Rear seat-belts and child booster seats

STATES OF JERSEY

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REAR SEAT BELTS AND CHILD BOOSTER SEATS

Lodged au Greffe on 12th February 2008 by Deputy P.V.F. Le Claire of St. Helier

STATES GREFFE

PROPOSITION

THE STATES are asked to decide whether they are of opinion

(a ) to agree that appropriate legislation should be introduced to require the wearing of rear seat belts

in vehicles;

( b ) to agree that appropriate legislation should be introduced to require the use of child seats or

booster seats for children under certain sizes, to ensure effective restraint of vehicle occupants who might not otherwise be appropriately restrained by seat belts alone; and

(c ) to request the Minister for Transport and Technical Services to make the necessary Orders under

the Road Traffic (Jersey) Law 1956 to give effect to the proposals.

DEPUTY P.V.F. LE CLAIRE OF ST. HELIER

REPORT

Introduction

On 8th February 2008 the Council of Ministers notified States members of the following decision:

S u m m ary of Council of Ministers' Meeting of 7th February 2008 A 4 . S eat belt legislation

T h e C ouncil considered an oral report from Deputy G.W.J. de Faye concerning recent media coverage of a

campaign by the head injury charity known as Headway (Jersey) to encourage the introduction of legislation requiring that all rear seat occupants in motor vehicles wear a seat belt.

D e p u ty de Faye explained that the Chief Minister had advised him that he was minded to bring a

proposition to the States Assembly calling for the introduction of compulsory seat belt legislation in the form suggested by Headway. In response Deputy de Faye had acknowledged that, like all States members, the Chief Minister was entitled to bring any proposition to the States.

D e p u ty de Faye had clarified that he would readily support the proposition proposed by the Chief Minister

on the basis that it would rightly provide the States Assembly with an opportunity to debate the issue. In this connexion he had agreed that the Transport and Technical Services Department should contribute to the report accompanying the proposition and had stated that he would expect to see similar contributions from both the Health and Social Services and Home Affairs Departments. Notwithstanding the foregoing, Deputy de Faye believed that the removal of personal freedoms in favour of criminal sanctions was a very serious matter; accordingly he believed that States members should be comprehensively informed on all the relevant issues before taking a decision.

T h e Council noted the position adopted by Deputy G.W.J. de Faye and determined that the Chief

Executive, in consultation with relevant officers from the Health and Social Services, Home Affairs and Transport and Technical Services Departments, should produce a detailed report for consideration by the Council at its next scheduled meeting highlighting the extent to which available evidence supported the introduction of legislation in Jersey to make the wearing of rear seat belts in motor vehicles compulsory.

Senior Officers of the Emergency Services and General Hospital have stated that no such statistics and data are held by The Police, The Fire and Rescue Service, The Ambulance Service or the General Hospital at this time nor has it been held historically. Therefore I have decided to proceed at this time, with this debate as the in principle decisions that it requests of the Transport and Technical Services Minister, does not impede the production of reports from the Council or The Ministers independently should they wish to do so. Delay in this regard though in my view will further undermine confidence in the States regarding this issue and our need to debate this as soon as possible. I also am aware that delay may mean a world of difference to vehicle occupants, pedestrians, the resources of the States and the islands infrastructure. The following communication outlines the position.

The Chief Officer at the States of Jersey Police, through the Chief Inspector, Community Safety, reminds us that the States of Jersey Police, as an enforcement agency, must be impartial in respect of any political debate in this matter but have provided the following information –

" W e do not as a matter of course hold statistics on injuries caused as a result of not wearing rear seat belts but rather on the overall level of injuries that arise from road traffic collisions. That said we can refer to at least two crashes in the last 4  years that have led to fatal injuries for 3 rear seat passengers who were not wearing belts. There was also a crash in 2005 which, although not fatal, saw significant distortion and pushing forwards of the front seats, attributable to the unrestrained rear seat passengers being thrown forward and crushing those seats.

T h e re are thought to be two other cases where rear seat passengers have died but due to the historic nature

thereof, I am unable to accurately report that non wearing of rear seat belts were an issue."

