Tag Archives: district health boards

Shyness of anti-fluoride election candidates

Why do anti-fluoride candidates standing for District Health Boards (DHBs) shy away from proper discuss of community water fluoridation? After all, they have usually raised the issue themselves – and often claim that those supporting CWF avoid the discussion.

In my article Fluoridation & democracy: Open letter to DHB candidate Andrew Buckley I raised this with Andrew Buckley who is standing for the Waikato DHGB. Despite writing an article on the issue on his webpage he refused to allow any proper discussion of the issue there. He allowed slavishly anti-fluoride comments but nothing from anyone who specifically disagreed with his (often incorrect) claims. My open letter to him  was an attempt to get that discussion going. I even offered him the right of reply and space here – but he refused. He effectively ran away from an issue he had raised himself.

Now this is also happening with Stan Litras, a candidate for Capital and Coast DHB. Stan is a well-known anti-fluoride campaigner – often producing anti-fluoride press releases from his astroturf one-man group “Fluoride Information Network for Dentists” (FIND). He is clearly standing on an anti-fluoride ticket and the discussion on his campaign Facebook page makes that clear.

For example:

stan-1

Notice specifically his claim of knowing the subject and claiming he can “defend” his “opinion.” Also, notice his claim that supporters of CWF “cannot defend their views in an open discussion with any reliable evidence.”

That is completely misleading. I have often critiqued his claims and have particularly taken issue with his misrepresentation and distortion of the science. I have always offered him a right of reply and he has always rejected it. If he can “defend” his “opinion” why does he run away from such discussions?

This post of his is typical of the way he distorts the science:

stan-2

Preventing discussion and banning critics

Far from welcomin g discussion of their claims these candidates actually do everything to prevent proper discussion. Andrew Buckley banned any comments from me (and presumably anyone else critical of his claims) on his page. And now Stan Litras has done the same. He removed some comments taking issue with his claims (one of them was mine) and has presumably banned the commenters. Hehas certainlyy banned me from further comments.

This is how he justifies his actions.

stan-3

So he is backing  away from claims that are still on his page and labelling anyone critical of his misinformation as a “pro-fluoride zealot!”

And isn’t it hypocritical for him to label others as “pseudoscientific” and blame them for the fact that he is standing specifically as an anti-fluoride candidate?

Oh, here are some of my articles on Stan’s misrepresentations and distortions – and I have always offered him the right of reply to these:

Anti-fluoridation campaigner, Stan Litras, misrepresents WHO
Cherry-picking and misinformation in Stan Litras’s anti-fluoride article
Anti-fluoride campaigners cherry-pick irrelevant overseas research but can’t find relevant New Zealand research
Anti-fluoridation cherry-pickers at it again
Misrepresentation of the new Cochrane fluoridation review
Fluoride Free NZ report disingenuous – conclusion
A challenge to anti-fluoridationers to justify their misrepresentation of New Zealand research
Fluoridation: News media should check press releases from anti-fluoridationists

Have you voted yet?

I know how confusing it is so hope you haven’t been fooled by any of these anti-fluoride candidates.

A Spinoff article Quack hunt: Our vital tool for stopping anti-science crackpots infiltrating your DHB is useful guide to the candidates for DHB positions.

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Fluoridation: One small step sideways?

elephant in room

Fluoridation. Let’s not ignore the elephant in the room – the need to separate scientific review from community consultation.

Most health officials and science-minded people welcomed the recent announcement of the government’s plan to transfer decisions on water fluoridation from local councils to district health boards (see Fluoridation decisions to be made by District Health Boards). But the welcome was, in most cases, luke warm. The health and scientific community would probably have preferred that central government take on that responsibility itself. Given that District Health Boards employ staff with much more scientific and health expertise than councils the decision was seen as one small step forward – by a government too timid and politically sensitive to local backlash to “go the whole hog.” But I believe this step ignores the elephant in the room – the need to separate the review of the science from political considerations such as community consultation.

On the other hand, anti-fluoride campaigners have presented the decision as a giant step backwards – at least in their public announcements and campaigns. But their disingenuous claims (describing the step as introducing mandatory fluoridation and removing democratic consultation) suggest this has more to do with scaremongering and rallying of the troops. In reality, they probably welcome the announcement of the plans as providing them yet another chance to deluge the public and politicians with their misinformation and scare stories.

I fear that the government’s moves may turn out to be only one step sideways – although the required legislative process does provide possibilities to make changes that clearly separate scientific consultation from community consultation. That would be a step forward

A small step sideways

Simply transferring the hysterical discussions from elected local councils to elected district health boards will provide the same level of access by ideologically and commercially motivated campaigners and their misinformation. In practice, the elected members of health boards may suffer the same degree of scientific ignorance, ideological biases and hubris amply demonstrated by local councils in the past.

Anti-fluoride campaigners recognise this. They already have supporters on some health boards and are consciously planning to increase their numbers with upcoming local body elections.

Jane Clifton recognised that this sideways step is the most likely outcome in her recent NZ Listener column (subscription required):

“Finally rolling up its sleeves to sort out this nonsense once and for all the Government has  . . .  relocated the decision with district health boards. DHB members are no less subject to fearsome lobbying than councils, so this major public health issue will remain the push-me, pull-you of unqualified, internet-schooled amateur lobbyists and ill-equipped local politicians.”

