I am pleased to have the opportunity to raise the subject of bicycle helmets for children. I do so for two reasons. First, the Royal Berkshire hospital in Reading has set up an organisation called Childhood Injury Prevention Service—CHIPS. It is run by Nurse Angela Lee, a clinical nurse specialist in the hospital who, because of her experience with young people coming in with head injuries from cycling, has started a campaign in support of bicycle helmets.
My second reason is a personal one. When I was a young boy of 11 or 12, my best friend died following a cycling accident. He hit a tree root in a wood, went over his bike handlebars, damaged his skull and brain and subsequently died. Therefore, I have a personal interest in the subject.
There is no doubt that, compared with the rest of the European Community, Britain has a good road accident record. In 1980, the United Kingdom had the best rate of deaths resulting from road accidents per million of the population, at 111, compared with the EC average of 184. In 1990, we slipped to second place at 94, behind the Netherlands at 92. The EC average was 153. Therefore, there was still a downward trend in Britain.
For the age group nought to 14, in 1980 and 1990 the United Kingdom had the best percentage rate in Europe, at 41.9 and 36.1 respectively, the European average being 69.6 and 47.1. Those figures come from the Department of Transport's international comparisons of transport statistics for 1970–90.
The same report also gives comparisons on the deaths of all pedal cyclists. Again, the United Kingdom is doing quite well. In 1980, the figure in the United Kingdom was 5.6 per million of the population, and the EC average was 14 per million. In 1990, the figure for the United Kingdom was 4.7, and the EC average was 9.8.
Other countries, such as Spain, Greece and Luxembourg, seem to do better, but that is probably because of the different number of cyclists in different countries.
In the Adjournment debate on road safety, the Minister who is kindly answering this debate said:
There are several times more accidents to cyclists per cycle mile"—
the amount of bicycle use—
in this country than there are in countries where cycling is practised so much more."—[Official Report, 25 November 1994; Vol. 250, c. 840.]
Those countries include Germany and the Netherlands.
The Policy Studies Institute makes a similar point. Cyclists in Great Britain account for only 1 per cent. of personal travel kilometres, but for 5 per cent. of road fatalities, so reducing accident rates for cyclists should perhaps be a priority.
Let us consider the number of cyclist fatalities. In 1993, there were 186. Serious injuries in 1993 totalled 3,610. Serious or slight injuries in 1993 totalled 23,574. In the Thames valley area, in 1993 there were seven fatalities and 904 serious or slight injuries.
A chart shows deaths in the various age groups from 1988 to 1992. There were 11 deaths among children aged one to four, 233 deaths among those aged five to 14, and 240 deaths among people 15 to 24. About two thirds of all cycle deaths are due to head injuries, but, for the age group five to 14, 82 per cent. of deaths—about four out of five—are due to such injuries.
As part of the "Health of the Nation" strategy, the Government hope to reduce the death rate for accidents among children aged under 15 by at least 33 per cent. by the year 2005—they want to reduce it from 6.7 per 100,000 of the population in 1990 to no more than 4.5 per 100,000 in 2005. They aim also to reduce the death rate for accidents among young people aged 15 to 24 by at least 25 per cent. by 2005—from 23.2 per 100,000 of the population in 1990 to no more than 17.4 per 100,000. The Government therefore take accidents among children seriously.
In written answers on this subject in June 1992, the then Minister with responsibility for roads and traffic quoted research from the Transport Research Laboratory which suggested that helmets would prevent 11 per cent. of serious head injuries, with a further 18 per cent. becoming only slight injuries. Many other answers were given over various times.
The Australians have spent more than a decade in promoting, educating, and then legislating on, bicycle helmet use. The United States of America has invested resources, and a number of states have introduced laws on bicycle helmets. Canada is taking an active line, and, Sweden has a progressive helmet policy. New Zealand is in its second year of mandatory helmet use.
