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Fluoridation Bill of Rights consideration

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Health (Fluoridation of Drinking Water) Amendment Act 2021

Some local authorities have been fluoridating the drinking water they supply for a number of years. Approximately half of New Zealanders have access to fluoridated drinking water.

The Health (Fluoridation of Drinking Water) Amendment Act 2021 amended the Health Act 1956 (the Act) to enable the Director-General of Health to direct local authorities to fluoridate drinking water supplies to establish nationally consistent decision-making on this health-centred matter.  

The Health (Fluoridation of Drinking Water) Amendment Act 2021, enables the Director-General of Health to direct local authorities to add fluoride to a drinking water supply. Any local authority that receives a direction to fluoridate one of its drinking water supplies must take all practicable steps to ensure the optimal level of fluoride for oral health benefits is present in that supply.

Local authorities may also choose to fluoridate any drinking water supplies without being directed to by the Director-General. Any local authority that was fluoridating a drinking water supply before the Health Act amendments came into effect must continue to do so. 

In deciding whether to make a direction to fluoridate, the Director-General is required to consider:

  • 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, taking into account the oral health status and size of the community as well as the financial costs including ongoing management and monitoring.

If the Director-General were to direct local authorities to fluoridate all drinking water supplies servicing populations over 500, it would result in over 80% of New Zealanders having access to fluoridated drinking water.

For further information on the legislative and legal framework for community water fluoridation, see:

Directions to fluoridate issued to 14 local authorities

The Director-General of Health has issued directions to 14 local authorities to fluoridate some or all of their water supplies. This follows a process as described in the Health Act 1956.

The 14 local authorities that have been directed to fluoridate 19 respective water supplies are:

Local authorities that received a direction to fluoridate in July 2022
Local authorityWater supplyServiced populationCompliance date
Kawerau District CouncilKawerau7,721Has begun fluoridating (compliance date was 30 September 2024)
Hastings District CouncilHastings Urban64,764Has partially begun fluoridating (compliance date was 30 June 2023)
Horowhenua District CouncilLevin22,000Has begun fluoridating (compliance date was 30 December 2024)
New Plymouth District CouncilNew Plymouth66,562Has begun fluoridating (compliance date was 31 July 2023)
Waipa District CouncilCambridge21,79431 July 2023
Whangarei District CouncilBream Bay14,80028 March 2025
Whangarei56,53028 March 2025
Rotorua Lakes CouncilRotorua Central44,00028 March 2025
Rotorua East13,00028 March 2025
Nelson City CouncilNelson52,400Has begun fluoridating (compliance date was 31 December 2024)
Far North District CouncilKaitaia5,40030 June 2024
Kerikeri6,70030 June 2024
Auckland CouncilOnehunga25,507Has begun fluoridating (compliance date was 30 June 2024)
Waiuku8,69730 June 2026
Tararua District CouncilDannevirke6,000Has begun fluoridating (compliance date was 30 September 2024)
Waitaki District CouncilOamaru15,561Has begun fluoridating (compliance date was 30 June 2024)
Tauranga City CouncilTauranga153,500Has begun fluoridating (compliance date was 30 November 2024)
Western Bay of Plenty District CouncilAthenree5,12531 July 2025
Wharawhara5,70031 July 2025

The Ministry of Health - Manatū Hauora is providing support for the local authorities that were in July 2022 directed to fluoridate, this includes funding for capital works. The compliance dates vary and are based on information provided by local authorities. 

For further details, see the information provided to the Director-General to inform decision-making on these drinking water supplies

Fluoridation Bill of Rights consideration

In November 2023, a High Court judgment found that the Director-General of Health should have explicitly considered the rights under the New Zealand Bill of Rights Act 1990 in making a decision on each direction to fluoridate.  

In a further judgment in February 2024, the Judge directed the Director-General of Health to assess whether each of the directions for local authorities is a justified limit on the right of persons in those districts to refuse medical treatment. That right is provided for in section 11 of the New Zealand Bill of Rights Act. The Judge confirmed that each of the directions remained in place.

The Director-General has assessed each direction as directed by the Judge.