Although  permission  to  include  this  information  has  been  expressly  permitted  by  the  Police,  it  clearly demonstrates that historically information collated and held by emergency services is limited. Again, in the view of the Senior Medical Consultants at the hospital it is not known whether it is even held in detail in the UK. This is borne out by the following report –

If there was a need perhaps to consider the financial elements, then aside from Ambulance Flights which I am told begin at around £3,000.00, then I submit the following information taken from UK Hansard.

4 J u n 2007: Column 108Wcontinued

T h e v alues reported in the "Highways Economic Note No.  1: 2005 Valuation of the Benefits of Prevention

of Road Accidents and Casualties" also cover a wide range of other costs incurred following accidents. These include the human costs of pain, grief and suffering, insurance and administrative costs, damage to property and lost output. Some element of these costs must be borne by the public sector, but reliable estimates as to the size of this burden are not available.

M  r . Paterson: To ask the Secretary of State for Transport what the average cost to the public purse of

each (a) fatal road traffic accident, (b) serious road traffic accident and (c) minor road traffic accident was in the latest period for which figures are available. [139668]

D r . L adyman: The values used to estimate the benefits of the prevention of road accidents are set out in

the "Highways Economic Note No.  1: 2005 Valuation of the Benefits of Prevention of Road Accidents and Casualties" which can be found on the DfT website at http://www.dft.gov.uk/pgr/roadsafety/ea/. Included within these values are the costs to public funds for medical, ambulance and police costs (emergency  services). The average  medical,  ambulance, and police  costs  assumed in  the  Highways Economic Note No.1 for 2005 are as follows:

F o r a f a ta l a c cident: £7,110

F o r a s e r io u s accident: £13,360

F o r a s l ig h t a ccident: £1,180

(2 0 0 5 p ri c e s )

T h e v alues reported in the "Highways Economic Note No.  1: 2005 Valuation of the Benefits of Prevention

of Road Accidents and Casualties" also cover a wide range of other costs incurred following accidents. These include the human costs of pain, grief and suffering, insurance and administrative costs, damage to property and lost output. Some element of these costs must be borne by the public sector, but reliable estimates as to the size of this burden are not available.

T h is is why the previous decision to collate the data and statistics available is a mute point and that is why

I have lodged this Proposition without further delay. States Members will I trust understand my decision and can now see that further delay is unnecessary in this consideration.

The Emergency Services Environment

From here we must also consider the difficult environment that our professionals have to work within. The stress and psychological impacts  that our professionals will encounter  in road traffic incidents must always be a consideration. The more we can do as legislators and policy-makers to increase their ability to perform at the highest possible levels, the better. This must also be driven however, by our ongoing empathy for their tasks and their well-being. This also must be taken into account with the big picture and that clearly involves not only their safety but society's as a whole.

The Minister of Transport and Technical Services (TTS) has a great sense of humour and a love for buses so I trust he will forgive me if I point out that effectively all passengers are rear-seated on buses and ask him to reflect on the following:

In answer to questions regarding the Bus Contract

F r o m the States of Jersey Hansard 24th October 2006:

D e p u ty G.W.J. de Faye:

In r e spect of the seat belts, seat belts were not part of the tendering requirements, but have effectively

arrived as one might call an add-on bonus.

Rear seat belt legislation has been in place in France since 1990 and in the UK since 1991. The recent campaign by the brain injury charity Headway has highlighted the need for the States to debate this important issue. Given the length of time that has now passed since the introduction of this legislation in France and the UK, it is important to realise that many Islanders will have since travelled to and within these countries by car and the practice should not be alien to many of us already. Whether or not States members should approve the progression of law in Jersey of this type of legislation, nearly 20  years after these countries have chosen to do so, is a matter for them. This Proposition, if approved, would request the Minister for Transport and Technical Services to bring forward the appropriate legislation which as normal, may be amended by States members at that time.

