Eyesight Tests (Drivers)

Meg Munn Excerpts

Wednesday 15th June 2011 Westminster Hall

[Meg Munn (Sheffield, Heeley) (Lab/Co-op)]

I am delighted to have secured a debate on eyesight regulations for drivers, especially as we are in the middle of national eye health week. As I speak, an event to mark the week is taking place in Parliament, and in my home city of Sheffield a wide range of organisations is holding an awareness day in the city centre. South Yorkshire police, in conjunction with the Sheffield Royal Society for the Blind, are focusing on the issue that brings me here today: the importance of good sight for driving and, in particular, drivers who do not realise that their sight is deteriorating.

I have been engaged on the subject for some time. I was contacted by my constituent Joy Barnes, whose niece tragically died in a road accident caused by a driver whose eyesight was not up to the necessary standard. Joy’s niece, Fiona Buckley, was just 43 when she died. She was born with spina bifida and hydrocephalus, so spent much of her adult life in a wheelchair. Fiona worked in the city centre Shopmobility service and in the Royal Hallamshire hospital as a welcomer. A bubbly person, she enjoyed a lively social life and, in her younger days, was an accomplished swimmer, later becoming an avid photographer and Scrabble player. Her family describe Fiona as a generous and courageous spirit.

At 10 pm on 6 December 2008, Fiona was crossing the road, with her friend Kay Pilley walking just behind. Witnesses said that the car approaching did not attempt to overtake or brake, but ran straight into them, and Fiona was thrown over the vehicle. She suffered a major head injury and her pelvis, spine and leg were broken. Six weeks later, she died in hospital from multiple organ failure. Kay suffered head and knee injuries and was treated at hospital; she could not remember what had happened.

Police officers subsequently tested the 87-year-old driver’s eyesight, and found that he could not read a car number plate from the required distance of 20.5 metres. He was later found to have cataracts in both eyes, which had probably been there for some 18 months. A doctor said it would give him “foggy or hazy” sight that could have rendered Fiona almost invisible to him. He also suffered from age-related macular degeneration, which blurs the central vision. With his right eye, he could see only from 6 metres what people with good vision can read from 24 metres. The driver admitted causing death by careless driving, but the judge decided not to punish him for killing Fiona. The driver was given only three penalty points. Fiona’s aunt, Joy Barnes, speaking on behalf of her wider family said:

“Fiona’s death hit us all hard. The driver should not have been on the roads with such poor eyesight and it is a travesty that nothing is done to make sure that drivers meet a minimum standard of sight. If this driver had been made to have a sight test to keep his licence then Fiona would still be with us.”

During the current driving test, the examiner gives the driver three chances to read a number plate, from 20 metres for vehicles displaying the new-style plate or 20.5 metres for old-style plates. Following that, the drivers of cars, small vans and motorbikes need not take any form of eye test for the rest of their life, unless they voluntarily report that they have a serious vision impairment to the Driver and Vehicle Licensing Agency. Once drivers have reached the age of 70, in order to renew their licence they are asked to confirm that they have acceptable vision, but they are not required to prove it.

The Department for Transport has been consulting on the medical standards that should apply to eyesight tests for safe driving. Astonishingly, the Department is proposing that the testing distance should be reduced from 20.5 metres to 17.5 metres. The Sheffield Royal Society for the Blind is extremely concerned that any relaxation in the requirements could be detrimental to road safety. Can the Minister give me details of the evidence that was considered before reaching that proposal? What is her evidence to suggest that such a test is adequate in any way?

The current eyesight test is simply no longer fit for purpose. In contrast with the tragic death of Fiona Buckley, it is not possible to attribute many road accidents directly to poor eyesight. Eyesight is often only one of the factors that might be involved; others include the time of day, the weather, the condition of the road and tiredness. However, it is common sense that poor vision will impair any driver’s performance, even taking into account all other conditions.

The distance number plate test has been in place since the 1930s and is outdated. It has remained unchanged, despite increased numbers of vehicles on the road and developments in road safety standards and clinical technology. It is not scientifically based and does not reflect modern day knowledge of vision. The number plate test also only measures visual acuity—put simply, the ability to see at a distance. It does not produce consistent results and can be affected by environmental conditions. Drivers can fail the test in different lighting or weather conditions. Several scientific publications have questioned the accuracy and reliability of the number plate test as a method of screening visual acuity. Also, it does not test visual field—put simply again, the ability to see around while looking straight ahead. Visual field loss can advance significantly without a person becoming aware of a problem. For instance, glaucoma is a condition that someone can have and yet pass a number plate test with insufficient field vision.

