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A local health authority's plans for the fluoridation of Southampton's tap water was not unlawful, the High Court ruled today.
A judge rejected accusations by Southampton resident Geraldine Milner that the decision-making process was "defective''.
Mr Justice Holman, sitting in London, ruled there was no substance in any of the grounds of complaint and the legal challenge must be dismissed.
Ms Milner brought her application for judicial review backed by local anti-fluoride campaign groups.
The South Central Strategic Health Authority (SCSHA) used statutory powers to instruct Southern Water, the local water provider, to go ahead with fluoridation in February 2009.
Other local authorities had put other fluoridation schemes on hold pending the outcome of the case.
Refusing the claim for judicial review, the judge expressed sympathy for people like Ms Milner who disagreed with fluoridation but said he had not been able to conclude that there had been any illegality in the decision-making process.
"I appreciate that that will deeply disappoint Ms Milner and the many objectors in the affected area, to whose position I am sympathetic.
"However it is important to stress that our democratic Parliament decided long ago that water can, in certain circumstances, be fluoridated.
"As I have endeavoured to show, and contrary perhaps to the belief of Ms Milner and others, it is not the law that fluoridation can only occur when a majority of the local population agree.
"Parliament has firmly entrusted area-specific decision making to the relevant strategic health authority (SHA).
"This SHA have not acted unlawfully and no court can interfere with their decision.''
Ms Milner was not in court today because one of her children was sick.
Her counsel, David Wolfe, said the health authority decision meant that approximately 195,000 people in Southampton and parts of south-west Hampshire "would have fluoride added to their water whether they liked it or not''.
The decision was made even though 72% of those who responded to public consultation opposed fluoridation, with just 28% in favour.
An opinion poll commissioned by the SCSHA produced a narrower result, with 38% against the scheme and 32% in favour and 29% "don't knows''.
Mr Wolfe said this showed the majority of the local population was opposed to fluoridation.
He accused the local strategic health authority of going against Government policy that no new fluoridation schemes should be introduced unless a majority was in favour.
Today Mr Justice Holman disagreed and ruled that was not the law.
The judge said adding fluoride to the public water supply was highly controversial.
Those in favour said it was an effective - and cost-effective - way of reducing the incidence of tooth decay.
It helped to overcome social inequality "between those children who are brought up with good standards of dental hygiene and those who are not''.
Opponents said the known "health disbenefits'' - in particular, the risk of fluorosis or mottling of teeth - outweighed any benefits.
They also said there might be risks "which are not yet fully known, such as increasing the risk of certain cancers''.
They regarded it as "ethically objectionable'', as a matter of personal autonomy, "to add anything to the supply of that most essential of commodities, water, that is not necessary for water purification''.
Opponents argued that, if people wanted to protect their own teeth and their children's teeth by the use of fluoride, they could use fluoride toothpaste or other fluoride products.
The judge said there was currently no fluoridation in Scotland, Wales or Northern Ireland.
In England, fluoridation does occur in certain areas in the West Midlands, Yorkshire and Tyneside and affects the water supply to about five million people.
The judge said whether it should extend to other areas was a matter for decision by the relevant SHA, taking into account the views of local people.
This the SCSHA had done.