The engagement of first-class professionals amongst our emergency services is held in high regard by the public. This practice of employment is married with our on-going efforts in their retained employment in the public sector. This is driven largely by the regulated requirement to meet obligations in respect of licensing from rules laid down by external governing bodies. This is particularly evident when it comes to the registration and ongoing certification of our Doctors and Nurses. The recent views expressed by the Minister for Home Affairs, that Police Officers progressing through to Chief Officers should have UK experience, is also of note. The emergency services in Jersey in many respects are aligned to best practice, which is drawn from operational and legislation employed within the UK. It follows then that in facilitating their professional objectives, we need also to progress our Laws and Policies likewise, in order to give our professional people the support that they require. This also extends further into areas regarding our responsibility and our duty of care for States employees. In reality this means much more than ensuring that we give them the best possible training, support and equipment available in order to allow them to accomplish their work to the highest possible standards. These essential elements need to be supported by appropriate legislation and the need to update that legislation, where there is a desire and a need for it, from time to time. The need to introduce this legislation from their perspective is key in our determinations. Having conducted interviews with senior officers in our emergency services, there is a clear level of support for the introduction of this type of legislation. The Senior Consultants at the General Hospital who have spoken to a wide range of professionals in Accident and Emergency regarding this issue over the last few weeks are clear. They are firmly of the belief that the legislation needs updating, to include the requirement of the introduction of compulsory rear seat belt measures and booster or child seat requirements. Having asked them to produce any supporting statistics and data that might better inform politicians in this regard, they have stated that there is little available in Jersey and they doubt the availability of it even in the UK. Their primary concern when injured people arrive at Accident and Emergency from a road traffic accident is to treat them for their injuries. This has been their focus and remains their focus, rather than collating statistics and data about the circumstances that resulted in the injuries occurring. Their considered view is that it just makes sense, commonsense. They have also communicated quite clearly that they desire and need the introduction of this type of legislation to make a positive impact on the lives of Islanders. In their view, if it saves just one person's life, or prevents a serious brain injury, even only once, in every 4  years, it will have been well worth it.

We must remember that the treatment and effects of vehicle accidents to the injured and their immediate families are sometimes lifelong, pronounced and life-changing for all concerned. Although there is an element of an economic argument, this must not be our sole concern and it is important that we remain sensitive that there are people within our community today that are recovering from the results of vehicle injury. It is to them and their families that we owe recognition in our deliberations.

The Chief Officer at the States of Jersey Fire and Rescue Service, the Area Manager, Risk Management and the Station Manager have given their professional opinion also, that concurs with the doctors and nurses, that despite the fact that no statistics or data are kept locally in this regard, there is a growing body of evidence and information globally that supports their view that legislation is needed. There is clear evidence when one speaks with these frontline officers that incidents to which they have been called in the past have left strong impressions upon them. They point out that, contrary to public opinion, Jersey roads are not as forgiving as they may appear to the general public. They remind us that many of our roads are narrow roads surrounded by granite walls. Granite walls, as with trees, which are the largest known elements involved with road accidents resulting in death, provide a very unforgiving environment for vehicles to encounter at any speed. Their experience is that they will attend incidents where there is barely a mark on the surroundings, despite the fact that the vehicle will often resemble a mangled and crushed can. The misconception that Jersey's low speed limits also reduce the risk is strongly countered, as the speed limit is compromised on a daily basis by drivers. Unfortunately many of these drivers are young and may be attempting to impress their friends in the rear of the vehicles. The possible head-on collision speeds involving one or more vehicles can easily exceed 100 mph when factored in together. Two vehicles travelling at 50 mph colliding will give very limited margin in their opinion for survivability. The impact of vehicles often results in passengers being in their words, "thrown around inside or ejected upon impact from the vehicles even at low speeds when not wearing a seat belt". They point out that more recently, we have seen 2 remarkable survival stories where vehicles that have been driven over cliffs, falling in excess of 150 feet, with the occupants receiving only minor injuries due to the fact that they were wearing their seat belts. The most seriously injured sustained only a broken ankle! (Members may recall these incidents at Geoffrey's Leap and Archirondel being reported in the JEP.)

Retired Surgeon Dr. John Myles has stated his support for the introduction of this legislation some 25 years after having successfully campaigned for the introduction of legislation for front seat belts. He says that "even when a driver applies the brakes suddenly at low speeds, whilst the passengers are not focussed on the direction and actions of the driver, when not wearing their own seat belts, this can often result in a serious head injury". In his considered experience, seat belts in any event are more effective at slow speeds. Studies have also shown that in cities and small towns this is generally the speed that is travelled by most drivers.

The Chief Officer of the Ambulance Service points out that we are not asking people to have to go through hoops here as the seat belts are in place in most circumstances now. In most cases the seat belts have been fitted already by the car manufacturers, who have a greater obligation these days than in the past where one could purchase seat belts with a new car as an added option, like one might today with an interior CD player or heated car seats. This is also complimented by the view that seat belts must be worn in the front which demonstrates their importance, which begs the question why not the back? The cost and time involved with Ambulances and Air Ambulances are factors which although secondary need to be factored in to our considerations. He also makes the point as did many other senior officers that the treatment does not stop there and can go on for lifetimes afterwards.