The current system also requires self-reporting and therefore relies on individual drivers being aware of the required standard, realising that they do not meet it and knowing that not notifying the DVLA of any problem is a criminal offence. However, many drivers do not notice what can be a gradual change in their vision, remaining unaware that they fall below the required legal eyesight standard.

[Jim Shannon (Strangford) (DUP)]

I can suggest one method of checking everyone’s eyesight, including mine. I register an interest as a diabetic—type 2 of course, controlled by diet. If people visit an optician every year, the optician tells them about their eyesight. Might that be a method whereby people can check if their eyesight is deteriorating?

[Meg Munn]

The hon. Gentleman makes an interesting point about what could be done if the current system, which puts the onus on the driver, continues. I will argue, for good reasons, that an eye test should be a requirement.

Many people with glaucoma do not have any symptoms until the condition is quite advanced. The National Institute for Health and Clinical Excellence guidance advises that once vision loss becomes apparent, up to 90% of optic nerve fibres might already have been damaged. The general manager of Sheffield Royal Society for the Blind, Steve Hambleton, said:

“when people are diagnosed with an eye condition that impacts upon their ability to drive safely, the onus is on the driver to notify DVLA. We encounter too many people who do not do this and continue to drive. In these days of data protection etc., it is extremely difficult if not impossible for organisations such as ours to advise DVLA of our concerns.”

Last month, I attended the launch of the UN decade of road safety, which was addressed by the Secretary of State for Transport. The UK has a proud record: Great Britain had the fourth fewest road deaths per million people, we have been in the top five performing countries throughout the past decade and we were in first place in 2009. Yet on eyesight testing, we are lagging behind many countries and many of our neighbours in the European Union. The EU has recently published directives to standardise driving licences and to harmonise European standards. The UK lags behind best performance of most other European countries in assessing drivers’ vision. A report released only this week outlines that a majority of EU member states assess visual acuity and visual fields in advance of issuing a first full driving licence. The UK is among the minority that requires no further assessment of vision throughout a driving career.

The 2006 and 2009 EU driving licence directives continue a long path to harmonise driving licences with the overall aim of improving road safety and facilitating enforcement throughout EU countries. Is the Minister really content to see our otherwise excellent record on road safety lag far behind the best practice of our near neighbours? Given that the EU directive recommends a visual field of at least 120 degrees, how can the number plate test be sufficient to comply?

The only way to make sure that drivers continue to have adequate vision is to make eyesight testing mandatory at regular intervals throughout the time they hold a licence. Drivers should have to provide regular proof that they have had their eyes tested by a medical professional and that they meet minimum standards for visual acuity and visual field. That should happen at least every 10 years, coinciding with drivers renewing their photo driving licence. That would be a simple and inexpensive step that would vastly improve the eyesight of drivers throughout the UK. I also recommend that when drivers reach the age of 70 and have to self-certify that they are fit to drive, they should be required to submit evidence from an appropriate professional that they have a safe and legal level of eyesight.

The present inadequacies must be addressed. That view is supported by the Optical Confederation, which represents 12,000 optometrists, and the 6,000 dispensing opticians and 7,000 optical businesses in the UK. Those organisations and many others concerned with road safety have submitted their concerns to the Department for Transport's consultation. Will the Minister report on the outcome of the consultation, and when will the Government respond to it?

Having good eyesight is one of the most basic requirements for safe driving. It is widely recognised that 90% of sensory information when driving comes from vision, which underlines the importance of always driving with good eyesight. Being an experienced and skilled driver who is aware of the dangers of the roads is simply meaningless if one is unable to spot hazards in time. Research shows that one in six drivers cannot see well enough to pass a very basic eyesight test. People who are reluctant to give up their driving licence cannot be relied on to inform the authorities if they have eyesight problems.

Making the changes that I suggest would have public support. In vox pop interviews this morning, my local radio station, Radio Sheffield, spoke to five people—only a few, but four of the five thought that those changes were sensible and saw no problem with them. BRAKE, the road safety charity, released a survey, which no doubt involved a few more people than the five in Sheffield, showing that 75% of drivers support compulsory eyesight testing for drivers every five years.

Continuing with a system of drivers self-reporting any problems that they may have is not the answer. Poor driver eyesight kills, and every death is devastating to the people involved. The Government should act on the professional advice, which commands support among drivers, and change the driving test to ensure that all drivers can see what lies ahead of them while on the road.

