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1.11 pm
The Parliamentary Under-Secretary of State for the Environment, Transport and the Regions (Ms Glenda Jackson): I thank the hon. Member for Torbay (Mr. Sanders) for affording the House the opportunity to discuss this extremely important issue. As he said in his opening remarks, it is essentially about road safety, although the main thrust of the hon. Gentleman's arguments has been driving restrictions for insulin-dependent diabetics and, as chair of the all-party parliamentary group for diabetes, the House would expect nothing less from him.
The Government are well aware, from representations from hon. Members, individual drivers and bodies such as the British Diabetic Association, of the strength of feeling among those who stand to lose their entitlement to drive medium-sized lorries and minibuses, particularly when they drive such vehicles for a living. We do not underestimate the consequences for those drivers and have every sympathy with their situation.
Of course, it is the duty of the Government to listen to all concerns and to consider all the implications. As the hon. Member for Torbay said, on 12 February my noble Friend the Baroness Hayman met representatives of the British Diabetic Association with him, my hon. Friend the Member for West Lancashire (Mr. Pickthall) and the hon. Member for Isle of Wight (Dr. Brand). Indeed, in an intervention my hon. Friend the Member for West Lancashire raised the case of one of his constituents and how the restriction is impacting on his life.
However, it is also the duty of the Government to take account of the wider interests of road safety and to make clear decisions, even if those decisions may sometimes have unwelcome consequences for some. It has been said that the change in the law that prompted these concerns is not based on well-founded evidence and that British drivers are being discriminated against compared with drivers from other European Union member states. Although I am sure that there is now general awareness of the effect of the new law, it would perhaps be helpful to say a few words about the background to the new requirements and explain how the change in legislation, which has been portrayed as being specifically directed against drivers with diabetes treated by insulin, has come into being.
For many years, the United Kingdom differed from the rest of Europe in that we had long-standing arrangements that allowed a person who passed a driving test in a car of any size to drive a wide range of vehicles, including lorries weighing up to 7.5 tonnes, category C1, and non-commercial passenger vehicles with up to 16 seats, category D1. If we were devising a new driving licence scheme for modern road, vehicle and traffic conditions, it is unlikely--probably unthinkable--that we would give entitlement to drive such a wide range of vehicles on the strength of a driving test that could be taken in the smallest car.
The second driving licence directive, which was adopted in 1991 and whose provisions the UK fully supports, requires anyone wishing to drive 3.5 to
7.5 tonne lorries or minibuses with 9 to 16 seats, to take separate driving tests and to meet the more stringent health requirements, which in the UK formerly applied only to drivers of large goods vehicles over 7.5 tonnes and buses and coaches. Given the size and weight of the vehicles in question, it is fair to say that those are sound and sensible requirements based on legitimate road safety interests. It is significant that during the consultations prior to implementation of the directive and in the period since it was implemented in the UK in January 1997, there have been almost no suggestions that anyone taking up driving for the first time should not have to comply with those requirements. Nor has the ban on people with certain medical conditions driving buses and lorries of over 7.5 tonnes and buses, which has applied for many years, been seriously questioned.
Also, if we were devising a driving licence scheme from the beginning, how would we decide which medical conditions should prevent a person from holding a licence or permit the driving of smaller vehicles yet preclude the driving of larger and heavier vehicles, bearing in mind the consequences if the person were involved in an accident? We would surely seek expert medical guidance on the risk associated with the particular medical condition. Assessment of medical evidence can be supported and supplemented by accident data, but lack of accident data should not invalidate the medical assessment.
The Secretary of State for the Environment, Transport and the Regions has a number of panels comprising experts in particular medical fields, which were set up to provide objective medical advice on the risk from driving by people with particular health conditions. One of those panels--the honorary advisory panel on driving and diabetes--has endorsed the decision that category C1 and D1 vehicles should be driven only by those who can meet the more stringent health requirements, which preclude among others insulin-treated diabetics. It would be irresponsible of the Government to ignore its advice.
Mr. Sanders:
Can the Minister confirm that at the last meeting of the honorary advisory panel on driving and diabetes the majority of people on the panel were not medical experts but departmental officials?
