1. Guy Harkin 23rd May 2007 Community, Health & Social Care Scrutiny Committee FluoridationUpdate

2. Guy Harkin 23rd May 2007 WATER ACT 2003 From request to require: But only after a consultation PCTs to request consultation if they believe a scheme to be appropriate and cost-effective SHA to undertake any consultation Conduct of any consultation heavily prescribed by regulations published under the Act

3. Guy Harkin 23rd May 2007 Letter from Chief Dental Officer July 2005 Draws attention to the benefits of water fluoridation Advises on co-operation between PCTs and SHAs Outlines the main features of Water Fluoridation Consultation Regulations 2005 Recommends that “in discharging their duty to improve the oral health of their populations, and in particular to reduce inequalities in oral health, PCTs should consider the option of fluoridating their water supplies”.

4. Guy Harkin 23rd May 2007 NHS RECONFIGURATION 2005/6 From 3 NWSHAs to a single NWSHA From 42 PCTs to 24 PCTs Concentration on managing change rather than on making progress on the Chief Dental Office’s advice Reluctance on behalf of PCTs to enter into arrangements which might limit the discretion of their successor bodies

5. Guy Harkin 23rd May 2007 Spring 2007 – Formulation of North West Fluoridation Evaluation group Consists of all 24 North West PCTs The aim is “To undertake enabling work in order to put the 24 PCTs in a position to make an informed choice on whether to request a formal consultation on water fluoridation under the 2003 Water Act.”

6. Guy Harkin 23rd May 2007 ACTIVITIES OF GM FEG Identifying both a region-wide scheme and such smaller schemes as seem practical and appropriate Establishing costs, both capital and revenue, with United Utilities Organising the mapping of dental disease against the water flows involved in each of the schemes identified Commissioning cost benefit analyses for each scheme considered to be practical and appropriate

7. Guy Harkin 23rd May 2007 CURRENT POSITION Capital and revenue cost for all United Utility treatment plants have been identified Four potential schemes have been identified for cost benefit evaluation - A Greater Manchester scheme (26 plants) - A Greater Manchester plus scheme (42 plants) - A scheme covering all plants operated within the North West (84 plants) - A scheme covering the largest plants in each part of the region (14 plants)

8. Guy Harkin 23rd May 2007 NEXT STEPS Further work to be done to establish the actual dose which would be delivered by option 4 to the population centre covered Mapping of option 4 against dental disease figures (first three options completed) Commissioning of cost benefit analysis for each of the 4 options Presentation on conclusions to the PCTs in September and October 2007