Correct to fluoridate but...

It is a no-brainer. Fluoride in New Zealand’s water supplies should be "topped up" for the sake of children’s health.

This mineral, found naturally in water anyway, helps protect and strengthen teeth and has little or no side-effects at recommended levels. For relatively modest cost, fluoride saves enormous amounts of pain and suffering as well as dental expenses. It is a marvellous public health measure with a long history of benefits. As is said these days, "the science is well and truly settled".

Yet, vociferous lobby groups and individuals have made a ruckus and have persuaded many councils around New Zealand that fluoride should not be added to water supplies. These people might be genuine in their beliefs about the dangers of and damage from fluoride, about the principle of "mass medication" and about individual and family choice. But the evidence is overwhelming. The community’s need outweigh any countervailing personal rights.

In the case of water, as well, it is possible to procure alternative supplies for drinking, even if at extra cost.

Decisive national action, based on best current knowledge and long "settled science", does not preclude an open mind should significant and credible new research emerge.

Even in the absence of such research, a scientific review took place on behalf of several councils in 2014. It was commissioned by the Prime Minister’s chief science adviser, Sir Peter Gluckman, and the president of the Royal Society of New Zealand and former University of Otago vice-chancellor and preventive medicine specialist, Prof Sir David Skegg.

Claims about increased risks of cancer, musculoskeletal and hormonal disorders and brain development effects were examined by a panel of experts and found to be unsupported by scientific evidence. The only side effect was mild dental fluorosis, not a serious concern, and this was thought to have been caused by swallowing fluoride toothpaste.

Caution is in order, however, about the Government’s announcement on fluoride. It concerns power and who makes the judgements.

Local decision-making and accountability are important for issues that might not be so clearly related to national health or so clearcut. We are collections of smaller communities and we should be wary of central government and experts deciding everything.

While we do agree with the plan for the Director-general of health to decide for fluoride, this Government’s slant towards centralisation needs to be warily watched.

We have had the example where thriving polytechnics in Otago and Southland have had their local power stripped and local links undermined.

We see proposals for more health board amalgamations and less local decision-making. We find the three Acts to replace the Resource Management Act will downgrade local involvement. We note the plans for Three Waters "reform" will see much of the role of councils disappear.

While the central and local balance on each matter needs to be judged individually, caution is sensible. Creating new or expanded central bureaucracies a long way from where the services are delivered can be retrograde.

Take the Waikouaiti water scare. The Dunedin City Council was slow off the mark but recovered to do a good job. In conjunction with health authorities, the local councillors, mayor and staff were close to the action and accountable.

Interestingly, the Government is even skipping health boards as the decision-making bodies on fluoride as proposed in a National Party Bill from 2016. The Government now plans to amend that Bill.

Nonetheless, evidence of benefits is widespread. In New Zealand, the teeth of the 60% of children in fluoridated areas are on average considerably better.

Fluoridation has been listed by the United States Centres for Disease Control and Prevention as one of the 10 great public health achievements of the 20th century.

The time is overdue for all this country’s vulnerable children to benefit from fluoridated water.