The fluoridation of water supplies in England and Wales is governed by the Water Industry Act 1991 as amended by the Water Act 2003. Currently there are no proposals to extend fluoridation in Scotland or Northern Ireland. The decision whether to fluoridate the water supply in a particular area is wholly a matter for the strategic health authority (SHA).
Read government guidance
Before making a decision, the SHA must now first consult and fully take into account the views of affected persons in accordance with the Water Fluoridation (Consultation) (England) Regulations 2005:
(a) once a decision to fluoridate has been taken, then this must be implemented by the water company on behalf of and at the expense of the health authority, in accordance with an agreement negotiated between them or as determined by the Department of Health (DoH);
(b) in addition, the DoH must grant the water company an indemnity against any third party liability that may arise, in accordance with the Water Supply (Fluoridation Indemnities) (England) Regulations 2005;
(c) these provisions are supplemented by –
(i) the Code of Practice on the Technical Aspects of Fluoridation 2005 issued by the Drinking Water Inspectorate of the Department for the Environment, Food and Rural Affairs;
(ii) guidance issued in September 2005 by the Chief Dental Officer of the DoH;
and will be supplemented by –
(iii) a model agreement to be issued by the DoH for use by health authorities and water companies.
Implementation in England
Although all necessary legislation is now in place, final implementation of the new regime in England now awaits the DoH completing its consultations on and issuing a model agreement.
Implementation in Wales
However, implementation in Wales and in areas straddling the English-Welsh border is dependent on and awaits action on the part of the National Assembly for Wales.
Background to water supply fluoridation
Water supplies have been fluoridated in parts of the UK since the 1960s. However, it was held in the Scottish case of McColl v Strathclyde Regional Council (1983) that fluoridating water supplies was unlawful. Parliament therefore passed the Water (Fluoridation) Act 1985 in order to put fluoridation on a legal footing. For England and Wales the provisions of the 1985 Act were subsequently included in the Water Industry Act 1991.
However, problems arose because the legislation in effect required health authorities and water companies to agree that it would be beneficial to fluoridate the water supply in particular areas. In practice it proved impossible for such agreements to be reached.