SAFE DRINKING WATER BILL

Second Reading

Adjourned debate on second reading.

(Continued from 7 April 2011.)

The Hon. A. BRESSINGTON (17:20): I rise to indicate my support for the second reading of the Safe Drinking Water Bill 2011 and my intention to move some amendments (which would probably be no surprise). The bill, which I believe has its origins in the Productivity Commission, has as its premise the right for consumers to expect safe drinking water when they turn on the tap. It seeks to achieve this objective by subjecting water providers to universal safety standards, inspection and reporting requirements.

In detail, the bill—subject to certain exemptions—covers all the several hundred water providers in South Australia. While the largest, of course, is SA Water, with some 94 per cent of consumers as customers, there are numerous smaller suppliers, such as water carters and other resellers. Further, there are those who indirectly provide drinking water from rainwater tanks or bores, such as bed and breakfasts, caravan parks and other forms of holiday accommodation.

To limit contamination or toxic outbreaks, the bill requires each of these providers to have a risk management plan, with separate monitoring and incident plans. The bill also requires relatively frequent (once a year for SA Water, and no less than once every two years for smaller providers) audits and inspections by suitably qualified environmental health officers, the results of which are then to be reported to the Department of Health. Further, if there is an outbreak or contamination, the bill requires the provider to notify its consumers, which I believe is an increase in the transparency of the current reporting of incidents. Obviously, I fully support these measures to limit the risk and effect of outbreaks.

Ironically, it is a government that is probably responsible for more illness in this state that is introducing the safe water bill, when it persists in artificially fluoridating the water supply of everybody, when the known health effects of that practice are now accepted worldwide. The United States has lowered its level of 'dosing', if you want to call it that, to 0.7 parts per million because of the findings of the United States Federal Department of Health and Human Services, following significant scientific risk assessments performed by the Environmental Protection Agency, which in part found over 40 per cent of American teens now show signs of dental fluorosis—a sign of excessive fluoride intake that can lead to severe pitting and staining of teeth.

Those reviews also confirm earlier research showing that the prolonged high intake of fluoride can increase the risk of skeletal fluorosis, leading to brittle bones, fractures and crippling bone abnormalities. The reason the South Australian Health Department gives not to follow that lead is that this is Australia—Australia, where we have not done any of this testing, where we have not done any of these audits or risk assessments, and where the science on the harms of fluoride has basically been shoved under the carpet and ignored.

At the end of last year or beginning of this year, I had an expert in the field of fluoridation, Dr Paul Connett, come here and address members from this place and the other, and members of the public and healthcare professionals who were interested in this issue. I know that there were members of the Labor party who were shocked by the information they received, and I know that because I have spoken to them myself, and they are now asking why we would persist with this practice when the health and wellbeing of not only our children but also of our sick and our elderly are being put at risk by an outdated and unscientific practice of putting rat poison in our water.

We know that fluoride has never been approved for human consumption. The way in which legislation has been drawn up and manipulated by federal and state governments, the TGA has no jurisdiction over any sort of assessments or studies on the efficacy of fluoride ingestion. So, that is a bypass, basically, of the watchdog of safety in this country. As far as putting medicines into people's bodies, they have to go through stringent testing, yet for sodium fluoride—and let me be clear, sodium fluoride (silicic acid) is rat poison—we are saying that it is okay to put this in our water supply at one part per million, based on junk science.

I am not going to rave on about this, because I have already made a very long speech on fluoridation, but I am going to put on the record, given the context of this bill and the title being the safe water bill, that the known symptoms of fluoride poisoning are:

arthritis—stiff, painful joints, with or without swelling;

asthma, especially after showering with chlorine-filtered water;

bony, painful lumps where tendons and ligaments attach to connective tissue;

chronic fatigue syndrome;

being very sensitive to cold temperature—always feeling cold, even after a hot bath or hot shower;

colic in bottle-fed babies, or colic developing when breastfed babies are weaned;

dental fluorosis;

diabetes: a worsening of symptoms;

diabetes insipidus (a kidney ailment)—excessive thirst, increased consumption of water that does not relieve thirst, dry throat and irritation frequent, diluted urine, especially at night;

eyes: moving black spots in front of the eyes;

fatigue: weakness and brain fog after bathing or showering in fluoridated water;

fibromyalgia: severe muscle weakness and/or pain, with extreme pain in various bony areas;

food intolerances that seem to come and go;

gastrointestinal problems: irritable bowel, nausea, diarrhoea, heartburn and upper bowel pain, especially after drinking water;

gum disease: irritated or bleeding gums despite good hygiene which are difficult to heal but which heal easily when you start using unfluoridated toothpaste and water;

heart palpitations and increased heart rate without exertion;

kidney disease: worsening symptoms; kidney stones;

skin: hives, blisters, rash on stomach or back within a fluoridated area or after bathing or showering;

drinking tea causes upset stomach, gastric pain, heart palpitations or the jitters, similar to strong coffee;

teeth: loosening or needing to be extracted despite good hygiene; and

thyroid diseases: underactive thyroid or overactive thyroid, goitre and nodules.

That is for adults. So, it may well be—and according to Dr A.K. Susheela, who has been diagnosing and treating fluoride toxicity for 35 years—that a great many people who are going to doctors for these ailments as adults are being misdiagnosed and therefore being prescribed medications they probably do not need. If that is the case, this government is responsible for that—and so is every previous government that has supported this practice without even considering that times change, science evolves and new information comes to light.

I think it is a bloody disgrace myself that we will not even call on Dr Susheela to come here and present to medical practitioners what she has found in her 35 years. You know what? If the science says that 3,700 healthcare professionals and 14 Nobel Laureates in science and medicine have this all wrong, we will yield. But no, turn a blind eye, a deaf ear, shove it all under the carpet and hope to God that these people never actually get tested for fluoride toxicity, and when they do they cannot even take it to a court of law. They have no common law rights the way we have legislated for fluoridation of our water supply.

I have just gone through the effects that it has on adults. Now, common in children—this is our children we are talking about, folks. Affliction of children due to fluoride poisoning is significantly different from adults. In children the adverse effects commence from intra-uterine life, if the mother is exposed to high fluoride. Infants with respiratory distress should be tested for fluoride in urine of the infant/drinking water, blood and urine of the mother. Fluoride ingestion by the infant from early developmental stages can lead to rickets, which may not respond to calcium and vitamin D treatment; unless the fluoride levels in urine/blood are lowered to normal range. In children the discolouration seen on the permanent teeth may not necessarily be due to dental caries or dirty teeth. But, in fact, dental fluorosis, which is, as I have said before, a sign of damage to the skeletal system.

