Chris Game, of the Institute of Local Government Studies, University of Birmingham, asks if the issues of fluoride in the water supply are really as clear-cut as they appear.
Secretary of State for Health Alan Johnson must reckon he's on a roll. Few of his predecessors have taken on the British Medical Association and managed even a draw. Yet he's got the doctors agreeing - albeit rather grouchily - to work longer hours.
His next trick might have been walking on water, but instead he wants to fluoridate it, which could well prove almost as difficult.
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The Minister is offering substantial funds to Strategic Health Authorities in England and Wales who can compel water companies to add fluoride to their water supply.
He believes this "is an effective and relatively easy way to address health inequalities - giving children from poorer backgrounds a dental health boost that can last a lifetime, reducing tooth decay and the dental work they need in the future".
Effective? Well, he will find plenty of highly voluble, expert and experienced doubt-ers who in recent years have become used to winning fluoridation arguments, rather than being browbeaten and bullied by the medico-political establishment.
As for "relatively easy", I fear the Minister is deluding himself at least as much as when he thought for a time last year that he was a shoo-in for Labour's deputy leadership.
With perhaps one exception - Birmingham's own decision - no fluoridation advance has ever been relatively easy, and it gets harder by the year. That is why he is only the latest in a string of Ministers who have tried both persuasion and legislation to extend fluoridation but failed.
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As the fight unfolds - for that's what it will be - most readers of The Birmingham Post readers will find themselves in an unusually interesting position: bystanders, yet with unique inside knowledge and experience that will be used and abused by both sides throughout the campaign.
Our position derives from Birmingham (minus Sutton but plus Solihull) having been the first major 海角视频 area to introduce fluoridation, back in 1964. It was followed in the 1970s and 1980s by most of the rest of the West Midlands - Coventry, the Black Country, and parts of Warwickshire, Worcestershire, South Staffordshire and Shropshire - but, contrary to most expectations, by very few others.
The West Midlands was the last significant scheme adopted, and today Severn Trent and South Staffs are among the very few 海角视频 water companies adding fluoride to their water.
The 3.7 million West Midlanders using fluoridated water - those of us living in 24 of the region's 30 Primary Care Trusts - thus constitute over 60 per cent of the 海角视频 total, the rest being mainly in the North-east around Newcastle.
More remarkably, we comprise roughly a third of the fluoridated water users in the whole European Union. Apart from Ireland, virtually every western European country, including several who did once fluoridate their water, has either rejected the practice - as the Scottish Executive did in 2004 - or banned it outright.
When Alan Johnson notes that 300 million people worldwide drink artificially fluoridated water, his 'world' is similar to the one of which Australia and the Boston Red Sox are cricket and baseball 'world champions': largely English-speaking with a touch of South America.
Two-thirds of the 300 million are Americans, and the rest mainly Canadians, Australians, New Zealanders and Brazilians. The governments of most of the other 95 per cent of the planet's population choose, on various medical, legal, ethical and environmental grounds, other ways of trying to improve their children's dental health.
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Birmingham, then, was a genuine pioneer, but 44 years on finds itself in a really rather small minority. Personally, that fact alone - though there are others - makes me pause for thought. Because for most of my life I've been as enthusiastic a fluoridator as Alan Johnson is today.
I wasn't in Birmingham in 1964 and don't remember what was then a city council decision - or, to be probably more politically accurate, a decision by the Council's Leader, Alderman Harry Watton, and his Labour group.
There was a vigorous anti-fluoridation lobby even then, and plenty of apocalyptic predictions of what the addition of fluoride at one part per million of water would do to its captive consumers.
Watton, though, would have had no doubts that what the Council was doing was as much to the long-term benefit of Birmingham residents as had been Joe Chamberlain's securing of the city's future water supply through the acquisition and flooding of Elan Valley back in the 1890s.
He, his more diligent colleagues and council officers would have read the evidence, particularly that reporting the apparently highly effective introduction of fluoridation in the US. The BMA and British Dental Association were strongly in favour. Why should either politicians or even potential users question this weight of professional opinion?
Actually, public consultation wasn't exactly Watton's style, but had there been any, I'd certainly have backed him. As it was, the decision apparently went through more straightforwardly than seems even imaginable today, warranting just one line in the Council's 500-page official history of the period.
Some other councils followed Birmingham's lead and created a kind of fluoridation belt from Rugby, through Birmingham, to
Bromsgrove, Redditch, Droitwich and Eve-sham. However, by the time the rest of the West Midlands entered the picture in 1978, almost everything had changed. Local government had been totally reorganized, and responsibility for any fluoridation initiative transferred to the 90 NHS Area Health Authorities (AHAs).
And our water was now supplied by the Severn Trent Water Authority and the South Staffordshire Waterworks Company, with - almost needless to say - entirely different boundaries from the AHAs and of course very different interests in fluoridation.
Just as today, the water suppliers' overriding concern was not tooth decay but basically to cover their backs, should fluoridation go wrong.
They stipulated, therefore, that AHAs - unlike local authorities, largely unelected bodies - wanting fluoridation should demonstrate that a majority of their water consumers were also in favour.
Fortunately for the fluoridators, the water authorities didn't insist on local referendums, but agreed to accept positive votes from an area's Community Health Councils (CHCs) - rather more independent and wide-ranging forerunners of today's Patients' Forums. Even this, though, proved problematic.
Encouraged by the campaigning efforts of a regional Fluoridation Publicity Action Group and letters from area dental and medical officers, most AHAs and most CHCs voted in favour of fluoridation. But Wolverhampton AHA - particularly its Labour councillor membership - was strongly anti, while its CHC was pro, and in Coventry and Shropshire there was precisely the reverse position.
It took over two years of frequently bitter and public argument and some fairly ruthless arm-twisting to bring all the necessary bodies into line, and even then Shropshire CHC's opposition to fluoridation in the Bridgnorth/Albrighton area that received water from the Wolverhampton supply was effectively overruled.
It was well over 10 years before all the affected areas were drinking their fluoridated water - and that was then. My strictly layperson's guess is that today the fluoridation argument will be harder for Alan Johnson or anyone else to win, in just about every respect.
Quite apart from the technical and noncoinciding boundary problems, we as consumers and citizens are much more suspicious of purportedly authoritative 'evidence' fed us by both governmental and professional bodies. If we're sceptical of claims concerning Weapons of Mass Destruction, how much more sceptical will we be when it comes to our children's health.
We expect nowadays to be properly consulted and to have our views listened to and truthfully represented.
And we are surely going to be far less ready to accept fluoridators' dismissive claims that there's no ethical difference between adding, say, chlorine to make water safe for drinking and administering in effect compulsory medication with proven side-effects and still seriously disputed benefits, even for children.
If there were a fluoridation referendum today, I honestly don't know how I'd vote.
I'm certain, though, that I'd take a great deal more persuading than in the days when fluoride toothpaste wasn't even on the market.