BMJ 2015;350:h659 doi: 10.1136/bmj.h659 (Published 11 February 2015)
Page 1 of 2
Editorials
EDITORIALS Crashes involving young drivers Still waiting for government action despite their costs in lives and money 1
2
Sarah Jones consultant in environmental health protection , Frank McKenna emeritus professor , 3 4 5 Stephen Stradling emeritus professor , Nicola Christie director , Tom Mullarkey chief executive , 6 7 David Davies executive director , Elizabeth Box head of research , Julie Townsend deputy chief 8 9 executive , James Dalton head of motor insurance Public Health Wales, Cardiff CF11 9LJ , UK; 2Department of Psychology, University of Reading, Reading, UK; 3Edinburgh Napier University, Altrincham, UK; 4Centre for Transport Studies, Department of Civil, Environmental and Geomatic Engineering, UCL, London, UK; 5 Royal Society for the Prevention of Accidents, Birmingham, UK; 6 Parliamentary Advisory Council for Transport Safety (an All-Party Group), London, UK; 7RAC Foundation, London, UK; 8Brake, Huddersfield, UK; 9Association of British Insurers, London, UK 1
A year after our call to the UK government to take urgent action to reduce deaths and injuries associated with young drivers1 there has been no progress. In the two years since the government’s promise of a green paper on young drivers’ safety, it is estimated that we could have avoided almost 9000 people being injured in road crashes involving young drivers, with 866 seriously or fatally injured and at a cost of £400m (€530m; $600m).2 One of the suggested reasons for delay is enthusiasm for motor insurance policies based on telematics or black box technology. This technology could play an important part in reducing young driver crashes, but it is unlikely to be the whole solution; telematics does not assess the presence of passengers, their behaviour, or their alcohol consumption. It will take some years to show the effect of telematics on crashes and casualties. Current users are self selected and may be significantly different from non-users. In the meantime, deaths and injuries are still occurring, and one intervention has repeatedly been shown to be effective—graduated licensing.3 What is lacking is the political will to act. Graduated driver licensing adds an intermediate phase between the learner and full licence. During this phase, exposure to high risk conditions is minimised by restricting late night driving, carriage of similar aged passengers, and driving after having consumed alcohol. These high risk conditions have repeatedly been associated with young driver crashes.4
New Zealand, Australia, the United States, and Canada have all implemented graduated driver licensing, and despite variations between jurisdictions it has been shown to reduce casualties.3 Since graduated driver licensing was first introduced in New Zealand in 1987 the pace of implementation has increased rapidly, the contexts in which it has been applied have widened, and the evidence of effectiveness has become more compelling
and robust. Calculating a single effect size and separating out the effects of the different elements of such schemes is very difficult, but it is reasonable to suggest a 20-30% decrease in crashes, casualties, and fatalities among young drivers.5
Northern Ireland has taken note, and a bill for a “graduated driver licensing lite” scheme is progressing through the legislature.6 Hopefully, the bill will be passed early this year, with implementation in 2016. Although Northern Ireland’s scheme is “lite,” with a proposed six month passenger restriction and a reduced alcohol limit, most schemes began with few restrictions before becoming stricter. Of concern is the proposal that the learner age is reduced to 16.5 years. It is difficult to predict the effects of this; however, age is a key risk factor for young driver crashes, and even with the restrictions the age at full licence will stay the same as it is now, potentially negating any benefits of the restrictions. There are legitimate concerns about the effects of graduated driver licensing on young people, most notably the potential for social exclusion. Current data suggest that around a quarter of 17-19 year olds hold a provisional or full driving licence. The government has said that it has not published the green paper because it is “wrestling with how to make things safer, while not unduly restricting the freedom of our young people.”7 However, the government has not undertaken research into the possible implications for access to work, training, education, or leisure activities.8 Internationally, graduated driver licensing has been shown to affect the activities of young drivers minimally, with a minor effect on employment.9 10 Other concerns include that this universal approach is unfair to, for example, female or “model” teens; the evidence is clear that all new drivers are at high risk of crashing because of their inexperience.4 Within this group, some are at higher risk of crashing than others, but the risk is increased for all.5 A risk of increased unlicensed driving is also often cited as a concern,
Correspondence to: S Jones [email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
BMJ 2015;350:h659 doi: 10.1136/bmj.h659 (Published 11 February 2015)
Page 2 of 2
EDITORIALS
and research has produced conflicting results, showing no change11 and an increase in unlicensed driving.12 However, current insurance premiums for young drivers are likely to provide the greatest incentive to drive unlicensed.
