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Mr. David Drew (Stroud) (Lab/Co-op): My hon. Friend the Minister has heard me make this point before, but I will do so again now because it is very important. When I talked to my local group representing those who suffer from macular degeneration, which, sadly, is a common problem in older age, I was staggered to learn that, virtually to a person, they had volunteered to give up driving. There was no medical requirement for them so to do, even though they themselves felt unsafe when driving. Does my hon. Friend agree that something needs to be done about that?
Dr. Iddon: I certainly do, and that intervention underlines the message that my Adjournment debate is intended to give to my hon. Friend the Minister.
Older drivers are badly affected by the glare from oncoming headlights. The visual field shrinks significantly beyond the age of 75. They suffer commonly from muscle and joint stiffness, which affects their ability to turn their head or body in the car. They are less able to monitor their position in dense traffic, reverse safely or change lanes safely as a result. Reaction times are also slower for older people. Of course, many older drivers are far more experienced than younger drivers. Nevertheless, in their late 60s and 70s, older drivers' impairments seem to outweigh any advantages that they may have accumulated with their years of experience and more cautious behaviour, and combined with their increased frailty, they are beginning to meet more risks on the road. However, many older drivers are
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aware of that increased risk and avoid more dangerous situations such as driving at night or in dense traffic.
Older drivers are more likely to take medication that may affect their driving. There is reliable evidence that certain prescribed medicines increase the risk of a road traffic accident, especially for older drivers. Anxiolytics as a class—benzodiazepines, for example—produce up to a fivefold increase in risk. Sedation and drowsiness are associated with pain-killing medicines containing opiates and opioids, including over-the-counter products. How many doctors discuss those increased risks with their older patients? Although some doctors are reluctant to advise their patients on driving, an increase in litigation, in which they are held liable in the event of an accident for not having advised a patient to stop driving, should act as a caution.
Certain diseases, such as epilepsy and diabetes, carry with them an increased risk of accidents on the road. A combination of those risks, which is more likely to occur in an older person, produces a much higher risk. Heart disease, however, is a fairly rare cause of traffic accidents. In a study of 2,000 acute collapses at the wheel while driving that led to a police-reported accident involving personal injury, only 10 per cent. were shown to be caused by a heart attack and 7 per cent. by stroke, the rest being due to epilepsy or diabetic hypoglycaemia. Many older people recover well enough from strokes to enable them to drive again.
A given dose of alcohol results in a higher blood alcohol concentration in an older person because of the reduced water content of the blood compared with a younger person of similar weight and sex. Alcohol can also increase night blindness and sensitivity to glare. The prevalence of dementing disorders is estimated to be as high as 47 per cent. for those aged 85 or older. Individuals with dementia are twice as likely to be involved in an accident as non-demented older people.
Not all older drivers are dangerous, although some clearly are. I am reminded of the case of veteran driver Tom Soulby, who got a lot of publicity last year—his 100th year—when he complained that his GP was insisting that he stop driving, after 82 years. Legislating on the ground of age is discriminatory. Therefore, if we are to deal with the dangers that some older drivers present on the road, we need to ascertain their fitness to drive in a more sensible way than we do now.
There are measures that the Government can encourage to make older drivers safer on the road. The motor industry is beginning to think about the design of motor vehicles with older drivers in mind. Design features include hand-operated braking and acceleration controls, other easily operated controls and easily readable instrument panels, swivelling seats, higher roofs and step-in access with rising seats, sliding doors, intelligent night vision systems and even rear view cameras. We can expect to see advertisements in future aiming cars at the older driver, alongside the racy adverts that are clearly aimed at the younger driver. Some useful changes, such as satellite navigation and sensors in front and rear bumpers are already with us.
We should not forget that older people are more at risk as pedestrians than as drivers. In general, older drivers are a lot safer than younger drivers. In 2004, the
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number of 16 to 19-year-olds and their passengers killed on Britain's roads increased by 12 per cent., while the annual rate for all drivers fell—I am glad to say—by 8 per cent.
In late 2004, the DVLA commissioned an independent review to assess the effectiveness of the present medical licensing system. It believes, as my constituents do, that the existing rules are outdated and inadequate.Research commissioned by the DVLA has shown that the present system is widely abused, with only 10 per cent. of drivers with a notifiable condition admitting it on the D45 form that they return to the DVLA. Further reports in the early part of this year indicate that the DVLA is about to embark on a public consultation on proposals to require drivers over the age of 75 to take a fitness-to-drive test every five years. It is proposed that those drivers who have reached that age will be required to bear the cost of attending an assessment centre to complete a paper-based test designed to examine their fitness to drive. A draft EU directive may require drivers over the age of 70 to renew their driving licences every five years instead of every three years, as now.
My constituent Mrs. Carol Brooks, and her family's solicitor Mr. Tim Woods, have also asked me to look at the Motability scheme and the safety record of its drivers. This scheme was launched in 1977, following the introduction of the mobility allowance the previous year. Prior to that, only disabled drivers who could drive themselves received help with transport. Most were supplied with a small, blue, single-seat, three-wheeled motorised invalid trike, which was incapable of carrying any passengers.