The discolouration of the permanent teeth can be due to dental fluorosis. Discolouration is always horizontally aligned on the enamel surface; discolouration shall be away from the gums; the discolouration shall occur in teeth in pairs (bilaterally). Fluoride poisoning effects in adults can be tracked to soft tissue manifestations besides skeletal derangements. We also know now that it is a cause of kidney disease, it is a cause of lowered IQ in our children, it is a cause of behavioural problems and learning difficulties in our children and it is also the cause of brain damage which is absolutely debilitating in our children. We also now have a situation in Lismore, on the north coast of New South Wales, where a hero of the environmental movement named Al Olshack has fought Rous Water, which was basically directed by the New South Wales Health Department to fluoridate the Northern Rivers water system. A movement in Lismore has taken steps and brought this before the Environmental Court.

Last week, the judgement of Justice Biscoe was handed down. It was a decision on a preliminary legal matter ruling that Rous Water was required to comply with sections 111 and 112 of the Environmental Planning and Assessment Act 1979 with respect to the impacts of fluoride on human health and the environment. The ruling means that the New South Wales Fluoridation Act of 1957 does not stand in isolation from the EP&A Act, as was previously understood. In his ruling, Justice Biscoe made it clear that he did not believe that the environmental and human impacts of fluoride have been adequately investigated and has allowed for this case to go to trial so that the evidence can be presented in his court.

As a matter of fact, that is a win for the anti-fluoride movement, although I hate to call it that because it always sounds like people who want to go to war with each other. The fact is that we have one court in Australia that is able to hear a case against water fluoridation that will allow all of this evidence to be presented and for a judicial ruling to be made on the efficacy of fluoridating water supplies.

I wonder what will happen in South Australia if that particular trial shows that this has been a bad practice for so many years and governments all around this country have rolled it out, steamrolled it, onto communities who have objected because they have done their research. For 40 years in South Australia the objections of many people have been ignored and they have been referred to as the lunatic fringe because they refuse to drink water with a toxic poison in it.

In conclusion, I would like to say that one of these days this issue is going to come home to roost whether it be that a government is forced to pay compensation for the harm that it has caused to children, the sick, the vulnerable and the elderly in this state or whether it be that each one of you in here who refuses, whether it be your portfolio or not, to look at the research that has been published and peer reviewed, because it has shown without a doubt that fluoride is contributing to ill health.

The former health minister in the Whitlam government now has to go away and live with the fact that he just did not do enough. That will be basically your lot when you leave here. You have sat on your hands and shut your mouth because of party politics and commercial agreements and agreed to poison thousands of people in this state. You have refused to take any responsibility within your party rooms to rectify that. Your lot will be the same as that former minister who expresses his absolute ongoing regret at the age of 87 that he did not do more to prevent this from happening. I hope you can all live with yourselves.

I want to put on the record that I was absolutely disappointed with the response of the Liberal Party to these amendments that I have put forward in this bill that because it was about fluoridation, it did not need to go to the party room. It did not need to go to the party room for discussion. They would be completely disregarded because the amendments referred to fluoridation. How pathetic! How pathetic is that for an opposition to take that point of view when children, our elderly, sick and vulnerable are being exposed possibly to something that they are highly sensitive to or completely allergic to?

We are talking about the low socioeconomic people of this state who, unlike myself and others, cannot afford to have a rainwater tank installed or cannot afford a reverse osmosis filter or cannot afford to substitute their tap water for bottled water. They are forced to drink and bathe in this crap and get sicker as time goes by. I know of families who are having their urine tested and sent over to Dr Susheela in India and, by having the diagnosis from those urine analyses, this place and the other place and the major parties in here are going to have a lot to answer for in years to come when all this unfolds. Believe me, it will unfold. The science will come out. The truth is out there and the truth will set you free. I believe on the fluoride issue that the truth will prevail, and you can all hang your heads in shame.

The Hon. G.E. GAGO (Minister for Regional Development, Minister for Public Sector Management, Minister for the Status of Women, Minister for Consumer Affairs, Minister for Government Enterprises, Minister for Gambling) (17:39): I understand there are no further second reading contributions. By way of concluding remarks, I thank honourable members who have made second reading contributions for the support that they have indicated and I hope to be able to persuade those who have concerns during the committee stage in a way that allays their concerns. There were a number of questions that were asked during the second reading contributions that I would take some time at this point to put on the record.

Access to reliable supplies of good quality drinking water is recognised as a basic human right and is a fundamental requirement for community wellbeing. Communities have a right to expect that their drinking water supplies are safe and that there are systems in place to ensure that this right is maintained and their health is protected. South Australia has avoided drinking water outbreaks associated with public water supplies, and incidents have been restricted and very well controlled.

To a large extent, this has relied on voluntary actions applied by the major water provider, SA Water, which has long worked collaboratively with the Department of Health to meet the shared goal of ensuring safe drinking water supplies. SA Water applies the risk management approach described in the Australian Drinking Water Guidelines and the World Health Organisation Guidelines for Drinking Water Quality for assuring drinking water safety. However, the arrangement with SA Water does not extend to all drinking water providers, and it is likely that the number of providers will increase in response to challenges associated with climate variations and growing populations.

The consequences of failure to provide safe drinking water can be very high in terms of public health, economic and social impacts. Development of the Safe Drinking Water Act is identified as action 92 in the Water for Good plan. Water for Good notes that, with increasingly diversified supplies and potential new providers, it is timely to develop and implement more prescriptive safe drinking water legislation to provide a more clearly defined framework for identifying roles, responsibilities and reporting requirements.

In 2000 the Productivity Commission criticised Australian drinking water regulation as being light handed, lacking certainty of compliance, transparency and accountability, and that legal responsibilities were not always clear. However, in recent years the level of regulation has been increasing due to a number of factors, including corporatisation of the drinking water industry, outsourcing of functions, greater private involvement and isolated but serious incidents in Australia and overseas.

