WATER FLUORIDATION BILL – Second Reading
A lot of uninformed debate and “truth decay”
that will be exposed and regretted in the future
as it cannot be erased from Hansard!
Let us see who said what!
Original Hansard ⇒HERE
Water Fluoridation Bill 12 March 2008
WATER FLUORIDATION BILL
Second Reading Resumed from 12 February (see page 74),
on motion of Mr Robertson—
[ Mr Langbroek – dentist ]
That the bill be now read a second time.
Mr LANGBROEK (Surfers Paradise—Lib) (12.03 pm):
I stand here today with great pride and conviction. As I address the Water Fluoridation Bill 2008 I am reminded of a favourite quote by John F Kennedy, ‘A man does what he must—in spite of personal consequences, in spite of obstacles and dangers and pressures and that is the basis of all human morality.
’This is the biggest change in dental health measures in Queensland for 40 years. Today I am proud to be a member of this parliament as we pass landmark legislation that will improve the health and wellbeing of all Queenslanders. I say ‘landmark’ because many said this day would never come. They said the oral health of Queenslanders was too entrenched in politics rather than in science and that this government did not have the courage or the conviction to make the tough decision in spite of the undisputed evidence of the health benefits of water fluoridation. Today I am proud to offer my support and that of the Queensland coalition for the Water Fluoridation Bill 2008. As the short title suggests, this bill provides a mandate to boost the health and wellbeing of Queenslanders by adding fluoride to bulk water supplies. It is a contentious issue as many members will attest and one which we have visited a number of times during my tenure as a member of this parliament. Today I am proud because today one of my core policies will take its place in Queensland’s statute books. At a quarter past four on 18 March 2004 I stood up in this chamber as a new member of parliament and addressed Queenslanders for the first time. After a long, exhausting campaign I was fortunate enough to take my place in the Queensland parliament. The people of Surfers Paradise had given me a voice. On that day I used that new-found voice and I spoke about the issues I am passionate about—improving local roads and infrastructure, providing better health services for all Queenslanders and offering better support for families and young people.In my manifesto maiden speech I spoke about the very issue we are debating in this parliament today—four years after I first raised it in this forum. As the first dentist to be elected to state parliament in 70 years—the last one being John Donnelly in the seat of Wynnum from 1935 to 1938—fluoridation was obviously going to be an issue for me. In my professional experience, spanning more than two decades, I am a firm believer in the virtues of water fluoridation as a means of improving oral health. As a health professional I am also aware of the areas where government could be doing better to achieve better clinical outcomes for patients. Fluoridation is one of those areas. I would like to quote my maiden speech. I stated—The argument for fluoridation is very strong. Fluoridation will make our children’s teeth better. We already add vitamins to many everyday items in our diets such as bread and cereal. Why not supplement our water with fluoride? The government is adamant on pursuing its Smart State mantra, yet how smart is it to place our children’s teeth at undue risk by not fluoridating our water? Back then I extended my hand to the then health minister Gordon Nuttall that I would be an ally in securing bipartisan support for water fluoridation in Queensland. Today I am proud to deliver on that promise. For the benefit of members I will share my professional opinion of and experience with fluoride.
Fluoride is a naturally occurring compound – [so is arsenic] found in the ecosystem in elements including water, flora and soil amongst others as well as in some foods. It is a common ingredient in many brands of toothpaste. Fluoride helps protect teeth against decay by providing a barrier against acids produced by sugar and bacteria in the mouth which attack the tooth’s surface. When consumed frequently and in small amounts, fluoride makes teeth far more resistant to decay than without treatment. Adding fluoride to drinking water is one way in which fluoride is consumed. It is the most clinically efficient, cost-effective and socially equitable means of administering fluoride to the population. During my years as a dentist I treated thousands of patients and I have lost count of the number of fillings I have done. Anyone who doubts the veracity of profluoride arguments should spend a day in a dental surgery. Most dentists do not enjoy drilling teeth, especially the teeth of small children and more especially when they have children of their own. Imagine seeing a child in severe cases having to be wheeled away for a general aesthetic so that their teeth can be fixed because they are too young to be compliant in a conscious state. People despise going to the dentist because we are perceived as purveyors of pain. Dentists can repair holes but the most frustrating aspect of the job is fixing problems that may have so easily been stemmed if patients had received the right treatment from the start. When it comes to treating cavities, the right treatment is ensuring the body has the optimal defence against tooth decay. Fluoride underpins this defence. Lifestyle factors such as diet and oral hygiene and inherited susceptibility certainly have a role to play, but mineral supplements delivered via drinking water remain the single most effective way of improving oral health.
12 Mar 2008 Water Fluoridation Bill 741
We have heard a lot about fluoride, certainly over the past few months since the Premier announced that she would introduce fluoride into Queensland’s bulk water supplies to provide 90 per cent of Queenslanders the benefits of fluoride by 2012. The sheer volume of correspondence that I have received, along with all of my parliamentary colleagues, is testament to the untruths and misinformation circulating about fluoridation. A Google search returns many hits to propaganda designed to stir fear in the community about fluoridation. The fervent antifluoridation following is the reason Queenslanders do not enjoy the health benefits of fluoridated water today. This Labor government has been far more concerned with pleasing the electorate with populist politics than making tough decisions for the greater good of this state.
Of some of the anti-fluoridationists’ claims, I was warned fluoride would cause allergies, arthritis, bone fractures, headaches and impotence, among other ailments. The nay-sayers believe that adding fluoride to water supplies increases the risk of cancer and even makes humans taller. As a dentist by profession, I want to make this point:
fluoride is not a poison or pesticide. Fluoride is not a form of mass medication or chemical terrorism. There is no credible scientific evidence to suggest that fluoride has any adverse effect on health. Anyone who doubts that fact should speak to members from Townsville, an area which has been enjoying the health benefits of fluoride since 1964. Townsville, the fourth largest city in Queensland, has been adding fluoride to its main water supply for more than four decades and yet the residents are no worse off than people throughout the rest of the state. In fact, they are better off than most Queenslanders. They have better oral health than the residents of Brisbane.
The Australian Dental Association of Queensland, of which I am a member, found in a study that children in Townsville have up to 45 per cent less tooth decay than their counterparts in Brisbane. The health minister backed this finding in his quotes in a Courier-Mail article on 18 December about how children in Uganda, a developing country, have better oral health than kids in Australia. The Australian Institute of Health and Welfare made the stark contrast with other Organisation for Economic Cooperation and Development—OECD—countries and found that Australian 12-year-olds ranked No. 8 of 44 behind England, Sweden, Denmark, the Netherlands and Uganda. The study also found that half of all Australian six-year-olds have two cavities on average and almost half of all 12-year-olds have cavities in their adult teeth. The statistics are worse in Queensland. Why? Because while children in every other part of Australia have enjoyed the benefits of water fluoridation, the Labor government chose to defer the tough decision in case it affected its electoral chances. I congratulate the Premier on finally acting on fluoridation, albeit belatedly.
The reality is that fluoridation will improve oral health in Queensland. The fact that Queenslanders have the worst teeth in the country can be directly attributed to the fact that we do not have fluoridated water in this state. Every state in Australia fluoridates its bulk water supplies. Every other state in Australia has been adding fluoride to drinking water since the 1960s and seventies—in some cases, more than four decades. Some 90 per cent of New South Wales residents drink fluoridated water, while 77 per cent of Victorians do, 80 per cent in South Australia, 86 per cent in WA, 91 per cent in the Northern Territory and 100 per cent in the Australian Capital Territory. Brisbane is the only capital city in Australia which does not fluoridate water.
As I mentioned, Queenslanders have the worst teeth in Australia despite the fact that the state government spends more money per capita than any other state or territory on dental care. In 2008-09 the government will spend $145 million on oral health, yet the investment is not paying dividends. An inquiry by the Australian Institute of Health and Welfare found that Queensland kids have more decay and up to twice the number of fillings of children in other states. Every year around 2,000 preschoolers are hospitalised for severe tooth decay and gum infections, often involving general anaesthetic as I mentioned earlier.
In Queensland about 80,000 public dental patients are waiting up to seven years for treatment. Projected figures indicate that introducing fluoride into our drinking water will dramatically lower waiting lists and reduce tooth decay by as much as 45 per cent. When one looks at this in dollar terms, it represents a staggering saving. Can I point out though that this will not happen if the downgrading of the public dental sector continues, as we have seen recently in Cairns and Townsville where the school dental service is now only going to do consultations and no treatment. I predict that the morale of dentists, therapists and oral health workers will be diminished. They will be deskilled and will look to leave the Public Service, causing those on waiting lists to continue to languish.
For every dollar spent on fluoridation, up to $80 per person is saved in dental costs. In Queensland this equates to at least $328 million. The amount of fluoride needed to achieve this saving and significantly improve Queensland’s oral health is between 0.6 and 0.9 parts of fluoride per million parts of water. In real terms, that is just one drop of fluoride in a bathtub full of water. The Queensland coalition will support this bill because we are firm believers in preventative health care. This is one of the polarities of the Queensland coalition and the Labor government. We believe that health care is not just about hospitals. Health care delivery begins well before patients present to hospital or take a seat in the dentist’s chair. Adding fluoride to Queensland’s water supply is one preventative health measure which will keep people out of hospital, and I note the health minister’s embracing of preventative measures. He is constantly mentioning preventative measures in relation to diabetes and heart disease. That is admirable and commendable and something that the government should be continuing.
742 Water Fluoridation Bill 12 Mar 2008
Despite the indisputable evidence of the benefits of fluoride, the Labor government has been sitting on its hands for a decade refusing to fluoridate Queensland’s water supplies. It has had a number of opportunities to implement this important preventative health initiative, yet each time it has backed down because it did not have the courage to take it to Queensland voters. The Beattie government offered in-principle support for fluoridation yet not one member of the Labor government ministry had the courage to deliver it. Former Premier Beattie even questioned the science of fluoridation even though his health minister supported it. Even when those opposite had the opportunity to put on record their support for fluoridation in this parliament, most failed to do so.
One of the very first things I did in my first term in parliament was introduce a private member’s bill to add fluoride to Queensland’s water supplies. On 1 September 2004 I brought the Fluoridation of Public Water Supplies Amendment Bill before the House to improve oral health throughout Queensland. Only five per cent of our population drinks fluoridated water in places like Townsville, as I have previously mentioned, as well as in Bamaga, Dalby, Mareeba and Moranbah. These towns have added fluoride to their bulk water supplies. Numerous other places in Queensland have naturally occurring fluoride in their water such as Adavale, Aramac, Barcaldine, Bedourie, Birdsville, Boulia, Cloncurry, Corfield, Julia Creek, Eromanga, Eulo, Gunana, Gilliat, Longreach, Ilfracombe, Jandowae, Karumba, Muttaburra, Thargomindah, Winton, Maxwellton, McKinley, Muckadilla, Quilpie, St George and Tara.
In introducing the Fluoridation of Public Water Supplies Amendment Bill, I wanted to ensure that all Queenslanders had the benefit of fluoridated water. As I have said, adding fluoride to water supplies is the most effective and socially equitable way of ensuring that everyone benefits from fluoridation. The bill would have amended the Fluoridation of Public Water Supplies Act 1963, mandating that all controlling entities of public water supplies add a specified level of fluoride to the water supply. The bill provided an exception for small communities in the same vein that the current bill does. That bill failed. In fact, not only was it defeated spectacularly by 71 to six but I copped a lot of criticism from the current government about my plans to legislate for local councils and to take away their right to have a say on fluoridation. Fast forward a few years and it seems the Bligh government has changed its tune. Not only does it want to quash councils’ rights to decide whether they introduce fluoride to water supplies; it wants to seize control of water assets completely and take the profits with it. It is this kind of politicised self-interest and inconsistency that is hampering this state when it comes to being a national leader in policy development.
Here we have a government that will not support good ideas if it does not think of them first. This is one of the biggest frustrations about being in opposition and something of which I am particularly aware. Water fluoridation is just one initiative that the Queensland coalition has brought before parliament, only to be defeated by those opposite. In 2006 I tried to change the laws to ban ice pipes. That was stymied, but only a few months later, after members opposite had voted against what I proposed, members opposite voted for amendments that were a carbon copy of those that I had proposed earlier and gave themselves a public pat on the back for doing something about tackling Queensland’s ice epidemic. There was no mention of the fact that a few months earlier they had been opposed to such a move.
Water fluoridation is but one policy that this government has plucked from the Queensland coalition’s policy books and plagiarised in this parliament. Another example is smoking in cars. The health minister gave me a royal dressing down when I suggested that we add a clause to the Tobacco and Other Smoking Products Bill—
Mr DEPUTY SPEAKER (Mr O’Brien): Order! The member will return to the subject of the bill.
Mr LANGBROEK: I am just pointing out that in this case with fluoride we have had a reversal of the government’s position. I am simply pointing out a couple of incidents where that has happened.
Mr DEPUTY SPEAKER: And I have asked you to return to the subject of the bill.
Mr LANGBROEK: I note that similar things happened with my private member’s bill about excessive amounts of alcohol. But I note that when the Treasurer’s legislation is introduced I am sure it will be seeking to do exactly that. I am confident the government members will support it then.
The point I am making is that if the government had honourable intentions we could tackle social and health problems much more effectively than we are currently with a divided House. If this government had the ticker, Queenslanders would have been long enjoying the benefits of fluoride and our dental waiting lists would be much better for it. Queenslanders need bipartisan leadership to ensure that we stay on top of the challenges that we face in daily life and in government.
When we last debated fluoride in this House, the Labor members voted against the Liberals’ bill, offering specious arguments for their dissent. They used personal criticism, urban myths and perceived popular opinion as reasons for voting against the bill. I am pleased the members opposite have finally seen sense on this issue.
I make no apologies for the fact that fluoridation has been one of my top priorities as a legislator, as a parent and as a professional dentist. Whilst I acknowledge fluoridation is an emotive issue, I also know that good policy is not always popular policy. In saying that, I think it is important to note that not everyone is against adding fluoride to drinking water. In fact, there is actually more support for
12 Mar 2008 Water Fluoridation Bill 743
fluoridation than there is opposition to it. Water fluoridation is endorsed by the Australian Dental Association, the Australian Medical Association, the National Health and Medical Research Council and the Public Health Association of Australia. Internationally, water fluoridation as a means of improving oral health has the support of the World Health Organisation, the British Medical Association and the Australian Medical Association, to name a few.
The world’s leading health authorities endorse fluoridation. That is because it has real, tangible benefits to those who consume a negligible amount of fluoride in their drinking water. The USA’s Centers for Disease Control and Prevention has endorsed fluoridation as one of the greatest public health achievements of the 20th century. I refer to one of Queensland Health’s own documents and a quote from Professor John Harris of the Centre for Social Ethics and Policy from the University of Manchester who states—
In considering the ethics of fluoridation… We should ask not are we entitled to impose fluoridation on unwilling people but are the unwilling people entitled to impose the risks, damage and costs of failure to fluoridate on the community at large.
In terms of public opinion, as the minister noted, the results of community surveys indicate a majority support for fluoridation in Queensland. It is interesting to note that a lot of the correspondence that I and my fellow honourable members of the Queensland parliament have received since the announcement that Queensland would fluoridate its bulk water supplies does not originate in this state. I received hundreds of emails and letters from all over the country and the world opposing fluoridation, and I am sure members remember the morning when our computers had to be stopped from receiving the volume of emails they were receiving due to them overloading the system.
An honourable member: Spam.
Mr LANGBROEK: Yes, it was classified as spam. However, just like many voters in by-elections, contentious issues such as fluoridation tend to attract a more vehement no vote than a yes vote. Whilst I appreciate everyone is entitled to their own views on fluoridation and any other important health issue, it is important to note that it is only one opinion—one that is not proved by any credible scientific evidence or endorsement.
As I have said before, there is a lot of misinformation and conspiracy theories about fluoridation. For Queenslanders to hold an informed view of fluoridation, it is important that they receive fact over fiction. Public education has a huge role to play in ensuring Queenslanders are educated about fluoride. That is why I am pleased to congratulate Queensland Health on its fluoridation campaign. It has certainly come up with numerous publications, many of which I have used as references for this speech. Many members have also been able to use that information to give to their constituents. As I say, I congratulate Queensland Health on that. This information is not propaganda, although some of the extreme antifluoridationists have likened us to Nazi Germany for imposing what they allege is mass medication on Queensland residents. This is about providing the right information to empower people and to inform their decisions about fluoride.
By passing this legislation, we are not forcing people to drink fluoridated water. Whilst clause 7 in part 3 requires suppliers to add fluoride to relevant public potable water supplies, with part 4 laying out the consequences for noncompliance with the legislation, adding fluoride to water will not force it down people’s throats. Obviously, the law will make it much more difficult for people to avoid fluoride consumption. However, people who do not want to drink fluoride do not have to drink public water. Of the people against fluoridation, statistics show that more than one-third of dissidents use unfluoridated tank water as their primary source of drinking water. Further, people who choose not to drink fluoridated water can filter their tap-water or drink bottled water, which does not contain fluoride. This legislation will not take away a person’s right to reject fluoridated drinking water if they choose to do so.