As a form of head protection, helmets have proved their capability for reducing head injury and severe of brain injury. Time and again, studies appear that demonstrate the benefit of the helmet in reducing the effect of an injury that can have such tragic, and all too often everlasting, consequences for the individual and his family.
The "Helmet Your Head" campaign based at the Royal Berkshire and Battle hospitals NHS trust, led by Sister Angela Lee, is actively promoting the use of bicycle helmets among the under-16s. The initiative has run since June 1992. It started from a purely emotive response to treating a continuous toll of young people with head or brain injuries. A number of those proved fatal, but many more people were left with long-term problems.
The campaign has proved successful. Helmet use has trebled, and the number of under-16s seeking casualty treatment for bicycle-related head injuries has decreased by 45 per cent. over the two-year period.
The helmet programme is educational, and provides the ability to purchase helmets at low cost. The campaign is run by taking into account the teenage group's fundamental concerns. Those were obtained through a questionnaire targeted specifically at the 11 to 16 age range. The teenagers' main concern was "image"—having the credibility to don a helmet, but, at the same time, maintaining their street credibility. The other factor that reduced helmet use was simply the cost of helmets.
Young people understand the benefits of wearing helmets, although they also seek justification to do so. That has been shown, by young persons' support of helmet legislation. The teenager looks on legislation as an endorsement of his use of a helmet—a form of justification to his friends.
We are still, however, a long way from mandatory helmet use in the United Kingdom. The first thing we need is a systematically active nationwide programme on helmet education and helmet purchase schemes, if we are not just planning to pay lip service to the issue.
There appear to be three stumbling blocks in the way of the wholehearted adoption of bicycle helmets. The first is the idea of risk transfer, or risk compensation. That has no scientific basis in relation to cyclists, especially the young person who, because of his youth, is adventurous, carefree and less concerned about what may happen. There is no evidence available for the theory, so it is unfounded and has served only to cause confusion and to distract people from the issue of head injury reduction.
The second cause of delay in the promotion of helmets is the attempt to blame our road system and the motorist. There is a valid argument about road structure and motorists' lack of judgment concerning cyclists, but those factors will persist, especially as decisions on vast expenditure to alter small and overcrowded roads will continue to be a problem, and will remain an issue into the next century. While the argument continues, cyclists will continue to sustain head injuries, unless policy makers stop playing Russian roulette and acknowledge helmets as a form of protection that is accessible straight away, or certainly purchasable within 24 hours.
Thirdly, there is an argument that helmets are designed for limited-impact crashes, and are therefore of little use when the cyclist is involved with a car. However, the current research findings from Australia are that helmets provided protection in most impacts sustained in such collisions. Moreover, even if the protection provided by the helmet is limited, common sense suggests that an impact-absorbing helmet must surely reduce the impact acceleration to the brain more than if the impact were directly on the skull.
Accidents are the major cause of death in young people over the age of one year. About eight out of 10 children ride bicycles, and it is estimated that about 100,000 people under 16 require hospital treatment for bicycle-related injuries every year. That figure accounts for more than half of treated casualties. As more than 50 per cent. of bicycle casualties sustain an injury to their heads—that is, an injury above the neck—in crude terms that means that another child is being treated every 10 minutes.
Helmet campaigns work. The Royal Berkshire hospital's programme is at present the United Kingdom's only co-operating helmet programme centre, as part of the World Health Organisation's global helmet programme. Helmet programmes have been shown to be effective all over the world. Programmes such as those in Australia, the "safe kids" projects in the United States, and the Swedish helmet campaign, all strive to promote helmets.
Such campaigns do not take the place of better cycle paths, nor do they transfer responsibility away from motorists. They are simply an effective method of protecting a vital functioning part of the individual who, in the unfortunate event of his risking a head injury by coming off his bicycle, will have an extra head covering that can reduce the impact acceleration to his head.