Personal choice

The statements regarding freedom of choice need to be tempered with an understanding of the dynamics of vehicle accidents and multiple occupants. If a vehicle is involved in a collision for example, ordinarily a successive impact or onward trajectory and further subsequent distances travelled will occur in many cases. For example if a car hits another car at a junction, the vehicles may take glancing blows and damage which affects the trajectory of the vehicles and alters their course. If the driver of both vehicles is unhurt, in any serious capacity, from this initial collision, their ability to continue to steer and brake is not necessarily affected so long as the vehicle is structurally and mechanically still capable of functioning. A secondary collision in this instance can be avoided as can a third or fourth. Having regard to the fact that this ability to control the vehicle after an initial impact is critical, consider the possibility that this might be interfered with by a concussion sustained to one or both of the drivers, from an unrestrained rear seat occupant. When one considers the implications of that, then one begins to understand that the drivers' subsequent actions, which are uncontrolled, then these may endanger other vehicles, pedestrians and or property due to their inability to continue to control and correct the vehicles movements. In fact in a position that is known as "Loss of Control". Where is the freedom of personal choice argument, when one is staring down the barrel of an out of control car, hurtling towards you and your loved ones? No, it is far too simple to dismiss out-of-hand, such a need to legislate in this case, based upon a question of personal freedom and choice. As pointed out by the Senior Emergency Officers, there are Health and Safety Laws about the heights of office furniture which everyone recognises as being questionable. This though is an area where there is no doubt that there is a real need and desire for the requirement to legislate. There is after all a great deal more at stake for onlookers than one might otherwise appreciate in any such eventuality than someone else's freedom of choice. From vehicles to personal property, the generally accepted fact is that the wearing of seat belts does save a lot of lives and in general the cost from additional injuries is significantly reduced or removed, where seat belts and restraints have been worn, when examining the after-effects and consequences of accidents involving vehicles.

It is accepted that there always will be incidents and arguments, that the drivers or passengers survived because in some cases, all be they rare, that the individuals were not, wearing them. These will, as now, in considered professional opinion, always remain a very small minority in reality. The arguments that can be made for the compulsory application of wearing seat belts though in their belief will far outweigh in the round the argument against not wearing them once they have been considered in the round. So why is there such a difficulty in introducing such legislation into our society? Perhaps we can reflect on the views published by The Parliamentary Advisory Council for Road Safety, from their publication Beyond 2010 – a holistic approach to road safety in Great Britain, which follows –

Leadership

In order for both the vision outlined in the preceding chapter to be adopted and a programme of action implemented to achieve it, a high level of political leadership is required. However, in project consultation interviews, it was frequently remarked that road safety policy has suffered from a lack of leadership at departmental and ministerial levels:

Lack of leadership from DfT [is a barrier to further progress]. Absolutely. There's never been a permanent secretary who's come from the Road Safety Division in that position. Road safety is not an internal priority, it has not attracted movers and shakers; partly because there's no political will. It's not on the public mind or on the political agenda. You need to start at the top, for example like in France where the President said something must be done and it became important because the President took an interest. The political will is very important, someone who has status, high profile We need high profile people in the community to come out in support There's a lack of leadership [in the UK], they won't be brave and say "this is the problem and this is what we'll do about it".

Other consulters felt that, because reductions in road casualties have been achieved and the targets are on track to be met, it is not an area that attracts political interest: "Because we're reaching the targets, there's not much attention, if we weren't reaching them they'd be more noticed". It is indeed frustrating that, while reductions have been and continue to be made, so many more deaths and injuries could be prevented if sufficient political pressure existed to introduce known policy, enforcement, educational and technological interventions.

Public opinion

People are fundamentally inconsistent with muddled thinking. A driver has a view about his neighbourhood and another for where he wants to drive.

There is a two-way relationship between political will and public opinion. Part of the difficulty in generating political leadership is the combination of the public's expressed concern about safety on the roads, at the same time as their ambivalence about some of the actions necessary to reduce casualties, particularly on the issue of speed management.