In 2003 Victoria enacted a specific Safe Drinking Water Act 2003, New South Wales enacted the Water Industry Competition Act 2006 for private sector water suppliers and Queensland enacted the Water Supply (Safety and Reliability) Act 2008. In South Australia provisions applying to drinking water were incorporated into the Food Act 2001 and the Food Regulations 2002. This was based on direction provided by the national Model Food Bill. Food Standards Australia and New Zealand recognises drinking water as a food. Legislation broadly defines a requirement to produce food that is fit for purpose and handled in a safe manner but does not provide direction to water providers on how this requirement should be achieved or how it should be measured.

This bill addresses the lack of clarity of the Food Act 2001 and provides a description for the actions required by providers to ensure drinking water to verify compliance with the Australian Drinking Water Guidelines. The bill will improve protection of public health, prevent disease and is consistent with objective 2 of the South Australian Strategic Plan 2007-16 'Improving Wellbeing'. The Department of Health and local government work jointly to ensure compliance with the Food Act, and it is proposed that the Department of Health will take primary responsibility for the administration and compliance with the Safe Drinking Water Act, and this will provide a uniform approach.

While SA Water provides about 94 per cent of the population with drinking water, there are broad range of other drinking water providers. The bill applies to those providers who are currently subject to the Food Act. Hence it will apply to providers who are responsible for the supplying of drinking water from independent sources. A list of sources is included and those it does not apply to and provisions for exemption as well, and if members need details I am happy to provide them.

Compliance requirements include that the level of detail in risk management plans as well as monitoring, reporting and inspection/audit frequencies will reflect the size, complexity and hence the level of public health risk of drinking water supplies, and the Department of Health will generate templates for:

registration of water supplies;

risk management plans for small water supplies; and

audits and inspections of water supplies (excluding large supplies).

Drinking water providers will be required to register with the department and must not supply drinking water unless they are registered. Registration will be a one-off event, with no associated fee, and will provide the department with important information as to the type, size and location of drinking water providers across the state. The department will be responsible for the upkeep and management of the register and will inform local councils of registered drinking water providers in their local area.

Risk management plans are recognised as the essential feature of assuring drinking water quality and a key component of the Australian Drinking Water Guidelines and the World Health Organisation Guidelines for Drinking-Water Quality. The framework for developing risk management plans described in the Australian Drinking Water Guidelines was developed with support from state and territory health agencies and drinking water utilities. Risk management plans have been successfully developed by all major water utilities and some medium providers.

In addition, risk management plans have been successfully adopted and applied by communities of fewer than 20 people. The Department of Health has undertaken considerable consultation with drinking water providers, especially smaller utilities and communities, to progress implementation of risk management plans. This assistance will continue to be offered.

The Department of Health considers that all drinking water supplies, except those supplied from domestic rainwater tanks, should be subject to water quality testing. Requirements proposed for small water systems will be based on current recommendations, including in the Department of Health fact sheets. In terms of audit and inspections, the Australian Drinking Water Guidelines recognise auditing of drinking water quality management as an important tool in confirming that systems are effective and producing desired outcomes.

Inspections and audits are prescribed in the bill to ensure that appropriate risk management plans are developed and implemented. Documentation, including monitoring results and maintenance schedules, will be examined as part of this process. Inspection and audit frequencies will be specified according to classes of drinking water providers, and inspectors and auditors will be approved for the purposes of the bill by the department with regard to appropriate technical skills, experience and competencies.

Environmental health officers employed by local councils who are currently undertaking inspections of food premises and/or have completed the core components of the Approved Lead Auditor in Food Safety Management Systems course offered by the department would be competent to undertake inspections for small drinking water suppliers. Audit of medium suppliers would require the completion of all components of the Lead Auditor in Food Safety Management Systems course or completion of the Drinking-Water Quality Management System Auditor Certification Scheme provided by RABQSA International. Many environmental health officers are approved food safety auditors, and it is proposed that this approval will be transferred to allow auditing under the bill.

In terms of Australian and international legislation, there is an increasing move towards specific drinking water legislation. The 2000 Model Food Bill, developed as part of the Intergovernmental Agreement on Food Regulation in Australia, identified the need to regulate drinking water quality either within a Food Act 2001 or alternative legislation. South Australia included drinking water within its Food Act 2001, as did Victoria before they introduced their act and associated regulations.

The Victorian Safe Drinking Water Act and regulations were developed to address inadequacies with the established regulatory framework and to provide a descriptive approach to assuring drinking water safety. The legislation includes requirements for drinking water providers to implement risk management plans, approve independent auditors and a range of other requirements.

New South Wales enacted the Water Industry Competition Act 2006 and associated regulations in 2008. The legislation applies to private sector water suppliers, and the regulations include requirements for implementation of risk management plans, auditing of plans by approved independent auditors and immediate reporting of incidents that threaten water quality.

Queensland passed the Water Supply (Safety and Reliability) Act 2008, and it also includes requirement for risk management plans, independent auditing of plans, immediate reporting of water quality incidents and publication of water quality results. Tasmania and the Australian Capital Territory have applied regulatory control through their public health legislation while including descriptive requirements in separate drinking water codes and guidelines.

In international legislation there has been growing support for drinking water regulations. The United States has long-established drinking water regulations and the EU regulates drinking water, also New Zealand and others. Requirements for risk management plans, annual reporting to health departments and immediate reporting of incidents are common components of the Australian regulatory requirements, and there are other mechanisms such as memorandums of understanding. Many elements of the draft Safe Drinking Water Bill are also similar to requirements contained in international legislation. We can provide a summary of that Australian international legislation if needed.

In terms of the cost of failure of the current system, the provision of safe drinking water is a continual challenge. The major risk to public health is the occurrence of an outbreak of disease from contaminated drinking water. While incidents and outbreaks occur infrequently in developed countries, the health, social and economic consequences can be severe. A contamination incident in Sydney in 1998 demonstrated the potential cost of a major water incident, even in the absence of illness.

Three 'boil water' notices were issued over several weeks following the detection of suspected contamination. The cost to Sydney Water was estimated at $75 million. The inclusion of hidden costs to the community increases that figure to $350 million. The Sydney incident was one of the primary catalysts for developing risk management approaches for ensuring drinking water safety in Australia. Disease outbreaks resulting from contaminated drinking water have occurred in other developed countries as well and have incurred considerable costs.

Responses to incidents and outbreaks typically involve subsequent imposition of increased standards, regulations and oversights. Both the Sydney and Walkerton incidents led to judicial inquiries. SA Water applies a risk management approach that minimises the likelihood of outbreaks. There have been infrequent water quality incidents requiring public notification and no evidence of outbreaks associated with the SA Water operated supplies. There have only been isolated occurrences of disease outbreaks detected in association with small non SA Water community supplies.