As part of the "Health of the Nation" targets, along with the Government's road casualty reduction targets, a more active stance must be taken if we are to move more effectively to promote helmets as a method of health protection. Health professionals have a direct responsibility to advocate their use. A unified display in hospital units, casualty departments, health centres, dentists' waiting rooms and schools could bring about greater awareness and more encouragement of helmet use.
Brain injuries are devastating. Bicycle helmets have a place in their reduction. Any further procrastination will be measured in human loss. Tomorrow may be too late. Therefore, there must immediately he more encouragement by the Government to make people wear cycle helmets.
The Department must also discuss with the Chancellor the problems caused by levying VAT on child helmets. If there is no VAT on children's clothes, perhaps there should be none on child helmets. Finally, in connection with any future road safety legislation or road traffic regulations, the Government must seriously consider making the wearing of helmets compulsory for cyclists under 16.
I am grateful to my hon. Friend the Member for Reading, West (Sir A. Durant) for allowing me to join in this short Adjournment debate.
Oleg Gordievsky, who played such a remarkable part in drawing the cold war to an end, nearly lost his life when he went through the windscreen of a car in a lane in this country. His life was saved because he was wearing a cycle helmet.
If brave people such as he would appear on children's television—or on parents' television—to say that it is not only fashionable and, as my hon. Friend said, goes with the right image, but that it makes sense to wear a lid when we go cycling, many more people would say, "If you can afford a bike, you can't afford not to have a helmet."
I pay tribute to my hon. Friend's remarkable speech, and to Sister Angela Lee of the Royal Berkshire hospital. They have both done a great service. It is sad that, 10 years ago, the Cyclists Touring Club, which did and still does so much to promote cycling, opposed cycle helmets on the ground that it was up to other road users to protect cyclists.
It is right that anyone who passes the driving test should he required to know the answer to the question of when a cyclist is most likely to be injured, which is either when other motor vehicles are turning left, or at roundabouts. There must be an awareness of that. Even so, there will be times when cyclists will come off their bikes because the screw that holds the front mudguard on has worked loose, the mudguard drops on the front wheel and the cyclist goes head over heels—that is where the protection will be necessary.
Nobody in the House could have made a better speech than my hon. Friend the Member for Reading, West. He said that, as The New England Journal of Medicine stated about nine years ago, about two thirds of dead cyclists have only a head injury, and about two thirds of those fatal head injuries would not have been fatal had the cyclists worn helmets. That does not excuse what other road users do, and I am not pretending that every cyclist always obeys the highway code, but the wearing of helmets would be a good way of reducing the number of deaths and serious injuries.
Much has been done with the help of the Department of Transport and the highway authorities. One example is the bicycle bridge at Cambridge—with the remarkable distinction of the big upturned "V" which holds the bridge across the 16 tracks of railway to keep the cyclists away from the through traffic. There are many other such examples, but whatever else is done, the cycle helmet makes a difference, in the same way that the seat belt makes a difference to those who travel in cars.
About 300 people a year used to die cycling; that figure is now down to about 230. The growing fashion of wearing cycle helmets is part of that progress. My hon. Friend was right not to argue for an instant law stating that cycle helmets would have to be worn. He is right to say that, if we can build up voluntary use and understanding, the trend will grow. There is currently a correspondence in the British Medical Journal about the experience in Australia. One factor that is accepted by all sides is that it is sensible to wear a helmet in case one has a crash on a bicycle.
I wish to comment on risk compensation, or what is otherwise known as homeostasis theory. It was put forward by Mayer Hillman, who received undue publicity with a juicy headline on a press notice about some research that he had carried out. I pay tribute to Mayer Hillman, because he has rightly argued that, if we had common sense time in winter in this country, we would save 100 lives and many injuries.
However, he is wrong to say that we should be careful about cycle helmets. I do not believe that any cyclist would ride more adventurously because he or she was wearing a helmet. I do not think that it is only those cyclists who are careful about their security who wear cycle helmets. Any parent or school that allows children to cycle to school should not only help them to work out a safe route for cycling, but should ensure that they wear safe gear, so that they are visible, and helmets.