For the small minority of people who will choose not to drink fluoridated water, the Queensland coalition is committed to assisting them with the purchase of reverse osmosis water filters. These water filters are most effective in extracting minerals, including fluoride, from tap-water and are relatively simple and inexpensive to install. In light of that, the coalition will move an amendment to the bill that will establish a government rebate scheme to compensate part of the cost of these water filters for those who are so fervently opposed to fluoridation. I envisage that this scheme would operate in much the same manner as the water tank rebate scheme and offer financial assistance to those members of the public who choose not to drink fluoridated water.
This bill will give effect to Queensland’s obligations under the national health plan. At the Australian Health Ministers’ Conference in 2004, the health ministers agreed to extend water fluoridation to all communities that had a population of 1,000 or more—a duty which the Queensland Labor government abrogated in 2005 when it voted down my bill to achieve this. With the passage of the Water Fluoridation Bill 2008, after four decades of being behind the eight ball, Queensland will finally be brought into line with other states.
I turn now to the mechanics of the bill. Division 2 outlines the objectives of the legislation as follows—
… to promote good oral health … by the safe fluoridation of … water supplies … to be achieved by requiring the safe fluoridation of relevant public potable water supplies.
744 Water Fluoridation Bill 12 Mar 2008
‘Relevant public potable water supply’ is defined in clause 6 as a water source serving at least 1,000 members of the public to be determined by an objective source, the Australian Bureau of Statistics’ latest census figures. Part 3 and its ensuing clauses lay down the legislative framework for achieving these objectives. As I mentioned earlier, clause 7 mandates the addition of fluoride to relevant water supplies. The time frame in which they must comply is determined by reference to regulation. Presumably, this subordinate legislation will specify the phases in which fluoride is to be introduced into Queensland water. This staged program, which is on public record, will see all major water treatment plants in south-east Queensland, including those at Molendinar and Mudgeeraba on the Gold Coast, introduce fluoride by the end of this year. By 2009-10, residents in Cairns, Gladstone, Mackay, Rockhampton, Toowoomba, the Fraser Coast, Gympie, Somerset, the South Burnett and the southern downs will be drinking fluoridated water, which will see approximately 80 per cent of Queenslanders consuming fluoride in their town water. By 2012, it is expected that 95 per cent of Queenslanders will be drinking fluoridated water. Clause 7 also refers to part 4 of the bill, which sets out the consequences for contravening that section. It also notes that clause 12 outlines the specific and logistical requirements to achieve compliance with the clause.
Clause 8 contains a number of exemptions from the requirement to add fluoride to water supplies. An exemption will be made in circumstances where water already contains naturally occurring fluoride if the level of fluoride falls within the concentration requirements prescribed by regulation. An exemption may also be granted if the natural chemistry of a water supply would not support the additive. As the health minister stated in his second reading speech, that may occur if the mineral content of the water is such that fluoride will not dissolve. An exemption may also be granted by the minister in a situation where he is satisfied that the addition of fluoride to a water supply is unlikely to result in a substantial ongoing health benefit to the community and that the water supply provides water to fewer than 1,000 people.
In order for one of these exemptions to apply, a water supplier must apply in writing to the minister for an exemption from the requirement under clause 7, providing all the necessary evidence required to satisfy one of the clause 8 exemptions. Clause 8 also requires the minister to refer the application to the Queensland Fluoridation Committee, which is established by clause 76 of the bill. One of the functions of this committee is to advise the minister of the operation and application of the legislation. As such, the committee will also assess the application for exemption and provide advice to the health minister on the merits of such an application. I am confident that the committee—comprising the chief health officer, the chief dental officer, representatives of the AMA, the ADA and other persons with medical or technical expertise—will be able to provide the best expert advice to discharge their obligations stated at clause 77 of the bill.
Part 4 of the bill addresses the consequence of noncompliance. Under this section if the health minister has reason to believe a water supplier is not complying with the requirement to add fluoride to water supplies, he may issue a show cause notice under section 15, giving the supplier 28 days to fulfil the legislative requirements. The subsequent clauses outline the actions that the minister may take to ensure that the legislation is complied with. Part 5 gives authorised persons power under the legislation to enforce the law, including the power to enter and inspect a water supply premises and the power to obtain information and seize evidence.
As the health minister stated, the bill creates a number of offences for which a water supplier and/ or their agents may be prosecuted. For example, it will be an offence for a person to obstruct the minister or a person authorised by the minister from taking action to fluoridate a public drinking water supply. The maximum penalty for this offence is $7,500. In addition, the Water Fluoridation Bill makes it an offence to obstruct the chief executive from taking action to remedy a contravention at clause 62, while clause 65 makes it an offence to obstruct a person in the exercise of power conferred under the legislation. Again, the maximum penalty for those offences is $7,500 or 100 penalty units. Other offences are created, such as providing false or misleading statements and/or documents at clauses 66 and 67, and impersonating an authorised person at clause 68.
The commencement of new offences under the Water Fluoridation Bill will ensure that the law may be adequately applied and enforced in Queensland. For Queenslanders to enjoy the health benefits of fluoridation, it is vital that the legislation is sufficiently monitored and enforced. I ask the minister to outline in detail how he will guarantee that all relevant public potable water supplies are fluoridated. I note that the bill provides for monitoring and enforcement as well as for the analysis of samples taken from a water source if a contravention of the bill is suspected. Will the same provision apply to water supplies not suspected of contravening the legislation? These matters were raised at a briefing and some answers were provided, but I seek clarification as to whether regular and random testing of non-suspect water supplies will be carried out either by the state government or local authorities—I presume it will be the state government, having taken over the water suppliers—and whether this testing will be carried out to ensure the successful operation of the legislation.
This bill will repeal the Fluoridation of Public Water Supplies Act 1963, recouping the state’s authority when it comes to fluoridation. The 1963 act devolved power over fluoridation to local governments. It was an unusual situation in that Queensland became the only state in Australia that
12 Mar 2008 Water Fluoridation Bill 745
vested full responsibility for the fluoridation of public water supplies into the hands of local governments. For the most part, local authorities were unprepared for and generally disinterested in decision making about oral health. The act was amended in 2005—I remember debating it in December 2005— achieving little in the way of offering leadership or direction to councils on the issue of water fluoridation. It was another means by which this government avoided making the tough decisions.
These amendments only reinforce the current position that councils have the right to fluoridate local water without consulting the public, as well as having the right to conduct a referendum on fluoridation. As the Australian Dental Association of Queensland branch pointed out, the state government’s tendency to hide behind the politicised legislation constituted an abrogation of the state’s responsibility to provide public health services. This was also noted by Peter Forster in the Queensland Health Systems Review. On page 52 of the final report, Forster stated—
Responsibility for fluoridation of Queensland drinking water rests with local governments. In every other state and territory the responsibility for decisions related to water fluoridation resides with the state or territory governments. Capital costs are funded by the state or territory governments and the recurrent costs are generally borne by local governments.
Mr Forster went on to recommend that the state government and Queensland Health engage with the community on the feasibility of introducing fluoride to drinking water, the consequences and the cost of water fluoridation. He noted that fluoridation was a matter of increasing importance given the unsustainable nature of current dental health programs. Forster noted that trends indicated Queensland Health would not be able to continue funding free public dental health services to Queenslanders without increasing waiting times to the point where dental care is so neglected that lifetime damage would be the consequence. We are seeing this with the school dental van program I mentioned before, which is being scaled back in some parts of Queensland. As the Premier and the health minister are on record as acknowledging, water fluoridation will go some of the way towards improving the oral health of Queenslanders.
The prevailing attitude of members opposite has been that they have always been happy to knowledge the benefits of fluoridation but then cower away from doing something about implementing what is seen as a controversial and unpopular policy. Whilst the majority of councils deferred the decision on fluoridation, some including the Gold Coast City Council offered free fluoride tablets to residents who wanted to access the oral health benefits of adding fluoride to their diets. Unfortunately, those programs were abolished several years ago when fluoride became difficult to obtain and the costs became too onerous for councils, and then debate ensued about potential liability issues so councils put it in the too-hard basket.
Interestingly, when the Gold Coast Bulletin reported on the council’s decision to scrap the program, then reporter Fiona Hamilton quizzed councillors about how many fillings they had and whether or not they grew up drinking fluoridated water. As this debate has progressed, many of us have heard similar anecdotal arguments. Anecdotally, the straw poll showed that generally those who had fluoride as a child, whether in the water supply or by supplement, had fewer cavities than those councillors who did not. I thought it was an interesting way to illustrate the impact of fluoride at a local level.
The Queensland coalition supports local government maintaining a voice over fluoridation. As the debate goes on we will hear more about why we should be listening to councils and residents. The reason we should be working closely with councils on fluoridation is this: Queensland’s water politics has long been entrenched in local government. As I have mentioned, the Labor government has a tendency to pass the buck to local government when it comes to making tough decisions on fluoride. This is something that members opposite agree on, because in 2004-05 it was the prime reason they gave for not supporting my bill which mirrored the current bill before the House. Can members imagine how different our dental waiting lists might look today if the government had supported the opposition’s initiative?
It is clear that Queensland is failing to provide adequate dental care. The Rudd government has been forced to pick up the slack for state governments by reimbursing parents part of the cost of dental check-ups. I might remind Mr Rudd and his health minister that up to the age of 15 teenage check-ups should be completely free to consumers. Check-ups and treatment procedures should be carried out through the school public dental program, which is a state program introduced by a coalition government. However, thanks to the Queensland government trying to cut costs, parents will be out of pocket for a service that should be provided free in schools. Families will be worse off even after the Prime Minister digs into his pockets for dental care. So much for caring for working families. Will the minister now be decreasing the oral health budget in Queensland?
In summing up, this is a historic day for Queensland. Today we will pass a law that has the capacity to improve the health of all Queenslanders. Anyone who has a genuine interest in fluoridation and who has done the research cannot refute the benefits of fluoride for oral health. As a legislator and dentist, bringing this policy to Queensland has been an ambition of mine since I was elected to parliament four years ago. Today I have realised that dream and I am incredibly proud to throw my support behind a bill that I hope—and my colleagues and my peers are happy to accept—will take away
746 Water Fluoridation Bill 12 Mar 2008
business from my professional colleagues. No dentist enjoys drilling teeth. Hopefully, through this significant public health measure we will see a reduction in the number of children presenting with painful cavities and dental problems.
Finally Queensland has caught up to the rest of country on this matter. I congratulate the Premier for doing something which none of her party colleagues had the guts to do. It is about time fluoride was taken out of the too-hard basket and it is about time the government started doing what it was elected to do, that is, making the tough decisions. We have a duty to make decisions that will benefit the people of Queensland. Fluoridation may be contentious and it may not be popular, but it is the right thing to do. After decades of buck passing, inaction and cowardice, Queensland water will finally be fluoridated.
In closing, I acknowledge the staff from the health department who provided insight into the bill. I thank them for their time and effort. I thank the various stakeholders who provided me with a lot of feedback on the bill. With their endorsement and on behalf of the Queensland coalition, I commend the bill to the House.
Mr HOBBS (Warrego—NPA) (12.38 pm): I am pleased today to speak to the Water Fluoridation Bill 2008. There is no doubt that this bill has caused a lot of controversy over many years and not just here in this state but wherever the issue of fluoridation has been debated. Certainly the people who are supportive of it and the people who are opposed to it are very passionate. It is one of those very interesting scenarios where someone has to make a decision.
We support the intention of this bill. I commend the shadow minister for his comments. As the shadow minister for local government, I believe that local governments, as well as the water authorities around the state, will obviously be one of the major groups involved in implementing this legislation that we pass today. The local government position has always been that if the state government wants this to occur it should pay for it. The state government has committed $35 million, which may be the right amount that we need for this to occur. But we would like to see a commitment from the minister that the total cost will be met by the state government and not necessarily the ratepayers. I think that is essential.
The Local Government Association has discussed this on numerous occasions.
The policy of the Local Government Association states—
Local Government believes it is a principle of ethical public health policy that mass, involuntary medication must never proceed without the express consent of the community.
Express consent of the community to fluoridate public water supplies should be sought either by the State Government or Local Government, if they choose to do so.
As oral health is a State Government responsibility and the State will receive a direct financial benefit from the fluoridation of public water supplies, the State Government should fully fund Local Government for the capital and recurrent costs of its introduction.The LGAQ further comments—… $35 million to support capital costs across the State, to be rolled out across the State by 2012. In addition, it is understood that the Government will fund a component of the recurrent costs of Councils in line with eligibility requirements under the Smaller Communities Assistance Program (SCAP).That is where the LGAQ stands. A few other issues are important to remember as well. I am sure that there will be benefits for dental health and suchlike, but only one per cent of the water reticulated to households is used for drinking purposes. That is one of the complications we have. While there will be some benefits, the reality is that a lot of the water may not be used for drinking purposes.The bill before the House has a lot of implications for those authorities who have to implement this process. We have to hope that that money can roll out fairly quickly. The government has been fairly slow in the past in providing funds. I think it is particularly important that there is no hold up. Once the program starts, the money has to start as well. Otherwise we will end up with a bit of a dog’s breakfast. As the shadow minister pointed out, there is a need to help those people who are fiercely opposed to this measure. There needs to be some assistance for those people who do not want to have fluoridation. They could do that simply by having a filter system. We could provide some financial assistance to help them defray those costs. Therefore, they will feel that they have been at least listened to, that we are not pushing something down their neck and that they have a choice.
Certainly we need a plebiscite or a referendum within those various communities. A news release put out by the LGQA states—
An independent survey commissioned by the Local Government Association of Queensland conducted early this week has shown strong support for fluoridation of the state’s water supplies… the survey shows 73 per cent of respondents favoured fluoridation, with 70 per cent of Brisbane metropolitan respondents approving, compared with the rest of the state’s 77 per cent approval.
“However, the survey showed there was strong view that there should be a referendum before fluoride was introduced to water supplies, with 63.8 per cent wanting to see a state-wide referendum” …
“If the decision were to be made locally, almost 56 per cent believed a local referendum should be mandatory” …
12 Mar 2008 Water Fluoridation Bill 747
That is probably the way to do it. I do not think we need to have it across the state; I think it should be the choice of individual areas. That is one way to at least respond and to listen to those people who are opposed to this. They have some valid points that they argued very strongly for. Many members in this House would have received millions of emails from both sides but certainly from those who are opposed to fluoridation. They have very, very strong views. They are very passionate in their views that fluoridation is not good for them. I think we should recognise that issue. We should understand it and we should try to do the best we possibly can to assist them to ensure that they have some way to work around it.
With those few words, I support the views of the shadow minister. He is obviously very passionate about this issue himself and he understands the issue. We support this legislation.
Ms STRUTHERS (Algester—ALP) (12.45 pm): As a community we have taken our teeth for granted for too long. From a young age we have all consumed too much soft drink and lots of lollies and sweets. We probably have not brushed and flossed our teeth enough, and we have put off going to the dentist often until we desperately need to. For some children and adults their oral health is extremely poor. Poor diet, poor oral hygiene and the inability to pay for dental care have all contributed to their poor teeth.
Every year around 2,000 preschoolers need to be hospitalised for severe dental decay. Tooth decay ranks as Australia’s most prevalent health problem, but we have not given due recognition to this. Twenty-five per cent of the Australian adult population has untreated dental decay. Dental and oral health certainly need to be given much more prominence in the health debate generally. Times are changing and this bill is part of a key wave of change. I commend the minister for his efforts in this regard and the staff of Queensland Health who have been quite amazing with their research and the information that they have provided to the members of the public and the government on this issue.
For oral health to improve in any community, three key steps are needed: ongoing public awareness about the importance of good diet and oral hygiene, greater access to affordable dental care and water fluoridation. I am confused by the position of the members opposite, though. In listening to the debate this morning, we had a very persuasive and compelling argument from the shadow minister and then we had the member for Warrego basically have two bob each way saying, ‘Yes, but we’ll have a referendum.’ Again, that shows that we have a very disjointed coalition. Those opposite need to sort their act out before they come in here debating bills.
All three steps that are needed to support and improve oral health in Queensland will be there in place if we get the green light today to go ahead with water fluoridation. The facts are that Queenslanders have the highest level of tooth decay and the lowest level of access to water fluoridation in Australia. Levels of tooth decay for Queensland children are much higher than those in other states and territories, and the gap may be widening. Sixty-seven per cent of Queensland children have experienced tooth decay by eight years of age. Does this say something? You bet. It is now widely acknowledged that topping up fluoride levels in water can reduce the risk of dental decay by up to 40 per cent. Evidence of improvements in oral health will be shown, as evidenced by research, within five years of implementation. A recent review of water fluoridation found an average of 2.25 fewer decayed teeth per child.
On the question of safety, many people are cautious and concerned about fluoridation. I have met many people in my own local area and at community cabinets where people have raised concern about fluoridation. This is a natural response to a very significant public health issue and intervention. These concerns have been taken seriously by this government, as they have by governments throughout the world. There is certainly no argument—and I do not hear anything from the opposition on this—that we have rushed into this. In fact, it is probably the opposite. The Australian Dental Association and the Australian Medical Association have been fiercely lobbying governments in Queensland for years to implement fluoridation, and I commend their persistence.