The public is indeed concerned about safety on the roads. A recent survey conducted for the Audit Commission showed that, "around one fifth of people identified speed and the volume of traffic among the issues that most need tackling to improve the quality of life for residents". Additionally, the 2007 RAC Report on Motoring highlighted that "driving and safety is by far the greatest area of concern for the vast majority of motorists".

Four out of the top eight issues of concern to motorists' were directly related to safety:

Issues of concern to motorists:

T h e behaviour of other drivers

O t h er people driving without insurance

T h e number of accidents on the road

T h e roadworthiness of other cars on the road 50

Further, 59% of RAC focus group participants agreed that the current level of death and serious injury is not acceptable: 30% agreed with the "need to cut deaths by at least a half" with the remaining 29% going a step further, nominating zero as the only acceptable level, following Sweden's model, although this was tempered with scepticism about whether it could be achieved.

With such a complex set of public opinions, combined with a frequently antagonistic national media, it is easy to see why political leadership has not been as robust as it might. But this dilemma is not new to road safety: at the time that two of the most important safety interventions were introduced – roadside breathalysers in 1967 and mandatory seatbelt use in 1983 – public, political and media opinion was similarly mixed. While it is true that drink driving remains a problem, there has been a general shift in attitude across society so that drinking and driving is now widely regarded as socially unacceptable. This shift, as well as the very high compliance rates for seat belt wearing, indicates that leadership in making decisions based on sound evidence can shape initially hostile public opinion.

Political leadership is needed to give greater priority in funding and resources to the whole range of casualty reduction interventions. Nonetheless, it is evident from the preceding discussion and the consultation interviews that, in this era, the issue of greatest contention is speed management, despite its status as one of the key contributors to crashes:

The next major challenge is to win hearts and minds of people about speed. We've done it for drink driving and seatbelts, but if we could crack public unacceptability of speed that would be a major contributor.

Car culture

The car is the last bastion of freedom. Germans don't think that because they have a car, and they have higher ownership rates, they must use it. The car is an Englishman's chariot.

There is a deeper philosophical issue underpinning these seemingly contradictory opinions and the hesitancy by government to implement known casualty reduction solutions. In a car-oriented culture such as the UK, cars have a status and emotional resonance unlike most other pieces of machinery. At a cultural, if not individual level, car ownership and driving are imbued with the symbolism of independence, spontaneity, wealth and power and so are perceived as much more than merely a convenient means of transport. This has profound implications for road safety policy because it constructs driving as an activity that should rightfully be unimpeded by regulations or the needs of other road users. The late Barbara Castle, minister responsible for the introduction of breathalysers, described the resistance to her decision in an interview with BBC One, highlighting this tension:

I was interfering, the opposition said, with people's civil rights. I said, I do not recognise anybody's civil right to kill somebody else because they're under the influenceThe publication of the first figures of the lives we saved were fantastic. It gave a fantastic boost and people saw the hollowness of the claim that I have my civil rights and Government hasn't any right to take them off me'.

From the introduction of the earliest speed limits to drink drive laws, seatbelts and speed cameras, it is this positioning of driving as an individual and independent activity that underlies opposition to safety-oriented interventions. A sophisticated awareness of the car's place in society and how that influences both driver behaviour and attitudes towards interventions will be an important element in successful casualty reduction strategies.

Co-ordinating the machinery of government

As road use is a highly regulated activity, it is also important that government departments work to support casualty reduction policies and programmes. The title of this report "Beyond 2010: a holistic approach to road safety" is perhaps the best description of how road safety policy needs to develop in the years following the expiry of the current set of targets. It was a frequent criticism in the project consultation interviews that, while road safety policy has been effective in reducing casualties, it has been quite insular. Expanding on the core areas, road safety now needs to move out of its silo and actively establish partnerships with other public and non- government agencies for whom improved road safety is not the prime focus, but where improvements support the achievement of their own objectives. As this report argues, such an approach goes towards creating a wider range of organisations active in, and advocates of, improving road safety. The Government similarly made this point in its second three year review of Tomorrow's Roads:

Road safety should not be viewed in isolation from other central and local government objectives. Policies to tackle climate change, social exclusion, obesity and urban renewal, to name a few, can all share our objectives to reduce casualties. We need to develop these connections further through working in partnership within and across organisations.

