Legislation, including statutory regulations, on water fluoridation

The Health and Social Care Act 2012 is the most up-to-date piece of legislation regarding water fluoridation in England.  It incorporates, in an amended form, the provisions of earlier Acts of Parliament on this subject, including the Water Fluoridation Act 1985, the Water Industry Act 1991 and the Water Act 2003.

The latter is significant because it removed an ambiguity in the decision-making process that resulted from different interpretations of the Water Fluoridation Act 1985.

Health authorities had taken the view that the 1985 Act gave them the final decision on whether or not to introduce a water fluoridation scheme to benefit their communities.  However, some of the water companies on whom health authorities depended to implement and operate new fluoridation schemes took a contrary position, insisting that  they had discretion as to whether or not they acceded to health authorities’ requests.

The Water Act 2003 resolved this impasse by placing a clear statutory duty on water companies to comply with health authorities’ requests made in accordance with the relevant regulations governing consultation and decision-making.  This requirement on water companies remains in force today.

Two sets of statutory regulations pertaining to water fluoridation are also currently in force:

  • The Water Supply (Fluoridation Indemnities) (England) Regulations 2005 set out the terms of an indemnity to be provided by the Secretary of State for Health to water companies operating fluoridation schemes.

  • The Water Fluoridation (Proposals and Consultation) (England) Regulations 2013 set out requirements on how local authorities must exercise their decision-making responsibilities when making proposals on water fluoridation.

Under the Health and Social Care Act 2013, local authorities with public health responsibilities are the public bodies that make decisions about water fluoridation in their areas.

Fluoridation proposals made by local authorities, such as whether to introduce, vary or terminate fluoridation schemes, are subject to public consultation.

Public Health England, on behalf of the Secretary of State for Health, has statutory duties with regard to implementing the decisions made by local authorities, entering into arrangements with water suppliers to give effect to those decisions, and monitoring the health effects of water fluoridation schemes.