Northumberland County and Water Fluoridation
Dear Public Health England
A recent newspaper report (Northumberland Gazette, 9th October 2019 - https://www.northumberlandgazette.co.uk/...) stated:
"The current [fluoridation] scheme covers areas in the former Alnwick district as well as parts in west Northumberland. Further north in the county is part of the existing scheme, but has not been receiving fluoridated water since the mid-2000s due to infrastructure failure; its restoration is being progressed by Public Health England.
The report to councillors notes that therefore some of Northumberland’s least deprived communities are receiving fluoridated water, while some of the most deprived are not.
The proposed extension would cover an area in the south-east of the county, from Blyth out to Bedlington and Morpeth and up the coast to Amble."
1. Please let me know the names of the Water Treatment Works which have not been supplying residents with artificially fluoridated water since the mid-2000s due to infrastructure failure.
2. How many people have not been drinking artificially fluoridated water since the mid-2000s? Were they advised that fluoridation had ceased?
3. Please name the Post Code Districts where artificial water fluoridation ceased in the mid-2000s.
4. Oral health surveys will have recorded the oral health of children living in the post code areas which have not been artificially fluoridated since the mid-2000s. Please interrogate your raw data at primary school level (or Ward level if data for schools has not been collected separately) and let me know, for each survey conducted immediately before cessation and in the years since fluoridation ceased, the sample size of examined children and the percentage of 5-year-olds with dental decay living in the relevant Post Code Districts. (Consent protocols changed in the mid-2000s but I would still like to see these statistics.)
5. Regarding the areas which are proposed for fluoridation - "from Blyth out to Bedlington and Morpeth and up the coast to Amble" please provide data collected in 2017 on % dental decay in the affected areas and sample size of 5-year-old children examined at primary school level (or at Ward level if data for schools has not been collected separately).
6. The newspaper report also stated "The capital costs of the proposed extension, for the plant and equipment etc, is around £2.15million, which would fall to the Department of Health and Social Care. " Please confirm that this expenditure would not be invoiced to Northumberland County Council if water fluoridation is extended and if deficient fluoridation equipment is replaced in the north of the County. (The newspaper statement is at odds with the actual experience of Cumbria County Council which has recently had to reimburse PHE for replacement fluoridation equipment capital costs.)
Yours faithfully,
Joy Warren
Dear Ms Warren,
Please find attached Public Health England's response to your request.
Kind regards,
FOI Team
Dear Public Health England,
Please pass this on to the person who conducts Freedom of Information reviews.
I am writing to request an internal review of Public Health England's handling of my FOI request 'Northumberland County and Water Fluoridation'. Your Ref: 733
Item (6) of my request for which I had a reply on 15th November.
Your reply stated "Public Health England has to date not required Local Authorities to reimburse the costs of capital equipment."
Since 2013, I have carefully collated revenue and capital costs of Water Fluoridation for England. I refer you to the reimbursement of fluoridation costs for Cumbria County Council and Nottinghamshire County Council which have been requested by PHE. In both cases, the amount of reimbursement demanded of these two local authorities increased during the years following the installation of replacement fluoridation equipment. The increases are such that they could not possibly be revenue costs.
I therefore still require an answer to my original question which was "Please confirm that this [capital] expenditure would not be invoiced to Northumberland County Council if water fluoridation is extended and if deficient fluoridation equipment is replaced in the north of the County. "
A full history of my FOI request and all correspondence is available on the Internet at this address: https://www.whatdotheyknow.com/request/n...
Yours faithfully,
Joy Warren
Dear Ms Warren,
We acknowledge receipt of your email and request for an internal review.
Public Accountability Unit
Public Health England
[PHE request email]
Tel: 020 8327 6920
www.gov.uk/phe Follow us on Twitter @PHE uk
Dear FOI,
I requested an Internal Review on 20th November. You acknowledged this request of 22nd November. It is now more than 20 working days since 22nd November. Please reply to my request for an internal review or let me have a reason for the delay in replying.
Yours sincerely,
Joy Warren
OFFICIAL
Dear Ms Warren,
I am writing in respect of your request for an internal review of recent
requests for information made to Public Health England’s (PHE) Freedom of
Information Team. You submitted your requests as you were dissatisfied
with the outcome of requests for information processed by the FOI Team
under case reference numbers 871 and 872.
