133 Molesworth
Street
PO Box 5013
Wellington 6140
New Zealand
T+64 4 496 2000
2 November 2022
Tanya
By email: [FYI request #20691 email]
Ref:
H2022013609
Tēnā koe Tanya
Response to your request for official information
Thank you for your requests under the Official Information Act 1982 (the Act) to Manatū
Hauora (the Ministry of Health) on 29 September 2022 and 4 October 2022 for information
regarding water fluoridation in Whanganui. Each part of your request is responded to below.
1. How does this direction take place?
2. What is needed to start the process?
To commence the process of considering water supplies for a potential direction to
fluoridate, the Director-General of Health (the Director-General) notifies a local authority that
water supplies under its control are being actively considered for a potential direction to
fluoridate.
The Director-General is required, under section 116 of the Health Act 1956, to invite written
comment from the local authority on:
• the estimated financial costs of adding fluoride to the drinking water, including any
additional costs of ongoing management and monitoring
• the date by which the local authority would be able to comply with a direction.
The Director-General must give the local authority at least 40 working days to provide
comments. When deciding whether to make a direction to fluoridate, the Director-General is
required to consider:
• the comments of the local authority
• scientific evidence on the effectiveness of adding fluoride to drinking water in
reducing the prevalence and severity of dental decay
• whether the benefits of adding fluoride to drinking water outweigh the costs
• advice from the Director of Public Health.
After issuing a direction, the Director-General must publish the direction and reasons for the
decision.
3. Please provide a copy of the process
The process is described in section 116 of the Health Act, which can be found at:
Health Act 1956 No 65 (as at 01 July 2022), Public Act Part 5A Fluoridation of drinking water
– New Zealand Legislation.
4. What can I do as an individual?
Decision-making to direct community water fluoridation sits with the Director-General and
follows the process outlined in my reply to questions 1 and 2.
5. What are the responsibilities of my local Council to be putting fluoride in the drinking
water?
Local authorities do not need to wait for a direction from the Director-General to start
fluoridating water supplies in their area. However, if they receive a direction, they must
implement fluoridation by the date set in the direction.
From July 2024, responsibility for implementing directions will sit with the new water service
entities, being established under the Three Waters Reform.
6. Please provide a copy of any and all communications from MoH to the Whanganui
Council relating to adding fluoride to the water (since 2018).
I have identified five documents within scope of this part of your request. Al documents are
itemised in Appendix 1 and copies of the documents are enclosed. Where information is
withheld under section 9 of the Act, 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.
7. Can the Director-General please direct Whanganui District Council to add fluoride to
the drinking water?
I note your support of community water fluoridation and your interest in the Whanganui water
supply being fluoridated.
You’ve asked about the possibility of a future direction from the Director-General of Health to
Whanganui District Council to fluoridate the Whanganui water supply. It is likely that further
directions wil be considered by the Director-General within the next year. Manatū Hauora is
currently working through a process to prioritise the remaining local authorities and water
supplies to be actively considered by the Director-General for potential directions to
fluoridate.
I trust this information fulfils your request. 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.
Page 2 of 4
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-of icial-information-act-requests.
Nāku noa, nā
Jane Chambers
Lead Public Health Policy and Regulation
Public Health Agency
Page 3 of 4
Appendix 1: List of documents for release
# Date
Document details
Decision on release
1a 11 November 2021 Email correspondence from Manatū Released in full.
Hauora to Chief Executives
1b 11 November 2021 Email attachment: Letter to Chief
Executives
1c N/A
Email attachment: Community water
fluoridation
2a 16 December 2021 Email correspondence from
Director-General of Health to Mayor
of Whanganui
2b 15 December 2021 Email attachment: Letter from
Director-General of Health to Mayor
of Whanganui
2c 15 December 2021 Email attachment: Letter to local
authority Chief Executives
2d N/A
Email attachment: Appendix One:
Non-fluoridated community water
supplies servicing populations of
500 or more
3a 16 December 2021 Email correspondence from Manatū
Hauora to local authority Chief
Executives
3b N/A
Email attachment: Completed
community water fluoridation
questionnaire
4 31 January – 8
Email correspondence between
Some information
March 2022
Manatū Hauora and Whanganui
withheld under section
District Council
9(2)(a) of the Act, to
protect privacy of
natural persons.