[The Minister of State, Department for Transport (Mrs Theresa Villiers)]

It is a pleasure to serve under your chairmanship, Mr Streeter. I congratulate the hon. Member for Sheffield, Heeley (Meg Munn) on securing this debate, on her speech today, and on her long-standing work on this important issue. It is a welcome opportunity to highlight the crucial point that those with defective eyesight that does not meet the required standards should not drive on our roads.

I want to put on record my sincere condolences for the hon. Lady’s constituent, Joy Barnes, on the tragic death of her niece, Fiona Buckley, in the incident that the hon. Lady described. The case was tragic, and I offer my sympathies to Fiona’s family and friends for their loss.

In responding to the issues raised by the hon. Lady, it may help if I reiterate and clarify the current arrangements for renewing the entitlement to drive. Most drivers do not need to renew that entitlement until the age of 70. They must then renew every three years for as long as they remain fit to drive. Someone at the age of 70 could be fitter, more alert and more active than some individuals who are younger, which is why licensing decisions are based on health rather than age. Although age is not always a reliable indicator of an individual’s physical and mental health, it is widely accepted that health can deteriorate in old age in ways that may affect the ability to drive safely.

When renewing their entitlement to drive, drivers must, as the hon. Lady said, complete a self-declaration affirming their ability to read a number plate from 20 metres away. They must also confirm that they do not have any medical condition that affects their ability to drive safely. That allows attention to be focused on those individuals who declare that they have a medical condition, those who have been found to have one, and those who need some sort of investigation to determine whether they can retain their licence to drive. Those detailed investigations into medical fitness to drive may include the collection of information from the driver and their doctor, a physical examination or a driving assessment.

The hon. Lady expressed concern about drivers who do not tell DVLA that they can no longer meet the level of fitness, including eyesight, needed for driving. One may speculate that that is because they worry about the impact of losing their licence, or because a medical condition makes them unaware of the implications of their failing health. That is why DVLA accepts notifications from third parties, and that is an important element of the enforcement process. Around 8,000 notifications of concern received from doctors, police and family members are investigated each year. Guidelines produced by the General Medical Council for doctors confirm that they are justified in telling DVLA about a patient who fails to stop driving following medical advice to do so. Similar guidelines have been produced by the College of Optometrists for its members.

DVLA forms and literature remind drivers of the ongoing requirement to meet the eyesight standard, and specifies that failure to meet the standard is an offence. Whenever DVLA contacts drivers, consideration is given to whether it is possible to highlight the continuing obligation to notify the DVLA of defective eyesight and appropriate medical conditions. We also seek to give information to drivers about the conditions that they must tell DVLA about relating to field of vision. That is an important part of the enforcement process. Directgov has an A-Z of medical conditions to help drivers to decide whether they need to tell DVLA of any aspect of their health. Detailed guidelines for doctors are also available to help them to advise their patients on medical notification requirements.

The Government’s view is that the current arrangements strike the right balance between road safety and personal mobility. There is not sufficient evidence to suggest that a more burdensome and costly regime would have a significantly positive effect on road safety. The majority of older people continue to drive safely, and to retain insight into their ability to do so.

[Meg Munn]

I understand what the Minister is saying about conditions, and being able to look things up, which is fine if someone knows that they have a problem, or someone has suggested that their sight is deteriorating, for example, but much of the evidence is that people simply do not know. Providing information does not help them, and unless they have a test they may not know that they are suffering a problem.

[Mrs Villiers]

As I said, whenever possible, the communications that DVLA sends to drivers refer to those conditions to alert them to the continuing need to ensure that they can pass the 20 metres test. One of the benefits of that test is that it is simple, and people can do it if they walk outside this building. We seek in those ways to alert people to the importance of doing that test regularly. On the whole, older people make sensible decisions about when and how they drive, and some older drivers voluntarily engage with local services to improve their driving skills and get independent advice.

The hon. Lady made a number of points about the effectiveness of the number plate test as a way of testing vision. As she said, the standard of vision required for safe driving requires someone to read a number plate at a distance of 20 metres. For people with visual field problems, other specific standards have to be met. All drivers are required by law to meet the appropriate eyesight standard at all times while driving. If they are unable to read a number plate, even if that is only because they failed to wear the appropriate prescribed glasses or lenses, they are committing an offence. Driving licence applicants must declare that they are able to read a number plate to obtain a licence. They will be asked to prove their ability to do that to their driving instructor during the practical driving test.

