possible comprehensive association of fluoride with chronic disease.

6. Fluoridation imposes an extraordinary risk on certain individuals who by reasons of occupation, environmental circumstances, state of health, dietary habits, etc., are already exposed to a relatively high intake of fluoride.

7. Fluoridation is compulsory mass medication without precedent. Mass therapy cannot ignore the possibility of "mass" side reactions.

8. The function of a public water supply is to provide pure, safe water for everybody, not to serve as a vehicle for drugs.

9. The rôle and efficiency of fluoride in dental caries reduction is a matter of active controversy; whatever the outcome, there are less hazardous and more efficient ways of obtaining such benefits as fluoride may offer than by putting it into the public water supply.

I think every one of those points raised in that statement published in 1957 or 1958 is as valid today as it was then.

Mr. MacEntee

And they were not valid then. That is the answer.

Mr. M.J. O'Higgins

We can examine that at as great a length as the Minister desires. I believe that they were valid then and that they are valid now. Quite apart from the nine points mentioned there, I believe there is another argument mentioned only incidentally in one of the points. That is the ethical argument, that neither the Minister nor anyone else has the right to impose medication on people whether they want it or not. That is what the Minister is doing if he forces this Bill through the House on a mandatory basis as he is doing.

There was a great deal of delay in introducing this Bill and I gave the Minister credit for delaying it because I assumed that he wanted to acquaint himself perfectly with the subject and evaluate the arguments, pro and con. The opening of the Second Reading discussion was prior to the local elections last June and I asked the Minister then: why not test the views of the people and find out by means of the local elections—or by referendum held in conjunction with the local elections—what the ordinary people who will be affected by this Bill think about it, whether they are prepared to allow themselves to be made guinea pigs and have medicine forced down their throats, whether they want it or not? If the Minister wants to act in that way he can do so, because he has the power and the numbers behind him to force this Bill through the Oireachtas, but I think he will find that, even from the political point of view, it is not wise for any Minister in this country to act in that way.

Mr. Loughman

I wish to correct one statement made by Deputy O'Higgins. I am not a member of any public body which passed a resolution concerning fluoridation of water. The only public body of which I am a member is Clonmel Corporation. I must confess that Tipperary Urban Council sent me a resolution asking me to vote against this matter and I wrote stating that I was going to support the measure and pointing out the reasons for doing so. They had attacked it on the two or three grounds running through all the speeches, compulsory medication — compulsory poisoning, practically—of the people, no proper control of the quantity any person would take.

I wrote to them expressing my views and since then I have heard nothing from the Urban District Council of Tipperary. I am sure that if they were serious in the examination of the measure before condemning it they would have communicated with me again. In fact, I had to point out to them that I felt the Tipperary Urban Council was not a competent body to express an opinion on this question. I still believe that, as the Minister said, public bodies are not the proper people to decide whether or not this particular treatment should be given generally. I told the members of Clonmel Corporation that I did not feel they were competent to judge in this particular matter and I could apply the same arguments to the members of Tipperary Urban Council for whom I have a great respect but I believe they were led away by strange stories they heard or read without giving any particular thought to this matter.

On the Second Reading I heard it said that this was compulsory medication. There has been compulsory medication for quite a long time and I want to point out that I lived in the county Deputy Esmonde represents where there was tremendous opposition to compulsory vaccination which I regard as compulsory medication.

Mr. M.J. O'Higgins

Was not that against an infectious or contagious disease?

Mr. Loughman

But it is compulsory medication just the same.

Mr. M.J. O'Higgins

There is a vast distinction.

Mr. Loughman

Perhaps there is, but it is still the same thing. I pointed out to Deputy Ryan on that occasion that we did put chlorine into the water for the purpose for purification and in fact I met people who wanted to use iodine instead of chlorine for other reasons. We have been doing these things for the purpose of giving people natural drinking water free from very many impurities. I queried Deputy Ryan on the question of pure water. I do not want to go into the matter from the scientific point of view; even distilled water to me is not entirely pure.