5a 23 June 2022
Email correspondence from Manatū Released in full.
Hauora to Whanganui District
Council
5b 22 June 2022
Email attachment: Letter from
Director-General of Health to
Whanganui District Council Chief
Executive
Page 4 of 4
Document 1a
Document Profile
Oral Health Filing
Status:
Final
Drawer:
Community Water Fluoridation
Date:
11/11/2021
Folder:
Stakeholder Correspondence
Title:
Fluoridation Bill update letter to
File Location:
council CEs
Unit:
Author:
Fluoride
Maintainer(s):
Vi Vu
Document Type:
Email
Summary:
Knowledge Content: Med
Tēnā koutou,
ACT 1982
Please see attached a letter regarding the Health (Fluoridation of Drinking Water) Amendment Bill and
factsheet.
Ngā mihi nui,
Oral health team
Population Health and Prevention
Ministry of Health
INFORMATION
http://www.health.govt.nz
Letter - Fluorid
ri ation B
ill.pdf Commun
Comm ity w
ater fluorida
ri tion factsheet.pdf
Please see Documents 1b and 1c below
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Document 1b
Implementation The Ministry of Health (the Ministry) intends to facilitate swift transition to the new
fluoridation decision-making process, and anticipates that the Director-General of
Health could commence issuing directions from mid-2022 onwards. Implementation will
be phased over time and there will be some funding available to support local
authorities with the costs of fluoridation-related capital works.
The Ministry is working through implementation details and expects to be able to
provide further information to you in the next month.
The Ministry acknowledges the significance of the Government’s Three Waters Reform
programme on local authorities, including the recent announcement of the creation of
the new water service entities. The Ministry of Health is working closely with the
Department of Internal Affairs to ensure that implementation planning aligns with the
reform programme and factors in current service delivery pressures across the water
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services sector.
Resources for your communities
You may receive queries from your communities about community water fluoridation
now that the new legislation has been passed. We encourage you to refer members of
the public or interested groups to the resources below. They reflect the position of the
Ministry of Health, World Health Organization, and Centres for Disease Control and
INFORMATION
Prevention that community water fluoridation is a safe, effective and affordable public
health measure to improve the oral health of communities.
https://www.fluoridefacts.govt.nz/
https://www.pmcsa.ac.nz/topics/fluoridation-an-update-on-evidence/
We look forward to working with you to implement these new changes that will have an
important health impact on the communities you serve. We will be in touch again
shortly.
Ngā mihi
Deborah Woodley
Riana Clarke
Deputy Director-General
National Clinical Director, Oral Health
Population Health and Prevention
Ministry of Health
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cc: Regional Council Chief Executives
Jon Lamonte, Chief Executive, Watercare
Colin Crampton, Chief Executive, Wellington Water
Bill Bayfield, Chief Executive, Taumata Arowai
District Health Board Chief Executives
Public Health Unit Managers
Page 2 of 2
Document 1c
Community water fluoridation
Only around half of all New Zealanders receive fluoridated drinking water. Until now, it’s been up
to local authorities (councils) to make decisions around fluoridating their water supplies. The
Director-General of Health now has the authority to decide if community drinking water supplies
should be fluoridated.
What is water fluoridation?
Fluoride already exists in water. Water fluoridation is when the natural level of fluoride in the
water supply is topped up to between 0.7 ppm and 1.0 ppm. This is the ideal amount for giving
protection against tooth decay. This is recommended by many national and international health
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bodies, including the World Health Organization.
The Ministry of Health recommends water fluoridation as a safe and effective way to prevent and
reduce tooth decay for everyone. The levels of fluoride in water are carefully monitored.
Is it safe?
The role of fluoride in water has been examined around the world – including in New Zealand –
over the last 60 years. There is strong evidence that there are no adverse effects of any
INFORMATION
significance from fluoridation at the levels used in New Zealand, and that it is beneficial to New
Zealanders of all ages. This is especially true for our most vulnerable communities
Is it effective?
Fluoride in water like a constant repair kit. It neutralises the effect of acids that cause decay and
helps to repair damage before it becomes permanent.
The most recent New Zealand Oral Health Survey (2009) shows that children and adolescents
have 40 percent less tooth decay over their lifetime if they live in areas with fluoridated water.