During the time that I served at the Department of Transport, I would have given my eye teeth to have the skill of my hon. Friend the Minister for Transport in London and to be able to announce that the road deaths were 3,700 or fewer a year. I pay tribute to him for being sensible. I am glad that he is here, and I hope that the reports of our Adjournment debate—even though, when we look at the Press Gallery, we discover that not everyone is there—will show that the issues we have discussed are just as important as British exports or the earlier questions that attracted the glamour and attention.
Nobody wants their child, husband, wife or parent to die unnecessarily in a bicycle crash. My hon. Friend the Member for Reading, West has described one of the ways of cutting the risk dramatically.
I congratulate my hon. Friend the Member for Reading, West (Sir A. Durant) on having secured tonight's debate on what, I agree, is an extremely important subject. I join my hon. Friend the Member for Eltham (Mr. Bottomley) in congratulating Angela Lee at the Royal Berkshire hospital.
As I think my hon. Friend knows, I was a member of the West Berkshire district health authority for some years, and, before that, of the Berkshire area health authority. I therefore have a great deal of experience of the Royal Berks, and much respect for the people who work there and the facilities available. I share my hon. Friends' objective. I too want cyclists to use helmets. The Government actively promote their use, particularly by children.
The issue that I want to discuss this evening is why, none the less, we do not have any plans at present to make it an offence to cycle without a helmet. I say that with the strong caveat that that does not suggest for one second any lack of concern or seriousness on my behalf or that of the Department about the issue.
I have become convinced in the past few years, as I have grappled with transport policy, in the wake of the excellent contribution of my hon. Friend the Member for Eltham (Mr. Bottomley) to the Department of Transport, which is still much remembered with great affection and respect, that cycling has been hugely undervalued in Britain. We do about 2.5 per cent. of all our journeys by bicycle. That compares with a European average of about 15 per cent. It includes countries such as Holland, which we think of simply as flat, and therefore rather susceptible to cycling. It also includes Switzerland. Whatever one says about Switzerland, it is not flat.
My hon. Friend the Member for Reading, West made the point that cycle injury rates show that one is about 10 times more likely to be injured in a cycle accident in Denmark than in Britain. I wonder whether that could have something to do with the fact that there is 10 times more cycling in Denmark than in the United Kingdom. The two are clearly related.
At the same time, cycling is a marvellous way to get about, particularly for short journeys. We published some research yesterday or the day before which showed that the quickest way that one can achieve any short journey in London is not by the private car but simply by cycling. Cycling was the quickest mode of transport. Many people in the House and elsewhere are coming to see that as something that they can use much to their advantage.
We are dealing not simply with the problem relating to our present cycle use. In a sense, we want to expand cycling as a means of transport to European levels. That means expanding it by considerable orders of magnitude. If we are to do that, the problem of cycle safety and the issue of how we persuade more people to wear cycle helmets become even more serious and important.
I shall not go over the casualty figures that my hon. Friend the Member for Reading, West mentioned. Suffice it to say that we now record fewer fatal and serious road accidents than in any year since records began in 1926. That is the most extraordinary achievement, and one attributable not to parties of the left or right but to dedicated officials and road safety officers, and people such as Miss Lee, up and down the country over the years. We are killing fewer people now, despite a fourteenfold increase in traffic. That is very good.
However, as my hon. Friends have pointed out, 174 cyclists were killed in 1994, about 4,000 were seriously injured and more than 20,000 received slight injuries. The tragedy is that 44 of those fatalities were to children aged 15 or below. There can be little doubt that, if every cyclist wore an approved helmet, those accident figures would be considerably reduced.
Last year, my Department commissioned the Transport Research Laboratory to review international research into the effectiveness of cycle helmets. That report looked at more than 50 separate research projects. It found that researchers worldwide were in agreement that cycle helmets could substantially reduce head injuries.
