Thank you very much, Mrs Brooke, for calling me to speak. I am delighted to have secured this debate on the remit of the Health and Safety Executive, and I am also delighted to see the Minister in her place. She is having a busy afternoon, so I am grateful that she is here in Westminster Hall to respond to the debate.
The Health and Safety Executive is an important organisation in today’s society, stating clearly that its role is
“to prevent people being killed, injured or made ill by work.”
The HSE has a great website where people can look up information by topic or industry, and obtain advice and guidance about health and safety at work. However, there is one huge gap in the HSE’s work, and it relates to driving for work purposes. HSE guidance for work-related road safety points to the Health and Safety at Work etc. Act 1974, which
“requires employers to take appropriate steps to ensure the health and safety of their employees and others who may be affected by their activities when at work. This includes the time when they are driving, or riding at work, whether this is in a company or hired vehicle, or in the employee’s own vehicle.”
“It is anomalous that the vast majority of work-related deaths are not examined by the Health and Safety Executive, purely because they occur on the roads. The Government should review the role of the Health and Safety Executive with regard to road safety to ensure that it fulfils its unique role in the strategy beyond 2010.”
A Department for Transport booklet signposted on the HSE’s website sets out basic steps that employers should take, but it does not provide the kind of excellent advice that is given for other workplace situations. Deaths and injuries in other workplaces are properly investigated by the HSE, and what is learned is made available to other organisations. That does not happen for work-related deaths and injuries on our roads.
A report by the HSE in March 2012, entitled “Health and safety in road haulage”, does not discuss issues relating to sleep or fatigue, or vehicles on the road. It focuses on manual handling and workshop safety, which, although important issues, are not the key one of work-related deaths on our roads.
In response to a recent question from my hon. Friend Paul Blomfield,the Under-Secretary of State for Transport, Mike Penning provided statistics about the proportion of work-related road deaths and injuries. He said that some of those deaths and injuries involved journeys
“where the journey purpose was known and recorded as ‘part of work’.”—[Hansard, 15 March 2012; Vol. 542, c. 391W.]
He said that 24% of serious injuries and 30% of road deaths in 2010 could be linked to work-related road traffic accidents. As there is no requirement to report work-related deaths, that is likely to be an underestimate. Even using those figures, we are talking about, on average, 11 deaths and 105 serious injuries every week.
Employers have a responsibility to report work-related injuries to the HSE under the Reporting of Injuries, Disease and Dangerous Occurrences Regulations 1995—RIDDOR—but that does not include a responsibility to report work-related road traffic accidents. Why are deaths and injuries resulting from those accidents not counted as workplace deaths and injuries? The Institute of Occupational Safety and Health argues that all work-related accidents, even those on public roads, should be included as a reporting requirement under regulations. It has repeatedly called for work-related road traffic accidents to be reportable and to be investigated by the HSE under RIDDOR.
The HSE recorded the number of workplace fatalities in 2010-11 as 171. However, those fatalities exclude fatalities of workers travelling on a public highway—in other words, fatalities in road traffic accidents. The HSE says:
“Such incidents are enforced by the police and reported to the Department for Transport.”
Using DFT statistics, “such incidents” equate to more than 550 work-related road traffic deaths in 2010, which is three times more than all the other deaths at work recorded for the most recent period.
The UK is rightly proud of the work that it has done to reduce deaths at work. The HSE’s website shows the steadily declining incidence of such deaths, which we should all welcome. However, because the fatal accidents being recorded exclude road traffic accidents, a full picture is simply not being provided. We do not know enough about why and how people at work die on the road, or how many members of the public are killed by people who drive for a living.
I became aware of this gap in the HSE’s coverage through an interest in the identification of obstructive sleep apnoea, particularly in lorry drivers. Some years ago, I was contacted by a constituent following the death of his 25-year-old nephew, Toby Tweddell, who was killed in 2006 by a lorry driven by somebody with undiagnosed obstructive sleep apnoea.
Will the hon. Lady join me in congratulating one of my constituents, Carole Upcraft of Orpington, for her tireless and much-needed campaign to alert us to the dangers of undiagnosed obstructive sleep apnoea, and to the need for early identification screening of drivers, particularly heavy goods vehicle drivers? We need to raise awareness of this condition in the haulage industry, and Mrs Upcraft’s campaign is performing a vital public service.