The current machinery of government does not lend itself well to cross-cutting activity. Building partnerships between the levels of government and communicating the intersections between road safety and other policy objectives is a specific task and a skill and requires dedicated attention. The road safety partnership grants aim to support collaborative projects, but there is scope for a high level body or agency to be responsible for progressing greater co-ordination to achieve casualty reductions. In the second three year review, the Government proposed the establishment of the Road Safety Delivery Board with a remit to do just this:

Working in partnership is the only way that we can continue to achieve further success. We will therefore set up a new national Road Safety Delivery Board to bring together representatives of our key delivery partners. The Board's task will be to sort out problems and issues, assist in developing closer partnerships and ensure that good practice is widely disseminated. We also intend to help further those local partnerships that are struggling.

An Ageing Population

It is not a new observation that the UK's population is ageing. This phenomenon and the implications of an increased proportion of older people have been widely debated, in particular in relation to the effect on revenues and health, social care and pensions spending. An ageing population will also affect the nature of road use and the casualty profile, factors which must be taken into account when considering casualty reduction strategies for the longer term.

The nature of the shift

The Depression of the 1930s and the death and disruption of the Second World War were followed by a boom in the number of people born in the years shortly after peace was established. Although the characteristics and cultural influence of this generation has been much discussed in the media, the UK actually experienced two baby-booms. The original was quite short lived, but a second, more sustained, increase happened during the 1960s. The ageing population is a product not only of these spikes in the birth rate, but simultaneous improvements in medical care and a decline in the fertility rate. Due to the combination of these factors, the 2001 census found for the first time that people 60 and over form a larger part of the population than children under 16 – 21% compared to 20%. The older age groups are set to grow and by 2031, the estimated number of people aged 50+ will be 27.2 million, a 36% increase on 2003 figures.

With the first generation of baby boomers currently entering their sixties and the second group due to approach that age range from the early 2020s, it is timely to consider the impact of larger numbers of older drivers in the medium to long term. It is clear that there will be larger numbers: the 2005 National Travel Survey (NTS) shows a clear trend in older licence holders:

Licence holding by gender and age (%)

One of the most significant trends is the large increase in the number of older women holding a driving licence. A consequence of women's large-scale entry into the paid workforce in the past two generations and the more car- oriented lifestyles that have become prevalent over the same period, as well as societal change that has increased women's financial and social independence, commentary in the NTS report observes that:

The proportion of women aged 60-69 holding a licence increased by a third between 1995/97 and 2005, from 45 to 61 per cent. Over the same period, the proportion of women aged 70 or over holding licences increased from one in five, to more than one in three. Licence holding will continue to increase in these age groups, as women currently in the younger age groups keep their licence as they grow older.

Licence holding indicates only the potential to drive, not the frequency or distance that is driven – that is, the level to which a person is exposed to risk and potential injury on the road as a car occupant. Comparisons over time of trips per person by mode recorded in the NTS show that between 1999/2001 and 2005 there was a marked increase in distance travelled: people 60-69 travelled 7,117 miles, an increase of 12%; and for the 70+ group, there was an increase of 15%.

Looking at the mileage driven by older people over the longer term, some very large increases become clear. Average distance travelled per person per year as a car driver (GB) (in miles)

The nature of the risk

The implications of these travel patterns for road safety in an ageing population are profound. Although there is little evidence of an increase in the incidence of road traffic accidents, older people are more fragile than their younger counterparts – they injure more easily, their injuries are more severe and heal less quickly. Compared with drivers aged 20-50  years, older people's fragility increases their risk of fatal injury by 1.75 times for drivers aged 60+, by 2.6  times at 70 and by over 5  times for drivers aged 80 and above. People aged 60+ are:

1 0 % of all casualties, but 21% of deaths

1 3 % of pedestrian casualties and 40% of pedestrian deaths

1 0 % of all driver casualties and 20% of driver deaths.