The introduction of graduated driver licensing could be a catalyst for public transport improvements, especially in rural areas, and encourage more young people to use public transport for longer. Such a policy could be a key element of a safer, healthier, and more sustainable future, not just for young people but for the entire population.
In addition to the powerful safety case for graduated driver licensing, there is also public support; 68% of the British public support its introduction for newly qualified drivers, with only 15% opposed.13 Unsurprisingly, young people are less keen to see graduated driver licensing implemented (only 41% of under 24s supported its introduction). However, even when people do not support graduated driver licensing they do not disobey it once it is implemented.14 The general election campaigns are now under way, and many promises are being made about what the parties will deliver if elected. With the next government will come, almost certainly, new transport ministers and the need to explain, once again, the importance of action to reduce the risk of crashes involving young drivers. We hope that come the 2020 election, no group will need to write to The BMJ to highlight the 30 000 deaths and injuries and £1.4bn cost that could have been avoided if graduated driver licensing had been introduced in the coming parliament. Competing interests: We have read and understood BMJ policy on declaration of interests and declare EB is non-executive director of the Road Safety Trust.
For personal use only: See rights and reprints http://www.bmj.com/permissions
Provenance and peer review: Not commissioned; externally peer reviewed. 1 2 3 4 5 6 7 8 9 10 11 12 13 14
Jones S, McKenna F, Stradling S, Christie N, Mullarkey T, Davies D, et al. Green paper on safety of young drivers has stalled. BMJ 2014:348:g476. Kinnear N, Lloyd L, Scoons J, Helman S. Graduated driver licensing: a regional analysis of potential casualty savings in Great Britain. RAC Foundation, 2014. Russell KF, Vandermeer B, Hartling L. Graduated driver licensing for reducing motor vehicle crashes among young drivers. Cochrane Database Syst Rev 2011;10:CD003300. Williams AF. Young driver risk factors: successful and unsuccessful approaches for dealing with them and an agenda for the future. Injury Prevention 2006;12(suppl 1): i4-8. Kinnear N, Lloyd L, Helman S, Husband P, Scoons J, Jones S, et al. Novice drivers: evidence review and evaluation. pre-driver training, graduated driver licensing and the new drivers act. project report RPN2553. Transport Research Laboratory, 2013. Department of Environment Northern Ireland. Road traffic (amendment) bill. 2014. www. niassembly.gov.uk/assembly-business/legislation/primary-legislation-current-bills/roadtraffic-amendment-bill/. Goodwill R. Driving: young people. Written answers to questions. Hansard 2013 Dec 18: col 629W. www.publications.parliament.uk/pa/cm201314/cmhansrd/cm131218/text/ 131218w0001.htm#13121870001081. Parliamentary Advisory Committee on Transport Safety. Response to PACTS’ FOI request on GDL research. 2014. www.pacts.org.uk/2014/10/response-to-pacts-foi-request-forinformation-on-gdl-research/. Brookland R, Begg D. Adolescent, and their parents, attitudes towards graduated driver licensing and subsequent risky driving and crashes in young adulthood. J Safety Res 2011;42:109-15. Williams AF, Nelson LA, Leaf WA. Responses of teenagers and their parents to California’s graduated licensing system. Accident Analysis and Prevention 2002;34:835-42. Frith WA, Perkins WA. The New Zealand graduated driver licensing system. In: Conference proceedings from national road safety seminar, Wellington, New Zealand, 1992. Vol 2:256-78. Males M. California’s graduated driver license law: effect on teenage drivers’ deaths through 2005. J Safety Res 2007;38:651-9. RAC Foundation. Young driver safety. A public attitude survey. RAC Foundation, 2014. Begg DJ, Stephenson S. Graduated driver licensing: the New Zealand experience. J Safety Res 2003;34:99-105.
