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

Examination of Witnesses (Questions 540-559)



  540. Were you consulted in any one of those committees about the decision to change the rules about safety cameras, last December?
  (Mr Brown) No, I do not recall that.

  541. Can I press you a bit further, because we received evidence from some of the local authorities in Northampton, Nottingham and Gloucester that they had put in place very innovative traffic calming measures that had had quite startling impacts on reductions in road traffic accidents. They say it was unfortunate that health authorities in those areas did not keep the records either in staffing reduction terms or in money terms of the impact that those, up to 50 per cent, reductions in accidents had had in those areas. Why is that the case? What will you do about it?
  (Yvette Cooper) I think it is true that there is a greater role that health could play at the local level in this kind of field. One of the constraints, obviously, is around capacity, but there is also a structural issue as well, that it has only been, really, in recent years that closer partnerships between health authorities and local government have been increasingly developed through health improvement programmes and local strategic partnerships, and so on. We have an opportunity with the development of Primary Care Trusts to take that a step further, because the Primary Care Trusts will each have a public health director and will be, effectively, taking public health closer to the community level. The potential, I think, is there for public health directors, potentially using information gathered from the Public Health Observatory, whose job it is to gather health information in different regions, to do much more close work with local strategic partnerships about things like where the hot-spots might be or, where you have got something working, how do you evaluate it and how do you link up the information. The problem that we have at the national level is that Primary Care Trusts are only really just getting going and that the data collection that we ask local areas to do is considerable already. So I think there is the potential to do considerably more than is being done, but that there will be capacity constraints in relation to how fast that is possible to achieve.

  542. It does sound a bit of a complicated answer to a relatively simple question, which is what percentage of accidents and emergency staff time is spent on road traffic accidents? Is that kept as a separate record so that it can be monitored—with graphs perhaps—so that if there is a new scheme we see the graph going down, and if it starts going up we get worried? Is that not a way in which your department could actually contribute in a major way to putting pressure on the rest of the government to get on with it?
  (Yvette Cooper) We do not classify the information in that way, at the moment.

  543. You do not?
  (Yvette Cooper) No, as I understand it.


  544. With the greatest respect, that information already exists in A&E departments, because you actually have the right to charge for road traffic accidents.
  (Yvette Cooper) We have the information on the in-patient data. I will ask Gordon to expand in detail on the things that we do have.
  (Mr Brown) The point is, Chairman, that essentially A&E data will cover many, many injuries—many of them being slight, many of them not connected with road traffic incidents. The data we do have is from hospital in-patients; those who have serious injuries and the ones that we want to focus more attention on. Those data are fed back and compared with the police data that come to the DTLR, and an attempt is made to gain a better understanding once the diagnosis has been made and the long-term effect of the accident has been established.

  545. But not the other emergency services. You do not seek to collate it from ambulance services or from fire brigades?
  (Mr Brown) What we are merely concerned about is the actual diagnosis of the injury at the time, and therefore when the person has been an in-patient—which, by itself, means that it is a more serious accident—we focus on those cases in particular, rather than what might be a relatively slight injury.

  Helen Jackson: Finally, what we get in our surgeries is the staffing shortages in accident and emergency hospitals. If you can cut down, surely, that staffing time because of a reduction in accidents, would that not help throughout?

  Chairman: "Yes" will do as an answer, Minister. Thank you.

  Ms King: On that point, is data collection not muddied by inaccurate reporting around the severity of injuries? You talk about in-patients, but if they die after 30 days they are recorded as seriously injured not dead. Obviously, that leaves a problem. I wonder if you agree with the BMA who said that under-reporting of road traffic injuries can have implications for assessing what costs traffic injuries impose on the NHS.


  546. Do you agree with that?
  (Yvette Cooper) I think I would accept that. Our data collection is not designed around road accidents. It has been designed around the needs of the NHS, specifically, to treat people and to fund appropriately within the NHS. That is the way the data system has been designed. Inevitably, the way that the data is collected has to cope with a lot of different demands on it. We have to balance the interests of not asking for too much data so that we have our health service spending its whole time collecting data. I do take the points that you are making, that there may well be better ways in which we can collect data around road accidents, and we will certainly look at that. The only caution I would give is that we may not be able to do it, given the other constraints on it. So I cannot give any guarantees about what is possible, but I will certainly look further at that issue.

  547. Let me be helpful to you, Minister, since we are a very helpful Committee. It needs two or three researchers, it needs a small budget from the Kings Fund and it needs somebody thinking clearly about how they use your existing information. You have it in the system, believe me. You have got to stop asking people to take more statistics on board, you have just got to look at what is under your nose.
  (Yvette Cooper) That is an issue, probably, about the data held by ambulance departments, but the issue we were discussing about what we had in terms of the data that is collected in A&E departments may be a more difficult area.

Mrs Ellman

  548. Has your concern about class differentials in accidents and safety been reflected in the Ten Year Plan for Transport?
  (Yvette Cooper) I think that the whole issue of inequality is picked up everywhere really. The concern about the class differences seems to be about deprived areas having higher incidents of speeding than less deprived areas, but also having more children on the streets and less places to play. Some of these issues are not simply about the transport side of it, it can be that the kids have no where else to go so they are playing on the street, there could be broader quality of life issues. There is much picked up in Neighbourhood Renewal Units as well in focussing on the whole quality of life issues and about giving children other places to play as well.