Pure water means something entirely different. We regard pure drinking water as water which will not harm the individual. I think the Minister is adopting a very wise course in view of the advice he has had from competent experts to save people from the damage and expense involved in dental caries. Practically every child now suffers one way or another from his teeth. If the present situation continues, the number requiring false teeth will keep increasing. I hope the Minister will succeed in benefiting people by this slight addition of fluorine to public water supplies. Deputy Ryan called it rat poison. It is sickening to have to listen to that kind of argument in a deliberative assembly. No Deputy should seek to suggest that the Minister and the House want to give the people rat poison. Surely there are other arguments which could be advanced if the Deputy wishes to resist the passage of this legislation. From a logical angle, he could have dealt with the Bill as one which seeks to benefit the people. I support the Bill one hundred per cent.

Mr. T.F. O'Higgins

I should like to repeat to some extent the observations I made on the Second Reading. When I was Minister for Health I set up this Consultative Council. As the Minister has said, it was a body composed of persons of knowledge and experience who would consider this vexed question of fluoridation very fully. I have little doubt that the Council considered the various views advanced for and against. With certain exceptions, certain reservations, the Council recommended fluoridation of public water supplies. Personally, I would be impressed by their recommendation but I read the recommendation—this is something which just cannot be shrugged off as of no importance—as being in favour of the amendment now proposed. I cannot find any other meaning in paragraph 41 other than that they were satisfied the proper course to adopt was to enable local authorities, which desired to do so, to fluoridate public water supplies. The Minister says that is not the meaning.

I should have thought that we had reached a stage now in which these reports are common form. There was a member of the Department acting as Secretary. Presumably he was charged with the duty of writing the report. In paragraph 41, the report recommends the introduction of any legislation which may be necessary to enable local authorities to discharge this function of fluoridation. That clearly implies that the Council, having considered the views on both sides, having had in mind the reservation of two of its members on ethical grounds, decided that it would recommend, while it favoured fluoridation, that local authorities should be entitled to fluoridate public water supplies, if they wished. Had they wanted to go further and do what the Minister says they intended to do, then paragraph 41 would read: "The Council recommends the introduction of legislation making it obligatory on local authorities to fluoridate their public water supply." That would have been the recommendation had the Council had it in mind that the proper course for the Government to adopt was to bring in legislation making it mandatory to fluoridate public water supplies. The Council made no such recommendation.

As the person who set up this Council, I would accept their recommendations in full. Where we differ with the Minister is in the Minister's rejection of the recommendation made by the Council. The Minister cannot blow hot and cold. He has praised the personnel. He has said they were a well-appointed body, well fitted to deal with this matter. Nevertheless, on this pivotal point in their report, he turns the recommendation aside and seeks to do something the Council never had in mind; he seeks to bring in legislation making it mandatory on all local authorities to add fluorine to their water supplies. This is dangerous ground and I urge on the Minister to take care where he is going.

It is very easy to have a surfeit of bureaucracy. I fear that is what we are getting here. I fear the Minister is being told by his advisers: "Do not bother about enabling legislation. A neater and better way to do it is to make it a statutory obligation on local authorities to fluoridate". Of course, that is neater. Of course, it is simpler. The Minister can press a button and everybody must do what he is told. But the Minister is acting contrary to a body of public spirited citizens who also advised in this matter.

This is an exercise in bureaucracy to which I do not subscribe. It is wrong. There are people who have strong feelings in this matter. I think they are wrong. I accept the recommendation here. But these people have strong feelings and it is ordinary elementary justice that such views and feelings should not be disregarded. If fluoridation is a good thing, we need not go further than enabling local authorities to fluoridate if they wish.

Deputy Loughman referred to compulsion under certain other statutes. That is an entirely different thing. There are diseases which endanger society. If smallpox broke out there could be an enormous social problem involving the welfare of the community. Because of that it is the law that every person must subject himself to vaccination. That is a different problem. There is no analogy. This is something new. It is something about which people have strong feelings, so strong that the Government of which I was a member authorised me to have the matter examined by a body of experts. That body recommended —dubitante in the case of two of its members——

Mr. MacEntee

That is not so.

Mr. T.F. O'Higgins

——in favour of fluoridation. As I read the report, they decided against mandatory legislation and recommended in favour of enabling legislation only. I would urge the Minister that the point of view we express here—it is the point of view expressed by the Council—is eminently reasonable and we should, therefore, go no further than giving power to local authorities to fluoridate public water supplies if they so wish.

