For decades a debate has raged about putting fluoride into Britain’s water supplies. Dentists say there are proven benefits in reducing tooth decay among children, giving them healthier teeth for the rest of their lives. Some experts warn, however, of possible links with bone cancer, stomach complaints and even birth defects. Underlying that debate has been an important civil liberties issue. Critics say fluoridation shows the nanny state at its worst. Does the government have the right to inflict what amounts to mass medication on the population just to protect children whose parents fail to ensure they care properly for their teeth?

Fluoridation is a controversial issue for the government to take on, having got its fingers burnt on genetically modified foods. At present 11% of people in Britain have fluoridated supplies, in the majority of which fluoride is artificially added. No new areas have been fluoridated since the water industry was privatised under the Thatcher government. The proposed legislation will allow the 28 strategic health authorities in England to order the fluoridation of water after local consultation. There is, however, little conclusive research either on the benefits, or the possible health costs, of such a policy. In America, the shift is in the opposite direction, more than 50 towns and cities having withdrawn fluoridated supplies since 1990. In France and Germany fluoride is added to table salt, but people have the choice of not using it, or of buying a non-fluoride product.

At a time when the government talks of modernising healthcare and transforming the 1948 model of the NHS, fluoridation is a curiously old-fashioned policy, a throwback to the days when people had neither the knowledge nor the means to make themselves healthier. Today, the shelves in every supermarket are stacked with fluoride toothpastes. Ministers talk of enhancing consumer choice but are proposing a policy that offers no choice. Evian and Malvern must be rubbing their hands. If the government goes ahead with the plan, the main beneficiaries will be the bottled water companies.