The government estimates that introducing community water fluoridation to all public drinking
water supplies would result in net savings of more than $600 million over 20 years - mostly to
consumers, and some to government?
How will decisions about community water fluoridation be made?
The new legislation allows the Director-General to make decisions about fluoridating public water
supplies only. They cannot direct the fluoridation of privately-owned water supplies.
Before issuing a direction to fluoridate a water supply, the Director-General must invite the
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affected local authority to give information in writing on the estimated cost and timing for
introducing fluoridation.
The new legislation requires the Director-General of Health to consider the scientific evidence of
the effectiveness of fluoridation in reducing dental decay, and whether the benefits outweigh the
financial costs. They must consider the oral health status (or likely oral health status) of the local
community, the size of the water supply and how much it’s likely to cost to introduce fluoridation.
The Director-General of Health is required under the new legislation to seek advice from the
Director of Public Health before issuing a direction. They may also consider other factors or
1
Document 1c
views. The new legislation does not require local authorities to consult with their communities on
decisions around fluoridating their water supplies.
Local authorities that are currently fluoridating drinking water supplies must continue to do so.
When will the Director-General of Health start issuing directions?
We expect the Director-General of Health could start issuing directions regarding some
community water supplies from mid-2022. It is expected that implementation wil be phased over
time. The Ministry wil be engaging further with local authorities about implementation in late
2021 and early 2022.
The Director-General of Health wil ensure when providing a date by which the local authority
must comply with a direction, that it is reasonably practical. In instances of non-compliance, the
Director-General of Health may take action to hold local authorities to account. See sections 116
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and 116J of the new legislation for more information.
Do local authorities need to wait for a direction to start fluoridating?
No. Local authorities may wish to consider whether to fluoridate water supplies in the absence of
the Director-General of Health issuing directions.
Who will pay for fluoridation?
INFORMATION
Some funding wil be available to support local authorities with the capital costs of fluoridation.
The operational costs of fluoridation wil remain with local authorities.
Who will ensure my water is safe to drink?
Local authorities and water suppliers wil still be responsible for providing safe drinking water to
their communities and need to meet water safety regulations. Water suppliers are required to
meet the Drinking water standards for New Zealand, which set maximum acceptable values for a
range of substances and organisms, including for fluoride.
How does the new legislation support equity?
Some communities and population groups in Aotearoa have worse oral health outcomes than
others. New Zealand stil has high rates of preventable tooth decay, particularly among Māori
and Pacific children and adults, and those in vulnerable communities.
The benefits of community water fluoridation are broadly spread, but are greater for Māori,
Pacific and those living in deprived communities.
Extending community water fluoridation aligns with the Treaty of Waitangi principles of equity
and active protection. Te Ao Mārama (the Māori Dental Ass
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Association support community water fluoridation.
Find out more
www.fluoridefacts.govt.nz | www.health.govt.nz/water-fluoridation
2
ACT 1982
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Document 2a
www.health.govt.nz
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- Letter Hamish (002) - signed.pdf
- Letter to local authority CEs.pdf
Please see Documents 2b and 2c below
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Document 2b
The Ministry of Health can provide general advice and support on the evidence for
fluoridation, and the steps needed to commence this process. I hope you will support
your communities with this important initiative.
Nāku noa, nā
Dr Ashley Bloomfield
Te Tumu Whakarae mō te Hauora
Director-General of Health
ACT 1982
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Document 2c
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Document 2c
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Document 2d
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Document 2d
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Document 2d
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Document 2d
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Document 2d
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Document 2d
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Document 3b
NOTE:
• If a supply is already fully fluoridated, please enter "installed- in use" in Column C and no further information is required for that supply.
• If there are additional non-fluoridated supplies servicing a population of 500 or over that are not listed please add these supplies in a new row and enter the required information.
• In some cases the water supply referred to may already be partly fluoridated, and therefore the information requested relates only to the zones of that supply that are non-fluoridated.
• In other cases zones rather than the parent water supply may be listed.