While helmets cannot prevent accidents, research shows that they are worth while. For example, one report concluded that, if all cyclists wore helmets, 30 per cent. of slightly injured cyclists would be uninjured, 11 per cent. of seriously injured cyclists would avoid injury and a further 18 per cent. of serious injuries would be reduced to slight injuries.
Children in particular can benefit from wearing cycle helmets. That is absolutely beyond peradventure. Our hospital-based research shows that 75 per cent. of cycle accidents to children aged 12 and under involved no other vehicle. Performing tricks, travelling too fast or simply falling off are the most important causes of accidents.
Nevertheless, more than 50 per cent. of injury accidents to cyclists involve some form of injury to the head, and the protection provided by a helmet is likely to be particularly effective for the type of relatively low-speed accident in which no other vehicle is involved. Against that background, one can fully understand the calls from my hon. Friend and others that we should move as fast as we can to make the wearing of cycle helmets compulsory.
The ambition we all share is to increase the wearing of helmets. I think that there would be support across the House for my hon. Friend the Minister's practical approach, which is the most effective one. Very few want to wave the magic wand of regulation. An increase in helmet wearing is what Sister Angela Lee and others have been pressing for.
In the next few minutes, I hope to rationalise the attitude that we are adopting and explain why I think we are on the right track, despite the fact that there are arguments for regulation and, as has been said, considerable arguments against.
There are clear benefits to be gained from wearing a cycle helmet. When introducing measures to protect people from injury—this is as true of seat belts as of cycle helmets—experience shows that there needs to be a high degree of public acceptance and voluntary wearing before compulsion can be considered if it is to be successful.
More than 80 per cent. of motor cyclists were voluntarily wearing helmets before that requirement became compulsory. Countries that introduced motor cycle helmet laws without previously having achieved high levels of voluntary wearing found that the new law was widely ignored, to the point that the legislation became worthless.
It is regrettable that some cyclists themselves are not in favour of wearing a helmet. Some cite civil liberty, which is perfectly understandable, although I think that the safety argument is more compelling. Some argue that it would be a disincentive to taking up cycling if we insisted that people wear a helmet. Both my hon. Friends have in their various ways disposed of that argument. A cycle helmet is now almost a mandatory fashion accessory rather than a great burden that the new cyclist has to bear, so I do not think that we need be detained by that argument.
A stronger argument is that we should not be considering making people dress up in body armour if they want to cycle, but that we should be making the roads safer. That, of course, sounds a very compelling argument, but the trouble with it is that it addresses the wrong issue.
I said that a large proportion of cycle accidents do not involve another vehicle. They do not involve a child being knocked off his bike by a juggernaut or by a car passing at high speed; they involve a child simply falling off his bike. Adults do it, too. The wearing of a helmet is just as important in that type of accident, however.
The risk compensation theory is very simple when one boils it down—I nearly said, "when one reduces it to absurdity", but I should not discredit the theory in that way, because it has some serious adherents, such as Mayer Hillman and John Adams. Basically, it says that one feels so much more comfortable when protected by a seat belt that one is tempted to drive much faster, which means that one is therefore less safe. In other words, the safer one feels, the less safe one is.
The logical deduction is that my job as Minister with responsibility for road safety should be to make cars as dangerous as I possibly can, to abandon all expenditure on road safety and, indeed, to reverse it by introducing a number of chicanes and abolishing most urban speed limits, because, on that basis, we could make life sufficiently dangerous that everyone would drive at a snail's pace and accidents would cease.
That is a fair summary of the theory, and I do not suppose that I need detain the House any further by seeking to analyse it or dismissing it. I just think that it is desperately misleading to pursue that course. We must make people not only feel safer, but be safer. Everyone understands that.
