King AnnetteHon ANNETTE KING (Deputy Leader—Labour): Labour will be supporting this bill to the Health Committee. I want to begin by commending Peter Dunne the Associate Minister of Health on his commitment to oral health. It is an area that I have a great deal of interest in—many know my background before I came to this House—but it has not been an area where there has been a lot of interest from other Associate Ministers of Health or Ministers of Health. But certainly Peter Dunne over the years has shown a commitment to improving the oral health of New Zealanders.But I have to say to Mr Dunne that I am a little disappointed in this bill because this bill is one that is now going to shift the decision making from local government to elected district health boards. Although that is a good halfway step it is not the full answer as to what is required here. You see one of the reasons that it has shifted away from local government is because it became highly political at a local level. Campaigns were run against fluoridation. Misinformation was spread. People stood for local government to oppose fluoridation. What we are doing in this bill is to shift the responsibility now to elected district health boards. Already we know—and I think it is in Hamilton where there has been some controversy over fluoridation—that one member of a district health board has stood solely for the purpose of opposing fluoridation. What we have done is to shift responsibility from one elected body to another elected body.I take the Minister's point that this is a health measure. This is not a water measure; it is a public health measure. The Minister said that population health is best addressed by elected district health boards at a local level. That is not the case in practically every other decision a district health board has to make. They are required by the Minister of Health who has absolute say over what they do through the letter of expectation to carry out the wishes of the Government of the day. So the idea that they have got some autonomy in making decisions around health is only very very at the edges if at all. So by shifting the responsibility to district health boards we will see once again the political pressure applied to those who are on those boards.I think if we are really committed to improving the oral health of young New Zealanders with all the science that we know with all the backing that occurs—there is no doubt about the science and the Minister mentioned that. But also the World Health Organization recommended that we boost fluoride to optimum levels. With all that why is this decision not being made as a public health measure by the Ministry of Health when it set a water standard. Why are we going to a halfway house? I suspect—and I am not sure but I suspect—the Associate Minister may well have liked to have gone the full hog but this is a halfway house.So we will support it to the select committee and I am interested in hearing submissions from the public on this measure. I hope those who are backed by evidence and science will come forward to make submissions on why we should be fluoridating water.Look this is a controversial issue. It has been controversial as long as everybody in this House has been alive and it will not go away. But we have—Simon O'Connor: Not that long then.Hon ANNETTE KING: Well I am not as old as the oldest person in this House but this issue has been around for as long as the oldest person in this House. I would remind the members opposite in the National Party—because this is a bill put up by their coalition partner—of what the Prime Minister's Chief Science Advisor and the Royal Society of New Zealand assisted by a panel of experts said in 2014. This is the man who has been chosen by the Government to give expert advice on such matters along with the Royal Society of New Zealand—one a respectable person one a respectable body—and they concluded there is compelling evidence that fluoridation of the water at recommended levels produces broad benefits for the dental health of New Zealand. Why would we be going to another halfway house on a measure that is shown to be able to give benefit to New Zealanders and the oral health of New Zealanders?Do you know when I started in my career many years ago the number of children with missing decayed and filled teeth was huge. In fact I trained in those days to do extractions on permanent teeth such was the state of New Zealanders' teeth. Over the years it has improved. It has certainly improved in areas where we have fluoridated water. What we do have in New Zealand now is dental decay that is the disease of poverty. You can see it in many parts of New Zealand.The best measure that would give them the best chance of lifetime teeth is fluoridation. We have those who will oppose it based on voodoo science and I think it is a real shame that we have been unable to crack this issue and to say this is a public health measure. We have done it on immunisation; we have done it on so many other issues in New Zealand. We said This is a public health measure that lifts the health status of all New Zealanders." but not in oral health. We continue to deny the need for us to take measures that will give every child in a fluoridated area the opportunity to have good teeth.I just so wish I had had that opportunity because one of the great costs to the health system of the future is going to be the baby boomers who retire not with false teeth but their own teeth and little ability to pay for that dental care. There is no help for adult New Zealanders who need dental care. The best thing that could happen to our young people becoming adults is that they go into their life with good teeth that need little work at all. Because if you want to see how you can blow a health budget—you will blow it if you have to provide oral health to all New Zealanders.Fluoridation is such a sensible measure. So I say to the Associate Minister: is he prepared to look at another option here? Is he prepared when this bill goes to the select committee—if the evidence and if the submissions are not form submissions that we often get when someone opposes something and they are all asked to send them in—to look at an alternative where in fact fluoridation is a standard set by the Ministry of Health the Director-General of Health as a public health measure? I ask the Associate Minister that in all seriousness because he did point out some of the terrible statistics around New Zealand children's teeth.The number of children hospitalised with tooth decay was a thousand extra 2 years ago compared with 2008. You look at the figures—the number of children hospitalised; think about that having to go into hospital because they have got tooth decay. Look at the number of children who have to have a general anaesthetic to remove their teeth. Sure there is an obligation for parents to make sure their children eat healthy food that we restrict the amount of sugary drinks etc. that children are consuming and that they clean their teeth but as we know that does not always happen and has not always happened. But there is one measure that would give them a good start and that is fluoridation of the water supply.I guarantee that we—all of us on the Health Committee—will be inundated by text messages emails and letters telling us that we should not be approaching this measure. But I say that our select committee has shown over time that it is prepared to look at the tough issues and I am sure it will but I want to see whether there is a better way of doing this that has real coverage of fluoridated water supply rather than as I have said this halfway measure.We will support the bill to select committee. We welcome the submissions I hope there will be there. We would welcome also expert advice coming before our committee. In fact I say to our chair Simon O'Connor that we ought to invite Professor Gluckman to come and give the evidence as to why this is a very good public health measure."