Healthy debate on issues of such significance is good for public accountability and safety. The fluoridation of public water supplies has been practised around the world for more than 60 years, and it is acknowledged as one of the 10 greatest public health achievements of the 20th century.
I must admit that over the years I have been a bit of a fence-sitter. I have had some doubts, but I have looked at a lot of the research from those years and I feel personally assured that one of the most credible bodies on this planet—the World Health Organisation—has given overwhelming endorsement to fluoridation. In addition, a recent national review of water fluoridation found no negative health effects and only a slight increase in dental flourosis.
I have said that there are three key steps to better oral health in Queensland. Fluoridation is one of those critical steps, and affordable, accessible and quality dental care is another. An oral health review is currently underway in Queensland. Queensland provides the most comprehensive public oral health service in Australia, with over 1.9 million people—which is more than 48 per cent of our population—eligible for care. So it is timely that we have a major review of this substantial system.
748 Water Fluoridation Bill 12 Mar 2008
The primary purpose of this review is to examine the delivery of public oral health services in Queensland and make recommendations for change. Already we have identified some possible reforms. These include providing public dental access to young people aged up to four years and after grade 10, integrating oral health care into general health care, and encouraging more committed, skilled and valued professionals to stay in the public oral health system.
The Bligh Labor government spends more on oral health per head of population than any other state, with our annual oral health budget at around $145 million. We have also the broadest eligibility criteria for adult oral health services of any state or territory. In late 2006, for instance, the estimated number of Queenslanders eligible for public oral health services was 1.7 million.
Finally, after years of neglect of dental care under the former Howard government, the Rudd Labor government will fund up to one million additional dental consultations for Australians needing dental treatment by establishing a Commonwealth dental health program. Over the past 11 years the Howard government withdrew $1.1 billion in dental services, despite the fact that 30 per cent of Australians reported avoiding dental care due to cost, 20 per cent said that the cost had prevented them from having recommended dental treatment and 18 per cent reported that they would have a lot of difficulty in paying a $100 dental bill.
Governments have a responsibility to make dental care available to those who have a limited capacity to pay. I participated actively in campaigns in a former life when I worked at the Queensland Council of Social Service. I was involved in the national ‘Biteback’ campaign, which was urging the federal government of the day, the Howard government, to reinstate the public dental scheme. It is a long time coming, but it is so pleasing to see the Rudd government doing this. I was also involved in the ‘It’s crunch time’ campaign. Both of these campaigns sought in different ways to provide more accessible and affordable oral health care. That is a key part in any step to improving oral health care.
The other required step in the battle to end tooth decay is public awareness of the importance of good nutrition and oral hygiene. Again, Queensland Health has been upping the ante in this regard with significant public awareness campaigns. Individual clinics around the state have also been joining in this effort.
I commend the minister for this bill. I support the thorough monitoring of water supplies once they are fluoridated and any future research to test for the impacts of fluoridation on oral health. For the fence-sitters in this debate I say again that the World Health Organisation says that fluoridation is a necessary thing, and there are not too many organisations more credible than the WHO.
Mr HINCHLIFFE (Stafford—ALP) (12.53 pm): Fluoridation is one of the most widely researched public health measures in the world and has overwhelming support from all the major medical and dental bodies here and overseas. The World Health Organisation, the Australian Dental Association and the Australian Medical Association are among those which have endorsed fluoride as an effective preventative dental health measure.
Research has shown that Queensland six-year-olds have nearly 30 per cent more decay in their baby teeth than the national average, with a similar result for permanent teeth in 12-year-olds. By contrast, a 1996 study in Townsville, where the water has been fluoridated since 1964, showed a significant difference in the level of tooth decay in children—with about 40 per cent less decay than in Brisbane children. Elsewhere in Queensland the communities of Dalby, Mareeba, Moranbah and Bamaga have fluoridated water supplies, and people in every other state and territory have been drinking fluoridated water for more than 30 years—resulting in significant oral health benefits for residents. I was born in Dalby and my family lived there for a further three years. I therefore have personal experience of drinking fluoridated water at a young age.
Mr Shine: They still remember you out there.
Mr HINCHLIFFE: They do still remember me out there. Both of my older brothers, who spent even more of these key early years in Dalby, had excellent teeth. I have read much literature on the subject of fluoridation and I concur with the experts that there is no credible evidence to link water fluoridation with adverse health effects. This information, along with the significant public support of health professionals and my own personal experience with fluoridated water, allows me to be very comfortable indeed with my decision to wholeheartedly support the fluoridation of the whole of Queensland’s water supply. The member for Algester made a very important point about the social justice measures involved in ensuring the fluoridation of the public water supply rather than relying on other methods of accessing the fullest range of oral health, and this point is particularly important in my decision making on this as well.
Other than the member for Algester, I do want to acknowledge the contribution of my honourable friend the member for Surfers Paradise. I acknowledge his factual account of the benefits of fluoridation. However, I cannot ignore the partisan slights of the member for Surfers Paradise in relation to Labor’s record on flouridation.
A government member: Will you drill some holes in his argument?
12 Mar 2008 Water Fluoridation Bill 749
Mr HINCHLIFFE: I will attempt to drill some holes in his argument. Historically, this issue was regarded by both sides of the House as a matter for determination by local authorities. I am glad that the coalition has agreed to join the Bligh government in overriding local councils on this important public health issue. However, on this issue, as with many others, it appears that a prospective single united conservative party has many holes in it. The member for Surfers Paradise told the House that water fluoridation is not ‘mass medication’, yet the member for Warrego described it in just those terms. The rickety coalition compromise—represented by the amendment to provide reverse osmosis water filters—just reminds us of the unscientific conspiracy theories entertained by the Nationals’ leadership, including the feminisation of fish.
I have also seen—and I hesitate to use this term, but it is the best collective noun I could come up with—a book depository of conspiracy theories about the dangers of water fluoridation. The member for Surfers Paradise referred to a long list of googled conspiracies and this inspired me to seek out one more. I have to say that the most credible fringe theory I have seen was authored by right-wing American satirist PJ O’Rourke. From his 1995 compilation Age and Guile Beat Youth, Innocence, and a Bad Haircut, I refer to his flow chart entitled ‘How Fluoridated Water Turns Kids into Communists’. For the information of all members and the entertainment of Queenslanders, I table a copy of the flow chart.
Tabled paper: Document titled ‘How Fluoridated Water Turns Kids into Communists’.
According to this satirical piece, there are a number of paths from the fluoridation of water supply to young people joining the Communist Party. While some honourable members may make reflections on representatives of the city of Townsville in this parliament, I can confirm that the resident of Townsville and only Communist Party member of the Queensland parliament, barrister Fred Paterson, joined the CPA well before the fluoridation of Townsville’s water supply in 1964. I am, however, attracted to the logic of the last path cited in Mr O’Rourke’s flow chart. He starts out with—
City government puts fluoride in public water supply
That moves on to—
Improved dental health results in fewer visits to dentist’s office
I know that the member for Surfers Paradise is particularly concerned about that! The flow chart then moves on as follows—
Fewer visits to dentist’s office make for less frequent exposure to Reader’s Digest
Less frequent exposure to Reader’s Digest causes child to be insufficiently alerted to the dangers of Communism Child is thus an easy target for Communist propaganda
Improper associates and dangerous propaganda result in child joining the Communist Party
I commend the bill and fluoridated drinking water to the House.
Sitting suspended from 12.59 pm to 2.30 pm.
Ms GRACE (Brisbane Central—ALP) (2.30 pm): The Water Fluoridation Bill 2008 will finally deliver for Queensland a holistic approach to better dental health. Dental decay rates can be reduced by up to 40 per cent through good oral hygiene, diet and nutrition and now water fluoridation. This initiative of the Bligh government announced on 5 December 2007 will be acknowledged as one of the most significant public health measures.
Research has confirmed that fluoride helps to repair minor dental tissue damage and promotes enamel resistance against tooth decay and this has been seen as a great benefit for both children and adults. I believe that it is not acceptable to continue to have Queenslanders missing out on the benefits of fluoridation. The current situation where Queenslanders have the worst rates of tooth decay in Australia should not be allowed to continue.
According to the Australian Institute of Health and Welfare, Queensland children have almost twice the number of fillings as Victorian children with our five- to 12-year-old children having more decay than their peers in any other state. My own personal experience with fluoride is when my daughter’s first teeth for some unexplained reason were what can only be described as chalky and during her childhood resulted in some of her teeth, particularly her eye teeth, ending up about half their normal size. In consulting with our dentist it was determined that the best thing that I could do to improve and ensure a second set of healthy teeth for my daughter was to give her fluoride, which I have done in the form of a tablet for many years. She is now 13. I also add that the fluoride tablets were not always available and were quite costly, which is why I believe water fluoridation is good—equitable public policy. I am pleased to report that due to my efforts my daughter now has perfect teeth and, unlike her mother who had a mouthful of cavities and fillings by 13—maybe due to Brisbane’s lack of fluoridated water—has no cavities or fillings whatsoever. Obviously good dental hygiene also assisted, but I am convinced that it was largely the fluoride treatment that gave her a great set of second teeth.
There is one major difference which may explain why Queenslanders have the worst rates of tooth decay compared with other states and this is that currently only five per cent of Queenslanders have access to fluoridated water and that Brisbane is the only Australian capital city that does not fluoridate its water supply. Queensland’s figure of five per cent access for its citizens compares most
750 Water Fluoridation Bill 12 Mar 2008
unfavourably across Australia where between 75 per cent and 100 per cent of state and territory populations have access to fluoridated water. To reverse this situation, this bill will enable government to work with local councils and water suppliers to provide fluoridated water for up to 80 per cent of Queenslanders within two years and more than 90 per cent of Queenslanders by 2012, with a fund of $35 million to roll out the capital program needed to meet these targets.
I believe that this is a definite step in the right direction. The Bligh government is not expecting local government to pay for this initiative and is putting its money behind good public policy and shouldering the burden. As other jurisdictions are recording an overall decline in tooth decay over two generations, Queensland spends more than any other state or territory on oral health, with over $145 million in this financial year. This bill will replace a statutory duty on all water suppliers who supply drinking water to over 1,000 persons to add fluoride to the public water supply under their control or management. In addition, water suppliers with less than 1,000 people may decide to add fluoride to the water supply but it will not be mandatory to do so. This acknowledges that not all drinking water supplies will be suitable for fluoridation. The bill also provides that the minister may grant an exemption of the obligation to fluoride. This is a most sensible provision and recognises that in some instances natural fluoride in the water is either at an average concentration or within the prescribed limits or above the maximum prescribed limit and therefore does not need any top up or where adding fluoride to the water is unlikely to result in a substantial ongoing oral health benefit. For example, this may occur where the town water is bore water which has a pungent odour and is generally not consumed by the community.
The bill also provides for the formation of the Queensland Fluoridation Committee, which will be an expert committee established to advise the minister about the safety and efficacy of fluoridation of drinking water supplies and also advise the minister when deciding whether to grant or not grant an exemption. I welcome the formation of the Queensland Fluoridation Committee, which I believe will play an important role in ensuring that the safety of the community is paramount and that this bill will deliver tangible benefits for the oral health of Queenslanders.
At this stage I think it is important to acknowledge that there are some in the community who are opposed and concerned at the prospect of fluoridated water. Indeed, I have received many emails and letters in opposition from constituents in my area and I have also met with constituents who have outlined their concerns to me in my office. I take this opportunity to thank them for the information they have provided to me and the frank discussions we have had over this issue. Any good debate hears all sides of the argument.
I can assure my constituents that I have read fully all the information provided. However, I believe that the ongoing dental health benefit through fluoridation, together with the large community support for this bill, outweighs these concerns. In addition, there is also extensive, credible, scientific evidence to dispel many fears about the health and safety of water fluoridation. In particular, I refer to the support by the Australian Dental Association, Queensland Branch, and the Dental Hygienists Association of Australia, Queensland Branch, which also support this bill. I must admit that the dentists and hygienists that I have spoken to in my electorate are very supportive of the bill and most congratulatory of the stance taken by the Premier and the Minister for Health.
We only need to compare the results of Queenslanders with the rest of Australia who have had water fluoridation for many years. Queenslanders have the highest level of tooth decay. Even when comparing children aged five to 12 in Townsville, which has had fluoridated water since 1964, with Brisbane children, Townsville children have 45 per cent less tooth decay. In both cases these improved dental health benefits have been achieved with fluoridation, with no adverse health and safety effects.
There are many common fluoride myths and beliefs, such as fluoride causes cancer, allergies, arthritis, bone fracture, excessive dental fluorosis and is bad for babies et cetera. In all of these cases there is ample scientific and medical evidence and support for fluoride to be added to our waterways. However, if members of the community are still not convinced by these findings and are concerned about fluoridated water it is important to note that there is still a choice for those who elect not to drink fluoridated water. These options include bottled water, tank water and reverse osmosis water filters. I welcome any reports from the soon-to-be-established expert Queensland Fluoridation Committee, which will report on any health and safety effects following the passing of this bill, which should provide some comfort to the community.
I look forward to the evidence of improvements in oral health which should be apparent within five years of implementation of water fluoridation achieved simply by adding a small amount of fluoride to top up the natural levels already present which equates to roughly one drop in a bathtub of water. Fluoridation is one of the most widely researched public health measures in the world and is endorsed by the World Health Organisation and a large number of scientific and medical bodies here and overseas.
As mentioned earlier, Townsville water has been fluoridated since 1964 and every other state and territory has been drinking fluoridated water for more than 30 years with no credible evidence to link water fluoridation with adverse health effects. It is for these reasons that I support the bill and welcome the improved benefits in oral health for Queenslanders that will follow. I take this opportunity to congratulate all members of the House who are supporting this bill but in particular to congratulate the
12 Mar 2008 Water Fluoridation Bill 751
Premier and the Minister for Health for finally having the political resolve to advance this policy which brings Queensland in line with every other state and territory on the issue of water fluoridation. I commend the bill to the House.
Ms LEE LONG (Tablelands—ONP) (2.40 pm): The bill before us today, the Water Fluoridation Bill, is designed to force the consumption of fluoride onto most Queenslanders whether they want it or not. The proposal is based on the presumption that fluoride in drinking water leads to healthier teeth and also that there are no negative side effects to be concerned about. The problem is that there is very strong scientific evidence on the other side of the argument as well. I have received copious amounts of correspondence on this issue from people almost unanimously against fluoridation, many citing learned papers, academic studies and a host of other documents against the use of fluoride and more particularly the adding of it to our mains and town water supply.
The science in favour of fluoridation is not clear. It is not clear on whether it is safe for adults and it is absolutely not clear on whether it is safe for infants and young children or nursing mothers or pregnant women. The Queensland Health web site states as a clear and established fact that fluoridated water benefits ‘every person of every age and that children benefit as soon as their teeth are formed’. Yet there is clear evidence that this is not true.
The European Union’s Scientific Committee on Cosmetic Products and Non-Food Products intended for Consumers issued an opinion on the safety of fluorine compounds in oral hygiene products for children under six which states, as an equally clear and established fact, that ‘fluoride in infant formula became a problem as a result of water fluoridation’. It also states that, in relation to studies into risk factors for dental fluorosis, findings showed that the early use of infant formula and fluoridated toothpaste in fluoridated areas were among identified risk factors. This is in direct opposition to the statement on the Queensland Health web site that claims that water fluoridation ‘poses no known health risks for babies and young children’. This same report made a number of other findings including that of ingested fluoride, about 50 per cent of which is retained in the bones and the rest is excreted via the kidneys.
Among the many pieces of correspondence that have come across my desk was one that I found most interesting. It indicated that there are many types of fluoride, all of which are poisonous. This document indicated that the kind of fluoride most often found naturally in water is calcium fluoride and, importantly, is basically insoluble and not easily absorbed by the body. Another type called sodium fluoride, in a very pure form, was used for many of the laboratory tests. This type is more readily absorbed. Yet a third type, silicofluoride, was what was actually being added to the water in a particular community. It was in fact a toxic waste product from fertiliser manufacture. So the fluoride being added, whether sodium fluoride or silicofluoride, is very different from the naturally occurring kind of fluoride. I believe it is impossible to describe the addition of a chemical that does not naturally occur in our water as ‘adjusting the levels of a naturally occurring substance’ and a blatant untruth.
Concerns are also raised in this same document, which is representative of the many I have received, about the potential for toxic exposure via the skin from bathing and washing clothes or the interaction of this chemical with others used in bathing products, such as sodium lauryl sulphate, which increases skin absorption. Even more worrying, silicofluorides are reported to contain other elements including arsenic, beryllium, mercury, lead and so on. To quote from this document, ‘You would have to be crazy to put that stuff in the water.’
What I am doing is highlighting the only unarguable fact on the issue, that there is no undisputed science in favour of fluoridation. That being the case, we should err on the side of caution. I do not believe this government should go ahead and ram through a process that is riddled with doubt and inconsistencies. Whatever happened to the precautionary principle?
I have to say that I found another point on the Queensland Health web site very hypocritical. The point is that this government does not accept that those who want fluoride should exercise their choice and use tablets or other supplements. It dismissively says that those who prefer unadulterated water must now exercise their choice and purchase expensive bottled water or instil costly reverse osmosis filters or access sources of water other than mains water.