Ms Jackson:
I cannot confirm or deny that, but I will certainly inquire into the matter and respond to the hon. Gentleman by letter. As I have argued, it is unlikely that the Government would have taken any decision that was not based on objective, informed and particular medical advice.
We do not have comprehensive accident data that could alone support the medical assessment that insulin-treated diabetics should not drive the heavier, larger vehicles. That is because information on the medical circumstances of those involved in accidents is not routinely collected, nor would it be practicable to do so. However, there have been individual studies. It has been found that insulin-treated diabetes was responsible for 17 per cent. of 1,605 police-reported accidents involving collapse at the wheel in which the driver survived and was minimally injured to the point that driving could subsequently be resumed. DVLA records also identified 23 hypoglycaemia-related serious accidents from November 1997 to mid-February 1998. The hon. Member
for Torbay contrasted those figures with those involving drink driving and driver fatigue. However, both of those conditions can and should be avoided. Collapse at the wheel due to hypoglycaemia, however, comes without warning.
Mr. Pickthall:
May I point out to my hon. Friend that that is simply not true? Most diabetics get considerable warning of a hypoglycaemic attack. We are worried because the ban treats all insulin diabetics as if they were the same, which is not the case. Unlike other drivers, most of us have regular medicals, eye tests and check-ups. Insulin-dependent diabetics are often safer on the roads than other people.
Ms Jackson:
I am grateful to my hon. Friend for that intervention, but I understand that the detailed and specific health checks to which he referred take place over three years. I apologise to the House if I have done so, but I do not believe that I said that all hypoglycaemic attacks that cause collapse come without warning. Attacks that occur without warning when a driver is at the wheel are the greatest cause for concern.
Mr. Richard Allan (Sheffield, Hallam):
What is the Minister's response to the telling point made by my hon. Friend the Member for Torbay (Mr. Sanders) about the actuarial position taken by insurers? Insurance companies are not known for doing people favours and are happy to load premiums when they believe that there is a risk. The Government must be aware that insurance companies do not believe that insulin-dependent diabetics pose a significant risk. Is not that one of the best indicators that insulin-dependent diabetics do not pose a genuine risk?
Ms Jackson:
It is worth repeating that accident statistics alone, on which actuarial tables are based, cannot be the deciding factor. The point at issue is whether people with a known medical condition that carries the risk of collapse at the wheel without warning should be permitted to drive vehicles that are of such weight and size that there could be serious consequences if they were involved in an accident. That assessment can be made only by those with the detailed medical knowledge to understand the implications and to look at the issue with detachment and objectivity.
For those reasons, we support the medical standards prescribed in the directive and the requirement that they should apply to drivers of vehicles weighing more than 3.5 tonnes or with more than eight passenger seats. Understandable concern has been provoked by the issue of whether those requirements should extend to drivers who already hold entitlements to drive such vehicles on the strength of the less stringent testing and health regime which, until the directive was implemented, applied in the United Kingdom. Is it reasonable for the Government to remove entitlements which, in many cases, have been held for years and, in some cases, are being used by drivers in their jobs? As I said during the debate on road safety in the House in January, it is better to err on the side of what some might call overcaution than to increase the risk of death and injury on our roads.
It has been said that the UK has implemented the directive over-zealously, and that that is not reflected in the approach taken by other member states. The directive prohibits the issuing or renewing of licences for the
vehicles in question to those with diabetes treated by insulin other than in "very exceptional cases". The advisory panel has advised that there are no exceptional cases that medical opinion would recognise as being lower risk than others, and that, while modern treatments have improved the control of diabetes, they have not eliminated the possibility of a hypoglycaemic attack.
On the basis of that advice, we have decided against individual assessment of drivers--a point that the hon. Member for Torbay asked me to address--other than for the purposes of holding a licence to drive a car. Some member states may have provided for exemptions from that requirement, but only to a limited extent in most cases, and only for non-professional drivers. We do not know what expert advice those states took in making such arrangements, but it is right that we should take our own counsel.
The United Kingdom's enviable road safety record has largely been achieved by taking firm decisions.
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