Fluoridation: Whakatane teaches us something we should already know

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Parliamentary Committee – proper place to discuss attitudes towards community water fluoridation?

So, the Whakatane District Council today reversed its decision to stop fluoridation (see Whakatane fluoride flip-flop). A decision made only a few weeks ago (see Fluoridation: Whakatane District Council makes the Hamilton mistake).  The new vote effectively acknowledges they had made a mistake – a mistake they would not have made if they had paid attention to what happened in Hamilton 2 – 3 years ago.

Well, really two mistakes:

1: Councils should not ignore the democratic will of the electorate without very good reasons. Sure, the referenda in Hamilton and Whakatane were non-binding. But they did represent the will of the people. And the council did not have adequate reasons for ignoring that will.

One difference in Whakatane is that only Ohope and Whakatane itself are fluoridated. The new resolution requests the council to decide whether to fluoridate other areas where the voters supported it – noticeably it effectively accepts the will of those voters opposed to fluoridation where they are a majority in a specific water treatment area.

2: Councils should not be so foolish as to think they can decide the science, or decide health matters. It amazes me that the mayor of Whakatane could acknowledge his council does not have scientific skills – yet he went ahead and got the council to make decisions about the science and health issues involved with community water fluoridation!

Perhaps he would not have done this if there had not been an ideologically and commercially motivated activist group pressuring the council. But that is no excuse.

Would this Mayor have succumbed to pressure from an activist group who disagreed with accepted science and technology of road and bridge building? Of house construction? Or any other matter the council considers. Just imagine what havoc a flat earth society or anti-gravity pressure group could play.

I would hope not. We cannot have such important issues endangered because a group with no skills in the matter takes it upon itself to think it can make decisions about the science, technology and health recommendations. Whatever pressure is coming from activist groups.

It is not the job of councils to decide such matters.

What should councils decide

Yes, they must decide on financial and operational matters involved with these issues. But they don’t get to decide the science and technology. It is hubris on their part to think they can.

Councils do have a role. As operators of water treatment plants they must decide on the financial and working matters. They must decide on the feasibility of specific water treatments.

Under current legislation, they must also take into account the attitudes of their electorate. The government and central health bodies recognise that community water fluoridation can be controversial for some people. Therefore, they encourage local communities to make the final decisions. It is noticeable that where Health Boards seek to extend community water fluoridation they use community consultation and education, including referenda, and do not impose a central demand.

In the end, no matter what the science says or what central health authorities recommend, it is up to communities to make up their minds on a controversial social policy – even if that results in a decision contrary to skilled recommendations.

But councils should not have any role in deciding the science or health policies. The appropriate bodies already do that and they make their recommendations. It is arrogant for councils to think they can, or should, rewrite those recommendations and conclusions about community water fluoridation.

Councils really have nothing to complain about

Councils complain they are being asked to make decisions they are not skilled to make – but that is up to them. If they accepted the conclusions and recommendation of the appropriate central bodies and limited their consideration to financial and working matters which are correctly within their skill set they would have nothing to complain about. Similarly, they should accept the democratic will of their voters on this issue (unless there are good financial or operational matters suggesting otherwise).

Perhaps there is need to remove councils from that assessment of community attitudes towards fluoridation. Let it be done by health boards.

As for the demand that so-called “independent”  or “alternative” groups have an input into decisions – surely the most appropriate place for that is at a central level – the parliamentary health committee or reviews by the Ministry of Health. Such considerations would be less influenced by the childish politics we often see at the local level – especially in election year (which is the case for Whakatane and was also for Hamilton).

Councils should stop sticking their noses into areas they have no authority or skills to make decisions on.

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7 responses to “Fluoridation: Whakatane teaches us something we should already know

  1. In the end, no matter what the science says or what central health authorities recommend, it is up to communities to make up their minds on a controversial social policy

    This irritates me. Why is the issue even controversial?

    Answer, because an activist movement consistently misrepresents the facts.

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  2. I agree, Richard.

    The science is plain and simple.

    The only controversy is the one the anti-fluoridationists repeatedly try to manufacture by misrepresenting the science and the facts.