Mr. MacEntee

I want to deal first with the point raised by Deputy Michael O'Higgins that there was a strong ethical objection to the proposal contained in the recommendation of the consultative council. My predecessor, Deputy T.F. O'Higgins, to some extent faintly echoed that suggestion when he said that two members of the Council had signed the report doubtfully. That does not happen to be true. If the Deputy would look at their signatures he would see the reservations they have with regard to the details of paragraph 37 and if he then turns to paragraph 37 itself he will see what they had in mind. The Council carefully considered the matter and carefully considered the advice sought and the report goes on to say:

the Council is satisfied that there is no ethical objection to the fluoridation of water supplies within the margin of safety recommended in this report.

These two lay men were not going to challenge the authoritative advice received. Their objection was that they were not bound by their terms of reference to consider that aspect of the matter. They felt that in doing so they would be going outside their terms of reference. If their objection was that in fact the practice would be unethical then they would not have signed the report. They would have signed a minority report to the effect that it was unethical.

Mr. T.F. O'Higgins

The Minister will not regard it as discourtesy of me if I leave the House for a few minutes?

Mr. MacEntee

No. The next point I would like to deal with has regard to what the Council had in mind when they made the recommendation contained in paragraph 41. Let us read that recommendation again:

The Council is in doubt as to whether local authorities have the necessary statutory authority to add fluorine to public water supplies.

As I have said the doubt they had was as to whether it was within the power of local authorities, acting as sanitary authorities, to add fluorine. Because this is a health measure, local authorities, acting as sanitary authorities, might not have the power to operate this health measure. Remember that they are acting as agents of the Minister for Health and the whole point was whether they had the necessary statutory authority to carry out, as sanitary authorities and normally responsible to the Minister for Local Government, the directions of the Minister for Health. That is the difficulty which the members of the Council had in mind.

Mr. M.J. O'Higgins

I do not want to cast doubt on what the Minister is saying but we must appreciate that he is giving us his own view on what the Council had in mind.

Mr. MacEntee

I agree. This is a question of the proper construction of the paragraph. Having said that I go on and take the next sentence which says:

the Council recommends the introduction of any legislation necessary to discharge this function.

Deputy Michael O'Higgins and Deputy Tom O'Higgins have argued that what the Council intended was that permissive legislation should be introduced to enable local authorities to fluoridate water if they so desired. In that connection the first thing we have to bear in mind is that this report was prepared by a body of men who numbered amongst them persons who have experience in drafting memoranda, minutes, and reports. There were officers of my Department and officers of the Department of Local Government and other members of the Council who were equally alive to the fact that a recommendation should be carefully drafted.

In his opening remarks in support of the amendment Deputy Tom O'Higgins said that what the second sentence means was this:

It recommends the introduction of any legislation which may be necessary to enable local authorities

Then the Deputy interpolated:

who desire to do so to discharge this function.

I think that if the Council had intended that this question of whether to fluoridate or not to fluoridate should be left to the sole discretion of the local authority they would have written into the second sentence of paragraph 41 some phrase which would have made it quite clear that the statutory authority was merely to enable those local authorities who desire to do so to fluoridate the water supply. But they did not write into that sentence the phrase:

"Those who desire to do so."

They left it in a form from which it is quite clear that any legislation that might be passed should clear up all doubt as to whether the local authorities, acting as the sanitary authority, have power to act on the directions of the Minister for Health and fluoridate the water supply. That was the sole purpose they had in mind when they made that recommendation. I submit again, that if they had wanted to make this legislation permissive in the sense in which it had been argued from the other side of the House they would have made that quite clear in the phraseology they used in drafting paragraph 41.

For that reason I would ask the Dáil to reject these amendments. I do not want to go over all the ground we covered on the Second Reading of the Bill for that would waste the time of the House, but may I say that Deputy Michael O'Higgins, when he read a document which he said had the authority of 1,500 dentists and doctors in America, forgot that there are approximately 216,000 physicians and 96,000 dentists in that country who are represented by dental and other professional associations which have very strongly recommended that piped public supplies of water be fluoridated.

Of course you will always get a minority of people opposed to any proposal that is put up; it is always easy to get minorities opposed to many things. Nobody wants to override the rights of minorities, but when you have a minority opposing some public recommendation merely because they have strong objections, which in so far as certain individuals are concerned— and I do not want Deputy Ryan to misrepresent what I am about to say; he is quite capable of doing that—are founded wholly on prejudice.

Mr. Ryan

If the Minister makes what is he about to say quite clear he will not be misrepresented.

