By Ken Perrott 24/03/2017 3


I have been in Wellington for the Parliamentary select committee hearings on fluoridation. Well, that was the excuse – I was really there to catch up with my family (always a joy and am amazed at how tall my grandson has become) and to enjoy the great food in Wellington cafes.

Havana Coffee Works in Tory Street, Wellington. Great coffee and chance to see roasting in action. On the site of what was the old Wellington Milk Department in the 1950s.

This time I also set out to acquire some freshly-roasted coffee beans from one if the many roasters in Wellington.

The Havana roaster turned out to be a surprise. Not only are their coffee beans excellent ( I am looking forward to getting home and drinking coffee made with them) – they are based in Tory Street as the site of what used to be the old Milk Department. Some of you may still remember the days when milk was delivered to your house in the middle of the night by a milkman. My Dad was one of those milkmen, and my siblings and I all spent time helping him deliver milk in the dead of night. So that building brought back memories. Even got to walk along Channing street on the way back to my hotel. You wouldn’t know it now but that street was very disreputable in the 50s because of the opium dens in the old houses.

Select Committee Hearings

These were interesting. Submissions were called for on  Health (Fluoridation of Drinking Water) Amendment Bill currently before parliament. This legislation is not about fluoridation itself. It is about how decisions should be made – about the process, not the science. In effect, it proposes transferring decisions from local councils to District Health Boards.

Pressure for the law change came from local councils who were sick to death of the hounding from activists and being forced into making decisions – not about whether to fluoridate or not – but about the science. Activist submitters continued to deluge them with passionately-worded submissions full of scientific claims – councillors with no scientific skills were being forced into making decisions about the science – were the activists correct in their claims that fluoridation causes all the ills known to mankind or should they accept the science presented by the experts. After all, activist submissions could look very sciencey – they were often full of citations to the scientific literature!

True to form the anti-fluoride activists deluged the select committee with submissions which were irrelevant to the bill – very few of them actually suggested changes or showed any evidence they had read the bill. No, they did their usual trick of preaching about the “science” – their claims of harmful effects from fluoridation and that it does nothing for oral health anyway.

It is amazing to hear people make outrageous claims about the scientific literature – claims which make clear they have never bothered to read the source they are citing. I guess they think they can get away with such porkies and misrepresentations because they are talking to politicians. However, my impression was this failed at these hearings – unless submitters raised suggestions about the process they were simply politely thanked and sent away.

So I found it frustrating to hear such lies being peddled about the science (and discussion by the public was not allowed) but confident in the fact the select committee was just humouring these people. Responses from committee members were always about process – not the scientific claims.

My submission

There were only a few submissions which dealt properly with the wording of the bill – the vast majority were just empty anti-fluoride rhetoric. I made a submission as an individual scientist but also as part of the Making Sense of Fluoride (MSoF) team. It was great to catch up with MSoF people who I tend to talk with on-line every day but have not till now met in person.

This was my oral submission:


As Monty Python used to say: “And now for something completely different.”

I support this bill as far as it goes but don’t think it will solve the basic problems without changing the way the science is considered. I want to suggest a change.

The current submissions show the problem. This committee has been inundated with large numbers of written and oral submissions. Many of these are duplicates or form letters. Most are opposed to community water fluoridation and usually make scientific claims – such as fluoride is a neurotoxin, that it causes a high prevalence of dental fluorosis or uses contaminated chemicals.

Submissions often cite scientific articles – some have even attached copies of these articles. This sort of thing can impress the layperson – perhaps some of the members of this committee are impressed? After all, it is easy to fool the ordinary person with scientific claims, citations, documents and publications. Advertisers do it all the time.

But this committee is simply not considering the science. Political committees – parliamentary, local body or District Health Board should not make scientific decisions. They do not have the skills for this. Yet that is what most of these submissions are asking of this committee. It’s what was being asked of local councils and it will be what is asked of DHBs.