While it should be stressed that many older people remain in excellent mental and physical health, it is the case that as we grow older, our vision, hearing, reaction time and physical mobility begin to deteriorate which can affect our abilities as road users. There is a strong correlation between disability and age: two thirds of disabled people are elderly and over half the population aged over 75 have a disability. The DfT summarises problems that can be encountered by some older drivers:

Amongst the most common problems experienced by older drivers is a loss of motor function, for example caused by  joint  stiffness,  particularly  in  the  neck,  and  slowness  of  movement  which  can  cause  difficulties  with observations at junctions and during parking manoeuvres, and safe operation of the car controls. Reduced visual functions are also common as part of the ageing process. These may include reduced acuity, difficulty adapting to darkness, or recovering from glare. In addition, any reduced visual field from disease processes means that the quality of information gained from the environment may be inadequate, increasing the probability of errors and misjudgements. Age-related decline in cognitive functions such as attention, anticipation, executive functioning and information processing means that older drivers tend to have difficulty in dealing with complex traffic situations and reduced capacity to respond quickly and flexibly to changing traffic situations.

It has been widely commented that many older people compensate' by restricting their driving in line with diminished  capabilities,  which  can  include  avoiding  roundabouts,  junctions,  night-driving,  motorways  and unfamiliar or congested roads such as town centres. However, considering the trends in travel outlined above, it is not unreasonable to conclude that this may be less evident in future. It must also be remembered that being in a car is not the only way in which to be exposed to risk on the road and around a fifth to a quarter of all trips, across all age groups are on foot.

If efforts to reduce road casualties are to be successful, interventions that respond to older people's needs by reducing the severity of injury in the case of a collision and increasing their capacity to travel safely will become necessary.

Recommendation: That the next road safety strategy includes a comprehensive sub-strategy dedicated to reducing the rate of KSI experienced by older (60+) people per km travelled.

Vehicle design

Chief amongst interventions that can assist older road users is improved seatbelt design and operation. Active safety technologies, discussed in the technology section of this report, could also hold potential benefits for older drivers in particular. However, many of these technologies are as yet unavailable to the motoring public at affordable prices. Even when they become more widely available, passive safety features, then, will continue to play a significant role in improving crash survivability and reducing the severity of injuries. Because older people are more frail, they are more susceptible to injury due to forces exerted onto the body by the seatbelt in a crash. This is especially an issue for older women, amongst whom osteoporosis is relatively common. This can be seen in an in-depth examination of injury statistics derived from the Co-operative Crash Injury Study by Welsh et al:

The results show that for frontal impacts, there were no statistical differences in head injury rates across driver age groupsHowever, when chest injuries were considered, major differences in injury rates were observed and the older driver age-group sustained a higher proportion of injuries to the chest region at the [maximum abbreviated injury scale] MAIS 3+ level when compared to the other age groups.

Improvements in seatbelt design and operation are the prime method by which chest injuries can be mitigated. More intelligent' seatbelts are a key element of advanced or SMART restraint systems, which also include airbags:

Traditional safety belts and air bags are set up to provide protection for a limited range of occupants and conditions, by deploying or restraining in a fixed manner. Smart restraint systems consider variables such as occupant weight, seating position, safety belt usage and vehicle deceleration to control belt forces and deploy the air bag optimally.

Some advanced restraint systems are already available, but at present are installed in cars towards the top of the price range and so are inaccessible to many drivers. History shows that expensive new technologies eventually trickle through the vehicle fleet to the more modestly priced models. It does take time and before that happens, less expensive alternatives could be installing four point – rather than three point – seatbelts and increasing the width of the standard seatbelt. Ford has undertaken customer research towards installing four point belts in their vehicles. It was reported that in trials, people of different sizes, "perceive four-point belts to be safer, as well as more comfortable and, depending on their design, easier to use than traditional three-point belts". Tests on a dummy have shown that the advantage for older vehicle occupants is that, "compared with a standard three point belt system with a load limiter, the double diagonal belt system, (also with load limiters), loaded the chest of the dummy in a more even way and the maximum chest deflection was significantly reduced".

Alternatively, wider belts could be used. In a study using a standard 50 mm and a 100 mm wide belt, the 50 mm belt showed "a deeper and narrower deformation on the right hand side of the rib cage compared to that produced by the 100 mm wide webbing". One difficulty with installing wider seatbelts is that the retractor is currently mounted on the door frame pillar and wider belts would require a wider retractor and a wider pillar, which could have negative implications for visibility.

More sensitive, intelligent' deployment and changes in design can, in particular, address the issue of older people sustaining fatal injuries as a consequence of the interaction of traditional seatbelts and frailty. The design and operation of seatbelts, then, will continue to play a major role in reducing deaths of older car occupants.