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  3. Citizens pay for health departments to sort out public health measures. All city officials have to do is refer to their expertise. Easy.

    Liked by 1 person

  4. Ken, the problem with simply accepting the will of the voters is that they are subject to the same onslaught of misinformation from antis as are governing bodies. The citizens of Whakatane and other areas of NZ are obviously intelligent enough to understand the difference between science and junk science. However when antis unleash their loads of hogwash onto populations which are more easily confused, it is far more difficult to provide accurate information to, and properly educate, these entire populations than it is to do so with a representative local body.

    Leaders are not elected to accede to the wishes of the electorate. If they were, we would have no taxes, among many other things, and the whole infrastructure would collapse. Leaders are elected to act in the best interests of their constituencies. Often these two concepts are in accord with each other. However, when they are not, it is the responsibility of leaders to give greater weight to the best available evidence, and recommendations from those best qualified to render appropriate ones. Voter surveys should most certainly be carefully considered and factored into these decisions. However they should not be the only factor on which to base these decisions.

    In my opinion, the mistake of the Whakatane leaders was not that they didn’t abide solely by the survey, but that they didn’t abide by the best available information and recommendations from those best qualified to render appropriate ones. In the end, the result was the same as if they had, but they could have saved a lot of time and energy had they acted responsibly in the first place.

    Steven D. Slott, DDS

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  5. Steven, I agree the mistake was that the council did not abide by the best available information and recommendations. But this boils down to them having the arrogance to think they “know better” despite admitting their lack of scientific skills. They wre stepping outside their role which in his case was limited to considering the financial and practical aspects of new or existing fluoridation schemes and listening to the views of the people. Unfortunately this sort of hubris is common in our councils.

    I may disagree with you about the role of electorate opinion. In the Whakatane district some of the areas returned a majority opposed to fluoridation and the council will not introduce CWF in those areas. I agree with that as I think that if voters have an irrational fear of a social policy then they should still be listened to. I think the correct approach here is that the health authorities, the district health board, need to consult with the people there and educate them. It is the role of the health authorities because they are the ones with the expertise, and whom he people should respect for that, not the council.

    I agree that leaders are elected to make decisions. I think many voters actually object to these sort of referenda because they see it as the council not doing the job. But I think in the case of voters having a widespread irrational but genuine fear – eg cell phone towers – then councils have to seriously consider whether to ignore that.

    My impression is that in NZ the law actually says the community must be consulted on CWF and this may be done via a council consultation process rather than a referendum. But unfortunately this process has been turned into councils doing a scientific “review” which is dangerous as they have not skill for this. The approach of health authorities here is not to impose CWF but to use education as part of the process of introducing CWF.

    In the end, a sensible person in the street does not attempt to understand the science. They really just want to know the expert recommendations and are happy to go along with that.

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  6. Agreed, Ken. Education is the key, and the responsibility of leadership. When the best available information and recommendations from those most qualified, differ from what the voters return, then education is the answer not simply acceeding to the opinions of those who voted in a referendum. Elected leaders are not only responsible for those who vote, but also for those who don’t vote for whatever reason. This is especially critical in healthcare issues. This is one major reason why the results of non-binding referenda should not be the only factor considered. They must be considered, certainly, but only along with the other factors.

    Certainly I’m speaking as an outsider, and my opinions can only be taken in that context. The Whakatane Councillors acted irresponsibly. There is little question of that. However, their irresponsibility was in putting their personal opinions ahead of the valid scientific evidence and recommendations from those to whom they should turn for proper advice, not in the fact that they didn’t vote simply based on the results of the survey. The same applies to those in the regions which did not fluoridate. If they voted against fluoridation simply based on the results of their surveys, they acted irresponsibly, and abdicated their leadership roles.

    Steven D. Slott, DDS

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  7. I think we basically agree, Steve.

    But let’s not allow councillors to think they have a responsibility of education in health matters – that would be a disaster. (But it happened in Hamilton, NZ, when the council (in its arrogance) issued a pamphlet making oral health recommendations after they decided to stop fluoridation),

    Councillors should accept expert findings and, once they have considered the other issues, if they feel there is need for education they should hand it back to the health authorities who, after all, initiate discussion of the fluoridation issue.

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