Cite this as: BMJ 2015;350:h659 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
Page 1 of 2
Editorials
EDITORIALS Crashes involving young drivers Still waiting for government action despite their costs in lives and money 1
2
Sarah Jones consultant in environmental health protection , Frank McKenna emeritus professor , 3 4 5 Stephen Stradling emeritus professor , Nicola Christie director , Tom Mullarkey chief executive , 6 7 David Davies executive director , Elizabeth Box head of research , Julie Townsend deputy chief 8 9 executive , James Dalton head of motor insurance Public Health Wales, Cardiff CF11 9LJ , UK; 2Department of Psychology, University of Reading, Reading, UK; 3Edinburgh Napier University, Altrincham, UK; 4Centre for Transport Studies, Department of Civil, Environmental and Geomatic Engineering, UCL, London, UK; 5 Royal Society for the Prevention of Accidents, Birmingham, UK; 6 Parliamentary Advisory Council for Transport Safety (an All-Party Group), London, UK; 7RAC Foundation, London, UK; 8Brake, Huddersfield, UK; 9Association of British Insurers, London, UK 1
A year after our call to the UK government to take urgent action to reduce deaths and injuries associated with young drivers1 there has been no progress. In the two years since the government’s promise of a green paper on young drivers’ safety, it is estimated that we could have avoided almost 9000 people being injured in road crashes involving young drivers, with 866 seriously or fatally injured and at a cost of £400m (€530m; $600m).2 One of the suggested reasons for delay is enthusiasm for motor insurance policies based on telematics or black box technology. This technology could play an important part in reducing young driver crashes, but it is unlikely to be the whole solution; telematics does not assess the presence of passengers, their behaviour, or their alcohol consumption. It will take some years to show the effect of telematics on crashes and casualties. Current users are self selected and may be significantly different from non-users. In the meantime, deaths and injuries are still occurring, and one intervention has repeatedly been shown to be effective—graduated licensing.3 What is lacking is the political will to act. Graduated driver licensing adds an intermediate phase between the learner and full licence. During this phase, exposure to high risk conditions is minimised by restricting late night driving, carriage of similar aged passengers, and driving after having consumed alcohol. These high risk conditions have repeatedly been associated with young driver crashes.4
New Zealand, Australia, the United States, and Canada have all implemented graduated driver licensing, and despite variations between jurisdictions it has been shown to reduce casualties.3 Since graduated driver licensing was first introduced in New Zealand in 1987 the pace of implementation has increased rapidly, the contexts in which it has been applied have widened, and the evidence of effectiveness has become more compelling
and robust. Calculating a single effect size and separating out the effects of the different elements of such schemes is very difficult, but it is reasonable to suggest a 20-30% decrease in crashes, casualties, and fatalities among young drivers.5
Northern Ireland has taken note, and a bill for a “graduated driver licensing lite” scheme is progressing through the legislature.6 Hopefully, the bill will be passed early this year, with implementation in 2016. Although Northern Ireland’s scheme is “lite,” with a proposed six month passenger restriction and a reduced alcohol limit, most schemes began with few restrictions before becoming stricter. Of concern is the proposal that the learner age is reduced to 16.5 years. It is difficult to predict the effects of this; however, age is a key risk factor for young driver crashes, and even with the restrictions the age at full licence will stay the same as it is now, potentially negating any benefits of the restrictions. There are legitimate concerns about the effects of graduated driver licensing on young people, most notably the potential for social exclusion. Current data suggest that around a quarter of 17-19 year olds hold a provisional or full driving licence. The government has said that it has not published the green paper because it is “wrestling with how to make things safer, while not unduly restricting the freedom of our young people.”7 However, the government has not undertaken research into the possible implications for access to work, training, education, or leisure activities.8 Internationally, graduated driver licensing has been shown to affect the activities of young drivers minimally, with a minor effect on employment.9 10 Other concerns include that this universal approach is unfair to, for example, female or “model” teens; the evidence is clear that all new drivers are at high risk of crashing because of their inexperience.4 Within this group, some are at higher risk of crashing than others, but the risk is increased for all.5 A risk of increased unlicensed driving is also often cited as a concern,
Correspondence to: S Jones [email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
BMJ 2015;350:h659 doi: 10.1136/bmj.h659 (Published 11 February 2015)
Page 2 of 2
EDITORIALS
and research has produced conflicting results, showing no change11 and an increase in unlicensed driving.12 However, current insurance premiums for young drivers are likely to provide the greatest incentive to drive unlicensed.