I assure the hon. Lady that we comply with EU directives on the visual field. The number plate test is not expected to test the visual field. A visual field problem is caused by an underlying medical condition, and those with such conditions are required by law to notify the DVLA, which has long-standing procedures in place to assess whether the minimum visual field requirements are met. Those requirements include referral to an optometrist for a specialist examination and report. The Government believe that the number plate test is an effective screening tool. Its use as a means of assessing whether a driver meets the required eyesight standard has been subject to departmental and Scientific Advisory Committee scrutiny, and it has stood the test of time.

The hon. Lady referred to a consultation document that was issued in relation to a possible revision of health standards for driving. That consultation looked at whether, instead of maintaining our current higher standard, the UK standard should be brought into line with the minimum required by the European Union. No decision has yet been made, but if it were proposed to align our standard with the minimum standard required by the EU, the distance over which someone is required to read a number plate would be reduced. Responses to the consultation are being analysed; some issues need further consideration and that is under way at the moment. It is important that any proposed changes are evaluated fully and that appropriate consideration is given to their potential impact. The points raised by the hon. Lady this afternoon will no doubt feed into the process of reaching an ultimate decision. Once an evaluation of the consultation responses is complete, the Government will take an informed decision on how to proceed and issue a formal response to the consultation.

In the meantime, there is much to be said in support of the current system. The number plate test is a simple and functional assessment of vision that can be easily carried out in the driving environment and reproduced regularly by an individual, as opposed to a periodic appointment with an optician. Although it is largely a test of visual acuity, to some extent it can test glare and contrast sensitivity. It provides a good indication that the licence holder meets—and continues to meet—the required visual acuity standards for driving. The test is easily reproduced at Driving Standards Agency test centres by examiners, and at the roadside by the police.

At a modest estimate of £20 per test, it would cost more than £20 million each year if an optician’s certificate or eyesight test were required by the 1 million motorists who apply for their first driving licence. If such a test were compulsory for each of the 2.5 million motorists who renew their driving licence each year because their photograph is 10 years old, it would cost more than £50 million a year.

[Meg Munn]

The Minister is generous in giving way again. Given the cost of motoring, the figures she mentions are tiny amounts of money compared with what people spend on learning to drive. Does she understand how complacent she sounds, and how angry my constituent will be at her response? Given her inability to offer any comfort to my constituent, will the Minister take on board the need to do a great deal more to raise awareness of this issue?

[Mrs Villiers]

I completely refute the allegation of complacency. The Government are very focused and place high priority on road safety. We are determined to continue the UK’s good record on road safety, but we believe that the current arrangements are an effective means of maintaining safety on our roads. We must take into account the costs of what the hon. Lady proposes. Household budgets are stretched at the moment and it is tough for people to add to those budgets commitments of this kind. If each of the 1.5 million motorists who renew their driving licence at the age of 70 were required to undergo such a test, that would cost a further £30 million each year—a significant sum of money. As all drivers over 70 are entitled to a free eyesight test, that additional burden and cost would fall on the Department of Health and the devolved Administrations. Added to that is the caution that, while an optician’s certificate, or equivalent, might provide assurance that someone has had their eyes tested, it would not guarantee that they could meet the current eyesight standard while driving, or that they used their prescribed glasses or corrective lenses. The optician’s test does not provide all the answers.

In conclusion, the Government are confident that current arrangements are effective and working well. The UK has one of the safest road networks in the world and I am afraid that we simply cannot justify the cost that indiscriminate, mandatory eyesight screening would impose on individuals, the Government and the devolved Administrations. Furthermore, there is little evidence to suggest that compulsory formal eyesight tests would have any marked positive effect on road safety.

The coalition Government take road safety seriously and are determined to maintain and improve the country’s long-standing and strong record. Any road death caused by defective vision is an avoidable and unnecessary tragedy, and all of us who use UK highways must take personal responsibility for ensuring that we have an appropriate level of vision for driving. I take the opportunity to place on the record how important it is that all drivers, regardless of age, do not simply wait for their next eye appointment, but check regularly that they can read a number plate from a distance of 20 metres. That simple test can alert individuals to a deterioration in their vision that they may not have noticed, and to the need to make an appointment to see their optician. The number plate test is saving lives on our roads. It is an effective test in which the Government continue to have confidence.