Indeed. I have had the pleasure of meeting the hon. Gentleman’s constituent, Mrs Upcraft. Along with members of others families who have been affected by this condition—such as my constituent, Seb Schmoller, his brother-in-law, Nick Tweddell, who is Toby’s father, and the rest of the Tweddell family, as well as Toby’s fiancée, Jenny—she has been involved in this campaign. These people are all determined that other people should not suffer in the way that they have suffered.
The link between untreated obstructive sleep apnoea and road traffic accidents is well established. Someone with that condition experiences repeated episodes of apnoea, whereby breathing is temporarily suspended because of a narrowing or closure of the airway in the upper throat during sleep. It results in episodes of brief awakening to restore normal breathing, of which the person may or may not be aware. The sustained failure to get proper restful sleep night after night means that the affected person is constantly tired and liable to fall asleep during the day.
Obstructive sleep apnoea affects many people, but despite it being a common, identifiable and treatable condition, knowledge of it among primary care practitioners remains poor, which means that the diagnosis rate is very low. It is estimated that 4% of men and 2% of women have the full syndrome—the symptoms of sleepiness I have described—and that up to 80% of cases may be undiagnosed.
The rate of obstructive sleep apnoea among lorry drivers is significantly higher than it is for the general population. There is a high correlation with being overweight, and the sedentary lifestyle of many who drive for a living increases their risk of developing it. According to medical experts, it is likely that between 10% and 20% of lorry drivers are affected by sleep problems. There are 400,000 large goods vehicle drivers in the UK, which means a minimum estimate of 40,000 affected drivers.
The Driver and Vehicle Licensing Agency estimates that 20% of serious road traffic accidents on major roads are caused by sleepy drivers. Clearly, the danger and damage caused by a heavy lorry crashing will be much greater than that caused by a car crashing, making sleep apnoea a significant health and safety at work issue. A 40-tonne lorry travelling at its maximum speed of 58 mph that fails to brake because the driver has fallen asleep, and that hits a queue of stationary vehicles, will crush at least the first car and its occupants. If it collides with the central reservation, it will probably flatten it, before continuing into the opposite carriageway, with all the consequent problems—even disaster—that that will cause. The number of road accidents, with the resulting deaths and serious injuries, can be substantially reduced by increasing the number of drivers who are diagnosed and successfully treated for this condition.
Obstructive sleep apnoea can be relatively easily diagnosed, with most sufferers being easily treated. In just two weeks, the benefits can be felt. Screening drivers within the workplace would be a significant contributor to the health and safety of lorry drivers and other road users. Some companies, such as Allied Bakeries, are taking that approach seriously, promoting awareness of the condition with their drivers and arranging to screen them. Some drivers describe the resulting treatment as life-changing. So far, 3% of approximately 1,000 of Allied Bakeries drivers have been successfully diagnosed with obstructive sleep apnoea and, following treatment, continue to work in the company.
Continuous positive airway pressure—or CPAP—treatment equipment costs less than three new lorry tyres or one tank of diesel fuel. That is a relatively small price, compared with the £1.5 million that the Department for Transport estimates to be the average cost of a fatal lorry collision, excluding the costs of any long-term health care, loss of income and insurance compensation for death and injury.
The British Lung Foundation is leading a major campaign to raise awareness of obstructive sleep apnoea, to improve diagnosis and treatment. It advises companies that employ drivers to encourage their staff to take part in screening programmes, while providing reassurance that people with sleep apnoea can, and do, continue in their jobs, if treated successfully.
Businesses in the UK sometimes complain that there is a complex regulatory environment—I should perhaps say “often complain”—but few argue with the important work that the Health and Safety Executive undertakes.
My hon. Friend makes an important point. That situation will be properly investigated and whatever was wrong put right, which is exactly what the Health and Safety Executive does, and does extraordinarily well. That is something of which we should all be proud.