The Director-General considers that in terms of section 5 of the New Zealand Bill of Rights Act, the direction to fluoridate each of the 19 water supplies is a justified limitation on the right to refuse medical treatment, and has reconfirmed each of the directions to fluoridate. The decision took into account:

  • the latest scientific evidence on the safety and effectiveness of community water fluoridation
  • local circumstances of the area impacted by each direction, including population data and oral health data.

You can find the Bill of Rights analysis and supporting documentation at: Director-General of Health consideration of community water fluoridation under the New Zealand Bill of Rights Act 1990

Will further directions to fluoridate drinking water be issued?

In November 2022 the Director-General wrote to 27 local authorities to advise that they are being actively considered for a direction to fluoridate in relation to one or more of their drinking water supplies.

These water supplies remain under active consideration, however the Director-General is taking further time. This is to allow consideration of the impact of several wider factors including reform across the water services sector, and service delivery pressures across the local government sector.

Drinking water supplies currently under active consideration for a direction to fluoridate
Local authorityWater supplyServiced population
Ōpōtiki District CouncilŌpōtiki4,530
Far North District CouncilKaikohe4,200
Paihia4,000
Kawakawa/Moerewa3,500
Omapere900
Okaihau800
Rawene600
Wairoa District CouncilWairoa4,650
Rotorua Lakes District CouncilNgongotaha4,826
Hamurana/Kaharoa1,700
Reporoa1,060
Rotoiti880
Mamaku868
Rotoma500
Whakatane District CouncilRangitaiki Plains2,897
Otumahi2,841
Murupara1,674
Taneatua790
Matata690
Ruatoki560
Kaipara District CouncilDargaville4,683
Maungaturoto980
Taupō District CouncilAcacia Bay2,381
Omori/Kuratau/Pukawa1,883
Kinloch1,696
Mangakino1,312
Motuoapa739
Ruapehu District CouncilTaumarunui4,870
Ohakune1,500
Raetihi749
Waitomo District CouncilTe Kuiti4,612
Piopio500
South Waikato District CouncilPutaruru4,116
Tirau700
Horowhenua District CouncilFoxton2,700
Foxton Beach1,900
Shannon1,436
Tokomaru550
Whanganui District CouncilWhanganui39,775
Rangitikei District CouncilMarton4,764
Taihape1,584
Bulls1,419
Western Bay of Plenty District CouncilMuttons8,550
Pongakawa4,850
Ohouere2,250
Youngson Road8,480
Tahawai (linked with Athenree)7,240
Waihi Beach (linked with Athenree)
Tararua District CouncilPahiatua2,700
Woodville1,500
Hauraki District CouncilWaihi4,927
Paeroa4,887
Kerepehi2,552
Waitakaruru2,076
Hastings District CouncilHaumoana / Te Awanga1,900
Whirinaki – Hawkes Bay800
Clive560
Waimārama500
Hutt City CouncilPetone7,491
Korokoro1,482
Napier City CouncilNapier59,055
Buller District CouncilWestport4,974
Reefton951
Westland District CouncilHokitika3,447
Franz Josef2,611
Kaikoura District CouncilKaikoura2,500
Waimate District CouncilWaimate3,000
Hook/Waituna Rural1,350
Marlborough District CouncilBlenheim24,028
Picton / Waikawa4,185
Renwick1,884
Awatere1,333
Riverlands Industrial740
Havelock618
Seddon535
Timaru District CouncilTimaru City26,832
Temuka4,620
Downlands – Te Ana Wai4,550
Geraldine2,121
Te Moana Scheme1,650
Pleasant Point1,200
Seadown895
Downlands-Waitohi700
Dunedin City CouncilWaikouaiti1,642
Outram750
Queenstown Lakes District CouncilQueenstown25,271
Wānaka13,633
Arrowtown4,366
Hawea3,767
Lake Hayes3,743
Arthurs Point1,631
Glenorchy1,232
Luggate855

Monitoring drinking water fluoridation levels in New Zealand

Water treatment plants are monitored regularly to ensure fluoride concentrations do not exceed the maximum acceptable value set out in the Water Services (Drinking Water Standards for New Zealand) Regulations 2022 (ie, 1.5 mg per litre). Taumata Arowai – the water services regulator – monitors compliance with the Drinking Water Standards, including for fluoride. Any exceedances must be reported to Taumata Arowai.

© Ministry of Health – Manatū Hauora