Mr. MacEntee

I am making myself very clear. A minority has an objection here but I suggest their objection is not well founded. Their personal feelings, their personal objections may be very strong, but the foundation upon which they base it seems to be very weak. After all, the community also has a duty to itself and to the children of the community. When, therefore, there is a process which, after most exhaustive investigation, has been recommended to us by the highest scientific authorities as being for the public good, surely we cannot deny the children of the community this protection against a disease which is rampant among us and which, apart from the suffering and inconvenience it causes is, by the unanimous opinion of the medical profession, a source of general ill-health and, consequently, of economic loss to the individual and the community.

The net issue is; would we be justified, having regard to the strong recommendations we have received, in depriving our children of the protection which a fluoridated public water supply would give them, even in face of objections from certain individuals in the country? Are we entitled to let the strong feelings of individuals, having regard to the fact that those feelings are not well-founded, override the good of the community as a whole? I think we are not. In a matter of this sort, the community must decide whether it is going to accept this protection.

Mr. M.J. O'Higgins

The community are not being allowed to decide. Who are the community?

Mr. MacEntee

Precisely.

Mr. M.J. O'Higgins

What about a referendum?

Mr. MacEntee

When I speak of the community I refer to the nation as a whole. It is here in Dáil Éireann that the community of the nation is represented. Here we have the leisure and the time to discuss matters like this is a way in which it cannot be discussed at any local level——

Mr. M.J. O'Higgins

Except in a referendum.

Mr. MacEntee

The people sent us here to discuss among other matters, policies and measures for the good of the general health of the community. They do not send representatives to the local authorities to discuss and determine complicated questions of public health policy. They have not been allowed to decide such questions in the past. For instance, when the Government decided many years ago that a local authority medical service should be set up, and when the members of the local authorities very strongly objected to that service and, indeed, refused to appoint county medical officers of health, the Government of the day, of which some Deputies of the present Opposition were members, had no hesitation in compelling the local authorities to establish these posts and to make these appointments. It was the Government of Cumann na nGaedheal.

Mr. M.J. O'Higgins

The Minister might as well talk about food subsidies. This has nothing to do with the Bill we are discussing.

Mr. MacEntee

It is precisely the same thing. These officers who were appointed to establish and operate the county medical services were given very wide powers indeed. They were given powers of entry, powers to vaccinate, to treat people against their will——

Mr. M.J. O'Higgins

Would the Minister give some instances?

Mr. MacEntee

And the Government then were urged——

Mr. M.J. O'Higgins

By Fianna Fáil?

Mr. MacEntee

Not so. The Government then were urged not to operate the County Medical Services.

Mr. M.J. O'Higgins

Who urged them?

Mr. MacEntee

Perhaps I used the wrong word. We did not, because a strange thing is that there were people of all Parties who took up a non-co-operative attitude on the matter and opposed the policy with regard to these services of the then Minister for Local Government and Public Health.

What I am arguing now is that ill-informed opposition to health proposals is not unusual in the history of the development of medical services in this or any other State. It has happened very often. Therefore when you have an issue which can be easily and readily misrepresented it is wise to have it dealt with and decided by those who have the leisure to discuss it; who have opportunities for making themselves acquainted with all sides of the proposal and who can, I hope, deliberate upon it calmly. That is why I was saying that however estimable the members of local authorities are, they have not the time to consider matters like this. They are unpaid; they have no allowance for expensive studies; they have to take time off from their own business; they have very little leisure to devote to the study of such a very complex matter and, therefore —I say it again; I make no apology—they are not competent to discuss a matter of this sort in the detailed way in which it is discussed and examined by these expert committees established to consider the merits or demerits of proposals of this sort. In every case where there has been an authoritative official body set up to consider the problem of fluoridation they have without exception recommended that it be carried out.

I referred on the last occasion to the recommendations of the committee of experts. I have referred today to the findings of our own Consultative Council. There is the New Zealand Report on the matter. I have here a note. I just happen to have it. It is in the Netherlands News of last August. Most Deputies, I am sure, receive this bulletin and I will quote from it. There is a paragraph in it headed “Fluoride Fight against Dental Decay”.

The Netherlands Minister for Social Affairs and Public Health has announced that a decree is shortly to be published in the State's interest authorising the addition of fluoride to drinking water to fight dental decay.

Mr. T.F. O'Higgins

Is the word used there "authorising"?

