Let’s get moving on f luoride
Some bulky items, a capital gains tax, less punitive approaches to criminal justice and substantive welfare reform seem to have been held up at the courier in Jacinda Ardern’s much-vaunted year of delivery.
But if you thought transformative politics was a tough gig, spare a thought for dental surgeons around Aotearoa who find themselves in the unenviable position of operating on children barely old enough to talk.
We could be sending fewer kids to the dentist in the first place though and perhaps it’s the lowhanging legislative fruit left to spoil which should be of bigger concern to Labour.
Take, for example, the Health (Fluoridation of Drinking Water) Amendment Bill, introduced by the then associate health minister Peter Dunne and backed by former minister of health Jonathan Coleman. Its genesis was an uptick in skirmishes in the Great New Zealand Fluoride Wars (1954-present).
Much to the dismay of the Ministry of Health, New Plymouth had been pillaged and Hamilton lost then recaptured. Faced with a polarised electorate and uncompromising positions, councils across New Zealand reached a consensus of their own: such decisions should be transferred back to central government.
Among their justifications was the peculiar situation where the ministry was lobbying district health boards to lobby individual councils to implement fluoridation programmes when central government could simply legislate a nationwide rollout.
The bill had one simple purpose: removing such decisions from councils mostly ill-equipped to interpret the voluminous amounts of dense scientific literature on the subject.
By handing the matter to DHBs, the Nationalled government had found a way to ‘‘keep it local’’ while the ministry was more likely to get what it had advocated all along – fluoridation across all urban areas where it was feasible.
Local government bodies were elated, and when Coleman tacked on a further $12 million
towards assisting councils’ transition to fluoridation, it seemed a decades-old debate would finally be shelved alongside the other conspiracy theories of the 20th century.
Dunne sponsored the bill. It was presented to the House in late 2016, and Labour MPs lined up to voice their support. Among them, Poto Williams and Jenny Salesa spoke of how oral health statistics provided ‘‘sobering reading’’, particularly the levels of preventable tooth decay prevalent among the disadvantaged in their communities.
David Parker stepped up to ask why the government was ‘‘kicking the issue down the road’’ by relying on DHBs, suggesting National ‘‘lacked the political courage’’ to protect the interests of the population by reverting control to central government.
Nonetheless, Parker fell in with his colleagues and signalled to the House that Labour would support the bill.
By the end of the session, not only had Labour, National and the Ma¯ ori Party voted for the legislation, but those often diametrically opposed, the Green Party and the selfproclaimed libertarian ACT. With only NZ First offering any resistance, the bill was dispatched to the health select committee.
But while the wheels of representative democracy began to turn, so did the cogs in our judicial system. South Taranaki District Council (STDC) successfully defended its right to fluoridate in the Court of Appeal and later in the Supreme Court.
But in a political climate where public participation in local government elections is frighteningly low, and emotions on specific issues run high, it cannot be guaranteed that councils will always move in step with Health Ministry advice.
Around this time we had an election. Dunne retired and the incoming Labour-led government had two options: junk the bill and revert to the preference of Parker et al or continue it under the sponsorship of new minister David Clark. Labour chose to keep the bill, and it sits untouched, bobbing up and down in the Government’s scheduled items of business.
One rationale for these delays might be that it is not worth the political capital at a time when suggestions are being tossed around regarding the long-term future of DHBs. But that would be of little comfort to dental professionals at the coalface, particularly as disparities in fluoridation coverage and the downstream consequences are no respecter of politics.
Rather frustratingly, the bill in its current form is unlikely to be a deal-breaker for the Labour and NZ First coalition so the latter could simply continue its opposition while the former used MMP the way it was intended, putting the heat back on National to help get this piece of legislation out for delivery.
It’s time to stop kicking the issue down the road.