Select Committee on Transport, Local Government and the Regions Minutes of Evidence

Examination of Witnesses (Questions 526-539)




  526. Good afternoon, Minister, thank you for joining us. Would you be kind enough to identify yourself, for the record?
  (Yvette Cooper) Thank you, Chairman. Yvette Cooper, Minister for Public Health, and this is Gordon Brown with me, who is the lead official in the Department.

  527. Are you quite sure?
  (Mr Brown) I do not look like him, do I?

  528. The wrong accent. Do you have any opening remarks, Minister, you would like to make?
  (Yvette Cooper) Only very briefly, as I know you have taken extensive evidence from other Ministers as well. Simply to say that we very much welcome the Committee's investigation in this area. Obviously, our perspective is from the point of view of public health and the broader impact on health these issues can have. We look at the prevention of accidental injury, the promotion of exercise and, also, the prevention of pollution. The one issue I would like to highlight and draw to the Committee's attention is the fact that children from social class 5 are five times more likely to die as pedestrians in a road accident than children from social class 1. So this is an important issue when it comes to tackling health inequalities as well. We have set national targets for the first time in terms of narrowing health inequalities. There is a lot of work going on across government as part of the cross-cutting review on health inequalities to feed into the spending review discussions, at the moment, so obviously this is one of the areas covered by that as well.

  529. So we can take it that your department regards this as important a public issue as, for example, changing the laws in relation to smog in the distant past?
  (Yvette Cooper) We would not see it in isolation, it is one of many issues. There is a specific issue in terms of the number of child accidents, in particular, but in addition to that there is an issue about quality of life and the impact that can have on health as well. So, for example, it is not simply about the actual accidents and the children who are harmed, or the people that are harmed or killed in accidents, it is in addition to all the other people who do not go out on the roads or do not walk to school, or do not use the roads for fear of accidents or fear of harm as well.

  530. So how are you going to give a lead to the population in these very important questions?
  (Yvette Cooper) We obviously support the work being done by the Department of Transport, Local Government and the Regions in things like the home zones and the 20-mile an hour limit. We work with both the Department of Transport, Local Government and the Regions and the Department for Education and Skills on issues around safe routes to school and encouraging more children to walk to school or cycle to school as well. What we are looking at, at the moment, is how we might be able to take those partnerships further at the local level. We are looking at that under the umbrella of the cross-cutting review on health inequalities; as to what role in the future, for example, the public health directors in Primary Care Trusts may be able to play in local strategic partnerships, working with the local strategic partnerships and with the local authorities around where are the key accident hot-spots, for example, or what additional work might be done in schools in order to prevent particular problems in particular local areas.

  531. Your department is sitting on some very specific and targeted information. Ambulance services, for example, can not only predict—where they have efficient systems—where particular accidents will take place, they can also predict the time of day. Indeed, some ambulance services organise the provision of vehicles on the basis of their predictive services. What effort does the department make to gather that information together and present it to those other departments who would most usefully be able to put it into operation?
  (Yvette Cooper) There is some work on data sharing at the local level. I think I might have to pass to Gordon on this.
  (Mr Brown) Basically, Chairman, there have been some examples of local partnerships where A&E, ambulance and emergency services work with the police and work with the fire brigade in tackling local problems. We do feel, however, there is greater scope for encouraging partnerships of this type. As you say, one part of the situation has particular data that is of use to another. We would particularly like to see this kind of data fed into the local highway authority.

  532. That is, if I may say so, aspirational. This information exists. Greater Manchester can predict when they are going to need ambulances, at what time of the day and what kind of accident, on the whole, they are going to meet. What effort is being made by your department to transmit those detailed statistics routinely to those who not only design the roads, but those who police the roads and those who control the roads? (After a short pause) Are you telling me that this is a voluntary arrangement between some ambulance trusts and some local police forces but there is no effort by your department to ask, for example, those of the ambulance services who have this data and have this software what they do with the information?
  (Yvette Cooper) Much of the software has been relatively recently introduced and it does not simply include accidents, it is predicting the overall need for ambulances in a particular area. I think what we need to do, Chairman, is get back to you on this. We will look into this in the department. This may be an area where we could do more. I will certainly look into that for you.

  Chairman: Thank you very much.