This forced adulteration of our water will leave Queenslanders who do not want fluoride additives in their mains water supply no other choice. Heaven knows, we pay enough for this water, and under future corporatised water supplies the costs will soar even further across the state. Most Queenslanders will be forced to drink this fluoridated water, shower in it, wash clothes in it, cook with it and so on because there will be no other readily accessible alternative.
It is interesting to see in just a few years how many ALP members have changed their tune on this subject. In 2005 most members of the ALP supported freedom of choice. In a debate in 2005 which called for the mandated introduction of fluoride, much like the bill before us today, the then health minister said—
The primary intent of the proposed bill before the House is for the state government to force local authorities to fluoridate water supplies under their control.
752 Water Fluoridation Bill 12 Mar 2008
The minister continued—
The bill removes any requirement or mechanism for consultation with those bodies that control public water supplies to communities, that is, local councils. For this reason the government will not be supporting the bill.
Why oppose it then and not now? What has changed to bring about this synchronised backflip by the ALP? He went on to say—
As a government we stand by the view that fluoridation should occur only when there has been a sufficient amount of consultation with local councils and communities.
Where and when has there been consultation and why has the ALP changed its mind as the opposition in 2005 was so strong? During the debate the member for Bundamba said—
Quite simply this bill is flawed. The member proposes that the state override local government, which our government cannot support.
She went on to say that the member moving the bill wanted ‘a Liberal Party dictatorship in relation to mandating the use of fluoride’. What is different about this bill that makes it any different from the dictatorship the member for Bundamba spoke about then? Today, it is the ALP establishing a dictatorship on fluoridation, just as it did with local government amalgamations. It will be interesting to see how the consciences of ALP members direct them today, especially the member for Bundamba.
The then ALP member for Bundaberg said that she could not support the mandated introduction of fluoride because, in part, ‘There are still many people in our communities who have concerns about this issue’. What has changed between 2005 and 2008 on that issue? There has still been no public consultation. There are still concerns and they are being expressed loudly by interested parties but the ALP appears to be deafened by its own arrogance. During the same debate the ALP member for Pumicestone said after describing sodium silicofluoride as rat poison—
Then there is the question of rights. We live in a democracy and my constituents say that this is mass enforced medication. No- one should be forced to take a form of medication if they are not sick.
The member for Aspley, a former nurse, was blunt when she said—
The introduction of water fluoridation at the hands of a ham-fisted state government disdainful of the impact on local councils and communities is not a preferred way of achieving good public health policy outcomes.
That exactly describes this government’s own health department in the words of one of its own members—that and the local government amalgamation debacle that proved what the ALP’s real opinion of local government actually is.
It is interesting to see how the voting went back in 2005—just three years ago. Like good party sheep, every single ALP member in the chamber voted against the mandated introduction of fluoride. That includes today’s Premier and health minister. Yet today the same ALP government members are ramming through exactly the same mandated introduction of fluoride to our drinking water. On this issue they flip-flop more than a dying fish. National Party members are also imitating a dying fish, flip-flopping just like the ALP on this issue. In the 2005 debate the member for Burnett said—
I will gladly support a bill that mandates milk in schoolchildren’s little lunch, but I will not support a bill that mandates fluoride in their water.
The member for Toowoomba South said—
We could put a lot of things in water to combat disease. Some would agree with that and some would not. We could forcibly block off takeaway food stores so that people do not get fat. We could probably put road blocks across pubs so that people do not drink too much alcohol. However, in life a lot of things are about making one’s own choices. It is not for us—
and this is what he said—
to forcibly put something into our drinking water that some people simply do not believe in and have a very strong objection to.
What has happened to change this very clearly expressed opinion? The member for Maroochydore said—
It is not good enough to force or mandate fluoridation of public water supplies in Queensland if the public does not support that. She also said—
Do not force it down people’s throats or ultimately people will revolt, and even if this law is passed it will not stand.
The National Party voted en masse at the time against the forced fluoridation of water, yet today it has changed its colours again. With this substance added to every drop of water that passes through our mains town water taps, our showers, our washing machines, our lawns and gardens and so on, the question also has to be asked: how much of it will flow through, polluting our creeks and rivers, and go out to sea? We hear often enough about the supposed damage from fertilisers, sewage and other products when they run off and reach the Great Barrier Reef. Yet today this government is telling us that we should add a dangerous chemical to every drop of water that our towns and cities use, and that is then sent out into the natural environment.
I, along with so many other Queenslanders, remain unconvinced of the science behind this government’s campaign. There are a great many scientific doubts and there are alternatives and I am still totally opposed to this government’s arrogant, dictatorial attitude. Surely the lessons of Howard’s demise are not beyond us. Arrogance is fatal, yet it seems it is endemic in George Street. I oppose the bill.
12 Mar 2008 Water Fluoridation Bill 753
Madam DEPUTY SPEAKER (Ms Palaszczuk): Order! Before calling the member for Kallangur, I welcome to the Legislative Assembly students, staff and parents from Hilder Road State School in the electorate of Ashgrove, which is represented in this chamber by Ms Kate Jones.
Hon. KW HAYWARD (Kallangur—ALP) (2.52 pm): I rise in this chamber to support the Water Fluoridation Bill. This is an important bill because it will enable the government to work with local councils and water suppliers to provide fluoridated water to up to 80 per cent of Queenslanders within the next two years and more than 90 per cent of Queenslanders by the year 2012.
There is a background to what this bill is all about, of course. The US Centers for Disease Control and Prevention has stated that the fluoridation of public water supplies was one of the 10 greatest public health achievements of the 20th century. Fluoridation is endorsed as safe and effective by more than 150 major health and scientific bodies in Australia and overseas, including the World Health Organisation, the National Health and Medical Research Council, the US Centers for Disease Control and Prevention, the Australian Dental Association and the Australian Medical Association. In fact, it is my recollection that during the 1990s, when I was the health minister in Queensland, the Australian Dental Association was very solid in its view about the matter of fluoridating water.
Over 317 million people worldwide have access to fluoridated water with no credible evidence of any ill health effects. Yet Queenslanders have the least access to fluoridated water of all Australians. Only five per cent of Queenslanders have access to fluoridated water—and we heard from the previous speaker in this debate all of the doom and gloom—but we need to compare that to 90 per cent of people in New South Wales, 86 per cent of people in Western Australia and 77 per cent of people in Victoria. It is right, and it is now time for the government to act to give Queenslanders access to this significant public health initiative.
Water fluoridation is the most effective means of delivering the benefits of fluoride to the greatest number of people irrespective of age, income or education level. It benefits a person’s teeth every time they drink water or consume food prepared with fluoridated water. As well as good oral hygiene, regular dental check-ups and a healthy diet, teeth need small amounts of fluoride throughout the day for the whole of a person’s life to prevent tooth decay. The improvements in people’s oral health as a result of fluoridation in parts of Queensland, Australia and the rest of the world are clear. A 1996 study showed that children in Townsville—a city in Queensland which has fluoridated water—had 40 per cent less tooth decay than Brisbane children. Assuming people behave rationally in Townsville and behave rationally in Brisbane—
Mr Lawlor: Big assumption!
Mr HAYWARD: But we are comparing both of them. Assuming that happens, the one factor that is different is the fact that Townsville water was fluoridated which resulted in 40 per cent less tooth decay than in Brisbane children. A recent Australian Institute of Health and Welfare study found that Queensland’s five- to 12-year-olds have more tooth decay than their peers in any other state and almost twice the number of fillings of Victorian children of the same age. The 1999 York review from the UK found a 15 per cent increase in children free from decay in fluoridated areas and an average total decay reduction of 2.25 teeth per child. In other words, decay was much reduced in fluoridated water areas. In 2007 the National Health and Medical Research Council, Australia’s peak body for supporting health and medical research, endorsed the York review’s findings.
The Australian Council of Social Service estimates that for every dollar invested in water fluoridation families save up to $80 per person in dental bills, and that is a significant thing. All of the time in this parliament we talk about issues—and I have been through meetings at lunchtime today on such issues—such as rebates for power or for this or for that. Recently at the federal level there was debate about the carers allowance and the allowance that pensioners receive for utilities. This is a simple measure: for every dollar invested we can save $80 per person in dental bills. Queensland spends more on oral health than any other state or territory—$137.7 million in 2006-07 alone. Yet this investment is limited in its capacity to make a difference while a key prevention strategy like fluoridation is missing.
Fluoridation is one of the most extensively researched public health measures in the world. I am sure that as this debate progresses certain speakers will refer to all sorts of information they have been able to drag up or find on the internet or wherever. But the fact is that fluoridation is endorsed as safe by all leading health and medical bodies around the globe. In 40 years of fluoridation there has been no credible evidence found linking fluoride with any ill effects. Studies purporting to link fluoride with ill health effects are generally of poor quality, published in biased publications and certainly not subject to independent peer review. Often opponents of fluoridation refer to research selectively, misquoting research to support their case. One can understand that. If one is an opponent of something, that is probably what one would do. The only condition definitively linked to excessive consumption of fluoride, including from ingesting toothpaste and misuse of fluoride tablets, is dental fluorosis. In most cases this is a mild cosmetic condition only.
The fact is that the great majority of Queenslanders support fluoridation. A number of studies conducted over recent years by the government, the Local Government Association of Queensland, the university sector and health professionals have consistently found that between 60 per cent and 70 per
754 Water Fluoridation Bill 12 Mar 2008
cent of Queenslanders want their water to be fluoridated. It is of great public health benefit. If it means anything, it means a lot less pain for people in that they do not have to have as much dental work done. Therefore, the government’s decision to fluoridate Queensland’s water supplies is about responding to Queenslanders’ very clear wishes.
In 2005 the government established a $5 million program to reimburse councils 100 per cent of the capital cost of fluoridating local drinking water supplies. Very disappointingly, no council took up the government’s offer. The government also enshrined in legislation the opportunity for councils to hold local polls to determine their community’s support for fluoridation. Again, no councils took up this offer. As a result, and in recognition of the strong support of Queenslanders for fluoridation, it is now time for the government to act. I support this bill.
Dr FLEGG (Moggill—Lib) (3.00 pm): I find this debate today amazing, because I was here in 2004 when the member for Surfers Paradise introduced a bill which was similar to the bill we are debating today. I was here in 2002 to hear those opposite saying the complete opposite to what they are saying now. Government members not only sit opposite; they also speak the opposite. It is quite an astonishing situation to stand here to watch this amazing backflip by the members opposite without even an acknowledgement by them of their failure to act and the costs associated with their failure to act when they had the opportunity to do so.
Fluoridation is widely accepted as one of the most important public health measures that we can apply. The essence of most public health measures is their universality. Effective public health measures need to be adopted universally. Across a whole range of aspects of our lives, we have no problem accepting universal measures. We accept universal vaccination for children. Sometimes universal vaccination comes with some hazards that are certainly not associated with fluoridation. But we accept the important public health benefit of protecting children from infectious disease. We accept supplementing foods such as breakfast cereals or bread with folate to stop spina bifida and neural tube defects. In that regard we hear not a word about mass medication, because it is important to protect the health and welfare of the whole population, particularly children.
We take it further in what I think could safely be called public health matters. We make seatbelts compulsory. We do not say, as we heard those opposite say in the fluoride debate in 2005, that there are other measures available, such as—
Mr Reeves: Don’t talk about the past; talk about the present. I wonder why you got dumped.
Dr FLEGG: It seems that some of the members opposite have not learned. If I had been forced into an embarrassing backdown such as they have I would not be trumpeting like the member for Mansfield is.
We make it compulsory to wear seatbelts. We do not say, ‘The seatbelt is there. You can choose to use it.’ We make it compulsory to wear bicycle helmets anywhere, even in places where there is no road. Why? Because for these measures to be effective they have to be applied universally. If you make these measures optional, the people who miss out are the ones who are the most vulnerable and who are the most at risk.
I acknowledge that, like other members, I have, as has my office, been contacted by people who have accepted some of the stories that get circulated on the internet. I accept that those people hold their strong views honestly. I have to say to them—as I have done—that I simply do not agree and that I do not believe that the evidence supports those sorts of ideas. In fact, fluoride is a naturally occurring compound. Our bodies are exposed to these sorts of compounds every day in everything we do— whether it is calcium, fluoride or chlorine. Chlorine was used as a chemical warfare agent, yet we hear very little about its use in water supplies. I do not quite understand why people would not be extrapolating some of their arguments to the use of chlorine. The reality is that some of these measures are necessary and should be applied universally.
There has been some discussion as to how and why fluoride works. Certainly, it appears that some of the effects of fluoride are as a result of its direct absorption into teeth. That is why, if we look at the figures, we see that over a long period there has been a decline in the incidence of tooth decay particularly through the use of fluoride toothpaste, where there is some absorption of the fluoride, and possibly the fluoridation of water having a direct effect as it is also absorbed into teeth. In some places the incidence of tooth decay has increased along with the increase in the use of bottled water and the decline in the use of town water.
I think it is fair to say that to a significant extent fluoridation is a socioeconomic issue. There is little doubt that children from disadvantaged families or children from families that have internal disruptions of one sort or another are much more likely to be overlooked. They are much less likely to have a routine in their lives that sees them using their fluoride toothpaste on a twice-daily basis. They are less likely to have parents who are organised enough to give them fluoride tablets every day. We have had a lot of debates in this place, including recently, about protecting people, particularly children, who are victims of social disadvantage. I have no doubt that fluoridation is another important measure by which to protect those children.
12 Mar 2008 Water Fluoridation Bill 755
I sometimes hear or read in Hansard contributions by members opposite about fluoride being mass medication. That myth should be debunked. It is quite clear that fluoride is a compound that occurs naturally. It occurs frequently in the water supply in any case. Through this bill, we are standardising it in the town water supplies that people consume—and in some areas that fluoride occurs naturally.
Queensland has paid a very high price for its failure to act on this issue. I see that the minister is present in the House. I put this question on record: could the minister provide an estimate of the yearly savings from the fluoridation of water? What has it cost the state of Queensland because in 2004 this government rejected the fluoridation of water bill that was introduced by the member for Surfers Paradise? Since that time we have continued to disadvantage Queensland children. We have paid millions of dollars simply for the fact that the government wanted to play politics with the issue of fluoridation, about which it has now belatedly introduced a bill.
The consequences go beyond cost. From the point of view of government and legislators, the cost is significant and should not be played down. However, this issue also goes to the health of children and the effect upon them of having to attend dentists. In this state we have the alarming incidence of children having to go under general anaesthetic sometimes to have large numbers of neglected teeth treated in a single operation. Every time you put a child under general anaesthetic, to a small degree that child is put at risk. In this state people have died under general anaesthetic while having their dental problems attended to. A very high profile case occurred not very long ago. It is unconscionable to subject children in this state to numerous instances of general anaesthetic simply because the government did not have the courage to introduce this measure sooner.
From a medical point of view, poor-quality dental health affects people’s general health. It affects their nutrition and it can cause various types of infection. It is the most common cause of bacteraemias, where germs get into the blood supply and potentially cause serious and occasionally fatal diseases. Of course, the best-known disease is infection of the heart valves. Frequently that occurs as a result of dental disease. There are a range of serious issues and consequences involved with this particular issue.
On a number of occasions the figures quoted grossly underestimate the incidence of dental disease in this state, because a massive proportion of the state’s population comes from southern states that have fluoridated their water supplies since the 1960s. In actual fact, the dental health of native-born Queenslanders is worse than the stated figures suggest. I have read a lot of misinformation, and some of it is even in Hansard. I will not go into that too much. Stories from the European scene have been quoted, where it has been alleged that we do not fluoridate for various reasons. In fact, sometimes the choice has been made to fluoridate salt instead of water, just as we put iodine in salt. Years ago the Western world had a serious problem with thyroid disease and we responded by putting iodine in salt. Now thyroid disease of that type is a rarity in the Western world because we came to grips with the issue of iodine deficiency, yet in 2008 we are still dealing with the issue of fluoride deficiency.
On 23 February 2005 I spoke on the Fluoridation of Public Water Supplies Amendment Bill. In that speech I referred to a Channel 10 news report into the Asian tsunami and the number of people killed in that tragedy. The report stated that frequently an Australian’s state of origin could be determined by the state of his or her teeth. If the teeth were appalling, the person was probably and generally from Queensland.
I note that the member for Pumicestone does not seem to be in the House today. If I had said what she said—
Mrs Reilly: She’s here today; she’s just not in the chamber.
Dr FLEGG: She is not in the chamber at the moment, and if I had said what she said in Hansard I probably would not want to be in the chamber, either. She interjected to dispute the benefits of water fluoridation. On 11 July 2004, the Sunday Mail carried a full-page article by Jessica Lawrence that dealt with the appalling dental health of Queensland children. She highlighted the burden that our hospital services bear from the number of young patients requiring general anaesthetic just to fix the effects of the lack of fluoridation in this state’s water.
I have looked back through the debate that was had in 2005. Some of the comments that were made ought to be placed on the record again, as I do not hear many of those opposite correcting the record that was so distorted at that time. The then minister, who has had something of a chequered history since then, which we will not go into, said—
The issue to be debated tonight is not whether fluoridation of water is an appropriate thing to do … The issue for debate is the best way to introduce water fluoridation.