I get letters from parents who ask me to make helmet wearing compulsory because, they say, their children would obey the law whereas they do not obey their parents. There is a real problem with that, as you well know, Madam Deputy Speaker. Making children below the age of criminal responsibility the criminals is not only paradoxical, but almost certainly self-defeating. In reality, one cannot go down that path. If we want to turn large numbers of children into criminals or even to dissuade them from cycling in the first place, there is no better way to do it. That does not mean that I do not think that there is value in compulsion in due course.
The experience of the Australian state of Victoria is rather helpful here. Cycle helmets were made compulsory there in 1990. The state undertook a lengthy, 10-year campaign to encourage voluntary wearing before compulsion was introduced. Nevertheless, it appeared that, during the first year, wearing rates did not exceed 75 per cent., despite a considerable enforcement effort.
Although the amount of adult cycling remained stable, it appeared that the introduction of helmet laws reduced the number of children, especially teenagers, who cycled. Since then, cycling by young people appears to be increasing again, although a not insignificant minority of cyclists continue to refuse to wear a helmet. I say for the record, however, that there is no doubt that the Victoria experiment has introduced greater helmet use, and has therefore reduced the number and severity of head injuries.
We have commissioned further research from the Transport Research Laboratory into cycle helmet wearing rates and public attitudes to helmets, and we shall publish it later this year. It looks as if the overall UK voluntary wearing rate, based on a survey of 10,000 cyclists throughout the country, is about 15 per cent. We shall continue to survey wearing rates over time to monitor the degree of voluntary use.
I want to convince cyclists of the good sense of helmet wearing and to continue to develop strategies to drive up the voluntary wearing rate. To that end, we are also researching attitudes to helmet wearing among cyclists to help us to develop new ways in which to encourage their use.
One of the things that I have found in talking to schoolchildren is that there is still a view that those who wear a helmet are rather sissy. An education programme is therefore necessary to convince children that those who wear helmets are not sissies, but very wise guys.
My hon. Friend makes 'a good point. One of our counters to that view is an initiative, which appears to have been very successful, to apply the cycle helmet rule on a whole-school basis. That makes a great deal of sense. It works on the basis that, if everyone cycling to school wears a helmet, the fear of ridicule tends to be overcome.
Several local authorities have copied a scheme, which was first introduced by Sheffield city council, to promote helmets by making them available to schools at a much-reduced price, provided that rules are introduced requiring helmets to be worn when cycling to and from school. Such initiatives seem to be effective, and they are to be applauded. My hon. Friend is right to draw attention to that point.
For the past few years, the Department of Transport has actively promoted cycle helmet use. The highway code advises cyclists to wear helmets which conform to recognised safety standards. Child cycle helmets are zero-rated for VAT purposes. In 1991, we screened a television advertisement called "Tough nuts are hard to crack," which was later turned into a television filler; it was a very good piece of work.
The on-going "cycle safe" campaign, launched in March 1993 to encourage safer cycling, was spearheaded by a television advertisement, "Brother", which again stressed the benefits of cycle helmet wearing. Last year, "cycle safe" issued four new posters encouraging cyclists of all ages, especially children, to wear cycle helmets. The posters spelled out the message with slogans such as
Wear a Helmet—You can't recycle a cyclist",
Don't hit the road without one.
Such slogans are sufficiently attractive and catchy to make young people appreciate that they need not feel that wearing a helmet is somehow deeply unfashionable, but that it is something done by sensible people of all ages.
For the reasons that I have outlined, we do not believe that we can yet move to compulsion. We are, however, keen to do what we can to develop our strategy of advertising the benefits of helmets and, indeed, of safe cycling in general. If we are to persuade more people to leave their cars at home and travel by bike, we need to encourage them to have greater confidence in the fact that there is a safe, efficient and environmentally friendly alternative to the motor car. The effect of promotion of the benefits of cycle helmet wearing will continue to be an integral part of that policy.
Question put and agreed to.
Adjourned accordingly at five minutes to Ten o'clock.