Mr Donohoe

  533. How often do you analyse the cost of death on the roads to your department?
  (Yvette Cooper) We have figures on the cost of treating all injuries. Unfortunately, the category includes treating all injuries and poisonings—that is the way the data is collected—which is roughly calculated at 2.2 billion in 2000. I know the DTLR have estimated the total medical and ambulance costs of traffic accidents in 2000 as £540 million. We know that each person who is admitted to hospital as a result of a traffic accident is estimated to cost the NHS an average of £494 per day, and each person who is treated without being admitted is estimated to cost an average of £402.

  534. Why do you not bill the driver in these circumstances, for the full cost?
  (Yvette Cooper) Where compensation is paid in respect of a traffic injury the Department of Health is able to recover the cost of hospital treatment from the insurer. So that was put in place. There are some difficult issues to balance here. There is, I think rightly, partly the principle of being able to recover compensation, but at the same time recognising that the health service provides care regardless, and does not make it conditional on being able to recover resources and so on. So we do do that kind of thing already.

  535. You do not have any direct control over that as an issue, do you? The control of that is within other departments, not yours, for the impact and that cost.
  (Yvette Cooper) In terms of the cost of actually causing the accident, do you mean, having the impact on the health service? Yes, that is right, and that is one of the reasons why we have got, for the first time, the cross-cutting spending review taking place across all departments. Part of the problem with health is that often many of the causes are actually outside the field of health, they are outside what the NHS does—whether it is unemployment, whether it is road traffic accidents, whether it is poverty or poor housing, and those kinds of things. So we have a wide range of areas where, effectively, health picks up the bill for problems that may be caused elsewhere. What you need to do is to take action across a whole range of fields in order to actually reduce the bill for health as well. So the reason for setting up a cross-cutting review around health inequalities was exactly to try and do that, with the Treasury holding the ring at the centre, to look at all of the different causes of ill-health and, particularly, health inequality, and where the priorities for investment should be if you want to turn that around. I know that is not an individual answer to your particular question, but I think it signifies the right sort of approach across all fields.

  536. Would it be better for your department to have control of the publicity budget rather than the Department of Transport?
  (Yvette Cooper) I do not think so. We often find when we are dealing with different health issues that it will cross-cut other departmental issues. I have given evidence to other committees and so on before and there is often discussion about are departmental boundaries drawn in the right place. I think if we tried to include everything which had a health impact in the Department of Health it would be huge. However, other people have, equally, tried to argue that all the things to do with public health should be taken out of the Department of Health. I do not think that would be the right approach either. I think it is right that the DTLR has control of that because, in the end, they have responsibility for implementing speed limits and making sure they are enforced, and all those kinds of issues as well. They also do the detailed research on the impact of speed limits or the impact of different proposals around roads, and on accident levels as well.

  Mr Donohoe: What are you doing to get your medical professionals out of their cars?


  537. That may be rather beyond you, Minister, speaking as somebody who has five doctors in their family.
  (Yvette Cooper) We actually have something that was put in the national service framework for coronary heart disease, to get local NHS trusts to draw up their own green transport plans for individual areas in order to try and promote and extend the support for healthy routes to work, ways of using bikes or walking to work, and so on. That is being drawn up as part of the national service framework and that is part of the requirement for the NHS in different areas, and is under way at the moment. Because the NHS is such a big employer in the country, that potentially could have considerable impact over time.

Helen Jackson

  538. How do you liaise with the DTLR and the Home Office about this issue of speeding and road safety? What are the mechanisms you use?
  (Yvette Cooper) The mechanisms are at official level, and I will pass over to Gordon to, maybe, say a little bit more about it. At the ministerial level we are in the process, at the moment, of discussions around the spending review process and around health inequalities. That is just taking place at the moment with different ministers. Perhaps Gordon can say more.
  (Mr Brown) Thank you, Chairman. There are various levels, as the Minister has said. There are various committee levels and we are invited to attend various transport committees and sit on those committees and be there to represent the Department of Health. There have also been various specialist groups that have been set up.

  539. Has there been one on speed?
  (Mr Brown) There has not been one on speed but there has been one on the spending review, which has just been mentioned, in which transport played quite a major part, especially in accidents. We also had an Accidental Injury Task Force which has been a cross-government and cross-sectoral task force, looking at all kinds of injury and accident—again, at which we had a DTLR representative.

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