Circumstances
You have submitted 40 Statutory Access requests relating to fluoridation
provision and research between 23 April 2013 and 2 December 2019. These
are detailed below together with the date that the requests were responded
to:
+------------------------------------------------------------------------+
| | | | |
| | | | |
| Case | Date | Details |Date replied|
| Number |received| | |
|---------+--------+----------------------------------------+------------|
| 130 |23/04/13|Bedfordshire dental decay in children | 21/05/13 |
|---------+--------+----------------------------------------+------------|
| 165 |21/05/13|Bedfordshire dental decay in children | 17/06/13 |
|---------+--------+----------------------------------------+------------|
| 238 |22/07/13|NDNS- Results fluoride exposure | 12/08/13 |
|---------+--------+----------------------------------------+------------|
| 276 |06/08/13|Organisation responsible for | 27/08/13 |
| | |fluoridation and water fluoridation | |
| | |programme in UK | |
|---------+--------+----------------------------------------+------------|
| 339 |16/09/13|Level of fluoride dosing plots and | 11/10/13 |
| | |target level of fluoride | |
|---------+--------+----------------------------------------+------------|
| 532 |04/12/14|Reduction in concentration of fluoride | 04/02/14 |
|---------+--------+----------------------------------------+------------|
| 188 |30/07/14|Cost of fluoride acid | 04/02/14 |
|---------+--------+----------------------------------------+------------|
| 241 |20/08/14|Cost of fluoride acid | 20/08/14 |
|---------+--------+----------------------------------------+------------|
| 280 |12/09/14|Cost of fluoridation | 04/09/14 |
|---------+--------+----------------------------------------+------------|
| 65 |15/05/15|Industry payments | 05/06/15 |
|---------+--------+----------------------------------------+------------|
| 194 |21/07/15|Cost of water fluoridation program | 06/8/15 |
| | |England 15/15 | |
|---------+--------+----------------------------------------+------------|
| 370 |01/11/15|Which organisations pay capital costs | 23/11/15 |
| | |for purchase of water fluoridation | |
| | |equipment. | |
|---------+--------+----------------------------------------+------------|
| 421 |23/11/15|Which organisations pay capital costs | 09/12/15 |
| | |for purchase of water fluoridation | |
| | |equipment. | |
|---------+--------+----------------------------------------+------------|
| 558 |11/01/17|Fluoridated water’s medicinal status | 23/11/15 |
|---------+--------+----------------------------------------+------------|
| 616 |02/02/17|Concentration of fluoride per litre of | 01/02/17 |
| | |water | |
|---------+--------+----------------------------------------+------------|
| 271 |09/07/17|Cost of water fluoridation program | 17/02/17 |
| | |England | |
|---------+--------+----------------------------------------+------------|
| 278 |12/07/17|Cost of fluoridation equipment, West | 01/08/17 |
| | |Cumbria | |
|---------+--------+----------------------------------------+------------|
| 312 |26/07/17|Cost of water fluoridation program, | 18/08/17 |
| | |15/16 | |
|---------+--------+----------------------------------------+------------|
| 378 |24/08/17|Concentration of fluoride added to | 13/09/17 |
| | |drinking water in fluoridated areas in | |
| | |England | |
|---------+--------+----------------------------------------+------------|
| 456 |17/09/17|Internal review of 387 | 06/10/17 |
|---------+--------+----------------------------------------+------------|
| 673 |24/11/17|Proposal re- fluoridation of central | 18/12/17 |
| | |Bedfordshire | |
|---------+--------+----------------------------------------+------------|
| 818 |25/01/18|Water fluoridation contact Bedfordshire | 20/02/18 |
|---------+--------+----------------------------------------+------------|
| 914 |27/02/18|Research proving safety of water | 20/03/18 |
| | |fluoridation | |
|---------+--------+----------------------------------------+------------|
| 947 |11/03/18|Fluoridation feasibility study -County | 26/03/18 |
| | |Durham | |
|---------+--------+----------------------------------------+------------|
| 961 |13/03/18|Oral Health strategy | 11/04/18 |
|---------+--------+----------------------------------------+------------|
|37 linked| | | 02/05/18 |
| to 975 | | | |
| |11/04/18|ROI calculation tool for estimating | |
| | |money saved by water fluoridation | |
|---------+--------+----------------------------------------+------------|
| 390 |30/07/18|Costs of water fluoridation 17/18 | 16/08/18 |
|---------+--------+----------------------------------------+------------|
| 668 |06/10/18|PHE (North of England) Water | 01/11/18 |
| | |Fluoridation meeting at the Stadium of | |
| | |Light, Sunderland, 19th September 2018 | |
|---------+--------+----------------------------------------+------------|
| 98 |27/04/19|Freedom of Information request - | 19/06/19 |
| | |Williamsgate Water Treatment Works, | |
| | |Cumbria and Water Fluoridation | |
|---------+--------+----------------------------------------+------------|
| 197 |19/06/19|Internal review of 98 | 29/07/19 |
|---------+--------+----------------------------------------+------------|
| 424 |15/07/19|Costs of Water Fluoridation F/Y | 21/08/19 |
| | |2018-2019 | |
