Fluoride decisions could prove costly

The decision to fluoridate water should be made by the government, otherwise health services could suffer, a Labour MP says.

During a visit to Whanganui with other Labour MPs, including health spokeswoman and deputy party leader Annette King, Trevor Mallard spoke about the proposed move for district health boards to take over the decision about whether or not to put fluoride in water supplies. A bill is expected to be introduced to Parliament later this year.

Mr Mallard said he was concerned about health boards fighting court cases brought by those opposed to water fluoridation, something which had been "very expensive for city councils".

"I'm quite anxious about the amount of money that DHBs are going to have to spend on lawyers and not on patients," he said.

"What health services are people not going to get because lawyers are being enriched as a result of the process?

"My personal view is actually the government should just take the decision."

Ms King said the Labour party policy was pro-fluoride, and she supported the move to take the decision away from local councils.

However she would be asking the Minister and Associate Minister of Health "what funding they have set aside for DHBs to be able to deal with court cases and legal fees".

Mr Mallard said having a "whole pile of regional decisions" would increase the chances of matters going to court, compared to if there was one "central decision".

Ms King said they would be encouraging DHBs to put in submissions on the proposed change.

"You've got a serious oral health problem in Whanganui, one of the most serious in New Zealand," she said.

She said the evidence of fluoride reducing decay in teeth was "huge".

Ms King also spoke of the updated NZ health strategy, saying she was worried about making health boards "compete".

She said she hadn't had a chance yet to go into the strategy update, but was concerned about funding being tied to improvement on new "measures" being made.

Some of these measures include looking at the number of acute hospital bed days, ambulatory sensitive hospitalisation rates, and patient experience of care, which Health Minister Jonathan Coleman announced would be "financially incentivised" as "placing some funding at risk is about driving quality improvement".

Ms King was of a different view.

"I'm worried about that, because DHBs struggle with the money they have got."

She felt the changed strategy would "pit" health boards against each other.

Mr Mallard said it "makes it a lot harder to collaborate if you're always competing".

He said national targets such as trying to increase the numbers of elective surgeries meant some health boards would focus on the "easiest" elective surgeries to get their numbers up, rather than "ones that can make the biggest difference".

They were full of praise for Whanganui District Health Board, however, and said they had just seen how Whanganui worked with a larger health board, Capital and Coast, for their forensic mental health service.

"We've just seen some very committed people working in mental health here," Ms King said.