However, under-reporting is known to be a factor associated with detection of water-borne illnesses. Prevalence of groundwater use in rural areas and high use of rainwater tanks may also have contributed to the lack of public health impacts from community water supplies. The bill, by providing greater clarity, will reduce the likelihood of disease outbreaks originating from drinking water and the issuing of avoidance mechanisms, such as 'boil water' advisories. The requirements of the bill will also facilitate public confidence in the safety of drinking water supplies.

Costs associated with meeting the requirements of the proposed legislation largely represent a transferral of costs from ensuring compliance with the intent of the Food Act 2001. Hence, the cost to comply with the proposed act are expected to be relatively minor for responsible providers. This has been confirmed by discussions with a range of drinking water providers during consultation, including medium-sized regional suppliers such as Coober Pedy and Leigh Creek.

Additional costs will be incurred by providers who are not applying good management practices considered necessary to ensure and confirm supply of safe drinking water and public health protection. There will also be minor inspection/auditing costs. Costs to small businesses will be minimised by incorporating flexibility within required elements, combining drinking water inspections and audits where possible with existing requirements and programs, and exempting some premises that supply rainwater for drinking.

The impact on responsible businesses will be small and offset by the benefits of improved clarity and intent. In addition, compliance with the proposed legislation will increase customer confidence in the products or services provided by water providers, including accommodation and food provided by bed and breakfast businesses, as well as reducing risk of disease outbreak and contamination incidents.

As raised during consultation, the bill supports consistency of practices applied across specific industries such as accommodation premises and water carters. If the bill passes, the department will develop an implementation plan to enable the Safe Drinking Water Act to become operational. Implementation will require development of regulations and supporting guidance and training. The bill refers to matters prescribed by regulations in a number of areas including registration, rainwater supply exemptions, functions of inspectors/auditors and testing requirements.

The Department of Health will consult with key stakeholders on the development of the regulations and provide accompanying information to clarify intent and application. The Department of Health will work closely with local government to ensure appropriate consultation on implementation and effective liaison in developing a shared understanding of the processes and resources required to implement and administer the act.

The development of a memorandum of understanding between the Department of Health and local government will be initiated as part of the implementation plan. Training will also be developed, particularly for the environmental health officers, in relation to the performance of inspections and audits. Templates and guidance will be prepared to assist drinking water providers meet the requirements of the proposed act. These will include registration forms, guidance on the preparation of risk management plans, including monitoring requirements, water quality criteria and incident protocols, generic templates for risk management plans for small water suppliers and templates for inspections and audits. Local government and drinking water providers will be consulted on the nature and content of written material. With those concluding remarks I commend the bill to house.

Bill read a second time.

[Sitting suspended from 17:57 to 19:45]

Committee Stage

In committee.

Clauses 1 and 2 passed.

Clause 3.

The Hon. A. BRESSINGTON: I move:

Page 6, after line 3 [clause 3(7)]—after paragraph (b) insert:

(ba) contains fluoride at a concentration greater than 0.7 mg per litre; or

This amendment seeks to reduce the current rate of fluorosilicic acid added to our water supply to 0.7 parts per million, down from one part per million. This is in line with the recommendation earlier this year by the United States federal Department of Health and Human Services following scientific risk assessments performed by the Environmental Protection Agency that in part found over 40 per cent of American teens now show signs of dental fluorosis.

I make the point that last September, I think it was, my office put in freedom of information requests from the Australian Dental Association (ADA) to try to get the analytical data that relates to the amount of fluorosis and tooth decay in South Australian areas, comparing them with non-fluoridated areas. It took six months for them to be able to compile that data, because it is not data that they normally compile and analyse.

Really, what we are doing here is flying blind on the amount of fluoride that we are adding to our water. I do not believe 0.7 parts per million is an ideal level either, because that figure has just been pulled out of thin air by somebody, but at least it is a start in reducing the amount of fluoride that people will be taking in through their drinking water, their bathing water and the water that they are cooking with.

A point for members to grasp is that, when we cook our children's vegetables or our own vegetables with fluoridated water, the concentration of fluoride in that water is increased by some 600 per cent because of the evaporation. Fluoride does not vaporise, so it stays in the water and the level of the water decreases with boiling. The same applies to making tea and coffee with that water as well. So, whatever steps we can take now to reduce the widespread dosing of people who may be sensitive I think would be a good step, and I commend the amendment to the house.

The Hon. G.E. GAGO: The government does not support this amendment. Drinking water is deemed to be safe, providing it complies with the Australian Drinking Water Guidelines. The current guideline value for fluoride is 1.5 milligrams per litre and water containing concentrations that are less than this value are deemed to be safe.

Reducing the fluoride limit in South Australia to 0.7 milligrams per litre would have significant ramifications for groundwater supplies in the state. All groundwater contains natural fluoride and concentrations above 0.7 milligrams per litre are fairly common, I am advised. This includes groundwater supply to communities such as Millicent, Naracoorte, Port MacDonnell, Melrose and Geranium. There is no justification for reducing the upper limit of 1.5 milligrams per litre or for declaring these supplies unsuitable for drinking.

The suggested amendment is based on a proposed recommendation from the United States Department of Health and Human Services to establish a single concentration of 0.7 milligrams per litre where fluoride is added to drinking water supplies. The current policy is that fluoride should be added to achieve concentrations between 0.7 and 1.2, based on ambient air temperatures and hence water consumption. Under this policy, higher concentrations are applied in colder areas where water consumption is lower. This is similar to existing policy in Australia, with the National Health and Medical Research Council recommending that fluoride should be added to achieve concentrations between 0.6 and 1.1 milligrams per litre, depending on climate.

In South Australia, fluoride is added to achieve 0.9 milligrams per litre. The reason for the proposed change in the United States policy is evidence of increased dental fluorosis in adolescents between 12 and 15 and the absence of evidence that water consumption is influenced by climate. The likely explanation for this increase was considered to be greater use of fluoridated toothpaste and drinking water fluoridation. The proposed change is not based on evidence of skeletal fluorosis as claimed.