Consideration of the science behind community water fluoridation requires people with scientific and health skills. Such people need to check evidence provided, check citations when they are presented, check what the scientific literature actually says (which could be very different to what submitters claim). Proper scientific consideration requires that the claims and cited scientific literature need to be considered intelligently and critically. The wider literature needs to be consulted. Cited claims need following up.

I have attached a couple of documents that do this – these are responses to documents used by several submitter arguing against community water fluoridation.

The current wording this bill requires DHBs to consider the scientific evidence. That just invites opponents of community water fluoridation to inundate DHBs with the sort of submission this committee has received – and local councils have been inundated with. DHBs are no better equipped to deal with this than this committee or local councils.

I suggest a change requiring DHBs to take advice on the scientific evidence from central bodies – the Ministry of Health and the Public Health Advisory Committee. This would transfer responsibility for scientific considerations to central bodies better equipped to do that evaluation.

The Public Health Advisory Committee has a legislated role to consider questions like this and advise the Minister. It is also able to consult interested organisations, experts like the Royal Society and the Prime Minister’s Chief Scientific Advisor who performed the most recent fluoridation review. It can also consult appropriate individuals.

This would not remove the right of lay persons to make submissions about the science – it simply redirects those submissions to a more appropriate body.

I think a change like this should be welcomed by everybody. It removes from DHBs the impossible job of making decisions about the science they are not equipped to make. It provides a proper venue for the science to be considered intelligently and critically. It is a credible and authoritative body for scientific organisations, health organisations, activist groups and the ordinary person who has concerns on this issue – whether for or against community water fluoridation.

After all – if someone has a genuine concern or has evidence they think will stand up to scientific scrutiny why should they want to waste time submitting it to a committee of politicians? Wouldn’t they be far happier knowing they are appealing to people who have the skills to evaluate their concerns properly?

Featured Image:  Midnighttonight / Wikimedia

 

 


3 Responses to “Activist confusion at fluoridation bill hearing (and coffee)”

  • Hello Ken. Congratulations on the submission. I think your suggestion has a lot of merit – especially from the point of view of reducing duplication of the assessment of evidence. I don’t agree, though, with the assertion that DHBs are no better equipped than local bodies to assess scientific evidence or lack skills. Assessing scientific evidence is something done all the time within DHBs as they assess how best to utilise the health dollar. Indeed, from what I have observed there is a strong push for evidence based medicine within DHBs. An example close to home is that the CDHB co-funds my current fellowship which is targeted at translating into practice the best research around acute care.

    • I take your point – and my written submission did argue that staff of the DHBs are more likely to be informed than staff of the councils.

      My oral comment referred to the elected/nominated board members, not the staff. I think the select committee members understood this as we discussed the role of political committees.

      However, without something in the act requiring the elected/nominated board to take advice from more competent bodies, I am afraid these political committees are just as likely to ignore advice from staff as the local councils did.

      In Hamilton councillors rejected advice from the DHB and I think that might be common among councils. However, several councils did commission the Royal Society and the Chief Science Advisor to do a review of the fluoridation science. I think a central body comes across as more credible (and less prone to the local personal animosities).

      I think the decision making by the DHBs will be valuable as they will have better access to local and regional health information than the central MoH will. (Although there is still a fear that DHBs will not properly consider the expenses in a place like Christchurch where capital plant for fluoridation would be extremely expesnive. I think the health committee got that message in the submissions).

      The trouble is that the content of about 90% of submissions on this subject inevitably makes scientific claims, cites the literature, etc., and these should be considered by a competent group – and a central group because those specific claims are about the basic science, not local conditions.

      I like the idea of the Public Health Advisory Committee taking on the task of considering such submissions. On the one hand it removes an impossible and expensive task from councils and DHB committees. On the other hand such a central body might demand better quality from the submitters.

      • Thanks for the clarification Ken. Very well argued.

        Yes, Christchurch has some significant infrastructure expenses at the moment (he says grimacing at the latest rates bill). As with any health intervention, a cost-benefit analysis is important the results of which need to be weighed against competing needs.