Expected date for
completion of capital
Estimated capital Budgeted capital works Estimated number of
works, if relevant (enter works cost to
costs to fluoridate supply months that would be
Name and contact
Water supply (servicing
What is the status of
Are fluoridation capital date)- ie: respond if
fluoridate supply if included in long term
required to fluoridate
details of key contact for
population of 500 people or
fluoridation infrastructure?
works underway or
answer to Column D was a direction is issued plans or budgets (dol ars water supply if a
Community Water
Local Authority- Water Supplier
more)
(select an option)
planned? (Yes/No)
yes
(dollars)
and al ocation year/s)
direction is issued
Fluoridation
Any other comments
Ashburton District Council
Ashburton
ACT 1982
Ashburton District Council
Rakaia
Bul er District Council
Westport
Bul er District Council
Reefton
Carterton District Council
Carterton
Central Hawke's Bay District Council
Waipawa
Central Hawke's Bay District Council
Waipukurau
Central Hawke's Bay District Council
Takapau
Central Otago District Council
Alexandra
Central Otago District Council
Clyde
Central Otago District Council
Cromwel
Central Otago District Council
Ranfurly
Central Otago District Council
Roxburgh
Christchurch city Council
Akaroa
Christchurch city Council
Brooklands / Kainga
INFORMATION
Christchurch city Council
Christchurch
Christchurch city Council
Lyttelton
Clutha District Council
Richardson Rural
Clutha District Council
Clydevale-Pomahaka Rural
Clutha District Council
Glenkenich Rural
Clutha District Council
Moa Flat
Clutha District Council
North Bruce Rural
Clutha District Council
Stirling
Clutha District Council
Waitahuna Rural
Dunedin City Council
Waikouaiti
Dunedin City Council
Outram
Far North District Council
Kaikohe
Far North District Council
Kaitaia
Far North District Council
Kawakawa / Moerewa
Far North District Council
Kerikeri
Far North District Council
Paihia
Far North District Council
Okaihau
Far North District Council
Omapere
Far North District Council
Rawene
Gore District Council
Gore
Gore District Council
Mataura
Grey District Council
Greymouth
Grey District Council
Runanga
Hastings District Council
Haumoana / Te Awanga
Hastings District Council
Clive
Hastings District Council
Whirinaki- Hawkes Bay
Hastings District Council
Hastings Urban
Hauraki District Council
Kerepehi
Hauraki District Council
Paeroa
Hauraki District Council
Waihi
Hauraki District Council
Waitakaruru
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Horowhenua District Council
Foxton
Horowhenua District Council
Foxton Beach
Horowhenua District Council
Levin
Horowhenua District Council
Shannon
Document 3b
Horowhenua District Council
Tokomaru
Hurunui District Council
Amberley
Hurunui District Council
Ashley Rural
Hurunui District Council
Amuri Plains Rural Water
Hurunui District Council
Broomfield
Hurunui District Council
Cheviot
Hurunui District Council
Hanmer
Hurunui District Council
Hawarden
Hurunui District Council
Motunau, Greta, Scargil
Hurunui District Council
Waitohi Upper
Hutt City Council
Petone
Hutt City Council
Korokoro
Kaikoura District Council
Kaikoura
Kaipara District Council
Dargavil e
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Kaipara District Council
Maungaturoto
Kapiti Coast District Council
Otaki
Kapiti Coast District Council
Paekakariki
Kapiti Coast District Council
Hautere
Kawerau District Council
Kawerau
Mackenzie District Council
Fairlie
Mackenzie District Council
Twizel
Mackenzie District Council
Tekapo
Manawatu District Council
Himatangi Beach
Manawatu District Council
Rongotea
Manawatu District Council
Sanson
Marlborough District Council
Blenheim
Marlborough District Council
Picton/Waikawa
Marlborough District Council
Renwick
INFORMATION
Marlborough District Council
Seddon
Marlborough District Council
Havelock
Marlborough District Council
Riverlands Industrial
Matamata Piako District Council
Matamata
Matamata Piako District Council
Morrinsvil e
Matamata Piako District Council
Te Aroha
Napier City Council
Napier
Napier City Council
Bayview
Nelson City Council
Nelson
New Plymouth District Council
Inglewood
New Plymouth District Council
New Plymouth
New Plymouth District Council
Oakura
New Plymouth District Council
Okato
Opotiki District Council
Opotiki
Otorohanga District Council
Otorohanga
Queenstown Lakes District Council
Arrowtown
Queenstown Lakes District Council
Arthurs Point
Queenstown Lakes District Council
Glenorchy
Queenstown Lakes District Council
Hawea
Queenstown Lakes District Council
Lake Hayes
Queenstown Lakes District Council
Queenstown
Queenstown Lakes District Council
Wanaka
Queenstown Lakes District Council
Luggate
Rangitikei District Council
Bul s
Rangitikei District Council
Marton
Rangitikei District Council