The situation in Australia is very different, where prevalence of dental fluorosis is decreasing. This reduction has largely been associated with better use of fluoridated toothpaste, including specific types designed for children. In Australia, the overall rate of dental fluorosis has markedly declined. In the early 1990s, the prevalence of fluorosis in Australian children was over 40 per cent, which is similar to current rates in the United States. By the early 2000s, the prevalence had halved. Nearly all of the dental fluorosis identified in Australia is classified as very mild to mild, which strengthens the teeth and is barely visible.

There is no evidence of skeletal fluorosis associated with fluoridated drinking water in Australia. The drivers for the proposed reduction in dose in the United States do not exist in South Australia. There is no evidence that South Australia should adopt a position that differs from the rest of Australia in relation to concentrations added to drinking water supplies or the upper limit of 1.5 milligrams per litre recommended by the Australian and World Health Organisation drinking water guidelines. I have been advised that the normal heating of fluids has very little influence on the concentration of fluoride.

The Hon. A. BRESSINGTON: I have a question for the minister. If we do not have doctors trained in Australia to test for fluoride accumulation, the Australian Medical Association, I think it is—I could be corrected on the organisation—has refused to do post-mortem bone studies on people who are suspected to have fluoride toxicity. If we do not do that sort of testing in Australia for people with osteoporosis or osteoarthritis—if we are not testing for fluoride—how can we possibly have any data in relation to that?

The Hon. G.E. GAGO: I have been advised that the review undertaken by peak health bodies here in Australia, including the National Health and Medical Research Council, have investigated the possibility of adverse effects of fluoridation and concluded that the evidence is limited to dental fluorosis.

The Hon. A. BRESSINGTON: I have a question for the minister. That information the minister says comes from the NHMRC, were they scientific studies done or a review of other literature written? My understanding is that there has been no scientific testing done in Australia on fluoride toxicity or fluoride build-up in the human body.

The Hon. G.E. GAGO: I have been advised that it is, in fact, a review of all worldwide research papers.

The Hon. A. BRESSINGTON: Did that review include the Harvard study by Dr Bassett, the study, from Harvard again, done by Dr Phyllis Mullenix and the 120 studies, I believe, that have been peer-reviewed and published? It is my understanding that very few, if any, of those particular studies that show adverse effects from fluoride were considered in any of those reviews.

The Hon. G.E. GAGO: I have been advised that the review considered all published research that had been done in the last 10 years, no matter what the source or outcome. For that research to be considered, it had to meet certain scientific criteria. I am advised that not all of the research was able to meet those criteria and qualify. However, all of this has been published. So, it has been very clear in terms of what research was included, what met the criteria and what research failed to meet that scientific criteria.

The Hon. A. BRESSINGTON: Another question for the minister: just to clarify that, are we saying here that our NHMRC review of the literature and the science here are of a higher standard than the department of neurotoxicology of Harvard University? Are we saying that we have had the same kind of testing done that they would do in Harvard and other toxicologists have done in their universities—Canada, Toronto, India, for example—and that none of those would meet the standards, scientifically, of little old Australia?

The Hon. G.E. GAGO: I have been advised that no, that is not what we are saying. Some of the research that was alluded to was likely to have been considered. Some of it was likely to have been included, having met the scientific criteria, and some of it not included.

The Hon. A. BRESSINGTON: All right. So, in 1991, the NHMRC made a recommendation that a full audit, if you like, or research should be done into the fluoride intake, in areas that were being proposed to be fluoridated or that were fluoridated, to see sources other than fluoride that people were consuming.

Can the minister explain why that particular recommendation was never followed through and clarify for the house that there has never been any sort of research done into the amount of fluoride, outside of drinking water, that people are actually taking in on a daily basis? Note that that was also a recommendation of the World Health Organization before fluoride was to be rolled out. They also recommended the same sort of study and review of the areas that were proposing fluoridation. Why haven't those reviews and that research been done?

The CHAIR: I remind the honourable member that this is not a court of law and the honourable minister is not under cross-examination, and it is the honourable member's amendment that we are talking about. The honourable minister can answer parts of that, if she wishes.

The Hon. G.E. GAGO: I have been advised that in 1999 the NHMRC published a draft report assessment of dietary intake of fluoride. Food Standards Australia and New Zealand has also recently published dietary intake of fluoride as part of its assessment and concluded that such intakes were safe.

The Hon. A. BRESSINGTON: Can the minister clarify how that assessment came about? What was the process of assessing daily fluoride intake?

The Hon. G.E. GAGO: I have been advised that Food Standards Australia and New Zealand used nutrition data and content of fluoride in various dietary components and I have been advised that their measures were standard measures for such compounds.

The Hon. J.M.A. LENSINK: The honourable member has three amendments to this bill which relate to fluoridation. The Liberal Party has a firm position that we do support fluoridation. I am not going to discuss the merits or otherwise of it this evening, but suffice to say that we trust the advice of the NHMRC as a longstanding body which has the authority on these matters. Therefore, we will not be supporting the honourable member's amendments.

The Hon. D.G.E. HOOD: None of us are experts on these matters and I think any of us who has done the reading on this would agree that it is incredibly complex, I certainly did. I would like to congratulate the Hon. Ms Bressington for examining these issues thoroughly. She has brought a number of articles to my attention, which I have read, and I must say that I was fascinated by the findings that have been handed down by very credible people about this issue.

I do not know whether or not there is too much fluoride in our water, I really do not. What I do know is that there are serious questions being asked by very credible people, and I think that in itself warrants not just this place but scientists to examine these issues thoroughly. We will support the amendments of the Hon. Ms Bressington. They are obviously going to be defeated, so it matters not in the end, but I believe that this is an issue that deserves further investigation.

So, I vote for these amendments hoping that sends a signal that this is a matter for inquiry. As I said, I do not know if there is too much fluoride in our water or not, but I do believe that this deserves a proper and thorough look.

The Hon. T.A. FRANKS: The Greens share the concerns raised by the Hon. Ann Bressington and also some of the sentiments just communicated by Family First. We note that around the world many countries do not have fluoride in their water; some do in their salt. However, Northern Ireland, Austria, the Czech Republic, France, Germany, Belgium, Luxembourg, Finland, Denmark, Norway, Sweden and the Netherlands are not countries to be ignored, and they have all chosen not to use fluoride in their water. Canada, East Germany, Cuba, and Finland have chosen to get rid of fluoride from their water.