Many of our major companies take great pride, not just in reducing accidents to a minimum but in seeking to carry out their business without any accidents at all. That is not just good for their employees but saves on business costs, making sense for everyone. Unfortunately, that approach does not extend sufficiently to those who employ drivers for a living. Astonishingly, when I first wrote to the Secretary of State for Work and Pensions about the matter, he replied that obstructive sleep apnoea in lorry drivers was not a health and safety issue. When I wrote again, he replied in more detail:
I do not accept that meeting Driver and Vehicle Licensing Agency requirements is enough to meet the Health and Safety Executive’s aim of requiring employers to take steps to reduce risks to as low a level as is reasonably practicable. In addition to the work that the DVLA and the police do on road safety, the Health and Safety Executive has an important role to play in influencing more employers and trade union safety representatives not only to be aware of the dangers of undiagnosed sleep apnoea, but actively to encourage screening.
I suspect that the Minister will tell me that the police, the DVLA, the Department for Transport and the Vehicle and Operator Services Agency adequately ensure enforcement of the legislation, but I do not accept that. Given the cost of driving accidents, in lives and money, I ask the Minister to take this matter to her Department and look at it again.
Currently, employers have the legal responsibility, and I will continue—with, I am sure, Members such as Joseph Johnson—to press more companies voluntarily to adopt the approach of Allied Bakeries, but the Government can make a positive change and ensure that the Health and Safety Executive’s expertise is brought to bear.
I congratulate the hon. Lady on bringing this matter to Westminster Hall. Does she feel perhaps that the findings of the report that she has presented today should be made known to the devolved Administrations, for example the Northern
Ireland Assembly, where the matter is a devolved one? The findings of the report would be important for those Administrations, so that they could also bring, or enable, legislative change, to prevent such tragedies.
The hon. Gentleman makes an important point. Nowadays, lorry drivers increasingly drive not just in their own countries but abroad, and we know that the European Union has been considering this matter. It is absolutely right that the devolved Assemblies should consider the issue in their Parliaments and ensure that they, too, address it.
Before I allow the Minister to respond, I want to make my fundamental point, which is that the Health and Safety Executive is a great body, which does a good job. It could do so much more in addressing the nearly two thirds of fatalities at work that happen not in the areas that the executive currently covers, but on the road.
My strong representation is that although other organisations, the police, the DVLA and the Department for Transport consider certain aspects of the matter, no one is doing the kind of proper forensic investigation of such accidents that would mean that information could be fed back into guidance and really begin to make a difference. The consequences of lorries crashing into people are horrific, as our constituents would testify, and I would like the Government seriously to consider the matter. I do not expect the Minister to wave her magic wand today, but I urge her to go back to her Department and have a good look at this.
It is a pleasure to serve under your chairmanship, Mrs Brooke, for what I think is the first time. I thank Meg Munn for introducing such a thoughtful debate today and commend her on her incredible work on road safety, which is something that I, too, have a passion about, so I hope that we can work on it together. I particularly commend her on her work on raising awareness of obstructive sleep apnoea, the effects that it can have on drivers and the tragic impact of accidents that result from tiredness. I have listened carefully to the points that she has made. We all know that any loss of life in a road accident is a tragedy, and the Government are committed to making transport safer.
There were 1,850 deaths on the roads in 2010, and 22,660 people were seriously injured. Although that is the lowest number of deaths since records began, each death or injury on the road, or at work, is a waste of human life and many of them are preventable. The hon. Lady is right to say that some 25% to 30% of road fatalities in 2010 were in accidents that involved someone at work.
Many medical conditions can already lead to the suspension of a driving licence, including obstructive sleep apnoea and changes in eyesight. Such suspensions are revoked only when it can be demonstrated that the treatment of the condition makes it safe to do so. Failure to report a medical condition to the Driver and Vehicle Licensing Agency is a criminal offence, and other restrictions include limitations on the hours that a heavy goods vehicle driver is allowed to work and the regime for monitoring tachographs to ensure compliance. Such measures have contributed to the reductions in deaths and injuries on the roads.
The Health and Safety at Work, etc. Act 1974 is key, as it places duties on both the employer and the employee to ensure that members of the public are not exposed to risks that can cause death or injury as a result of work. As the hon. Lady rightly says, health and safety at work are important, and the Health and Safety Executive has an extremely wide remit, with the potential for involvement in a broad range of issues; it is absolutely sensible, therefore, to draw up some pragmatic boundaries for its operations.