Taihape
Rotorua Lakes Council
Hamurana/Kaharoa
Rotorua Lakes Council
Ngongotaha
Rotorua Lakes Council
Reporoa
Rotorua Lakes Council
Rotorua Central
Rotorua Lakes Council
Rotorua East
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Rotorua Lakes Council
Mamaku
Rotorua Lakes Council
Rotoiti
Ruapehu District Council
Ohakune
Ruapehu District Council
Taumarunui
Document 3b
Ruapehu District Council
Raetihi
Selwyn District Council
Darfield
Selwyn District Council
Kirwee
Selwyn District Council
Leeston
Selwyn District Council
Lincoln
Selwyn District Council
Malvern Hil s RWS
Selwyn District Council
Prebbleton
Selwyn District Council
Rol eston
Selwyn District Council
Selwyn RWS
Selwyn District Council
West Melton
Selwyn District Council
Sheffield/Waddington
Selwyn District Council
Southbridge
Selwyn District Council
Springfield
Selwyn District Council
Springston
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Selwyn District Council
Tai Tapu
South Taranaki District Council
Eltham
South Taranaki District Council
Opunake
South Taranaki District Council
Patea
South Taranaki District Council
Waimate West
South Taranaki District Council
Waverley
South Waikato Distict Council
Putaruru
South Waikato Distict Council
Tirau
South Wairarapa District Council
Featherston
South Wairarapa District Council
Greytown
South Wairarapa District Council
Martinborough
Southland District Council
Edendale/Wyndham
Southland District Council
Lumsden/Balfour
Southland District Council
Riverton
INFORMATION
Southland District Council
Te Anau
Southland District Council
Winton
Southland District Council
Ohai/Nightcaps
Southland District Council
Otautau
Southland District Council
Tuatapere
Tararua District Council
Dannevirke
Tararua District Council
Pahiatua
Tararua District Council
Woodvil e
Tasman District Council
Hope/Brightwater
Tasman District Council
Motueka
Tasman District Council
Richmond/Waimea Industrial
Tasman District Council
Waimea Mapua Ruby Bay
Tasman District Council
Wakefield
Taupo District Council
Acacia Bay
Taupo District Council
Kinloch
Taupo District Council
Mangakino
Taupo District Council
Omori/Kuratau/Pukawa
Taupo District Council
Motuoapa
Tauranga City Council
Tauranga
Thames Coromandel District Council
Coromandel
Thames Coromandel District Council
Tairua
Thames Coromandel District Council
Whangamata
Thames Coromandel District Council
Whitianga
Thames Coromandel District Council
Pauanui
Timaru District Council
Downlands
Timaru District Council
Geraldine
Timaru District Council
Pleasant Point
Timaru District Council
Te Moana Scheme
Timaru District Council
Temuka
Timaru District Council
Timaru City
Timaru District Council
Seadown
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Upper Hutt City Council
Kaitoke
Waikato District Council
Raglan
Waimakariri District Council
Kaiapoi
Waimakariri District Council
Mandevil e
Document 3b
Waimakariri District Council
Oxford Urban - Rural No. 2
Waimakariri District Council
Rangiora
Waimakariri District Council
Waikuku
Waimakariri District Council
Pegasus - Woodend
Waimakariri District Council
Oxford Rural No1
Waimakariri District Council
West Eyreton
Waimate District Council
Hook/Waituna Rural
Waimate District Council
Waimate
Waimate District Council
Lower Waihao Rural
Waipa District Council
Cambridge
Waipa District Council
Kihikihi
Waipa District Council
Pukerimu Rural
Waipa District Council
Te Awamutu & Pirongia
Wairoa District Council
Wairoa
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Waitaki District Council
Oamaru
Waitaki District Council
Waihemo
Waitaki District Council
Lower Waitaki, Rural
Waitaki District Council
Tokarahi/Livingstone
Waitomo District Council
Te Kuiti
Waitomo District Council
Piopio
Watercare Services Ltd
Shakespear Regional Park
Watercare Services Ltd
Greenlane Hospital
Watercare Services Ltd
Helensvil e/Parakai
Watercare Services Ltd
Snel s/Algies
Watercare Services Ltd
Waiuku
Watercare Services Ltd
Warkworth
Watercare Services Ltd
Wel sford/Te Hana
Watercare Services Ltd
Bombay
INFORMATION
Watercare Services Ltd
Broadway Park, Newmarket
Watercare Services Ltd
Huia Vil age
Watercare Services Ltd
Muriwai
Watercare Services Ltd
Auckland
Western Bay of Plenty District Council Athenree
Western Bay of Plenty District Council Katikati
Western Bay of Plenty District Council Omokoroa Minden
Western Bay of Plenty District Council Pongakawa
Western Bay of Plenty District Council Te Puke
Westland District Council
Hokitika
Westland District Council
Franz Josef
Whakatane District Council
Murupara
Whakatane District Council
Rangitaiki Plains
Whakatane District Council
Matata
Whakatane District Council
Ruatoki
Whakatane District Council
Taneatua
Whakatane District Council
Otumahi
Hi Costs due to Land Acquisition.