Mr. MacEntee

It does not matter. He would not authorise it if he were not convinced that the measure should be adopted. He would not authorise it if he were not convinced as to the efficacy of fluoridation to prevent dental caries. I do not say to cure it but to prevent it. We have the report of the British Ministry of Health on the same subject.

Mr. M.J. O'Higgins

Surely the Minister sees that it is not a question of the merits in this amendment?

Mr. MacEntee

Deputy Michael O'Higgins is, I think, perhaps the most expert debater in this Dáil.

Mr. M.J. O'Higgins

Thanks.

Mr. MacEntee

While he says now that it is not a question of the merits that many people feel that this proposal should be adopted, that water should be fluoridated, and so on, when he was speaking to his amendment he went on to quote a statement issued on behalf of, apparently, an American organisation which numbers 1,500 doctors and dentists. As against this may I point out there are over 300,000 medical men and dentists in the United States of America who support fluoridation. I am glad to have it on record that it is not on the merits——

Mr. M.J. O'Higgins

In this amendment.

Mr. MacEntee

——that we do not differ, apparently, on the merits of this proposal, that Deputy Michael O'Higgins and my predecessor, Deputy Thomas O'Higgins, and myself are all at one so far as the merits are concerned.

Mr. M.J. O'Higgins

That is not so. I would hate the Minister to have it on his conscience that he misrepresented me. I am simply saying that so far as this amendment goes it is not a question of the merits of fluoridation.

Mr. MacEntee

If so, why did the Deputy drag in the question of merits?

Mr. M.J. O'Higgins

I am prepared to answer the Minister if he will allow me. He has asked me a fair question. The reason I gave the quotation was simply that the Minister had said in effect that there was no-one of any competence opposed to the idea of fluoridation. I quoted that to show that the Minister's statement was, as I said, too sweeping.

Mr. MacEntee

Oh. Well, I still say there is no-one of comparable competence to those who have been selected by the various Governments to investigate and advise upon this matter. So, we will put it this way, that Deputy O'Higgins has quoted 1,500 people of lesser competence and I have quoted the opinions of the most competent persons in this matter.

But, I was going on to quote from the Report of the United Kingdom Mission on The Fluoridation of Domestic Water Supplies in North America. Here is what they have said:

Epidemiological studies in America have demonstrated beyond doubt that among children and adults who have been born and brought up in areas where the drinking water contains fluoride at the level of one part per 1,000,000 or more there is much less dental caries than in areas where the water is free from fluoride. Compared with areas where the drinking water contains little or no fluoride—

as is the case, unfortunately, with us—

there is about 60 per cent. less dental caries among children aged 12 to 14 years and about six times as many children have permanent teeth which are free from caries (18 to 29 per cent. compared to about 4 per cent.) A few studies among adults both in England and the United States show that the effect of fluoride persists up to about 40 years of age.

They go on then to recommend in general that they should adopt fluoridation in Great Britain.

The same way with the Report of the Royal Medical Board of Sweden. The overwhelming mass of highly expert professional opinion is in favour of this measure and the only question now that is between us, apparently, is as to whether we should give effect to what I believe to be the real purport of paragraph 41 of the recommendations of the Consultative Council and confer upon the local authorities the necessary statutory power to add fluoride to the public water supplies.

Mr. Ryan

To listen to the Minister one would think that at long last we had a panacea, that we had the cure for the common cold, for headache, for stomach pains, wind, and dirty tongues. We do not dispute that fluoridation will improve the teeth of children, but it will not prevent dental decay. It will delay it and it is all wrong that this House should be asked to sit in judgment on a matter such as this. The truth is that the Minister does not want the House to criticise him at all. He does not want any debate here. He wants us to accept his opinion and the opinion of some people who are in favour of fluoridation without allowing us to examine the results of valid tests conducted by expert people which show the dangerous toxic effects which fluoridation has on people.

From what the Minister has said it is quite clear there are two points of view on this matter. Therefore we of Fine Gael say it is not right that one man, or a Government or a Party supporting a Government should say to the Irish people; "You are going to take this poisonous substance in the water whether you want it or not", and that is precisely what the Minister is doing.