|---------+--------+----------------------------------------+------------|
| 418 |30/07/19|Freedom of Information request - | 16/08/19 |
| | |Williamsgate Water Treatment Works, | |
| | |Cumbria and Water Fluoridation | |
|---------+--------+----------------------------------------+------------|
| 656 |30/09/19|Costs of Water Fluoridation F/Y | 22/10/19 |
|linked to| |2018-2019 | |
| 424 | | | |
|---------+--------+----------------------------------------+------------|
| 733 |19/10/19|Northumberland County and Water | 15/11/19 |
| | |Fluoridation | |
|---------+--------+----------------------------------------+------------|
| 734 |19/10/19|Water Fluoridation: Incompatibility with| 15/11/19 |
| | |EU and UK Law | |
|---------+--------+----------------------------------------+------------|
| 795 |03/11/19|Correlation between Hypothyroidism and | 28/11/19 |
| | |Fluoride Concentration in Drinking Water| |
| | | | |
| | | | |
|---------+--------+----------------------------------------+------------|
| 856 |17/11/19|Water Fluoridation Feasibility Report | 16/11/19 |
| | |2019 North East of England | |
|---------+--------+----------------------------------------+------------|
| 871 |20/11/19|Internal Review request -Northumberland | |
|linked to| |County and Water Fluoridation | |
| 733 | | | |
|---------+--------+----------------------------------------+------------|
| 872 |20/11/19|Internal review of Freedom of | |
|linked to| |Information request - Water | |
| 734 | |Fluoridation: Incompatibility with EU | |
| | |and UK Law | |
|---------+--------+----------------------------------------+------------|
| 915 |2/12/19 |Correlation between Systemic Water | |
| | |Fluoridation and Hypothyroidism | |
+------------------------------------------------------------------------+
You stated that the responses issued to you under requests 733 and 734
failed to fully address your questions.
Findings
Having looked at all the circumstances, it would be helpful to clarify
PHE’s remit. PHE is an executive agency of the Department of Health and
Social Care and a distinct delivery organisation with operational autonomy
to advise and support government, local authorities and the NHS in a
professionally independent manner. We are responsible for encouraging
discussions, advising government and supporting action by local
government, the NHS and other people and organisations, leading the
national health protection service, and preparing for public health
emergencies, sharing our information and expertise with local authorities,
industry and the NHS, to help them make improvements in the public’s
health and researching, collecting and analysing data to improve our
understanding of health and provide answers to public health problems.
You asked PHE a number of question about the safety of, costs of, risks
and benefits of the water fluoridation programme in England. It has
answered your requests as fully as possible citing the available evidence
and by doing this it has fulfilled its responsibilities as detailed above.
Your requests to the FOI team have been responded to in a timely manner
after consultation with the relevant departments within PHE. Your EIR
request 915 ‘Correlation between Systemic Water Fluoridation and
Hypothyroidism’ remains outstanding and will be responded to within
statutory timeframes.
Please see the responses to the two remaining requests below:
EIR 871
Further to your email of 20 November 2019, we have looked at your original
question and believe we have addressed your request fully.
You stated that you would like an internal review, however, we believe
that this did not form part of your original question. We can therefore,
treat your email of 20 November 2019 as a new request should you wish. If
you would like us to treat your email of 20 November as a new request,
please could you confirm this by email.
EIR 872
PHE are not able to provide further information in addition to that given
in our previous response (EIR 734).
From your line of questioning it is evident that you dispute PHE’s
position and the evidence on which this is based. You are entitled to your
view but it is counter-productive for both parties to continue to engage
in communication about information which is largely in the public domain
and on which we cannot reach a consensus as to its efficacy. We have fully
complied with our obligations to furnish you with information that falls
within the scope of your requests.
Referral process
FOI correspondence
Please note that you have the right to an independent review by the
Information Commissioner’s Office at Wycliffe House, Water Lane, Wilmslow,
Cheshire SK9 5AF.
Complaints referral
Your concerns have now been fully investigated and we are not able to take
them forward in the way you have requested. As such, you can refer your
complaint to your MP for escalation to the Parliamentary and Health
Service Ombudsman to review the case. You can contact the Ombudsman
through the website at [1]www.ombudsman.org.uk or by writing to the
following address:
The Parliamentary and Health Service Ombudsman
Millbank Tower
Millbank
London SW1P 4QP
Tel: 0345 015 4033
Email: [2][email address]
Yours sincerely,
Melissa
Melissa McMahon
Complaints Manager
Public Health England
[3][email address]
[4]www.gov.uk/phe Follow us on [5]Twitter @PHE_uk
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