She says controversies like this are “beyond” councils as demonstrated by the “wondrous variety in their deliberations over fluoridation.”

A real step forward possible

According to the Ministry of Health, the government’s plans require an amendment to the New Zealand Public Health and Disability Act 2000. Page 19 of this act has the following section describing a public health advisory committee:

14 Public health advisory committee

(1) The national advisory committee on health and disability must establish a committee called the public health advisory committee to provide independent advice to the Minister and to the national advisory committee on health and disability on the following matters:
(a) public health issues, including factors underlying the health of people and communities:
(b) the promotion of public health:
(c) the monitoring of public health:
(d) any other matters the national advisory committee on health and disability specifies by notice to the committee.
(2) The advice given by the public health advisory committee is to be formulated after consultation by the committee with any interested organisation or individual that the committee considers appropriate.
(3) The Minister must make publicly available, and present to the House of Representatives, a copy of any advice given by the public health advisory committee.”

I think this advisory committee should be given responsibility for the  overseeing and regular review of the science around community water fluoridation. It could do this by commissioning bodies like the Royal Society of NZ and the Office of the PM’s Chief Scientific Advisor in the same way the Auckland Council on behalf of several local Councils did last year to produce the report Health effects of water fluoridation : A review of the scientific evidence (Eason et al., 2014). Maybe an approach similar to the previous National Fluoridation Information Service, which continually reviewed the literature, could be used. Or maybe such scientific consultation could be tailored to fit the specific situation taking into account any movement in the science and public concern.

Clause 2 above enables consultation with “any interested organisation or individual that the committee considers appropriate.” That would give scope for the credible serious opponents to the currently accepted science but, hopefully, would exclude (or reduce the significance of) the  mindless political campaigner and form letters in submissions.

Yes, the anti-fluoride campaigners would moan about the requirement that submitters be “appropriate” – but the honest ones should welcome the chance to present their scientific claims to a scientifically credible body.

Ideally, then, legislation could provide that scientific consideration is separated from the community consultation when fluoridation of a community is considered. It could make clear that the elected district health boards should not consider the science – that they are not the appropriate body for this. Their role should be to make recommendations after consideration from their staff on the oral health of a community and the need and practical possibility for community water fluoridation.  The board would also have a responsibility to consult the community to determine if fluoridation proposals are supported.

But, please, don’t let such elected boards become bogged down with sifting through piles of submitted misinformation about the science as councils have been. Otherwise, we will just see a future demand, this time from DHBs, for central government to take responsibility for the issue.

Deja vu!

Conclusions

At the moment, we are unclear how the new legislation will pan out. Anti-fluoride campaigners are taking advantage of  the current situation to scaremonger (both about fluoridation and about democracy in general) and spread misinformation. They are making the most of this – and probably enjoying the opportunity as these sort of campaigners recognise that the campaign itself brings more psychological  benefits than the actual decisions.

But the drafting and consideration of this new legislation provide opportunities to turn what could be just a small step sideways into an actual step forward. This could be the time to attempt a separation of scientific considerations and reviews from community consultations.

Perhaps the health and scientific communities could learn a little from the anti-fluoride campaigners activity though. Rather than allowing such campaigners to bombard our lawmakers with their misinformation without challenge, as is currently happening, perhaps there is some scope for sensible lobbying to strengthen the legislation by clarifying that scientific considerations must take place at the central government level and be separated from local consultations.

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Fluoridation decisions to be made by District Health Boards

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Image credit: Constant Contact

This has been on the cards for a while. In recent years ideologically and commercially motivated activists have played havoc with the consultations organised by local body councils. Councils have shown by their own actions they are not capable of considering the scientific and health evidence related to community water fluoridation. The political intrigues of local bodies and the lack of scientific skills have prevented sensible decisions in many cases – and resulted in reversals of decisions – sometimes within a few weeks. yet New Zealanders have in most places voted to support community water fluoridation.

Councils have asked the central government to remove decisions on fluoridation from their responsibility. And now the government has decided to do just that.

This is the text of today’s  press release from the Hon Dr Jonathan Coleman, Minister of Health, and the Hon Peter Dunne, Associate Minister of Health (see Fluoridation decision to move to DHBs):


DHBs rather than local authorities will decide on which community water supplies are fluoridated under proposed changes announced today by Health Minister Jonathan Coleman and Associate Health Minister Peter Dunne.

“New Zealand has high rates of preventable tooth decay and increasing access to fluoridated water will improve oral health, and mean fewer costly trips to the dentist for more New Zealanders,” says Dr Coleman.

“This change could benefit over 1.4 million New Zealanders who live in places where networked community water supplies are not currently fluoridated.

“Water fluoridation has been endorsed by the World Health Organization and other international health authorities as the most effective public health measure for the prevention of dental decay.”

DHBs currently provide expert advice on fluoridation to local authorities.

“Moving the decision-making process from local councils to DHBs is recognition that water fluoridation is a health-related issue,” says Mr Dunne.

“Deciding which water supplies should be fluoridated aligns closely to DHBs’ current responsibilities and expertise. It makes sense for DHBs to make fluoridation decisions for their communities based on local health priorities and by assessing health-related evidence.”

A Bill is expected to be introduced to Parliament later this year. Members of the public and organisations will have an opportunity to make submissions to the Health Select Committee as it considers the Bill.

See also: DHBs could make call on fluoridating water

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