It amounts to this: a number of persons who were appointed on a council have read a number of reviews on this matter of dental decay and fluoridation and the Minister says: "I am going to present to the Irish people a bottle of medicine containing sodium fluoride and they can drink it in any quantity they like. One person can drink ten gallons and another can drink an egg cup full of it. This will cure dental caries and it will have precisely the same effect whether you drink ten gallons of it or an egg cup full." That to my mind is medical lunacy.

Imagine a doctor coming into a house and without examining the people there leaving a bottle of medicine and saying: "You can drink that in any way you like. Little Johnny can swallow the whole lot and mammy can drink the dregs and you will be free from stomach pain ever after." If that be possible, I cannot understand why so many expert people throughout the length and breadth of the world have had second thoughts on this matter and conducted tests over several years past which indicate that there are dangers in relation to the use of fluoridated water supplies. It is not true to say that one part per million is safe, because some animals have been treated with one part per million and they have died sooner than expected, and others developed ailments which were not developed in similar animals which were not consuming fluoridated water supplies. No matter what the Minister may like to accuse me of, it is clear that some expert opinion is very much against it.

In referring to my speech on the Second Stage the Minister used such phrases as "a jumble of irrelevancies and reckless rhetoric." He said that my speech was demagogic and stupid. I was accused of trading upon ignorance and conscience. I was supposed to have recited a farrago of nonsense. These are not the kind of remarks which ought to come from some person who is asking the Irish people to consider a serious medical question, and I do not intend to compete with the Minister on that level. He did say earlier that this question could not be discussed at any lower level. I can only take it he was referring to his own level of conducting a debate. This matter is far too serious for that kind of thing.

The Minister has deliberately and unfairly referred to the report of a Committee of the World Health Organisation as evidence that the World Health Organisation supported his theories. It is clearly printed on the front of this report, available through the Minister's generosity in our own Library, that the views in it are not necessarily representative of the decisions or the stated policy of the World Health Organisation.

Mr. MacEntee

That is all——

Mr. Ryan

The Minister says that is all—some rude word which I will not repeat. Either it means what it says or it does not. I am quite sure that a body like the World Health Organisation would not print that statement unless it meant what it said. The Minister has tried to bowl us over by quoting to us the eminent men who sat on the Consultative Council. They are all eminent men in their own field. I do not accept their prescriptions for myself or for my children or for any Irish man, woman or child whom they have not medically examined. That is the basis of my objection.

It may be said that it is only one in 100,000 who may react unfavourably, who may be allergic to sodium fluoride. I think the number of people who react to penicillin or acromycin, other dangerous toxic drugs, is also infinitesimally small but the fact is these drugs are not given to people except under examination and when a doctor is watching carefully all the time. Here we are being asked to accept a poisonous substance without this minute medical care. Admittedly it is a very small and insignificant amount that is being put into the water supply but one of the aspects of this which should give us food for thought is that as we get older our capacity to excrete the poisonous substance from our system declines and after a period of 40 or 50 years a person may have a considerable and dangerous amount of sodium fluoride in his system.

An Leas-Cheann Comhairle

I must ask the Deputy to relate his remarks to the amendment which concerns the question of compulsion or choice in regard to local authorities.

Mr. Ryan

I am relating them in the same way as the Minister did. This matter is vital and should be brought down nearer the people and not be thrown at them, in their ignorance and indifference, by a Minister in the House, and that is what the Minister is doing.

Mr. Booth

What is the difference between having it done by the local authority and by the central Government?

Mr. Ryan

As far as I am personally concerned, on principle I am against this being done unless there is a supply of pure water available to people in the area which is having a fluoridated water supply.

Mr. Booth

Deputy O'Higgins does not agree.

Mr. Ryan

That may be so but I have a fundamental objection to poison being given to myself and my children by people who have not examined us and do know what effect it will have on us. It is not true for the Minister to say that a minority are trying to prevent a benefit being conferred on the public. I do not care a hoot how many people take sodium chloride. If the Minister took a dessert spoonful of it many people would be glad but, if a desert spoonful is lethal, I should not be glad because the Minister has his uses. However, I am dead against anybody compelling me and my children to take it.

I think it is against the interests of all the young children in Ireland that we should pass a compulsory measure telling parents that their children should drink fluoridated water when there is a cheaper, reasonably efficient, alternative system available under which they can provide fluorine for their children in tablet form. I believe that if we could spread the responsibility of thinking on this matter we should get somewhere and that is why I am in favour of the amendment tabled by Deputy O'Higgins.

Progress reported; Committee to sit again.