The UK population is both ageing and likely to keep driving, further, in larger numbers and for longer than previous generations. To improve safety while maintaining mobility will require a multi-faceted approach, encompassing vehicle design, vehicle safety technology and the provision of more comfortable, reliable public transport as an attractive alternative.

Underpinning these changes will be the provision of engaging and clear information about ageing and driving. With their increased frailty and potentially declining capabilities, an older population poses a significant challenge to the road safety profession and the early implementation of a co-ordinated strategy is important to address these issues.

Young Drivers

After the test I drove like a bit of a prat really. I passed first time, was a bit arrogant and thought I was a very good driver. I then had a crash. I thought I was excellent until I had the crash. (male, 21)

The United Kingdom has a long history of effective interventions to reduce death and injury caused by road traffic accidents, which has led to its position as one of the best-performing countries for road safety. However, the reduction in casualty levels has not been uniform and there is still an unacceptably – and disproportionately – high number of young people who kill and injure themselves and other road users each year.

The scale of the problem

The recently published House of Commons Transport Select Committee's report on novice drivers provides a summary of several statistics to illustrate the problem:

in 1 998, drivers aged 17–21 accounted for 7% of the total driving population, but they comprised 13% of drivers involved in collisions;

o n e in eight driving licence holders is aged under 25, yet one in three drivers who die in a collision is under 25, and almost one in two drivers killed at night is under 25;

2 7 % of 17–19 year-old males are involved in a road collision as a driver in their first year of driving;

1 ,0 7 7 people died in 2005 in crashes involving a driver aged 17–25 (of whom 377 were drivers aged 17– 25).

This is particularly concerning given that the National Travel Survey 2005 shows that the proportion of young people with a full driving licence has been declining: in 1992-94, 48% of people aged 17-20 held a full licence; after a low in 2004 of 27%, it rose to 32% in 2005. With almost 1200 young drivers aged 16-19 killed or seriously injured in 2005 – more than three every day – the levels of death and injury are grossly disproportionate to the number of licence holders. It is also important to note that there is a strong gender imbalance. The table below shows the gap in the number of 17-19  year old male versus female drivers killed and seriously injured:

The large differences in casualty numbers are not a function of differing licensing rates.

Looking at the number of licences held by 17-20 year olds between 2002- 2005, the largest difference between the genders was only 10% in 2005: in that year 37% of young men held a licence compared to 27% of young women.

Learning and licensing

Taken together, the statistics above indicate that a significantly different approach to

learning and licensing is needed as an immediate intervention to improve young people's safety on the road. In recent  months  this  serious  issue  has  received  substantial  attention.  The  DfT's  second  three  year  review emphasised the need to tackle the casualty rate of novice drivers, announcing a review and overhaul of learning to drive:

The time has come to reform fundamentally the way people learn to drive. We need to do more than tinker with the particular elements, we need to overhaul the current system for learning, including pre-driver education, testing and maintaining driving skills through life. We need a comprehensive package of reforms: education to influence attitudes long before people reach 17, a thorough training process and a reformed testing process which tests that learners can drive safely, not just master how to control a car. We also need to do more to help drivers develop and maintain high standards for life, especially if they drive for work.

In the review, the Department outlines how reform will be based on a three point framework:

A n ew competency and knowledge framework setting out what a candidate must know and be able to do;

A m odern training syllabus setting out what a candidate needs to learn; and

A sy stematic set of assessment criteria setting out how the testing stage will establish that a candidate has covered the syllabus properly and can demonstrate the required level of competence.

The Transport Select Committee, as mentioned above, also recently examined the issue of young drivers. In their wide-ranging consideration of the issue, the Committee supported the concept of a more structured approach and recommended robust measures to achieve it. In particular, the report gave a detailed description of how learning, testing and licensing might be reformed to reduce casualties. Without being overly repetitive, it is helpful to outline the policy options discussed in the report as it is the most recent and comprehensive analysis.

Learning

In recognition of the important role driving instructors play in preparing young people for safe independent driving, the report recommends mandatory continuing professional development to improve the quality of instruction. This reflects evidence taken by the Committee that driving instruction needs to be professionalized to "extend the skills and knowledge base of approved driving instructors so that they can deliver some of these new interventions, some of these ways of getting drivers to understand what the risks are".