133 Molesworth Street
PO Box 5013
Wellington 6140
New Zealand
T+64 4 496 2000
19 December 2023
J Bruning
By email: [FYI request #24829 email]
Ref: H2023033161
Tēnā koe
Response to your request for official information
Thank you for your request under the Official Information Act 1982 (the Act) to Manatū Hauora
(the Ministry of Health) on 22 November 2023 for information regarding decisions to fluoridate
water in Aotearoa New Zealand. Each part of your request is responded to below.
Manatū Hauora (Ministry of Health) have informed Whangārei District Council that while
they are considering the judgement’s implications WDC are to continue fluoridation
preparations as initially directed by Manatū Hauora.
“(a) Please supply all advice legal and policy advice which provide the underpinning
rationale to justify your instruction to continue.”
I have identified one letter between Crown Law and Manatū Hauora in scope of this part of your
request. This letter is withheld in full under section 9(2)(h) of the Act to maintain legal
professional privilege. I have considered the countervailing public interest in release in making
this decision and consider that it does not outweigh the need to withhold at this time.
You may also be interested in the media update published on 17 November 2023 on the Court
decision on the Ministry’s website
: www.health.govt.nz/news-media/news-items/fluoride-legal-
decision-update/.
2] Director-General Ashley Bloomfield cites a 2021 Update by the Office of the Prime
Minister and Cabinet's Chief Science Adviser as rationale for the safety and efficacy of
fluoridation of drinking water. (A Cochrane Review cited by him does not consider
neurotoxicity of fluoride). This 2021 Update did not consider existing levels of fluoride
children's urine, and the existing science that demonstrates that children absorb and take-
up far more fluoride in their bones than adults. As such, children in New Zealand can have
18% higher levels of fluoride than older populations.
(a) Please provide all policy advice, emails and memos held by the Ministry of Health that
discuss this paper and its findings:
‘t Mannetje A, Coakley J, Douwes J. (2018) Report of the Biological Monitoring of
Selected Chemicals of Concern. Results of the New Zealand biological monitoring
programme, 2014-2016. Technical Report 2017-1. March. Centre for Public Health
Research. Massey University. Wellington
This part of your request is refused under section 18(e) of the Act as the information does not
exist.
(b) Please provide all reasoning by the (i) Ministry of Health and the (i) Director-General
considering the safety of exposures in drinking water balanced against current levels in
urine in New Zealand children, and the potential risk of neurotoxicity (cognitive and IQ)
based on additive exposures from natural sources and levels in drinking water.
Information assessing the health and safety and environmental impacts of fluoridating
drinking water is publicly available within this document:
www.health.govt.nz/system/files/documents/pages/binder_of_fluoridation_information_redacted
_v5.pdf.
[3] The Office of the Prime Minister and Cabinet's Chief Science Adviser is not a
regulatory body and has not risk assessed fluoride to understand the lowest level where
drinking water exposures may harm children under 7 - for cognitive and IQ loss.
(a) Please provide advice and reasoning directed to and by the (i) Ministry of Health and
the (ii) Director-General as to why a 2021 Update by a politically appointed body, rather
than a regulatory body should constitute a sufficiently rigorous scientific analysis to justify
the safety and efficacy of fluoridated drinking water and exposures to hydrofluorosilicic
acid, and its co-ingredients in New Zealand.
This part of your request is refused under section 18(e) of the Act as the information does not
exist.
(b) Please supply scientific advice on the lowest safe exposure to for babies in utero and
children up to age 7 on the lowest safe level (mg/L) of fluoridated drinking water that wil
prevent IQ and cognitive loss received by the (i) Ministry of Health and the (i ) Director-
General.
Please refer to the link above for information assessing the health and safety of fluoridation of
drinking water.
[4] Ministry of Health data in Auckland inconsistently demonstrates that the small marginal
difference in fluoridated drinking water wil barely alleviate the oral and dental health
burden experienced by low-income communities. It shows poor dental health burdens are
vastly and disproportionately experienced by low-income communities, and this is seen by
your data on year 8s (12-13 year olds).
https://www.health.govt.nz/system/files/documents/pages/cw-01-02_2022-calendar-year-
8.xlsx
(a) Please advise any policy discussion from January 2021 to the current date where the
(i) Ministry of Health and the (i ) Director-General discuss low income and disadvantaged
communities and how a strategy of redressing dental and oral health inequities through
supply of toothbrushes and toothpaste to schools and medical clinics in these
communities, and a programme of continuing education across these communities may
prevent tooth decay and dental caries. Please include costings for such a strategy.
I have identified two documents within scope of this part of your request, listed below. All
documents are itemised at Appendix 1 and copies of the documents are enclosed. Where
information is withheld, this is outlined in the Appendix and noted in the document itself.
Page 2 of 4
• Memo: Toothbrush/Toothpaste implementation
• Memo: Toothbrush/toothpaste delivery model
As part of the health and disability system reforms, as of 1 July 2022 implementation of this
programme has now transferred to Te Whatu Ora - Health New Zealand. If you would like any
further information, you may wish to contact Te Whatu Ora at
[email address].
[5] Please supply the legal and policy basis which enabled the 2016 Select Committee
report and the 2021 Inquiry Committee Report, to brush aside and dismiss all public
concerns that were submitted about the health risk of fluoridated drinking water for these
two committee processes involved in the passing of the Health (Fluoridation of Drinking
Water) Amendment Bill.
Al advice provided to and considered by the relevant select committees is publicly available on
Parliament’s website at
: www.parliament.nz.
I trust this information fulfils your request. If you wish to discuss any aspect of your request with
us, including this decision, please feel free to contact the OIA Services Team on:
[email address].
Under section 28(3) of the Act, you have the right to ask the Ombudsman to review any
decisions made under this request. The Ombudsman may be contacted by email at:
[email address] or by calling 0800 802 602.
Please note that this response, with your personal details removed, may be published on the
Manatū Hauora website at:
www.health.govt.nz/about-ministry/information-releases/responses-
official-information-act-requests.
Nāku noa, nā
Jane Chambers
Group Manager, Public Health Policy and Regulation
Public Health Agency | Te Pou Hauora Tūmatanui
Page 3 of 4
Appendix 1: List of documents for release
#
Date
Document details
Decision on release
1
21 October 2021
Memo: Toothbrush/Toothpaste
Some information withheld
implementation
under section 9(2)(a) of the
Act, to protect the privacy of
natural persons.
2
30 November 2021 Memo: Toothbrush/Toothpaste
Released in full.
delivery model
3
15 November 2023 Letter from Crown Law to the
Withheld in full under section
Ministry of Health
: New Health
9(2)(h) of the Act to maintain
New Zealand Ltd v Director-
legal professional privilege.
General of Health and Anor
Page 4 of 4