Possible 3 yrs to aquire land to extend
foot print of treatment plant.
Construction of new facility to
Whanganui District Council
Whanganui Aramoho
Not Instal ed
No
1,621,000
48 Dave Rudolph
accomadate treatment process.
Whanganui District Council
Whanganui Reservoir
Not Instal ed
No
544,000
12 Dave Rudolph
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Document 3b
The design of the flouridation plant
must ensure monitoring and control
of the flouridation process. Rural sites
have no communications instal ed
costs wil be high. Under the new
water regulator Taumata Arowai a
new site wil be included if
flouridation becomes mandated as it
now fal s under a population base of >
Whanganui District Council
Whanganui Mowhanau
Not Instal ed
No
311,000
12 Dave Rudolph
than 500.
Whangarei District Council
Bream Bay
Whangarei District Council
Whangarei
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Document 4
Kia ora Mark,
Thanks for sending through the spread sheet. That is much appreciated.
Can you please confirm the population size that each supply serves as per below.
Supply name
Population size the supply serves
Whanganui Aramoho
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Whanganui Reservoir
Whanganui Mowhanau
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Ngā mihi,
Vi
From: Mark Hughes <[email address]>
Sent: Tuesday, 8 March 2022 9:07 am
To: Vi Vu <[email address]>
Subject: FW: Fluoridation of Drinking Water
Kia Ora
Please find the completed spread sheet as requested.
Kind regards
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Mark
ACT 1982
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Document 4
From: Mark Hughes <[email address]>
Sent: Monday, 31 January 2022 2:05 pm
To: Fluoride <[email address]>
Subject: Fluoridation of Drinking Water
Hi
As per the DG’s letter of 15 December requiring information un-fluoridated drinking water, we
note that :-
“I request that you provide this information by completing and returning the attached
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spreadsheet….”
Unfortunately, no spreadsheet was attached to the copy we received.
Could you therefore send a copy to me directly ?
Many thanks
INFORMATION
Mark
Mark Hughes | General Manager - Infrastructure
P: +64 06 349 3023 | M: s 9(2)(a)
www.whanganui.govt.nz
Whanganui District Council | 101 Guyton Street | PO Box 637 | Whanganui 4500
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Document 5a
From: Ben Volz <[email address]> On Behalf Of Fluoride
Sent: Thursday, 23 June 2022 5:27 pm
To: [email address]
Subject: Letter: Community Water Fluoridation
Tena Koe David
Please find attached a letter from Dr Ashley Bloomfield regarding community water fluoridation.
Nga Mihi
Oral Health team
Ministry of Health
Please see Document 5b below
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Document 5b
we still have high rates of preventable tooth decay, particularly amongst Māori and
Pacific people, and people living in deprived communities. Evidence shows that
community water fluoridation both improves the oral health of everyone and also has a
proportionately larger benefit for these groups.
Thank you for your co-operation as we work together to improve the oral health of the
communities we each serve.
Nāku noa, nā
ACT 1982
Dr Ashley Bloomfield
Te Tumu Whakarae mō te Hauora
Director-General of Health
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