The Greens in the UK, Canada, New Zealand and Europe have raised concerns about the levels of fluoride. What we have to remember is that this is something that cannot be regulated in dosage. We put a certain amount in the water, or we have existing levels of fluoride in our water, but we cannot control the dosage. We do regulate in some areas, such as children's toothpaste, to have a lower level of fluoride.

In America they have a certain level—a very low level—in baby products, and baby formula is not to have fluoride in it. We think that there is enough concern out there, which has been raised both by the Hon. Ann Bressington and the experts that she has brought to this place, and we thank her for bringing this issue to our attention.

We believe that there is an issue to be addressed here, not simply to be ignored. We think also that there has been a lot of corporate science (or junk science) involved in this debate. We would like to see some independent science, and we think that the governments of this country have a role to play in leadership in that area.

The Hon. J.A. DARLEY: I support the Hon. Ann Bressington's amendments for the same reasons already mentioned by Family First and the Greens.

The Hon. K.L. VINCENT: I was just going to say pretty much the same thing as everyone else has already said. For what it is worth, I support the amendment.

Amendment negatived.

The Hon. A. BRESSINGTON: I move:

Page 6, after line 7 [clause 3(7)]—After paragraph (c) insert:

(ca) has been declared by the Environment, Resources and Development court to be unsafe by order made under Part 7 division 4; or

I indicate that amendment No. 4 is consequential on amendment No. 2, which I have moved, and I will speak to both of them now. This amendment addresses what I consider to be a fundamental flaw in the current bill, namely, that it relies upon the state to initiate a prosecution against a drinking water provider for providing unsafe drinking water. While this may be appropriate if the bill is solely regulated by SA Water, the fact is this bill now regulates all water providers, including small water carters and other minor providers who will undoubtedly fail to attract the same level of attention and urgency.

Modelled on section 104 of the Environment Protection Act 1993, my amendment will enable a consumer to initiate action in the Environment, Resources and Development Court to have polluted drinking water found unsafe. Currently, such determinations are made by the minister or the state, with no avenue for a court to hear argument that is likely to be detailed technical evidence and, if satisfied, make such a determination.

In effect, the bill proposes to create a consumer's right to safe drinking water and yet provides no means for a consumer to enforce this right themselves. My amendment creates such a means. It is my hope that such an action will finally enable a court in this state to decide on the scientific evidence whether or not fluoridated water is safe.

Further, this section will enable a constituent to initiate an action to compel a water provider to meet their obligations under this act, to restrain a provider from breaching the act, or to take any remedial action necessary. While these are traditionally powers vested in the regulator, I see the proposed amendments as an additional level of accountability (which is a bit of a joke) on water providers and an avenue for constituents to enforce their right to safe drinking water.

More significantly, the bill currently also fails to provide a means to compensate consumers directly affected by the provision of unsafe drinking water. This is in contrast to the Environment Protection Act 1993, which enables individuals who have suffered loss or damages, or incurred expense in undertaking remedial action, to be duly compensated. Again, my amendment rectifies this with the Environment, Resources and Development Court able to order reasonable compensation from the water provider and, of course, number four is acceptance onto a fluoride tolerance register.

This is basically giving consumers a right. If they can prove that they are sensitive to fluoride and they can come up with the medical evidence to do so, they should be able to be heard in a court and have a judicial finding made and, once and for all, at least have an avenue of recourse for having to consume water that they may be either sensitive to or completely allergic to.

The Hon. G.E. GAGO: We are not dealing with the register now, though, are we?

The Hon. A. Bressington: No.

The Hon. G.E. GAGO: The government does not support these amendments. The aim of the Safe Drinking Water Bill is to provide a clear direction to drinking water providers on how to achieve safety and describe how safety will be measured. The bill also provides safety mechanisms to enforcement agencies to compel drinking water providers to meet obligations under the bill. Safety will be defined in terms of compliance and management principles and guideline values described in the Australian Drinking Water Guidelines.

A feature of the bill is that it has been designed to be practical and to describe requirements that can be applied in a manner that is commensurate with risk. This is particularly important for operators of small and moderate water supplies which can include professional and volunteer water carters and owners of small accommodation premises such as bed and breakfasts and caravan parks.

There was a good deal of discussion in another place that focused on addressing concerns and providing reassurance that the bill was not too onerous and did not place too many barriers or impediments to providers of drinking water supplies, particularly in small rural communities. Concerns were also expressed that, if too many impediments were included, an undesirable consequence of the bill could be that some providers might decide to opt out of providing drinking water and instead provide exactly the same water but market it and sell it as domestic non-drinkable water which is not subject to the provisions and protections afforded by the bill.

Alternatively, some providers may stop supplying water altogether. The outcome of discussions in the other place was general acceptance that the bill was pitched at a reasonable level. This amendment adds a significant layer of complexity in that anyone supplied with water in a very small rural community, for example (a bed and breakfast or caravan park) could initiate an action in the Environment, Resources and Development Court seeking compliance with the bill. Given that ensuring compliance is the responsibility of the enforcement agencies, it is assumed that the intent is to enable action to be taken when a person is not satisfied with the actions taken by enforcement agencies. This will add uncertainty for drinking water providers and could contribute to difficulties as raised in the discussions in another place.

It is also assumed that such action could include a consideration of fluoride or any other parameter where a person disagreed with the basis of the Australian Drinking Water Guidelines, again increasing the complexity of the bill potentially. The amendment includes an ability for a person to seek payment of compensation for injury, loss or damage. This type of remedy is available through common law, and inclusion in the bill is not considered necessary.

The Hon. A. BRESSINGTON: Is the minister saying, just for the record, that if a person has medical records that show and prove that they are fluoride toxic, and that they may have kidney problems, for example, and that fluoridated water is aggravating that condition or may have actually caused that condition, or if a person suffering from thyroid problems (either overactive or underactive) can prove through medical testing that it is caused by fluoride, can the minister explain to the committee what recourse those people have to require that the water coming out of their tap is safe for them?

The Hon. G.E. GAGO: I am advised that they would be entitled to take civil action in the same way as someone, for instance, affected by food poisoning.

The Hon. A. BRESSINGTON: It is my understanding that there is no court that can take any evidence on fluoride in this state, that there is no civil remedy available to people who have health concerns due to fluoride. I will check that.

If I can clarify that, apparently a civil court is not able to determine whether water is safe or unsafe. So, first, there have to be criteria in place for a person to be able to get a judgement, because a civil court will rely on the safe drinking water guidelines. We do not have a fluoridation act, I believe, in South Australia, as other states have, that can be tried and tested; so the civil court will not be able to find whether water is safe or unsafe. We have to knock that off before anyone can take civil action. That is my understanding.