  549. What about the areas where it is about transport issues, the home zone areas and the lower speed areas, do you think there is sufficient funding in the Ten Year Plan to deal with the concerns you have expressed?
  (Yvette Cooper) I think the issue is how we use the resources we have to best tackle the inequality issue. That is one of the things that the cross-cutting review round health and equality is trying to pick up, whether it be home zones, whether it be about issues about speed restrictions or whether it be about the work done through healthy schools. We have a lot of programmes at the moment where we could focus increasingly round inequality. The Healthy Schools programme, which includes issues about safe routes to schools, have not been heavily focussed on inequalities before and that is one of the things we are looking at as well and making that more focussed on inequality. If your question is, could we do more to focus to on the inequality, yes, I am sure we could and that is what we are trying to do at the moment.

  550. Do you feel there is a sufficient link between the concerns you are expressing and the priorities in that Ten Year Plan for them to be reflected locally?
  (Yvette Cooper) We found when we have had the discussions under the umbrella for the cost-cutting review a lot of commitment on the transport side on looking at the health and equality issues. Have we got there yet? The answer is no, but we have certainly found a lot of commitment from the Department to look at health and equality issues in terms of their policies and how it impacts.

Mr O'Brien

  551. Minister, the question of the speed of traffic on urban roads is an issue we are addressing and we hope that you will. I put it to you there has been a report published in Nottingham and their survey shows that the closer people live to main roads the more likely they are to develop asthma. Have you done anything on that?
  (Yvette Cooper) Some research has been funded. The research you are talking about was part funded by the Department of Health round asthma. In previous years there had been some mixed evidence round asthma in children but this, I think, was quite important. The Department of Health Committee on the Medical Effects of Air Pollutants is going to consider a whole series of studies round traffic pollution and closeness to roads because it does seem to be, as you say, about the proximity to roads having an impact on asthma. I think one of the interesting issues will be whether there is further work that we can then do as a result of that. The difficulty is what interventions you can then do that would work. I think that that study did not so much look at speed it looked at the density of traffic.

  552. That comes to the next question, do you support the implementation of 20 mph speed limits in these areas?
  (Yvette Cooper) I think 20 mph speed limits are extremely important, they have a big impact on accidents and that is why we support the implementation of those. There is a separate issue between the accidents which are linked to speed and the pollution linked to traffic density.

  553. If you support the 20 mph speed limit and the fact that slower moving machines can generate more pollution because of the density how does that impact on this research that you are aware of and what are you doing about it?
  (Yvette Cooper) I think that is why a lot of the work round the 20 mph zones speeds have been in heavily pedestrianised areas but you are right, there is a tension between maintaining traffic flow, so you do not have slow, concentrated traffic making pollution worse as well, that is a tension and I do not think there is an easy solution to it. We need further study and further research into the issues round asthma and pollution.
  (Mr Brown) I entirely agree with that. I understand that basically highway authorities do have a variety of approaches they can take to traffic flows and were further research possible in this area that might help them to direct how traffic flows and how it could be directed away from the areas of pedestrian density.

  554. We have been told in the past that pollution does effect the condition of asthma, this report says that it creates asthma, do you agree with that?
  (Yvette Cooper) We take the evidence and the advice of the experts in this area and that is why we have asked the Committee on the Medical Effects of Air Pollution to look at this study in the light of all of the other studies, as well as advising us. We can certainly write to the Committee again when we have further advice on that.


  555. When you are looking at the 20 mph zones will you bear in mind that some ambulance services get unhappy if they have trouble with them in residential areas, they also get unhappy if they get it outside A&E departments in major hospitals. Someone needs to use a bit of common sense. Will you sort that one out for us? Was that a "yes" minister?
  (Yvette Cooper) Yes, but in the end it has to be sorted out at a local level.

  Chairman: We have "yes", we will let you worry about the rest.

Mr Betts

  556. In response to an earlier question you said that you and your department had not been consulted by the Department of Transport before their decision to make an announcement about the sighting and colour of speed cameras, do you think you should have been consulted?
  (Yvette Cooper) I am not aware of the discussion that took place at that time. In the end it is the responsibility for their department to actually enforce the speed limits and enforce the issues round speed. We are concerned about the impact that it has on accidents but in the end they are the ones with the expertise on how you enforce that and how you have the impact.
  (Mr Brown) The task force were, in fact, aware of work that had been done in Lancashire on this very area and as a result of that work were supportive of the evidence this was showing, the emerging evidence that these speed cameras could have a great effect in reducing accidents. Had we been consulted I am sure we would have been very supportive.

  557. What sort of criteria do you think should be used in making these decisions from your point of view and from a public health point of view?
  (Mr Brown) In supporting interventions which are shown to have good success for reducing accidents.

  558. The criteria is about reducing accidents. You do not believe the criteria should be used according to whether the public are in support of such cameras?
  (Mr Brown) Compliance is always an important factor

  559. The overriding criteria should be the reduction of accidents.
  (Yvette Cooper) In the end public acceptability does matter. If you were purely concerned about health you would say, "do not let anybody smoke", on other hand if people want to smoke they have a right to smoke. In the end all of the issues round public health do have to take account of public attitude, what is acceptable to the public as well. From the Department of Health we cannot simply take a view that only health concerns matter, we can provide the advice and the response in terms of health considerations but every department has to take account of public acceptability.

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