According to a parliamentary answer of 13 June 2005, more than 30 motor manufacturers supply over 140,000 new vehicles to the scheme annually, thus giving 400,000 disabled people mobility. Of those who benefit from the scheme, 33 per cent. are not actually the drivers of the vehicle, and around 10 per cent. of the drivers who benefit from the scheme require special adaptations to the vehicle to enable them to drive safely and in comfort.
The point has been made to me by Mrs. Brooks that the scheme is extremely generous with respect to the choice of vehicle. In her opinion, a significant number of disabled older drivers are allowed to purchase quite powerful vehicles. Therefore, does my hon. Friend the Minister feel that there is adequate oversight of the scheme to ensure that the purchased vehicle is suited to the capabilities of the older disabled driver?
We cannot discriminate against older drivers, but the fact is that they become an increasing risk to themselves and other road users with advancing age. In my opinion, more can be done to minimise the risk—by the Government, through legislation, regulation and careful planning of the road network and its signage, and by the manufacturers of motor vehicles designed with older people in mind.
The evidence shows that we cannot leave older drivers to assess their own ability. Most are reluctant to give up the convenience of driving their own car, especially after a lifetime of motoring.
I look forward to my hon. Friend's response.
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7.52 pm
The Minister of State, Department for Transport (Dr. Stephen Ladyman): I begin by congratulating my hon. Friend the Member for Bolton, South-East (Dr. Iddon) on securing this debate. This is not his only contribution to road safety: he is a doughty campaigner on road safety in general, and he has bent my ear about this matter for some time. He is quite right to do so; the case of Amicie Nwokeochar is tragic and very sad, and we have to learn from it.
As my hon. Friend said, Amicie's death was the result of an accident caused by a man who was nearly 90 years old and who was subsequently found guilty of careless driving. For obvious reasons, I shall not comment directly on the case, which raises some general matters of which account should be taken.
I agree with my hon. Friend that we should do everything that is reasonably possible to avoid any repetition of such a dreadful accident. That is why the Government take the matter at the heart of this debate, and the issue of road safety in general, so seriously. My hon. Friend was involved in the Second Reading debate of the Road Safety Bill just a few days ago. He will know that it contains various measures designed to help to reduce road traffic casualties. I very much welcomed his contribution to last week's debate.
None of us can avoid the ageing process. The way in which it affects our mobility and fitness to drive will, of course, vary from individual to individual, but it is understandable that many motorists should want to continue to drive for as long as they are physically and mentally able.
The ageing of the population is one of the major structural changes facing the UK. The safety implications of our wish to remain mobile and independent will come increasingly to the fore as life expectancy and the average age of the population rises. Sadly, that will also increase the potential for older drivers to be casualties in road crashes, not necessarily as the cause but as a victim. It is very important, therefore, that we carefully consider not only the safety of older drivers but their relationship with other road users.
The public have every right to be concerned where older drivers have been involved in or have been responsible for accidents. Such incidents are often tragic and the issues they raise must never be forgotten, but, compared with the general picture of road traffic casualties and their causes, they tend to be the exception.
A great deal of research has been conducted into the accident involvement of and casualty causation for older drivers. Studies have shown consistently that older drivers do not pose a significant excess risk of injury to other road users compared with drivers of other ages, particularly young drivers. My hon. Friend is also concerned about the rate of accidents caused by younger drivers.
The indications are that many older drivers tend to regulate themselves by driving lower mileages, and keep within their limitations by avoiding, or reducing their driving at, higher risk times such as rush hours, at night and in the winter. This research has also shown that older drivers, when involved in accidents, are themselves more likely to be injured than others.
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In our view, the crucial factor is not age but the physical and mental fitness of the driver to drive competently and safely. Old age alone should not be a bar to driving; my hon. Friend the Member for Bolton, South-East would share that sentiment. A number of statutory requirements currently apply to older drivers. The present driver licensing system recognises that, after the age of 70, there is a greater likelihood that health will deteriorate in ways that might affect driving. Licences expire at that age and must be renewed every three years thereafter. At each renewal, applicants are required to answer questions about their health and eyesight and to certify that they meet the required standards.
There is a further legal requirement for drivers of any age to inform the Driver and Vehicle Licensing Agency if they become aware of the onset or worsening of any health condition that might affect their fitness to drive safely. Failure to do so is a serious offence. When such notification is received, the DVLA will make medical inquiries and reach a decision about future entitlement to drive.
My hon. Friend the Member for Stroud (Mr. Drew), who is concerned about road safety, raised the issue of macular degeneration and related issues. The same rules apply to people suffering from macular degeneration as apply to any other eyesight condition. If it is shown that somebody suffers from macular degeneration, which they ought to indicate to the DVLA, the DVLA will be responsible for making sure that an appropriate eye examination is performed and a judgment is made about fitness to continue to drive.
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