The Hon. G.E. GAGO: I have been advised that the honourable member is right and a civil court cannot make a determination about whether water is safe or unsafe in relation to fluoride per se. However, the court can make a finding on damages if a causal link is established between the agent or, in this instance, fluoride and harm or damage caused to the person.

The Hon. S.G. WADE: Can I clarify that. If the contaminate was not fluoride, would a civil court be able to make a determination?

The Hon. G.E. GAGO: I have been advised that the answer is yes, so long as it is a finding to do with damages and a causal link is established between the agent and the damages or harm caused.

The Hon. A. BRESSINGTON: So, in order for a civil court to find a breach of duty of care, they have to use the safe drinking water guidelines as a guideline to show negligence. If the state is fluoridating at the level recommended by the safe drinking water guidelines, then no civil court is actually going to find the provider—that is, SA Water—negligent because it is within those parameters. Even if a person has proof that they are fluoride toxic, they are not going to be able to present that evidence at court; that is my understanding. There is actually no civil remedy for any person who is fluoride toxic in this state.

The Hon. G.E. GAGO: I can only reiterate that a civil court can make findings on damages, providing they are able to establish a causal link between the agent, such as fluoride, and the harm or damage caused. That is the remedy. I have already outlined that. I do not think I can elaborate on that any further.

The Hon. S.G. WADE: I must confess that I am not understanding the issues the honourable member's amendment is raising. In the minister's response, what I am failing to grasp is how a court can award damages if they are not in a position to establish a cause. The damages are in response to a cause. I thought I was understanding the minister in the context of subclause (7) to be explaining that a court was not competent to declare water to be unsafe, but it would be competent under paragraph (a), for example, to identify that a particular person had experienced harm. That is a different story to what I am hearing the minister present, so I just wanted to home in as to what is the limit of the court's competence, and does it relate to general unsafeness or personal harm to this particular individual?

The Hon. G.E. GAGO: I have been advised that the court's primary concern would be looking at the harm to the individual, that one of the benefits of the act would be that concentrations of all these parameters would be placed on the public record. These could be taken into consideration by the court together with other information, such as recommendations from the NHMRC, and also other evidence tendered from other sources, such as the one cited by the Hon. Ann Bressington.

The Hon. A. BRESSINGTON: One more question: will the minister agree that in order to establish a breach of duty of care the court would have to find that the water supplier had not adhered to the safe drinking water guidelines, which allow for the fluoridation of our water supply at 1 to 1.5 parts per million? If that is part of the safe drinking water guidelines, the court cannot really find a breach of duty of care if they are adhering to that, so it is a circular argument and a circular process that people would have to go through, to no outcome.

The Hon. S.G. WADE: I might add an addendum to that question—and I ask the minister to comment on the Hon. Ann Bressington's amendment—but surely one response to the honourable member's question is: yes, but how would this improve it? If the Environment, Resources and Development Court has to rely on the safe drinking water guidelines to declare it to be unsafe, it would be doing the same circular process in the proposed CA.

The Hon. G.E. GAGO: That is the point I have been trying to make, thank you. The government agrees with the Hon. Stephen Wade's comment.

The Hon. S.G. WADE: I interpose another thought which may or may not complicate matters, but I would ask for the council's forgiveness if it does. It might be that, not having been fully involved in the debate, I am missing other elements of the act. The Hon. Ann Bressington's questions about a person and the community draw my attention to subclause (7)(a), which states that water is unsafe if it causes or is likely to cause harm to a person who consumes that water. The Hon. Ann Bressington is highlighting that some individuals have an allergic reaction—I do not know if that is the word—or a reaction to fluoride.

The Hon. A. Bressington: A toxic reaction.

The Hon. S.G. WADE: A toxic reaction to fluoride. In those circumstances, that water being put out by a water provider would make the water unsafe in terms of subclause (7)(a). I do not know whether part of the response is that you do not expect a person who is fluoride toxic to consume water that a water provider supplies if they know that it has fluoride in it.

It seems that subclause (7)(a) sets quite a high standard, which means that anybody—even an individual who might suffer harm from the water—causes that water to be defined as unsafe, whereas (7)(d) talks about water that is otherwise reasonably fit for human consumption. So you could say, for the community as a whole, fluoridated water is reasonably fit for human consumption. Might subclause (7)(a) put a duty of care, or whatever the legal term is, on a water provider who puts fluoridated water out into the community when there is a significant number of people with fluoride toxicity?

The Hon. A. BRESSINGTON: I made a mistake before by referring to the safe drinking water guidelines. It is the National Drinking Water Guidelines that we are referring to, so different from this bill here. We already have the National Drinking Water Guidelines which outline that fluoride is to be added at so many parts per million. That is not relevant to this bill; the court would have to refer to the National Drinking Water Guidelines to make a determination if there was a breach of duty of care, and the court is not going to find that if the water authority is adhering to those guidelines. As I said, it is a circular argument, a circular process, with no end outcome of civil remedy for anybody who is fluoride toxic.

The Hon. G.E. GAGO: Yes, you are right, so therefore the amendment would not change things.

Amendment negatived; clause passed.

Clauses 4 to 27 passed.

New clauses 27A and 27B.

The Hon. A. BRESSINGTON: I move:

Page 17, after line 40—Insert:

Division 3—Fluoride

27A—Fluoride intolerance register

(1) The Chief Executive may include a person on a register to be called the fluoride intolerance register.

(2) An application for registration under subsection (1) may be made by a person or by a class of persons prescribed by regulation.

(3) An application for registration under subsection (1) must—

(a) be made to the Chief Executive in the manner and form approved by the Chief Executive; and

(b) be accompanied by the fee fixed by regulation; and

(c) be accompanied by a medical certificate in respect of each person named in the application that—

(i) certifies that the person has a fluoride-related illness or condition of a kind prescribed by regulation; and

(ii) is signed by a medical practitioner; and

(iii) is, according to its terms, based on an examination of the person conducted by the medical practitioner within 28 days before the date of the application.

(4) A person is entitled to be registered on the fluoride intolerance register or to have his or her registration renewed if the Chief Executive is satisfied that the application has been properly made under this section.