He went on to say that this should be a matter for local councils and that it should not be a matter for the government.
The member for Bundamba made some quite amazing comments. I see that the member for Bundamba is not in the chamber, either. Once again, if I had made the comments she made I would not want to be here, either. She said—
The member is talking about mandating. Quite simply, the bill is flawed. The member proposes that the state override local government, which our government cannot support.
756 Water Fluoridation Bill 12 Mar 2008
I am interested to hear the contribution that she will make later, as she believes that in this matter the state government cannot override local government. She went on to say that this is a local issue and should only be introduced ‘wherever it receives the consent of the community’. She went on to attack members of the Liberal Party. In relation to the member for Surfers Paradise she said—
What he wants is a Liberal Party dictatorship in relation to mandating the use of fluoride.
Today I am happy and proud to support the government in mandating fluoride and, unlike the member for Bundamba, I certainly will not be accusing it of being a dictatorship.
The member for Nudgee, who is now in the ministry, said that he would vote in support of a proposal if the Brisbane City Council conducted a public poll. He went on to say that his wife was a dental therapist who had treated and provided dental care to schoolchildren aged from four to 18 in the public and private school system. He described the horrific extent of dental disease that his wife encountered in Queensland public and private schools. Even with that knowledge, in 2005 the member for Nudgee, who now sits in the cabinet, did not have the courage to support fluoridation. The list goes on and on. In this House Mr English said—
The Liberal Party wants us to believe that the end justifies the means. However, I cannot support that. I cannot support mandatorily overriding community sentiment.
He went on to say—
I believe the positive health outcomes as a result of fluoridation cannot be forced upon local councils.
The member for Glass House said—
I expect that any council wanting to introduce fluoridated water would give residents the chance to express their support …
Her view does not extend to the state government. She went on to say—
The best way for the Queensland Liberal Party to help dental health is not to force fluoridation on everyone but to convince their colleagues in Canberra to fulfil their responsibilities properly.
Basically, she went on to claim that treating kids with dental disease was better than preventing it.
However, the biggest booby prize belongs to the member for Pumicestone, who made the most outrageous comments. She began her speech by saying that she was speaking on behalf of her constituents who oppose compulsory fluoridation. What about the majority of her constituents who support it? I practise medicine in the honourable member’s electorate and I can inform her that the dental health of her constituents is dreadful. Within this state they will be among the biggest beneficiaries from the measure taken here today. She went on to say—
After all, dosing entire populations with a rat poison—
I think she is a bit mixed up between fluoride and warfarin there, but nevertheless that is what she said in Hansard—
for all of their lives could reasonably have adverse effects.
She goes on to say that we should be looking at things like the rate of the use of sugar in our society and mentioned that she had seen coca-cola in toddlers’ bottles. I note that, despite her concern about sugar, the member voted against my bill to ban soft drink sales in schools, so she was not all that concerned about sugar in any case. She went on to say—
Obviously the Liberal Party is not basing its argument on scientific fact …
I support this measure and I think the government is doing the right thing. It is belated and it is hypocritical following comments by government members last time, but nevertheless it is better late than never. This is an important measure. It will save millions of dollars in the state of Queensland. It will improve the health, wellbeing and lives of many children. The benefits of this have been enjoyed for 40 years and more in other Australian capital cities without ill effect. It is high time that this measure was also brought in for the welfare of the people here in Queensland.
Mr GIBSON (Gympie—NPA) (3.20 pm): It is a pleasure for me to rise and add my voice to this contentious issue of fluoridation of local water supplies. In my maiden speech to this parliament I said that I want the people of Gympie to know that I will fight for their interests because in the end I must return to live amongst them, and I will do that with my head held high.
Mr Lawlor: You could always move to Southport. Mr GIBSON: I take that interjection.
Mr Reeves: I wouldn’t have.
Mr GIBSON: I will take that interjection because there is no desire for me to move down there, although I do know that the Gold Coast Bulletin makes reference to me far more than it does any local members almost. I seem to be getting an outstanding run in the Gold Coast Bulletin.
Mr Reeves: Tickets, please. What do you think of that, member for Surfers Paradise?
Madam DEPUTY SPEAKER (Ms van Litsenburg): Order!
Mr GIBSON: Thank you, Madam Deputy Speaker. However, on this issue I did feel it was important that I find out what the people of Gympie wanted. The best way for me to do that was to conduct a telephone poll, and that was done with 144 residents over two days in the past few weeks.
12 Mar 2008 Water Fluoridation Bill 757
The results of this poll were very interesting for me and I think perhaps reflect the broader community’s view on water fluoridation. There were two questions. It was not designed to be a push poll. Two simple questions were asked of people. The first question was, ‘Do you support or oppose the fluoridation of the water supply?’ Of the respondents, 45 per cent of residents supported fluoridation, 31 per cent were opposed to it and 23 per cent were undecided. This is a large number and shows that the vote would go either way.
In relation to the question, ‘Should local communities be allowed to vote on whether fluoride is introduced in the local supply?’, interestingly there was overwhelming support for the community to be given a voice. Eighty-seven per cent of people indicated that they would want to vote. Indeed, those people who supported fluoride in the poll also supported the opportunity to be given a say. It is a very important principle, I believe, that on contentious issues we engage with the community. I note that there has been some television advertising, but I also note, based on the responses that my electorate office has received, that there is a great deal of unrest. Many people feel that this has been forced upon them—many people who perhaps do not understand the complexities of the issue or who are taking that very simple approach of googling the information and then finding that which supports their personal point of view and which may not necessarily always be correct.
Ms Nolan: Where do you stand?
Mr GIBSON: My personal position is that I support fluoride. I do so very clearly from a personal perspective. Whilst I was in the Army I moved around. I have lived in Townsville and in other states around Australia.
Ms Nolan: So this is just lip-service.
Mr GIBSON: No, it is not lip-service. I think it is really disappointing that we see this attitude to it.
Ms Nolan: You know your position but you thought you’d just give a nod to the others—just give a nod.
Mr GIBSON: I take those interjections because this disappoints me the most. I appreciate that people can change their position on an issue. We have had a ‘road to Damascus’ experience both in the Labor Party and in the National Party in terms of members’ views on this issue compared to what has been stated previously in debate. People—and it has been reported and referred to in many speeches— who were clearly opposed to fluoridation have now changed their position. I do not begrudge anyone that. In fact, I am really comfortable with that. It shows that people are willing to challenge their views. It shows that people are willing to rethink on an issue and then come to a new conclusion based on the evidence available to them. That is a sign of a healthy democracy. It is a sign of individuals who are willing to represent their constituency based on the information available to them.
If I had been in this parliament when the vote was taken in 2005, I hope and I believe that I would have voted in support of fluoridation because of the personal experience that we have had as a family. We have five children. Three of our eldest children have grown up in states where fluoride was freely available in the water. The two youngest children have grown up here in Queensland. Our two youngest children have had tooth extractions. I do not believe that we as a family have changed our diet that significantly. I do not believe that we are drinking any more or less soft drink or having any more or less sugary foods. I believe that the fluoride our children experienced in the early stages of their life in places where fluoride was in the water has had an impact on their oral health.
Having said that, though, we have to recognise that there are alternative points of view. That was the point behind conducting the polling—to find out the views of people in my electorate. I believe that, because of the 23 per cent who are undecided, there is an obligation on us to conduct better education on the issue of fluoride. There is an opportunity here for us to bring the electorate with us, for us to bring the people of Queensland along so that they understand the benefits of this. The moment a government takes heavy-handed action it will immediately lose the people. It will lose their support because we will start to see those ridiculous conspiracy theories that kick in, and unfortunately logic is often lost in that. Politics is indeed a strange profession.
Ms Nolan: It is on the National Party side.
Mr GIBSON: And, indeed, on the Labor Party side. It is a strange profession where people who refer to fluoride as rat poison will probably now vote to support its introduction. It is a strange profession because we are all faced with challenges. What disappoints me the most in this House is when good legislation is brought in and then is voted down because of party politics. I think the legislation introduced in 2005 was good legislation. I think it could have been made better, and I believe that we could have amended it to ensure its passage. That is what this House is about. It is not about just looking at our party manifesto and saying, ‘We support this,’ or, ‘We’re against this and there’s no room to budge.’ This is meant to be a House of debate. This is meant to be a place where people can engage with each other and listen to the arguments that are put forward rather than listen to the political apparatchik that chew in our ears telling us that this one issue must go this way or that way.
The National Party has a fortunate position in that we have a policy of ‘electorate first’. I have used that once in this House already in the short time I have been here. That was on the hospital boards bill, when I said that I would not support it because that is what the people of my electorate wanted me
758 Water Fluoridation Bill 12 Mar 2008
to do. I appreciate that not all other parties offer that. A case in point is the former member for Noosa, Cate Molloy, who very clearly came out against the proposed dam at Traveston Crossing and then suffered the political consequences from her own party for that.
From all the correspondence that I have received from my electorate there is one piece I wish to take some elements from. Whilst my constituent was opposed to fluoridation, I think she sums up the concerns that people have. Shirley, who lives at Rainbow Beach, wrote to me and said, ‘David, I feel very strongly that the addition of fluoride to the public water supply will take away my right to determine what I put into my body.’ She says—and it is her view—that it will also endanger her health and the health of those in the community. Interestingly, she then says in her final paragraph that we should continue to allow individuals the right to choose. I believe we need to take this one step further. We should have given individuals the right to be heard.
I heard some members say earlier that, because councils had the opportunity to conduct a poll but they did not do that, somehow that is a reason for us to act now. I do not agree with that. What I do agree with and what I do think should have happened and could still happen is that we should engage with the people of Queensland on this contentious issue. We should enable them to be educated on fluoridation through a government education program on its benefits and then we should enable their views to be heard on it.
This was not an election issue. There is no clear mandate for this to be introduced. I think we all have to accept that. Personally, I can see that this is necessary and it is something that would be of benefit, but I am not comfortable with the idea of us overriding the rights of Queenslanders. I am not comfortable with us not listening to what they want to say. That is why I engaged, in my own very small way, in a process of giving them that opportunity.
I respect the reasons that people use to speak against fluoride. I respect the concerns that people have with regard to forced medication and other issues, but I do believe that we can look at this as an opportunity for us to work together. There will be an amendment before this House that could enable the people of Queensland to have a voice. If we are genuine about doing our job, then we can embrace that amendment. Yes, it will cost some dollars, but what is the price of bringing the majority of Queenslanders along with us so that they understand the values and benefits of fluoridation?
I hope we take this opportunity to work in a truly bipartisan way, to look at the amendment and, if necessary, knock some of the edges off it but take it at its point of giving the people of Queensland a voice. Yes, fluoridation is good, but it is also good to allow the people to come along with us. The arguments that were put forward by the Labor Party members and others when they spoke against the bill that was introduced back in 2005 really summed up this issue of saying that we need to have the community onside. A few television advertisements clearly have not done that. There is an opportunity in the amendment for us to do something, and I will certainly be speaking more about that. I commend this bill to the House.
Mrs MILLER (Bundamba—ALP) (3.32 pm): I rise in support of the Water Fluoridation Bill 2008. Dental health is an important issue in the electorate of Bundamba and it is important across all age groups and socioeconomic spectrums—all of them. I have received only a handful of comments, letters and emails from constituents who are in fact against fluoride in the water. I have, however, received enormous support in favour of water fluoridation, as these people understand the benefits of having good dental health.
I noticed that the member for Moggill was talking about social disadvantage before. Well, I am about to give him a lesson in social disadvantage in my electorate across many generations. The older people in my community recall how they were hospitalised, many in their teens, to have all their teeth pulled out and then be measured up for false teeth after a week or so. Many remember the experience as being horrifying, almost barbaric, but they were told that because they were poor and because they would not be able to afford good dental health they had to have this done as a preventative measure.
My parents were amongst this generation of Ipswich people. They went into the Ipswich Hospital—or the St Andrew’s Hospital as it was then—and they had their teeth ripped out of their head by the dentist. They had to suffer all the pain and the indignity as their gums heeled over several days before they could then be fitted with dentures so they would not have the cost later on in life of good dental health. That is what you call social disadvantage—people who could not afford, through no fault of their own, to have private medical insurance or good dental health.
I have spoken to many people in the Bundamba electorate in national seniors organisations and other organisations and I have spoken to the community elders, those people in their 70s, 80s and 90s. Many of them—in fact, it is almost universal—support this legislation because they do not want any other generation to go through the pain and the indignity they had to go through when they were younger.
Many people in the electorate of Bundamba have very little money as most of it is spent on the mortgage or rent and putting food on the table. There is very little spare money and there is a low proportion of families who have private health insurance. In fact, we could probably count those in my area who have private health insurance in the hundreds rather than the thousands. So what happens if these families have issues with their teeth? I am about to tell you what happens.
12 Mar 2008 Water Fluoridation Bill 759
Usually, if they can scrape some money together—by borrowing it from family and friends—they can go to a dentist and have an examination to see how much it will cost to get their teeth fixed. If, for example, they need a root canal treatment, constituents are often advised that it could cost around $2,000. They then go into a sheer, blind panic. If there need to be extensive fillings, it may cost several hundreds of dollars, if not thousands of dollars, and they also get worried and go into a panic. So the final quote they get from the dentist is: ‘How much does it cost to have my teeth pulled out?’ I can tell members that that is what happens in my electorate. Most of the dentists end up pulling out the teeth of my constituents. That is just absolutely shocking. In the electorate of Bundamba, we can tell how well-off people are in financial terms generally by the state of their teeth. If they cannot afford preventative dental care, as I said before, my constituents get their teeth pulled out.
It is important that we look after the next generation, the little ones in our community. I have a good friend Vicki who is the mother of two teenage children. She has one tooth in her mouth and she is proud of that tooth. She is a great mother and a valued member of our community, but over the years she has sacrificed her own teeth to make sure that her children’s teeth are well looked after. The dental health of our teenagers has been boosted recently with an announcement by the Rudd government in relation to dental health. I welcome this initiative and I was grateful to be able to thank him personally when he was here a couple of weeks ago to turn the sod on the Ipswich Motorway.
Water fluoridation will result in benefits that will improve dental health. It will result in less pain and suffering in the community. There will be a reduction in the loss of income because we will actually have people at work. We will also have economic savings in public health, specifically dental health care.
I am proud to stand here to support what I believe is a well thought out, well-constructed Water Fluoridation Bill presented by our Labor government. As the member for Tablelands pointed out, no, I did not support the tory bill. I did not support it because I am a member of the Labor Party and a proud member of the Labor Party. As I recall, there was no consultation with local government by those tories at that time. If the member for Moggill were in the House, I would invite him to come over to my electorate so I could teach him a little bit about social disadvantage.
Mr Reeves interjected.
Mrs MILLER: If he wants to come over and set up a bulk-billing practice in my electorate, good on him. If the member for Moggill would like to cross the river and leave the toffs over there in Moggill and come to Riverview or Goodna, I will show him social disadvantage. He will be able to see it and he will be able to breathe it. He will know exactly what it is like for people who suffer social and economic disadvantage every day of the week. In fact, it makes me sick to hear him try to lecture us on disadvantaged communities.
In my view, this bill will go a long way to improving dental health for the future generations in my electorate. I want the people in my electorate to have the same opportunities that others right across Queensland have. I can tell members that dental health is an important issue in my area. I am very proud to support a Labor bill, not a tory bill.
Mrs REILLY (Mudgeeraba—ALP) (3.40pm): I am pleased to rise in support of the Water Fluoridation Bill 2008. I do so with the full understanding and knowledge that there are some people in my community and the Queensland community who are vehemently opposed to the bill and the intent of the bill. However, I am firm in my conviction that these people are in the minority and that this bill, which will result in the fluoridation of Queensland’s water supply over the next five years, enjoys the support of the overwhelming majority of Queenslanders.
Surveys conducted over recent years by the Office of Economic and Statistical Research, the Local Government Association of Queensland, Central Queensland University and the Queensland Oral Health Alliance have consistently demonstrated that between 60per cent and 70per cent of Queenslanders support the fluoridation of drinking water.
We are charged in this place as legislators to make hard decisions and to do what is right based on the best available information at the time and our own convictions and policy on behalf of our constituency and indeed for their benefit. As several previous speakers have said, there is a social justice agenda here; no-one has articulated that better than the member for Bundamba, who preceded me. This social justice agenda recognises that for some residents of Queensland—those from lower socioeconomic backgrounds, people in remote communities and Aboriginal and Torres Strait Islander people—fluoridation may be the only answer to their future and potential oral health.
I am delighted to see bipartisan support for this move, albeit with the other side taking the opportunity to take a few pot shots at the government. I want to acknowledge that it was the member for Surfers Paradise, John-Paul Langbroek, a former dentist, who first pushed for water fluoridation in this House. I have talked to him about it and the state of my children’s oral health over the many years that I have known John-Paul. It is outside the realms of possibility—it is pure science fiction—to imagine that any government would knowingly harm or poison its electors, as has been the charge from some of the more outrageous opponents of the bill. As for inadvertently mass poisoning electors—that is, doing it
760 Water Fluoridation Bill 12 Mar 2008
accidentally—I am more than comfortable with the level of research, science and investigation undertaken not only by my government but also by many, many credible sources which indicate and guarantee that water fluoridation is safe and beneficial.
