The Message: When Public Policy Goes Wrong

And so we finally have the answers. Those who have been following our investigation into the mandatory fluoridation of the water supply in Ireland will be intrigued to see what the Minister with responsibility for fluoridation policy, Alex White, has to say in response to the 27 detailed questions put to him in these pages three issues ago.

In the spirit of fairness, we have decided to print the answers in full, without editorial intervention. In recent months, we have given a huge amount of space to the arguments against fluoride. Its defendants are entitled to have their case heard too.
Upfront, it has to be stated that – spread over six pages of the magazine – for the uninvolved it does not exactly make riveting reading. A lot of what is being said is technical. It would be unfair to blame that on the Minister or his advisers in the department – or indeed the ‘expert body’ on fluoride, whose ideology undoubtedly informs the answers. When it comes to detailed issues of public policy, more often than not, there is a lot of verbiage to wade through, in order to understand what the hell is going on and why.
But for anyone who has engaged with the debate, the document is a fascinating one. It is, in effect, the ultimate statement on behalf of the Irish State about the thinking behind, and the rationale for, what is a highly controversial form of mass medication. It will be pored over by everyone who is interested in the subject, both here in Ireland and indeed across the world.
For this issue of Hot Press at least, we have decided to let the Minister’s words speak for themselves. We want to see what readers think. And we also want to observe the way in which the content of this major statement of public policy is digested by opponents of fluoridation. We look forward to giving a platform to the responses, beginning next issue.
There are some things, however, that I think are worth saying.
The first is that while the Minister’s name is at the bottom of the letter sent to Adrienne Murphy, the writer who has conducted the investigation on Hot Press’ behalf, the document is clearly written on his behalf by public servants in the Department of Health and/or the government appointed Expert Body on fluoridation. It is impossible to know just how deeply Alex White has, to appropriate a relevant term, ingested all of this. Time, presumably will tell.
The second is that I am reminded that this is the same department that advised the then-Minister for Health, Michael Noonan, on the Hepatitis C scandal.
To recall: back in 1994, the Blood Transfusion Service Board (BTSB) was forced to issue an alert that women who, between 1977 and 1994, had been prescribed Anti D to prevent them having ‘blue babies’ were likely to have been administered a product contaminated with the Hepatitis C virus.
An expert group – that familiar term – was appointed to deal with the fall-out and make recommendations. What followed was one of the most appalling instances of mistreatment of Irish citizens of the past 50 years. It emerged later that, as far back as 1995, the Attorney General told the Government that the BTSB was liable. And yet, the BTSB – without demur from the Department of Health or the Government of the day – chose to fight tooth and nail against the compensation case which was taken by Brigid McCole, a mother of 12 from Donegal, who was dying as a result of the Hepatitis C infection. And they also threatened to seek all of their costs from her.
Brigid died in 1996 at the age of 54. Her husband, Bernard ‘Brianie’ McCole committed suicide in 2000. He had never recovered from the trauma of the loss of the woman he loved, or from the family’s mistreatment at the hands of the State. “He stood by her,” a report on his funeral in the Irish Independent said, “as she fought to expose the truth about those who knew of the contamination at the Blood Transfusion Service Board and at the Department of Health. Then he witnessed the rabid might of institutions of the State and their agents, who turned on her to silence the truth.”
The word ‘scandal’ is often lightly used in journalism, but what happened in relation to the BTSB and Hepatitis C was utterly scandalous. The fact that the contamination happened was appalling, but – while it is crucial to have adequate safeguards in place and clearly there weren’t – this in itself falls loosely into the category of systemic error. Sometimes people make mistakes and shit happens. The anger of those who are victims is righteous and understandable. But it is not always the case that individuals working within the system are directly, personally responsible.
The real scandal, however, was in the response of the Department of Health and the Government. Rather than quickly acknowledging responsibility and creating a forum via which compensation claims could be processed, the public servants of the Department of Health and the Minister decided it would be better to resist any claims and to force a dying woman to take on the huge financial risk of taking her case against the State to the High Court.
I don’t know if it possible to properly distinguish between the separate contributions of the permanent secretariat, and of the ‘expert group’, to the decisions that were taken . And most likely, all of those involved in that disgraceful scenario have moved on. However, in the long run, no-one would try to claim that the members of the ‘expert group’ did the job which had been entrusted to them adequately. And, whoever was most culpable, it is eternally to the discredit of the Department, of the expert group, of the BTSB and of the Minister of the time Michael Noonan that they behaved collectively in such an abominable way towards desperately vulnerable Irish citizens.
Nor is that the only scandal over which the Department of Health has presided in recent times. I won’t rehash the details of the organ-retention scandal here, except to recall that body parts were removed and retained, without permission, from children who died in Irish hospitals. This extraordinary practice happened under the watch of the Department of Health – and, unless I am mistaken, there has never been an adequate explanation regarding what happened, who was affected and what kind of money was made from the sale of, for example, pituitary glands, which apparently was common practice in certain Irish hospitals.
And then there is the case of the deeply unpleasant, violent and misogynistic practices carried out by the obstetrician Dr. Michael Neary in Our Lady of Lourdes Hospital in Drogheda, records of whose activities in carrying out caesarian hysterectomies unnecessarily were, as I understand it, being sent on a routine basis every year to the department. Not to mention, of course, the shocking and unnecessary death last year of Savita Halappanaver in Galway University Hospital…
Health is a huge brief. The scope for things going wrong is, it has to be acknowledged, wide. But to say that the performance of the Department of Health has not been good over the years is to understate it. I hope that their defence of the fluoridation of the water supply does not become something that in the future they – or their successors – will come to very seriously regret.