The introduction of graduated driver licensing could be a catalyst for public transport improvements, especially in rural areas, and encourage more young people to use public transport for longer. Such a policy could be a key element of a safer, healthier, and more sustainable future, not just for young people but for the entire population.
In addition to the powerful safety case for graduated driver licensing, there is also public support; 68% of the British public support its introduction for newly qualified drivers, with only 15% opposed.13 Unsurprisingly, young people are less keen to see graduated driver licensing implemented (only 41% of under 24s supported its introduction). However, even when people do not support graduated driver licensing they do not disobey it once it is implemented.14 The general election campaigns are now under way, and many promises are being made about what the parties will deliver if elected. With the next government will come, almost certainly, new transport ministers and the need to explain, once again, the importance of action to reduce the risk of crashes involving young drivers. We hope that come the 2020 election, no group will need to write to The BMJ to highlight the 30 000 deaths and injuries and £1.4bn cost that could have been avoided if graduated driver licensing had been introduced in the coming parliament. Competing interests: We have read and understood BMJ policy on declaration of interests and declare EB is non-executive director of the Road Safety Trust.
For personal use only: See rights and reprints http://www.bmj.com/permissions
Provenance and peer review: Not commissioned; externally peer reviewed. 1 2 3 4 5 6 7 8 9 10 11 12 13 14
Jones S, McKenna F, Stradling S, Christie N, Mullarkey T, Davies D, et al. Green paper on safety of young drivers has stalled. BMJ 2014:348:g476. Kinnear N, Lloyd L, Scoons J, Helman S. Graduated driver licensing: a regional analysis of potential casualty savings in Great Britain. RAC Foundation, 2014. Russell KF, Vandermeer B, Hartling L. Graduated driver licensing for reducing motor vehicle crashes among young drivers. Cochrane Database Syst Rev 2011;10:CD003300. Williams AF. Young driver risk factors: successful and unsuccessful approaches for dealing with them and an agenda for the future. Injury Prevention 2006;12(suppl 1): i4-8. Kinnear N, Lloyd L, Helman S, Husband P, Scoons J, Jones S, et al. Novice drivers: evidence review and evaluation. pre-driver training, graduated driver licensing and the new drivers act. project report RPN2553. Transport Research Laboratory, 2013. Department of Environment Northern Ireland. Road traffic (amendment) bill. 2014. www. niassembly.gov.uk/assembly-business/legislation/primary-legislation-current-bills/roadtraffic-amendment-bill/. Goodwill R. Driving: young people. Written answers to questions. Hansard 2013 Dec 18: col 629W. www.publications.parliament.uk/pa/cm201314/cmhansrd/cm131218/text/ 131218w0001.htm#13121870001081. Parliamentary Advisory Committee on Transport Safety. Response to PACTS’ FOI request on GDL research. 2014. www.pacts.org.uk/2014/10/response-to-pacts-foi-request-forinformation-on-gdl-research/. Brookland R, Begg D. Adolescent, and their parents, attitudes towards graduated driver licensing and subsequent risky driving and crashes in young adulthood. J Safety Res 2011;42:109-15. Williams AF, Nelson LA, Leaf WA. Responses of teenagers and their parents to California’s graduated licensing system. Accident Analysis and Prevention 2002;34:835-42. Frith WA, Perkins WA. The New Zealand graduated driver licensing system. In: Conference proceedings from national road safety seminar, Wellington, New Zealand, 1992. Vol 2:256-78. Males M. California’s graduated driver license law: effect on teenage drivers’ deaths through 2005. J Safety Res 2007;38:651-9. RAC Foundation. Young driver safety. A public attitude survey. RAC Foundation, 2014. Begg DJ, Stephenson S. Graduated driver licensing: the New Zealand experience. J Safety Res 2003;34:99-105.
Cite this as: BMJ 2015;350:h659 © BMJ Publishing Group Ltd 2015
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