Fluoridating Queensland’s water supply brings us into line with the rest of Australia’s population. Fluoride has been in all other states for more than 30 years. It was introduced in Townsville in 1964. Coming from the Gold Coast as I do, where a person would be lucky to find one in 10 people in a room born in Queensland, the rest having migrated to the state from other states where they have had fluoride in their water their whole lives, I have not actually encountered any opposition to this on the ground in my personal discussions with constituents, friends or acquaintances. I have, however, received a number of emails, many of them spams from overseas, from opponents of fluoride. They come from far and wide. A very small percentage, maybe two to three, are actual constituents from my electorate. There are a great many from fictitious or deceased individuals that, while amusing in a disturbing sort of way, did little to bring credibility to their argument in opposition.
I want to point to a couple of issues that these opponents to water fluoridation have raised that I have taken some time to research. They raise the experience of a number of European countries, claims from detractors, some who are scientists and medical professionals, that fluoride causes negative health effects or that it provides negligible oral health benefits or they run the argument that fluoridation is akin to mass medication and they simply object to being force-fed. I will come back to some of those arguments in a moment, but I want to place some facts on the record.
Queenslanders have the worst teeth in Australia with tooth decay now affecting 50 per cent of children by the age of six and 95 per cent of adults. Currently only five per cent of Queenslanders can access fluoridated water and Brisbane is the only capital city that does not provide water fluoridation. Other states have between 75 per cent and 100 per cent access and four states are constructing even more fluoride plants. These states are recording an overall decline in tooth decay over two generations.
Children aged five to 12 in Townsville have 45 per cent less tooth decay than Brisbane children. Around 67 per cent of Queensland children have experienced tooth decay by the age of eight and every year around 2,000 preschoolers need to be hospitalised for severe dental decay. My son Louis, who is now eight, is one of these. I was shuddering and trying to block my ears when the member for Moggill described the very severe and serious risks involved in anaesthetising young children, particularly for the purpose of something like dental work which could be so avoidable. Hospitalisation means having dental work such as deep fillings or extractions done under general anaesthetic that could not be done on a two, three or four-year-old. Believe me, it happens. I have watched Louis go under twice in his short little life. The first time he was nearly four and the second time he was six. I spent those agonising, guilt ridden, anxious hours waiting for him to wake up swearing that if I could do something to make sure my children and my grandchildren do not have to go through this then I would do it. Guess what? Here I am in a unique position, unlike the other mums who go through this every day, where I can come into this place and I can do something. In this case I am doing the very thing that the dental professionals who worked on my son asked me to do. They begged me to do it. ‘This could have been avoided’, they said, ‘Deliver fluoridated water in this state’.
To me it is a very simple proposition. Why would the very practitioner who made money from me and my son’s rotten teeth be asking me to introduce a measure which will hopefully and ultimately reduce his own workload and potentially cut back on an avenue of his income—a very lucrative avenue of income? The answer is not something nefarious or twisted; we are not in some conspiracy here. It is actually quite simple. Dentists, and dentists like my son’s paediatric dentist, believe that fluoridated water will make the difference. They actually do not want to be putting little kids under anaesthetic to rip out their teeth, do painful fillings or put in place silver crowns to try to save teeth. It may be lucrative, but it is nasty, risky and unpleasant and they would rather be doing basic scale and cleans. Every dentist that I have ever spoken to, including the one in this House, is a firm advocate for water fluoridation. Snap—that is enough for me.
As a result of my experience I have long been an advocate for water fluoridation. I have made that position known in my role as often as I could. I was delighted when Premier Anna Bligh took the courageous step of announcing that 95 per cent of the state will be fluoridated by 2012. Why is it a courageous step? Simply because it is interventionist. It is courageous because opponents to fluoridation are vehement and passionate in their opposition, some might say a little unreasonable. While they are not in the majority, they are organised, networked, loud and unbending. It is courageous also because there has been ongoing debate worldwide with varying outcomes. I make no apology first up for supporting interventionist policy.
A Labor government needs to be active and interventionist. That is what a Labor government can be, particularly on issues which will make a long-term difference and deliver long-term community and health benefits. Many actions of Labor governments are interventionist and are most usually welcomed, from the restriction of harmful substances to efforts to curb teenage binge drinking as we have been talking about recently; from immunisation to banning smoking in public areas to alcohol management
12 Mar 2008 Water Fluoridation Bill 761
plans in Aboriginal communities. There is a fair and reasonable expectation that governments will, and that Labor governments especially do, step in and step up where needed and this is distinctly one of those occasions.
It is safe to say that in much of Europe, however, especially northern Europe, a part of the world with a very different history, tradition and cultural ethos to Australia, the UK and the US, there is not that expectation. In fact, there is very much a culture, if my own European-born parents are anything to go by, that the state should and does leave its citizens pretty much to their own devices when it comes to personal choice and health. In much of Europe people still smoke in airports, offices, railway stations, restaurants and pretty much damn well where they please. There are highways with no speed limits. There is a fairly broad tolerance of a wide range of drug use and suggestions that binge drinking or drinking copious amounts of alcohol on a regular basis should be curtailed are simply not on the radar. Our system of government and community expectation of governance has more in common with Britain, Canada and the United States where fluoridation began and where it is still being rolled out to new communities.
Water fluoridation is practised in approximately 60 countries, meaning that some 360 million people worldwide are drinking fluoridated water. These countries are not obscure, small places that cannot be found in an atlas; they include Hong Kong, Malaysia, Singapore, Israel, New Zealand, Ireland and, most recently, South Africa. The European countries which have rejected fluoridation have done so in the main because they could not do it if they wanted to. They do not have centralised water supply systems, some have particularly high levels of oral health—good for them—others do not, or because of a philosophical objection to intervention on community health. They just do not believe that the state should do these things. We come from a different perspective.
Most of these countries have introduced salt fluoridation. So that means that they eat it rather than drink it. It is interesting to note that amongst the European countries that have rejected water fluoridation, seven out of 10 have higher levels of decay, missing and filled teeth than Australia which, for the purposes of comparison, considers Australia is 100 per cent fluoridated even though it clearly is not yet. The World Health Organisation and the Pan American Health Organisation have endorsed water fluoridation since 1964 with the most extensive investigations and most significant number of published documents of the effects of fluoride being undertaken in Australia and Britain. One of the concerns raised is the dose of fluoride, suggesting that a range of people who ingest higher than average amounts of water will be overfluoridated.
The news is that sportspeople, babies, diabetics and people with kidney disease also live in other states of Australia and there is no credible evidence of any harm being experienced due to overexposure after up to 40 years of fluoridation. The amount of fluoride to be added to Queensland water will be in accordance with Australian drinking water guidelines and below the World Health Organisation guidelines. Legislation will also regulate the concentration according to air temperatures and level of fluoride naturally present in the water supply. In warmer climates where we expect people to drink more water there will be a lesser concentration of fluoride. I remember reading that a person would need to drink a bathtub full of water a day to get anything over the minimum dose. The government has supported water fluoridation—
Mr Lawlor: Whose bathwater would you have to drink?
Mrs REILLY: It depends whose bathwater you would be tempted to drink, member for Southport. Thanks for that interesting interjection. There is a view that the government has done some sort of backflip or changed its mind in some way. I have never changed my mind on this. I have had this view from the start of the debate and since I first heard of fluoride in water. But the issue had been whether we had the correct legislation before the House, whether we had the support of Queenslanders and whether we had enough documentation to actually support the personal-felt belief that we had about the safety of fluoride. We have those things now.
In 2005 we were committed to this. We established a $6 million program to reimburse councils. But councils did not want to do it. That was their choice. They did not want to take up the offer. So now it is time for the state to act. Sure, I wish we had acted earlier. We now have the benefit of hindsight. We now have additional information to back up our move.
Ms Darling: And we’re going to do it right.
Mrs REILLY: And we are going to do it right. Thank you, member for Sandgate. I will be one of the first Queenslanders to drink fluoridated water as the Mudgeeraba water treatment plant is one of six to come on line this year. I could not be happier about it. I just hope that it is not too late for my two-year- old’s teeth. I congratulate the Premier and the health minister, in particular, on taking this step.
I want to thank all the public servants who have put in an enormous amount of work to get this information through to us so that we can inform our constituents. I thank all the health professionals who have worked with the government to get us to this stage. I commend the bill to the House.
762 Water Fluoridation Bill 12 Mar 2008
Mr FOLEY (Maryborough—Ind) (3.52 pm): Let me start by saying that I do not believe that fluoride is going to make people grow three heads or develop some sort of strange system. I do believe that fluoride is significantly effective in mitigating tooth decay. It is not a question of whether or not fluoride works. Of course it does. That is demonstrated by the Townsville experience. In my mind it is a question of how it is most efficiently delivered.
During our last sitting week I had quite a long talk with the only person who is really qualified to answer this question in our parliament, the member for Surfers Paradise, who is a dentist. He and I had a long discussion about topical versus systemic. He told me that modern dental thinking says that it is more efficient to deliver fluoride topically than ingesting it. It is a question of efficiency of delivery.
Adding fluoride to water in a mass manner, which is what we are considering here, also means that we are flushing our toilets with it, washing our cars with it and, before we had a water crisis, hosing our driveways down with it. It is very much a shotgun approach to delivering fluoride. In an ideal world if fluoride could be delivered topically, which it is through fluoridated toothpaste and vigilant parents, that would be a much more efficient method of delivery than putting a microdose in our water supply.
This is an issue I have very much struggled with. I am personally in favour of fluoride for mitigating tooth decay but I have had an extraordinary amount of lobbying from those in my electorate who are against adding it in a mass manner. We have already been through all the arguments about mass medication and all those sorts of things.
I made a commitment when I came into this place that I would reflect the wishes of my electorate unless they were sensitive issues such as issues of a moral nature or so forth. I must say that the jury is still out in my mind as to what the real position is in my electorate. There has been so much passionate lobbying by people who are antifluoride, whereas those in favour of fluoride have tended to say, ‘We think it is a good idea,’ and not done any lobbying.
The argument that the sort of people who could not be bothered applying fluoride topically need it in the water supply is a specious argument in some respects because they are also often the sorts of parents who feed their kids a steady diet of cordial, soft drink and lollies. The parents who could not be bothered caring for their kids teeth are often the parents who do not encourage their kids to drink water and if they drink tea and coffee have loads of sugar in it.
I find it amazing that members on the other side of the House have had a Damascus road experience. Many members today have stood up and passionately spoken in favour of fluoride yet in 2005 they all voted against it. I think that underscores how the political party system in Australia really makes a mockery of democracy.
If we fluoridate water but we are not vigilant about making kids clean their teeth and watch their diet they will still have tooth decay. I know lots of people who use water filters. When we consider that one per cent of potable water is actually drunk but humans then put fluoride in 100 per cent of water, it seems to me to be a very inefficient means of delivery.
My brother-in-law who grew up in Maryborough has the most incredible teeth. He does not have a single decay at over 40 years of age and yet he grew up in a town that has no fluoride in the water supply. The only conclusion that I can come to is that he had a mum—he grew up in a single parent family—who was extremely vigilant about tooth hygiene. I am not sure whether or not he used fluoride tablets.
I am not arguing against the efficacy of fluoride for mitigating tooth decay—I think that is absolutely proven—but to put it in our water supply I am still not convinced is the most efficient method of delivery. I have very mixed feelings about this particular debate and may not even make up my mind until we call a division.
Mr PEARCE (Fitzroy—ALP) (3.58 pm): I rise to support the Water Fluoridation Bill 2008. A letter from the Central Queensland Health Collaborative states—
The collaborative supports public water fluoridation due to the overwhelming evidence that it is the safest, most effective and most equitable means of improving the oral health of Queenslanders.
We take the advice of international experts including the World Health Organisation that there is no creditable evidence that links optimal community water fluoridation to any adverse health effect.
I table a copy of that letter.
Tabled paper: Copy of a circular letter, dated 11 February 2008, from Peter Shanahan, Chair, CQ Health Collaborative, Rockhampton in relation to the fluoridation of public water supplies in Queensland.
The CQ collaborative is made up of respected health professionals from the private, public and non-government sectors who are in touch with the health needs of families in central Queensland. I know a few of the people on the collaborative. It is through my knowledge of them and the respect that I have for them that I am convinced that we are going down the right track by introducing this legislation.
The collaborative’s words of support sum up my position on the intent of this legislation, which is to impose an obligation on all water suppliers that supply drinking water to the public to add fluoride to supplies for populations greater than 1,000 and to do this without fear of causing health issues for those drinking the fluoride treated water.
12 Mar 2008 Water Fluoridation Bill 763
One of the most compelling examples of the strengths of the argument put forward in support of fluoridation in fact exists in Queensland. Townsville children aged between five and 12 years have 45 per cent less tooth decay than Brisbane children. Townsville’s water has been fluoridated since 1964. With an open mind and alert to the fact that nothing is perfect, I have searched for evidence to support the concerns of those who have contacted my office that fluoridation might, for instance, cause allergies, brittle bones, decreased thyroid function, damage to the immune system, lower IQ and even cancer. But I keep coming back to the fact that numerous studies—any number of systemic reviews—have confirmed and continue to confirm the safety and effectiveness of water fluoridation in reducing dental decay for the whole population. I say to every member in this House that over their years of existence on this planet listening to the news, reading newspapers—
Ms Jones: How many years?
Mr PEARCE: However long you have been here; it is all right for you, young one. Mr DEPUTY SPEAKER (Mr Wendt): Member for Ashgrove!
Mr PEARCE: Thank you for your protection, Mr Deputy Speaker. I have not seen, heard or read stories about health impacts on populations that have had access to drinking water treated with fluoride. I have not been able to find one single example. I could not even find an example on the net where people have actually had a health impact.
From a personal perspective, I believe that fluoridation has been beneficial to my family. Before moving from New South Wales to Queensland, my sons lived in places where drinking water was treated with fluoride and they never had any tooth decay problems. In fact, my sons have only had minor teeth problems in their late 20s and early 30s and I personally believe that is because they got such a good start to oral health and the benefits of fluoride in the water. As a government, do we not have an obligation to try to give each and every Queensland child the best start to oral health that we can?
The statistics confirm that children from lower socioeconomic groups are at the greatest risk of tooth decay. This is because they are not applying proper oral health care or, perhaps more likely, they are less able to afford regular visits to the dentist. The introduction of fluoride to drinking water is going to be of significant benefit to these children. At the same time, protection from tooth decay will be enhanced through fluoridation for those who are taking appropriate steps to look after their teeth and the teeth of their children.
In introducing fluoridation across the state, the minister has taken what I consider to be a sensible action by setting up a Queensland Fluoridation Committee. Consisting of 18 members, the committee will advise the minister about the safety and efficacy of fluoridation of public water supplies and about the general operation and application of the same. That is a good, accountable process for the minister to have in place. The committee will have the expertise to appropriately assess the introduction of fluoridation under the legislation before us. The committee will appropriately advise the minister so that the people of Queensland get the best possible outcome in protecting our state’s children from high levels of tooth decay.
In supporting this legislation, I acknowledge that there are those with concerns about the introduction of fluoride to our public water supplies. I say to them as a member in this place that I have an obligation to reflect the views of my constituents and to support actions that I believe are genuinely in their best interests. Since the Premier’s announcement on 5 December 2007 that the government would tackle the poor condition of Queensland oral health by introducing fluoride to the state’s water supplies, my staff have reported to me that, as far as they can ascertain, given the fact that some correspondents have failed to provide a residential address, I have had only one letter or email—and that was just this week—from a constituent opposing the introduction of water fluoridation. I do acknowledge that I have had several hundred emails of opposition from residents based outside Fitzroy, the majority of which seem to have come from—
Ms Stone interjected.
Mr PEARCE: They had no addresses on them; that is correct. The majority of these seemed to come from the south-east of Queensland. With regard to phone calls, a check of my office records shows that since the Premier’s announcement we have had just one phone call regarding the issue, and this was from a health professional working in the field of school dentistry who expressed their wholehearted support for the government’s decision. They confirmed that day in, day out they see many children with bad teeth and they welcome the decision to introduce fluoridation as they genuinely believe that this will make a substantial difference. These comments come from someone at the coalface who is dealing on a daily basis with the staggeringly worrying oral health statistics of Queensland schoolchildren. The lack of response from my own constituents suggests to me that support for water fluoridation within Queensland is high.
I note the 2007 survey undertaken by Professor Kerry Mummery of the Centre for Social Science Research based at the Central Queensland University. This survey was conducted by means of computer assisted telephone interview surveys from a sample of the Queensland population. The
764 Water Fluoridation Bill 12 Mar 2008
results revealed that 70 per cent of the total sample surveyed supported water fluoridation, with more than 71 per cent of the sample population agreeing that water fluoridation was safe. If these sample survey results are representative of the views held by the people of the Fitzroy electorate, the broader central Queensland region and indeed the state of Queensland, then I am duty-bound to support the bill before the House.