The HSE takes action when workers or members of the public are put at risk, except when more specific regulations already exist. For example, it would not normally act in cases of clinical or medical negligence, or aircraft incidents, for which there are other more directly relevant regulators or legislation. The situation is the same on the roads, where the Road Traffic Act 1991 applies and the police have primacy.
Sitting suspended for a Division in the House.
On resuming —
To take up where I left off, alongside the police, a number of agencies also have an interest, including the Vehicle and Operator Services Agency—VOSA—and the DVLA, each of which has a clearly defined role.
The DVLA rightly takes the lead on medical fitness. It issues driving licences based on assurances from drivers that they are fit to drive. People with vision problems or any other medical condition therefore need to consider whether changes to their condition impact on their ability to drive, and they must report any such changes to the DVLA. Indeed, as I am sure the hon. Member for Sheffield, Heeley knows, one of those notifiable conditions is OSA. For drivers of heavy goods vehicles and passenger service vehicles, the law is more stringent. They must cease driving on diagnosis, and they cannot resume driving until the DVLA has received confirmation from a specialist that their condition is controlled.
As hon. Members would expect, the Government want to look at how we can prevent accidents. We always need to do more to prevent them and to ensure that employers and employees take their responsibilities seriously. The HSE, with the Department for Transport, produces guidance to help companies whose staff drive to work. That guidance, “Driving at Work: Managing work-related road safety”, spells out the need for employers to be satisfied that their drivers are fit and healthy, so that they drive safely and do not put others at risk.
The HSE also established the road distribution action group, which was a partnership between employers’ groups, trade unions and regulators, whose aim was to improve health and safety at work and to reduce accidents and ill health in the road haulage and distribution industry. The group produced guidance for the distribution industry on managing driver fatigue.
The Freight Transport Association also produces a monthly update on health and safety issues, which regularly includes information on driver fatigue, and the Driving for Better Business website provides advice on road safety issues.
Most cases of OSA go undiagnosed, so we need to consider that one of the most effective and realistic ways to reduce road accidents that result from the condition is to encourage all drivers not to drive when tired. I am sure that the same signs, electronic or otherwise, are put up on the motorways in the hon. Lady’s area as in mine. The Department for Transport issues such advice through its “Think!” campaign on fatigue, which was given a national award by Brake, the road safety charity. I am sure that many hon. Members will have seen the campaign on motorways such as the M3, which goes through my constituency.
I of course welcome anything that draws people’s attention to the issue, but the problem with obstructive sleep apnoea is that people who have it feel tired all the time and often do not know the reason why. They do not therefore think that that message is as applicable to them as it is to someone who has had a long day or who was up late the previous night. It is an important message, but it is not sufficient.
I understand the hon. Lady’s point. That is why there is a clear responsibility on employers and employees to think more generally about their health. That is as it should be, because we have to remember that drivers can experience a broad range of health conditions that could affect their capabilities. They might, for example, suffer from diabetes, heart conditions or migraines, to name but a few. Drivers and employers need to think broadly about health issues, including sleep apnoea, on a continuing basis. An individual process for each condition might not be manageable, but we have to make sure that employers and employees think about health issues. It is also important that they keep track of innovations in relation to our understanding of different conditions and how they can affect people, particularly in the workplace.
Given the broad range of health issues involved, it is difficult to set out a definite requirement for each one. We have to remember personal responsibility and the fact that the legal and moral obligation of all drivers to drive safely and to report any health condition to their employer exists in law. OSA is treatable when identified, and we need to ensure—the hon. Lady is doing an extremely good job on this—that employers are aware of the condition and that they have processes in place to monitor all sorts of health conditions, including OSA, in employees who drive as part of their work.
By calling for this debate, the hon. Lady has shown what Members of Parliament can do to highlight and underline such issues and to ensure that not only Ministers, but other organisations and employers keep abreast of what they should take into consideration with regard to the health of employees. I will use this debate as an opportunity to discuss the issue with the Minister of State, Department for Work and Pensions, my right hon. Friend Chris Grayling, who sends his apologies for not being able to attend, because he is on Government business in Europe.
I will also bring the hon. Lady’s good work to the attention of the FTA, the DFT and the road distribution action group. I want to ensure that important groups take on board the importance of monitoring the scale of road accidents at work and to press home the importance of continuing to work to make our roads as safe as possible.