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

Memorandum by the British Medical Association (RTS 150)


  The BMA is a voluntary professional association of doctors, and their trade union, which promotes the science of medicine and maintains the honour and interests of the medical profession. With over 123,000 members, it represents around 80 per cent of the medical profession in the UK. The BMA is also a scientific and educational body and a publishing house.

  The BMA has for some time taken an interest in the impact of road transport on health and has produced a number of policy publications including Road Transport and Health in 1997.[100]

  The BMA considers that measures should be taken to reduce motor vehicle speeds in urban areas.[101] Most pedestrians and cycle casualties occur as a result of an urban traffic accident. The critical factor is the speed of motor vehicles, since a cyclist or a pedestrian hit by a vehicle travelling at more than 30 mph is likely to sustain severe injuries, whereas at speeds under 20 mph casualties are likely to be slight. For this reason, effective measures to reduce the speed of motor vehicles are essential in protecting vulnerable road users. These include rigorous police enforcement of existing speed limits[102] and physical changes to road design and layout to slow down motor vehicles in urban areas. Traffic-calming measures include road-humps and speed tables, road narrowing, kerb extensions and mini-roundabouts. Careful consideration should be given to the needs of cyclists when designing these features, for example in providing alternatives to physical obstacles such as ramps and humps in the roads and in considering road space for cycling when reducing the width of a carriageway. It would be unfortunate if measures to enhance the safety of cyclists (and pedestrians) by reducing the speed of motor vehicles within designated zones had the effect of discouraging cyclists from these very areas. Safer cycling conditions would also be provided if cycle networks were introduced in urban areas.

  Publicity and education campaigns could raise drivers' awareness of more vulnerable road users such as cyclists. Such awareness should in turn lead to a reduction in road casualties101. As well as improving road safety education in schools, the BMA recommends that the DLTR could improve the education of drivers by including hazard perception and awareness of cycling with the introduction of a practical cycling section in the Driving Test100.

  Cycling should be actively promoted as an effective means of improving public health. Regular cycling, like other forms of exercise, improves the health of individuals by improving strength and endurance and contributing to lower blood pressure and weight. On a population basis, regular exercise such as cycling is associated with lower rates of mortality, especially from coronary heart disease. The issue of children's exercise is crucial not only because of its link with their health and fitness in later life, but also because habits such as taking part in and enjoying physical activity are most easily acquired in childhood and may be difficult to acquire later.101

  Health derived national motor reduction targets should be established by a Traffic Reduction Unit. The percentage of children travelling to school by foot and by bike set against casualty rates (especially 10-14 year olds) could be used as an indicator of progress.100 All relevant government departments should support initiatives such as the establishment of traffic free zones, safe walk to school routes, and cycling lanes.101 We recommend that the DTLR provides increased funding for local authority 20 mph schemes, to approve a minimum of 500 additional 20 mph zones by the end of 2002, and to set targets for further increase thereafter. Furthermore, we suggest the DTLR investigate the cost effectiveness for uniform in-car speed limiters in terms of environmental and health benefits.100

  In order to monitor progress in reducing road traffic accidents, the Health sector should adopt a primary role in the collection of high quality data on injuries and their consequences. Future research strategies into injury prevention should include details of cost effectiveness.[103] Accuracy and availability of accident information and statistics should be improved. Many accidents go unreported, even those involving serious injury. This under reporting could have implications for assessing what costs traffic injuries have to the NHS99. In our policy report, Injury Prevention,103 we recommend the establishment of a comprehensive injury surveillance system that should include data from surveys of exposure to known avoidable hazards, eg child pedestrian exposure to non-traffic calmed roads. We acknowledge that there is strong evidence of effect on traffic calming on injuries to child pedestrians.

  Injury prevention is not cheap. The initial costs can be high, but savings are possible in the long run through prevention of injuries and resulting care and rehabilitation costs.103 Reducing traffic speeds make roads more safe, resulting in a reduction in road traffic injuries. A decrease in the amount of these injuries would reduce the burden on the NHS to treat them. Moreover, by making roads safer, the public are more likely to cycle and walk therefore realising the health benefits of doing so.

  I hope these comments are of assistance and I look forward to reading the report of the Committee in due course.

M J Lowe

Deputy Secretary

February 2002

100   British Medical Association, Road Transport and Health, London: BMA, 1997. Back

101   British Medical Association, Cycling towards health and safety, London: BMA, 1992. Back

102   British Medical Association, Growing up in Britain: ensuring a healthy future for our children, London: BMA, 1999. Back

103   British Medical Association, Injury Prevention, London: BMA, 2001. Back

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