One of the main arguments that keeps being raised by opponents of fluoridation is that many western European countries do not add fluoride to their water supplies. The argument goes that if progressive countries such as Denmark and Sweden, which have high life expectancy rates, do not fluoridate their water supplies then why is Queensland going down this track? There is a range of reasons western European countries do not fluoridate their water supplies. The reasons include already having sufficient levels of naturally-occurring fluoride and high levels of good oral hygiene which obviate the need for fluoridation. Belgium is an example of this. With regard to cost-effectiveness, many European water supplies supply only very small populations through reservoirs rather than dams. So water fluoridation is not a cost-effective means of delivering the benefits of fluoride in those countries. For a similar reason, we are mandating the addition of fluoride only to water supplies supplying over 1,000 people. For some countries other methods of distributing fluoride are more appropriate—for example, through salt fluoridation.
In short, it is necessary to look at the unique situation of each country before jumping to conclusions about their position on fluoride. The assertion that western European countries are reversing the trend towards fluoridation is typical of the antifluoridation lobby. It is selective about the information it quotes and typically misquotes this in a way which promotes its agenda. It is worth noting that the British government this month committed £42 million to increase the rate of fluoridation beyond its current 10 per cent of the population. So it would seem that at least one European jurisdiction is following a similar path to Queensland. This legislation is necessary. This legislation is common sense, and it is a pleasure for me to support it on behalf of the people of Fitzroy.
Ms BARRY (Aspley—ALP) (4.07 pm): I, too, rise to support the Water Fluoridation Bill with enthusiasm. I want to say from the outset that I support water fluoridation and I always have. It is only the implementation process about which I have disagreed with the member for Surfers Paradise previously in this place. In fact, in my speech, to which a number of members have referred, I made the comment that a heavy responsibility would have been put on councils in terms of both the cost of fluoridation and education. Indeed, with this decision to fluoridate the water, this government has recompensed councils for water assets and taken on the financial responsibility for the fluoridation and education. We have done so much more, and it is a process that I agree with. I understand the shared frustration that many in the health profession have had with respect to this particular matter, but I am particularly pleased that this Premier has had the courage, with this health minister, to move and to make those commitments that I previously outlined.
I would have to say that, in my seven years in this place, in relation to changes to policies and legislation about matters that health professionals hold near and dear, the two PPs—patience and perseverance—are the most important things that you can have. The bill requires that public potable water suppliers that supply potable water for over 1,000 persons must add fluoride to the supply under their control. Additionally, those suppliers to fewer than 1,000 people may add fluoride, but it is not mandatory. The addition of fluoride must be added in a way and a form that is prescribed by regulation. This introduction of fluoride will take place over four years and it will take the percentage of Queenslanders who have access to fluoridated water from five per cent to 90 per cent by 2012.
The consultation on the bill has been extensive and the legislation has received support from the majority of professional organisations that have an interest in matters relating to oral health and general public health. The bill also has its objectors, and I am aware of a number of my own constituents who have written to me objecting to the bill. That said, I believe that the overwhelming majority of my constituency support the bill.
When the minister and the Premier made the announcement in January of this year to introduce fluoride into our water supplies, I wrote to the minister and advised him that I believe this decision will have one of the most dramatic and positive effects on the long-term health of Queenslanders that we have seen in a generation. It is up there with the introduction of penicillin, the efforts to stamp out smoking and the introduction of the Gardasil vaccination against cervical cancer as an action that will change the health of future generations. The detractors of this legislation are prone to quote the effects of the addition of fluoride on the health of the general population. Most of those claims about fluoride are unfounded and untrue. As with all matters that require real leadership, there must be a consideration of the facts and the consideration at the forefront of the decision making should be the best outcome for the majority.
The facts are that poor oral health is one of the most significant comorbidity factors in ill health and disease for both the young and the elderly. Poor oral health leads to a raft of medical problems, such as circulatory diseases, coronary heart disease, cerebrovascular accidents—or strokes—diabetes, respiratory disease, arthritis, cancer and preterm and low birth weight babies. In children, tooth decay
12 Mar 2008 Water Fluoridation Bill 765
and the pain that that tooth decay brings leads to eating problems, sleep disturbances and poor concentration at school. People with poor dental health are often the people who are most at risk of suffering from this range of diseases, many of which are preventable or at least treatable.
All too often people with poor oral health are reluctant to seek help, because they are embarrassed about the state of their mouths. People feel inhibited by the fact that they will be labelled lazy or dirty because they have poor dental health. Missing teeth, gum disease, halitosis—which is bad breath—and black and stained teeth are all the obvious signs of poor oral health. People with poor oral health often develop a strategy to avoid drawing attention to their mouths and the problems they suffer from as a result of that poor dental health. They develop malnutrition, avoid social contact and fail to seek help even when in pain as they are often embarrassed about having delayed seeking help for so long.
We know that diet, oral care and a tendency to develop dental caries owing to our hereditary disposition are all factors affecting the state of our mouths. It is truly a shame that my children may indeed suffer from the same poor oral health outcomes as experienced by me and my family not only because of bad luck in the hereditary lottery but also because of the lack of available fluoridated water in Queensland as they grew up. When my children were young, as a single mum I simply could not afford to buy fluoride tablets. Today, it remains the case that many cannot afford to buy fluoride tablets for their children.
There can be no greater example of the tragedy of poor oral health than in the impact that it has on the elderly. All too often we see senior citizens whose lives are diminished greatly by poor oral health. That combined with poor access to dental health services for the aged, particularly those in nursing homes, is a double whammy for our seniors. We must be the last generation of Queenslanders who are victims of preventable health problems caused directly and indirectly by poor oral health. We must accept that improving our oral health will directly improve the health outcomes for a generation and greatly reduce our healthcare costs in the future.
The greater good of fluoridated water supplies is overwhelmingly evident. That is why I am offering my strong support. This is an important bill and one that I believe is among the most significant that we have passed in my time in this place. I am proud to support the bill.
Mr WELLINGTON (Nicklin—Ind) (4.14 pm): It gives me a great deal of pleasure to rise to speak to the Water Fluoridation Bill 2008. In speaking to this bill, I reflect on other speeches that I have made in the chamber in the past in relation to the very contentious topic of water fluoridation. I note that in his second reading speech the minister indicated the level of consultation that the government has undertaken in relation to this very contentious issue.
In my electorate there certainly is a divide between those who support water fluoridation and those who do not. I note that some of the people who are most passionate about not supporting fluoridation certainly appear to have very good dental and oral hygiene. I speak with dentists and nurses and I hear about and see evidence of the shocking incidence of dental decay in young children in our primary schools. When I make inquiries about this issue, it concerns me to find out that some children whose parents, can I say, may be struggling seem to have the worst dental decay. When I speak with other people involved in this field they talk about the high level of sugar content in the drinks that children are drinking today, the large quantities of soft drink that many children and young people are drinking as if it is simply water because it is so cheap, and the prevalence of these sugar based drinks that parents are providing to their children from a very early age.
I am genuinely concerned about the lack of appropriate parental supervision of children. Clearly, the dental decay that children are experiencing is as a result of bad parenting. When I speak with dentists and nurses in the dental industry, I ask them to give comparisons between the level of dental decay today to that of the past. It is frightening to hear from them that the level of dental decay in our children has increased significantly. It seems to me that the only reason we are seeing that significant increase in the level of dental decay in small children in our community is the increased prevalence of soft drinks that children are taking to school and which they are consuming in much greater quantities than children did in the past. In the past, we did not have the high prevalence of the sugar based drinks that we certainly have today.
I am at the crossroads with this bill. Do I support it or do I not? In this instance I am going to support the bill, because, quite frankly, I am concerned about what I see happening in my community with the high level of dental decay in our young children which simply should not be happening. If it is the case that parents are not able to provide their children with proper dental care, it seems to me that governments are going to have to take the responsibility for that. Unfortunately, with such issues it is always the case that governments have to take some responsibility because parents are not providing the appropriate level of care that is required.
If there are people in our community who are passionately against drinking fluoridated water, then maybe they should use the range of other water products that are available. I am concerned about the high level of sugar based drinks that we are consuming, but it seems to be a fact of life. These drinks are so cheap that they certainly have a growing market.
766 Water Fluoridation Bill 12 Mar 2008
I will be supporting the bill. I know that is a position that is different from the one that I took a number of years ago when this matter came before the House. I refer to the extensive consultation that the minister has referred to. I believe that the government has a responsibility to improve the dental hygiene of all Queenslanders.
Mrs CUNNINGHAM (Gladstone—Ind) (4.19 pm): I rise to oppose the legislation. I do so because overwhelmingly people in my community have told me that they are not happy with the mandatory nature of this fluoridation legislation. Because I have been requested to do so, I will read into Hansard the concerns provided to me by various organisations and by some members of my local community. I believe that it is very important that their thoughts and concerns are put on the record.
Many of us have received hundreds and hundreds of emails opposing mandatory fluoridation, and it is easy to argue that some of those are mass produced emails. During the last sitting of parliament IT advised us that it had put a block on some American emails because approximately 14,000 emails had been received in a couple of hours. We knew that the intent of the overwhelming majority of those emails was to oppose mandatory fluoridation.
Queenslanders Against Water Fluoridation has been very active in sending information. I want to read from one of its emails. It states—
If fluoride is allowed to be added to bottled water it means even more choice for people who wish to use fluoride, adding to fluoridated toothpaste, mouthwash, fluoride tablets and drops.
While I do not believe that bottled water should be fluoridated, QAWF is saying that there are other options available to consumers who wish to use fluoride. The email continues—
Recent years has seen reports of increasing children’s teeth decay rates in heavily fluoridated Australian states and the consumption of bottled water has been put forward as an explanation by the Australian Dental Association.
At odds with this, is a 2004 study, that looked at South Australian children who had always consumed fluoridated water and those who had never consumed fluoridated water and found “no significant difference” in the decay rates of permanent teeth of children aged between 10 and 15 years.
Certainly the QAWF has been vigilant in supplying to members of parliament information and its point of view. On 23 February the QAWF sent an email that made some allegations about the information on which the Queensland Premier and the health minister based their decision to mandate fluoridation. I will not read all of that email because some of it is quite inflammatory. In part it states—
Examination of the source of the data used reveals that Qld Health staff have changed results from “teeth surfaces” to “teeth” a four to five fold difference …
They are saying that the statistics should be divided by four or five to get the genuine incidence of tooth decay. The email states that this one change in wording led to—
… a false and exaggerated impression of tooth decay favouring fluoridated Townsville. Brisbane children were falsely shown as having 2 more decayed baby teeth than Townsville children, when in reality, averaged out, it would have been only a fraction of a tooth. The data from permanent teeth in children aged 6 to 12 years old which was available but not used by Qld Health, showed on average only a tiny fraction of a tooth difference in decay rates …
Freedom of Information shows that a senior Oral Health adviser to the Health Minister had written in 2006 that there are no scientific studies to prove water fluoridation is safe.
The QAWF presents further information which it certainly has the resources to identify.
My office has sponsored an e-petition and a paper petition requesting a referendum on this issue, which is contentious. The response from the community indicates the strength of feeling among people who are opposed to mandated fluoridation. When I looked this morning, the e-petition had 2,363 signatures. The paper petition is gathering signatures, although not at that fast rate. The e-petition has not been in the system for very long. As I said, the petitions ask for a referendum so that the people of Queensland can have a say about what they ingest through the reticulated water supply. I think that is a very reasonable request to make.
There are other contributing factors to children’s oral health, and the member for Nicklin talked about sweet drinks et cetera. In this chamber members have acknowledged how difficult it is for some families to afford private oral health care. The cost of going to a dentist can be prohibitive. More and more families that are under financial stress rely on the oral health facilities provided by the state. Those services were partly funded by the federal government, but it pulled out of that funding arrangement. Under Prime Minister Kevin Rudd, the federal government is looking at re-funding those sorts of programs. A contributing factor to problems with children’s teeth is the fact that they are not getting the regular check-ups that they need. With the school van process, the time frame between visits is lengthening and children’s teeth are not getting the attention that they need.
Merilyn Haines, a writer for the QAWF, has requested that the debate on this bill be held over until the numbers in the e-petition and the paper petition are finalised. I acknowledge that it is the government’s prerogative to hold the debate at any time it sees fit; however, to date I believe that the e- petition, the paper petition and the volume of paperwork that we have all received indicate that there is an overwhelming opposition to mandatory fluoridation.
12 Mar 2008 Water Fluoridation Bill 767
I have received a number of emails as well as verbal comments from people in my electorate. Some people are in favour of the legislation. Not for one minute would I say that every single person who has spoken to me on this issue has said, ‘We don’t want mass fluoridation.’ A small number are in favour of the proposal, but I would have to say that overwhelmingly there is opposition to the mandatory nature of the legislation.
Mr Rex Warren, the national president of the Australian Chemical Trauma Alliance, has written to all members of parliament. He said—
ACTA does not support forced fluoridation of Queensland drinking water supplies and does not believe assurances of safety based on the “no credible evidence” terminology used in the government’s advertising campaign. I personally recall federal authorities claiming “no credible evidence” when ACTA and other environmental health organizations raised serious concerns about some (registered for use) pesticides about 12 years ago in relation to chemicals that are now banned world-wide.
ACTA is also concerned mistakes in previous campaigns by dental health lobbyists claiming high levels of tooth decay on the lack of fluoridation involving cities that had fluoridated drinking water for many years. A case of distorting the truth due to over enthusiasm or does fluoridation in fact make no difference?
When thirty three per cent of the Australian population already suffer adverse reactions from chemical sensitivity to some degree, it makes no sense whatsoever to add another toxic chemical to our drinking water. When in fact it makes more sense to add magnesium to not only strengthen teeth and bone, banish calcium oxalate kidney stones and reduce calcification of the arteries in the population.
With magnesium, everyone benefits.
With fluoride (despite claims to the contrary) it can cause serious health problems, especially when ingested long term in conjunction with the many other toxic pollutants we are exposed to in the modern world.
Rex sent a copy of that letter to all of us. Rex lives in my electorate. His son has some very severe intellectual and behavioural disabilities. Rex is very attuned to the impact and effect on an individual’s health and behaviour as a result of what they ingest. He is not speaking from an uninformed or ill-informed position—quite the opposite. He has made this a very sharp focus of his interest and his life because of his son Alexander. I place that before this parliament.
The other email that I wish to read into the record is, I believe, a very telling one. The Clinton branch of the ALP have written to a number of MPs. They state—
We … ask that compulsory fluoridation of our water be stopped because we have very serious concerns about:
mass fluoridation takes away our right to choose
possibility that bottled water may be contaminated with fluoride compounds
fluoridation being a waste of money as most water is for non-drinking purposes
the dose varying dramatically with how much people drink
Local regions were promised 5 years to consider the changeover but are given less than 3 years. Comprehensive information about the dangers of Water Fluoridation can be obtained from—and then they give a number of web sites. They go on—The latest National Children’s Dental Survey (pub 17 Dec 2007) in the “National Summary”, page 25 shows 75.1% of Queensland Children aged 5 to 12 yrs, have no decay at all in their permanent teeth. At the end is a Fact Sheet with websites—and they have included those in this email. They go on—
A decision about mass medication must be subject to scientific rigour, ample open public debate, and the highest standards of ethics and truthfulness. Our concerns are based on information that
fluoridation began after early studies which were very poor quality and non-scientific
the pressures to introduce fluoride compounds comes from industries which benefit financially
these chemicals have never undergone safety studies
Further concerns are that if a referendum is passed to mass fluoridate
it is being done without each person’s Informed Consent (which means Truthful Information about that medication and a demonstration that they have understood)
a referendum does not permit for each person’s informed consent
prescribing medication for individuals/entire population must be subject to strong ethical principles
it is a “compulsory mass medication” as it is not given to individuals according to need, but given to all regardless. No amount of home filtration or bottled water can screen a person from the fluoride. Numerous studies have shown fluoridation to cause harm
It has been revealed that there has been an apparent cover-up of evidence from Harvard School of Dental Medicine linking fluoridation with elevated risks of a fatal bone cancer in young boys. Osteosarcoma (the Harvard study director, Chester Douglass, failed to report the seven-fold increased risk seen in the work he oversaw)
Eleven studies since 1990 found an association between fluoridation and hip fracture About the promotional literature: It fails to present the most telling scientific evidence of all. In cities that have ceased fluoridation the studies show that decay rates have decreased over the following decade such as where fluoridation has been discontinued in Canada, Germany, Cuba and Finland. Other areas of misinformation promulgated by fluoridation authorities are too numerous to discuss here, and include the effects of fluoride exposure on the endocrine and nervous systems, nature of the industrial, contaminated, non-pharmaceutical grade chemicals used. Thankyou for your consideration for citizens of Queensland.
768 Water Fluoridation Bill 12 Mar 2008
It is signed by the Clinton branch of the Australian Labor Party, again a branch that is in my electorate. So these people have had access to presumably any party information that might be circulated. I do not know how the structure of the party system works in terms of internal information, but they have been sufficiently concerned. The few members of the Clinton branch that I do know are from a cross-section of the community. They are from varying walks of life and varying interests. They have put pen to paper and sent this email to a number of electorate offices including mine. There is a list of electorates at the top of the email. They are expressing significant concern about mass fluoridation and the mandatory nature of it.