(5) An applicant for registration under subsection (1) or for the renewal of registration must provide the Chief Executive with any information required by the Chief Executive for the purposes of determining the application.

(6) Subject to this Division, a person's registration under this section remains in force for a period of three years.

(7) If it appears to the Chief Executive, from a medical practitioner's certificate or declaration, that a person registered on the fluoride intolerance register is not eligible to be so registered, the Chief Executive must, by written notice to the person, suspend or cancel the person's registration.

(8) If a person's registration has been suspended or cancelled under subsection (7), the Chief Executive must not remove the suspension or re-register the person on the fluoride intolerance register unless the person has given the Chief Executive two medical certificates that—

(a) certify that the person has a fluoride-related illness or condition of a kind prescribed by regulation; and

(b) have been signed by different medical practitioners; and

(c) are, according to the terms of the certificates, based on examinations of the person conducted by the medical practitioners within 14 days before the date of the person's application for removal of the suspension or re-registration.

(9) The Chief Executive may, at any time, alter information contained on the fluoride intolerance register to ensure that the register is kept up-to-date.

(10) In this section—

medical practitioner means a person registered under the Health Practitioner Regulation National Law to practise in the medical profession (other than as a student).

27B—Fluoride removal notices

(1) The Chief Executive must, on the registration of a person on the fluoride intolerance register, on each renewal of such registration and at such other times as the Chief Executive may consider appropriate, issue a fluoride removal notice to SA Water in respect of drinking water supplied to premises of the person.

(2) A fluoride removal notice—

(a) must be in the form of a written notice served on SA Water; and

(b) must specify the name, and address of the registered person in respect of whom the notice is to apply; and

(c) must include a requirement that specified action be taken by SA Water in accordance with guidelines issued from time to time by the Chief Executive to remove fluoride from the drinking water supplied by SA Water to the registered person or to premises at which the registered person resides; and

(d) must specify a period (which must not exceed 28 days from the date of the notice) within which the requirements of the notice must be complied with; and

(e) must state that SA Water may, within 14 days, appeal to the District Court against the notice.

(3) SA Water must ensure that the requirements of a fluoride removal notice are complied with.

(4) The costs involved in carrying out the requirements of a fluoride removal notice are to be borne by SA Water.

(5) SA Water may, in taking action under a fluoride removal notice, enter any relevant land at any reasonable time.

(6) A person must not hinder or obstruct a person taking action under a fluoride removal notice.

Maximum penalty: $25,000.

(7) SA Water may, if satisfied that it is no longer necessary to provide for the removal of fluoride at particular premises, remove any equipment or item installed at the premises under a fluoride removal notice.

(8) In this section—

SA Water means South Australian Water Corporation established under the South Australian Water Corporation Act 1994.

This is to establish a fluoride intolerance register so that people who are experiencing adverse effects from fluoride—if they have gone through medical testing and it has been confirmed that it is fluoride that is causing their health problems or contributing to those health problems—will be able to register on this fluoride intolerance register and they will then be able to seek remedy from SA Water. If they can prove that they are fluoride toxic, they can then have fluoride removed from their drinking water. That would mean that SA Water would be responsible for installing probably either a tank to collect rainwater or a reverse osmosis filter stage 7. I think they are retailing now for about $350 each. That would be SA Water's responsibility if people can prove the medical condition to enable them to get onto this register.

I think, given that we are all standing up and saying, 'Fluoride is good, drink up. Don't worry about how much you're taking in and don't worry about the recommendations of the NHMRC' and 'It's all good; everything is fine,' stand by it and allow a register to be established. Allow people to get medical evidence, present it and go onto this register and then have SA Water legally responsible for removing fluoride from people's water—if they can prove they are fluoride toxic. It is pretty simple.

The Hon. G.E. GAGO: The government does not support this amendment. Fluoride intolerance is a condition that has been raised by the anti-fluoridation lobby and relates to claims of increased sensitivity of some people to fluoride leading to a range of conditions including effects on the gastrointestinal system, immune system, kidneys and liver. There are three issues that we believe need to be considered. First and most importantly, with the exception of very mild to mild dental fluorosis, which is decreasing in prevalence, fluoridation is not considered to cause harmful effects. The concentrations added to drinking water supplies where harmful effects have been linked to fluoride occur at much higher concentrations, observed in countries and regions such as India, China and parts of Africa, where naturally occurring concentrations of up to 50 milligrams per litre have been recorded.

Secondly, with one exception, there is no evidence for hypersensitivity or allergic responses to fluoride which is a common component of fresh marine waters and a range of foods including tea. The possible exceptions are those with renal impairment who can retain high concentrations of fluoride. For example, in its 2006 report the United States National Research Council noted that while gastrointestinal irritation, hepatic function and immunological responses are unlikely to occur in the general population at concentrations below four milligrams per litre, those with renal impairment may have increased susceptibility.

However, Kidney Health Australia has stated that there is no evidence that consumption of optimally fluoridated drinking water poses any health risks even to those with severe kidney disease. In a similar vein, expert medical advice has indicated that there is no clinical or scientific evidence of allergies or immune responses associated with fluoridated drinking water supplies.

The third issue is one of practicality. The amendment refers to removal of fluoride by SA Water but it is unclear why it excludes reference to all water supplies containing fluoride and, in particular, to groundwater supplies which all contain fluoride. Notwithstanding this issue, the practicality is that there is no evidence to support the amendment.

The Hon. A. BRESSINGTON: Can the minister make clear to the council what training has been undertaken to train medical practitioners in Australia and South Australia to be able to diagnose fluoride toxicity or sensitivity? What data has been collected on that through medical practitioners and specialists and if, in fact, doctors are trained to recognise that fluoride toxicity even exists?

The Hon. G.E. GAGO: I believe I have already answered this question, which was to refer to a review undertaken by the peak health bodies, including the National Health and Medical Research Council, which investigated the possibility of adverse effects of fluoride and concluded that the evidence is limited to dental fluorosis only.

The committee divided on new clauses 27A and 27B:

Majority of 9 for the noes.

New clauses thus negatived.

Remaining clauses (28 to 53), schedule and title passed.

Bill reported without amendment.

Third Reading

The Hon. G.E. GAGO (Minister for Regional Development, Minister for Public Sector Management, Minister for the Status of Women, Minister for Consumer Affairs, Minister for Government Enterprises, Minister for Gambling) (20:53): I move:

That this bill be now read a third time.

Bill read a third time and passed.