Given the speakers so far, when a division is called there may not be sufficient numbers to even register a count, but I do not believe that invalidates in any way the concerns expressed by people in my community and in the broader community about the nature of mandatory fluoridation. The fact is that the information that has been placed in the community, particularly the ads sponsored by the Queensland government, have only been to confirm the Queensland government’s decision. There has been no objective information about concerns. There has been no objective and independent information about possible implications of fluoridation. On that basis other speakers may say that the concerns are ill- founded, but there has been nothing given to the community to alter their perspective to convince them otherwise. That is why many, many people hold very active and aggressive concerns about mandatory fluoridation.
As I said, the overwhelming majority of people in my community who have spoken to me are opposed to mandatory fluoridation. In fact, I can only remember a handful, if that—and I am being generous—of emails that I have received that have actually been in favour of it. I think that shows a significant amount of interest in the community and a significant level of concern. I have no misgivings about opposing this legislation.
Mr MOORHEAD (Waterford—ALP) (4.34 pm): It is with great pleasure that I rise to support the Water Fluoridation Bill 2008. The reforms contained in this bill will make significant improvements in the dental health of the people of the Waterford electorate, whom I represent in this place, as well as the residents of Queensland.
The question of water fluoridation has traditionally been a decision left with local government. However, with the state government taking responsibility for more and more of our state’s bulk water supply, this decision is one that falls for this parliament to determine. Water fluoridation as a public health initiative has been used for more than 50 years and is used around the world. In falling behind on fluoridation, Queensland’s dental health has suffered. Any dentist I have ever spoken to about this issue will say that they can tell whether a person is raised in Queensland as soon as they open their mouth. I must say that I am probably one of them. This bill will give Queensland’s residents, particularly our children, the same opportunity as our interstate cousins.
The evidence of the benefits of fluoridation is comprehensive and thorough. I have listened to those constituents who have contacted me with their concerns, but the best advice available supports this important public health measure. But these concerns will be monitored by the Queensland Fluoridation Committee, an independent statutory body created by this bill to provide advice on safety and efficacy of fluoridation of potable water.
The Bligh government has also put its money where its mouth is when it comes to fluoridation. This bill is matched with a $35 million commitment in funding and will see 54 per cent of Queenslanders having access to fluoridated water by the end of this year, 80 per cent by the end of 2009 and 95 per cent of Queenslanders by 2012. What this shows is that the Bligh government is moving forward with this important initiative for the health of Queenslanders. For the cost of $1.50 per person per year Queenslanders will see improved oral health and less need for remedial dental work. This is yet another initiative by the Bligh government to have Queensland Health continue to focus on preventing people needing to go to hospital while continuing to provide quality health services to those who need them.
There is no coincidence that Queensland has the highest level of tooth decay in Australia but by far the lowest levels of access to fluoridated water. It came as a shock to me that 67 per cent of Queensland children under the age of eight years have experienced tooth decay. The path of a person’s dental health is established during these early years. There are many Queensland children who are starting their life with poor dental health. Less than five per cent of Queensland residents have access to fluoridated water. The next lowest level of access in Australia is the Northern Territory, with 70 per cent access, while most other states have 80 per cent access, 90 per cent access or even more. Fluoride is not a new thing, with all other capital cities in Australia fluoridating water since the 1960s and 1970s.
Water fluoridation is the addition of less than one part per million, or one drop in a bathtub, of fluoride to drinking water when it is treated. Fluoride’s value to improving dental health is in preventing decay. Evidence from previous implementation of fluoridation has shown improvements in dental health within five years. Fluoride will reduce the pressure on family dental expenses as well as on the dental programs run by Queensland Health, and hopefully with the Rudd government there will also be dental programs run by the Commonwealth government.
12 Mar 2008 Water Fluoridation Bill 769
In my view, the long-term future of a fluoridated Queensland will see Queensland Health able to provide more preventative treatment, particularly more school dental clinics for children, with less pressure from decay. When the evidence of fluoridation shows a reduction in decay of 40 per cent, public health dentists will be able to spend less time filling cavities and more time preventing decay. Water fluoridation has been practised for more than 60 years, commencing in Grand Rapids, Michigan in 1945 and in Australia in Beaconsfield, Tasmania in 1953. In Queensland, fluoridated water has been available in Townsville, Bamaga, Dalby, Mareeba and Moranbah and in many other communities where the levels of fluoride in water already meet the standards proposed in this bill.
The decision to add fluoride to the water is not taken lightly. While fluoride is something that naturally occurs in varying levels in drinking water, there have been numerous and extensive studies on the benefits and risks of adding fluoride to drinking water. I commend to members of the House the National Health and Medical Research Council 2007 report entitled A systematic review of the efficacy and safety of fluoridation. While there are numerous studies, I would like to mention just a few of the study outcomes.
Studies have shown that water fluoridation has led to an average of 2.25 fewer decayed teeth per child—that is a reduction of 225 decayed teeth for every 100 children; that children aged between five and 12 years living in fluoridated Townsville have 45 per cent less tooth decay than children in non- fluoridated Brisbane and south-east Queensland; and that for each $1 invested in water fluoridation the estimated saving in dental bills is between $12.60 and $80 per person. This saving is particularly important for those people who struggle to pay for dental treatment. On a crude calculation, these savings mean that the state government’s $35 million investment will save Queenslanders $440 million and possibly more than $2 billion. It also means less time and pain suffered in dental chairs. Most importantly, it means dignity for those who might be embarrassed by the state of their teeth should they continue to decline.
The state of our teeth is something very personal and it is something that is seen by all we meet. Eating a steak in public is something that some people cannot enjoy because they risk exposing their poor dental health. I was particularly touched by the comments of the member for Aspley, who summed it up quite well by saying that some people are afraid they will be considered dirty or lazy because of the state of their teeth. That is a real fear that people have when their dental health declines. They fear being judged by people they meet simply on the basis of their dental health.
I must acknowledge that water fluoridation is something that some people feel strongly about, both for and against. I thank the eight constituents who live in my electorate who have contacted me with their concerns with this bill, and I hope I have addressed their concerns in my response to them and in my contribution today. I assure them that I have taken their views very seriously. I know that they are views which are genuinely held. However, there have been many reviews and much research which support water fluoridation. I must also recognise the Australian Dental Association for its continuing advocacy in support of fluoridation, including local advocates such as Dr Michael Foley. The ADA presented the Premier with a petition of more than 25,000 signatures in support of water fluoridation.
However, as every dentist will tell you, fluoridation is not the magic bullet for every dental health problem in Queensland. It is not that easy. We must continue to ensure that dental health is promoted through healthy diets, dental hygiene, including brushing and flossing, and regular dental check-ups. Water fluoridation will make a great contribution to the dental health of Queenslanders, young and old. This will be of most benefit to families, including many in my electorate, who cannot afford to provide their children with the dental treatment they would like to.
Water fluoridation is an important social justice measure. It means that the minimum level of dental health in our community will be lifted, regardless of income or parental support for preventative measures. I am proud to be able to support this important public health reform. Water fluoridation will mean better dental health for Queenslanders. Better dental health means a better quality of life for the people of Queensland. I commend the bill to the House.
Mrs SCOTT (Woodridge—ALP) (4.43 pm): The addition of fluoride to the water supply is one of those issues which evokes strong opinions, and the amount of correspondence and emails we have each received is testament to how a negative campaign can be mounted by engendering fear in a section of the population. I believe that many of those who oppose the Water Fluoridation Bill do so with the best of intentions. However, I believe there has been a lot of misinformation peddled. Dental caries is a serious issue and rotting teeth can affect the entire system, cause pain and suffering, affect eating and sleeping, as well as have a detrimental effect on a person’s self-confidence and social life.
The cost of this entirely unnecessary impost on our health system is huge. In 2007-08 alone, some $145 million has been spent on oral health. Having spent 10 years as a dental nurse—seven of them in Queensland—I have seen many young children in distress with a high number of decayed teeth and requiring a general anaesthetic for extractions. In fact, back in the days when I worked for dentists in Toowoomba in the sixties, we actually performed general anaesthetics in the dental surgery, and I can attest to the fact that there were times when lives were almost lost.
770 Water Fluoridation Bill 12 Mar 2008
I believe the incidence of dental decay has increased in recent years due to the high incidence of sugary drinks, poor food choices, lack of oral hygiene and the absence of sufficient fluoride in our water. It is easy for those who oppose the fluoridation of our water supply to say it can be easily remedied with a healthy diet, good oral hygiene and fluoride tablets. Changing lifestyle habits that have been established over many years and that sometimes are intergenerational is not as easy as simply mounting a public information campaign. There are children who never see a toothbrush until they start school and are given a toothbrush and taught how to clean their teeth. Some do not know the names of simple vegetables and fruit. They are fed preprepared meals, takeaways and white bread, and at the checkout counter often parents take the line of least resistance and give their children sweets to suck on. So to suggest that these families would purchase fluoride tablets and each day ensure their children take them is to live in fairyland.
Fluoridating our water supply is the only way that we can improve the plight of many of these children. Introducing healthy tuckshop food has been a great start. Although it may not change the habits of high school students, it is having an appreciable impact in our primary schools and we do hope that this will continue as habits of healthy eating throughout their lives.
This bill will ensure that within two years 80 per cent of Queenslanders will have access to fluoridated water and that by 2012 that will rise to 90 per cent. It is time Queenslanders were given the same protection from tooth decay that the populations in other states have enjoyed for many years. Having spent 17 years outside of the state in both New South Wales and Victoria, and having given birth to my three sons in Sydney, I can attest to the good dental health my children have enjoyed.
The amount of fluoride added to the water supply is indeed small but significant, being between 0.6 and 0.9 parts of fluoride per million parts of water—not a drop in a bucket but a drop in a bathtub. Adequate safeguards will be in place to ensure compliance with the act, and appropriate training will be given to operators of our water supplies. Capital costs will be borne by the state government, with funding of $35 million having been allocated. When compared with the annual cost of our oral health, this is indeed money well spent.
In years to come this measure will save the state massive health costs, save our children and adults pain and suffering, and increase general health and wellbeing with no detrimental effect. In Logan City we have a superb school dental health service led by a wonderful, dedicated man, Dr Trevor Holcombe. Here, many masters degree students from the University of Queensland are able to obtain valuable clinic experience, and we are fortunate that our children are able to access such a service. However, with such a high incidence of tooth decay, the pressures are huge. A visit to the dental service at Logan Hospital makes it clear that they are simply unable to cope with the demand. This legislation will ensure that in years to come our services will change and there will be far fewer extractions and a greater ability for our services to really care in a positive way to ensure healthy teeth.
I want to commend the Premier, Anna Bligh, for her decisive action in moving quickly to bring this legislation to the House. I am proud to be part of a government which is seeking to improve the health of our children and families in many diverse ways—promoting healthy eating and keeping active, cutting out harmful substances such as cigarettes and drugs, cutting down on alcohol, and now adding fluoride to our water supply. I commend the bill to the House.
Mr MALONE (Mirani—NPA) (4.49 pm): It is with pleasure that I rise to support the Water Fluoridation Bill 2008. Finally the government has accepted the overwhelming body of medical and scientific evidence that fluoride is safe and is the best way to protect the teeth of Queenslanders. I place on record my admiration for the clear and strong statement of support put forward earlier in the House by the member for Surfers Paradise who, as we all know, is a practising dentist and the best expert in the chamber to comment on the benefits of adding fluoride to our drinking water.
For years we have heard of the very poor state of dental health in Queensland, particularly amongst young Queenslanders. The Americanisation of diets, and in particular the diets of our young people, has resulted in the adoption of sweet foods and sweet carbonated drinks. We all know how cheap they are, how they are pushed and are accepted by young people in our community. Carbonated drinks, along with highly refined fast foods, are the real culprits. They are advertised very widely and it is virtually impossible to keep young people away from the bad habits that are formed at a young age and will continue into later life. We have heard plenty of reports in the parliament today about how it is easier to give in to a child in the fast lane in the supermarket when they want a packet of lollies. It has been a few years since I have had to chastise my children, but certainly my grandchildren are doing the same thing. At the end of the day it is about parenting and healthy lifestyles.
Queensland has one of the highest rates of dental decay in the Western world. It is so bad that our standards have been called Third World. It is a terrible situation and one that none of us can be very proud of. We need to move beyond Third World dental standards. Medical and scientific experts tell us overwhelmingly that the best way to do that is to add fluoride in approximately one part per million to our drinking water supplies. It is a low-cost addition to the filtering and chlorination that already occurs and the cost benefits are enormous. We have only to look at the dental records of communities around the world where fluoride occurs mostly naturally in drinking water through groundwater supplies to see that it works well and it works very safely. I note that despite claims of danger and damage—certainly all of
12 Mar 2008 Water Fluoridation Bill 771
us have received emails to that effect—as far as I am aware, and certainly from indications by the member for Surfers Paradise, there is not one documented case of disease or bone damage that has been caused by fluoridated water.
The issue before us has become quite difficult. As I said earlier, we have all received masses of emails. It has certainly created a situation in all electorates where there are people who are very strongly opposed to adding fluoride to water. There are two aspects to that. The first aspect is that there are a lot of people who are opposed to being forced into a situation where they have to accept the fluoridation of their water supply. The second aspect, of course, is the fact that they are opposed to the fluoridation. The opposition has drafted two amendments to the bill whereby we give the opportunity to people in our state to have a say as to whether they want to fluoridate the water or, alternatively, for those who are opposed to actually ingesting fluoride, to subsidise the cost of filtration for them. I think that is a good compromise. As I said, there are real concerns about those two aspects in our community and I accept that. I personally believe there are major health benefits to the fluoridation of water, but there are other views within the community that we must recognise. The members of parliament who have spoken very eloquently on the subject recognise that.
There are not many here today who can remember back to the old school dentist who used to come in with a collapsible chair and a foot-driven drill that used to pedal away and be driven through leather belts et cetera. If it ever got into your mouth—and most boys I knew would not let it; they would bite the dentist’s finger off—the reality was that it felt like a jackhammer in your mouth and the pain was pretty ordinary, too. We have come a long way since those days. It is a real shame to see young children go to the dentist and have teeth extracted simply as a result of a bad diet and a lack of good dental hygiene. The simple method would be to make sure that everyone cleaned their teeth on a regular basis and had a healthy diet. I am sure that through our education program we could go some way towards that. But I am sure that the people in our community that are most affected by this situation would probably not take any notice of it and we would still have a huge number of children in our community who would be guaranteed to have bad teeth.
The greatest event in my dental history was when I was in high school and I got a kick in the mouth with a football boot. I consequently lost two teeth. We did not have the fancy technology that we have nowadays where they are able to save the teeth so I lost two teeth out of that. Technology has come a long way, as I am sure the member for Surfers Paradise can tell us. I am sure that his bank balance can attest to the costs involved in that. With those few words, I support the bill before the House. Be assured, though, that I have some concerns in terms of the application and other aspects.
Mr NICHOLLS (Clayfield—Lib) (4.56 pm): From the start let me say that I am very happy to be able to support and commend the Premier, the health minister, the shadow health minister—my friend the member for Surfers Paradise—and others in supporting this long overdue legislation that will effectively see most Queenslanders drinking fluoridated water in the very near future.
Supporting this bill is pretty straightforward for me. It is about supporting the oral health of Queenslanders. It is supporting not only the health of Queenslanders today but also the health of many generations of Queenslanders in the future. When the Premier announced it I actually wrote a letter to her saying how impressed I was that this government was able to put aside some of the fearmongering and the scaremongering that we have all been subject to and to take possibly the last single remaining medical initiative in Queensland to ensure good health for all of us. Perhaps it is not necessary for people who are well-to-do, who can afford to go to the dentist, who know the right food to eat and who practice the right oral hygiene; perhaps the people who do not have those skills, people generally regarded as less well off, will benefit the most. Government is about helping those people who will benefit the most from these sorts of initiatives. It follows in the great tradition of science and public health, from the introduction of sewerage, clean water supplies and dealing with polio, diptheria and smallpox. This is the latest in a long line of outstanding public health measures that benefit a whole community.
The coalition supports the bill on the basis of the introduction of a similar private member’s bill by the member for Surfers Paradise back in 2004, a bill that unfortunately, due to the politics of the time, was defeated 70-6. It would have been better to have had that bill in place four years ago and to be four years further down the track in the fluoridation of water, but that was those times. I can remember back to 1997 and the Brisbane City Council election at that time when water fluoridation was probably the single biggest issue. To his eternal shame, Jim Soorley campaigned on the basis of pure blatant politics and the politics of fear, shame and envy. He was successful in doing so. There is possibly a lesson to be learnt there as well. We have moved on 10 years since then and we are now at the stage where we can debate this maturely and rationally and we can do the things we should be doing. We should be accepting the science. We should be accepting a rational logic. We should be accepting the evidence of experts, not only here in Australia but around the world.
It will not be betraying confidence to reveal that the health minister and I had a discussion about this at a function at the Brisbane Powerhouse back in 2004. This is when we first discussed the benefits and otherwise of the fluoridation of water and what needed to be done to get fluoride into the Brisbane water system. As a parliamentarian I am glad to be able to support him and the government today in the introduction of fluoride to our water supply. I put that clearly on the record.
772 Water Fluoridation Bill 12 Mar 2008
Mr Robertson: You have a good memory.