Medical Bureau of Road Safety: Discussion with Chairman Designate

I ask members to switch off their mobile telephones. I appreciate that the change to the scheduled time for this meeting has affected members' plans. With the agreement of members, we will first discuss with the chairmen designate of the Medical Bureau of Road Safety and Drogheda Port Authority their intended roles and meet in private session thereafter.

I welcome Dr. Declan Bedford, chairman designate of the Medical Bureau of Road Safety. I know Dr. Bedford in a previous capacity when we were both members of the North Eastern Health Board. Dr. Bedford was a man of great repute and an important member of the board who, in addition to having an interest in health matters generally, was also interested in public health, particularly alcohol and public health.

By virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by absolute privilege in respect of their evidence to the committee. However, if they are directed by the committee to cease giving evidence on a particular matter and continue to so do, they are entitled thereafter only to qualified privilege in respect of their evidence. They are directed that only evidence connected with the subject matter of these proceedings is to be given and asked to respect the parliamentary practice to the effect that, where possible, they should not criticise or make charges against a person, persons or entity by name or in such a way as to make him, her or it identifiable.

Members are reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the Houses or an official either by name or in such a way as to make him or her identifiable. I invite Dr. Bedford to make his opening statement.

Dr. Declan Bedford

I am a specialist in public health medicine with a particular interest in alcohol and road safety. I am a medical graduate of University College Dublin. I worked as a specialist in public health medicine with the Health Service Executive, HSE, and acted as director of public health in the north east for seven years until my retirement from the HSE in August 2012. I am a fellow of the faculty of public health medicine of the Royal College of Physicians of Ireland. I have been involved in research for many years and my published research covers a wide range of public health topics, including suicide and mental health, alcohol, men's health, injury prevention, infectious diseases, health services and use of hospital services. I am employed part-time by the Royal College of Surgeons in Ireland, RCSI, in health systems research development and adviser to the RCSI hospitals group. As a matter of interest, I will retire from this position at the end of this month.

I am a former member of the North Eastern Health Board and the board of the faculty of public health medicine. I was also a member of the drug treatment centre board and I am a board member of Alcohol Action Ireland. I have been a board member of the Medical Bureau of Road Safety for two years. Since December 2012, I have been the chairman of the Health Research Board, HRB, a statutory agency under the aegis of the Department of Health. We are the lead agency responsible for supporting and funding health research. We lead and support excellent research and generate relevant knowledge and promote its application in policy and practice. Our annual budget is approximately €50 million and at any one time we have close to €200 million allocated to ongoing research projects.

I am chairman of the working party on traffic medicine in the Royal College of Physicians of Ireland, RCPI, as part of the national office for traffic medicine. Our office was jointly established by the Royal College of Physicians of Ireland and the Road Safety Authority of Ireland in 2011, bringing the specialty of traffic medicine to Ireland for the first time. Our goal is to help doctors and licensing authorities promote safe mobility. The term "traffic medicine" evolved to embrace all the disciplines, techniques and methods aimed at reducing the harm traffic crashes inflict on human beings. The best known element of traffic medicine is the need for medical certification showing fitness to drive. We publish guidelines on fitness to drive called Sláinte agus Tiomáint which are updated annually.

As chairman of the Medical Bureau of Road Safety, I will work to ensure the bureau continues to achieve its mission to provide a high-quality national forensic service in alcohol and drug detection in support of the effective operation of the road traffic legislation. I will work with the director and other board members to ensure we continue to review, on an ongoing basis, how we operate to ensure we comply with the new code of practice for the governance of State bodies introduced in August 2016.

I will work with the director and other board members to ensure we continue to implement our five-year strategic plan and objectives. These include continuing to provide a high-quality national forensic service in alcohol and drug analysis, the provision of bureau certificates and court assistance; maintaining the ISO 17025 accreditation status achieved for analytical programmes within the bureau and extending the accreditation to additional areas; adapting and incorporating into bureau activities any new legislation requirements; building up a forensic toxicology knowledge base within the bureau scientific staff; ensuring all the work in the bureau is maintained and improved, where possible, to a high standard of quality that is required of a national forensic laboratory in an efficient and cost-effective way; and maintaining effective management systems and operating within best accounting practices and frameworks.

I welcome the witness. How is the bureau able to find out if people are drug driving?

Dr. Declan Bedford

The Medical Bureau of Road Safety itself has done research on samples. Bigger studies, such as the Driving Under the Influence of Drugs, Alcohol and Medicines, DRUID, study across Europe, with which Ireland was involved, assessed people and found out what proportion of drivers had drugs in their system. It has been ongoing for quite a while in Ireland. We know that cannabis-type drugs are the most common type of drug found in Ireland.

What are Dr. Bedford's views on reducing the alcohol limit? Does he have a view?

Dr. Declan Bedford

Alcohol impairs driving. I was involved in research in my department years ago. We carried out research on men. We asked men why they did not drink and drive and why they obeyed the rules of the road. The only reason they did not drink and drive was the fear of getting caught. It was not because they did not think it was a bad idea to drink and drive. The main deterrent was the fear of getting caught. My view, and the view of my colleagues, on that was that what was required was highly visible enforcement in order that people felt there was a chance of getting caught and that the penalty had to be high enough to ensure people would not want to get caught. We need highly visible enforcement of what we have got. We should see how that works and, after that, reducing the limit would be good. Men have told us that highly visible enforcement is required, and international evidence shows that it works as well. At the same time we have a 20 mg limit now for professional drivers and people like that, which is basically a level of zero. However, nothing works if people have a perception that they are not going to get caught.

Are there measures that can be taken from a technology point of view? We have spoken about the fact that Garda resources are quite important. Have there been advances there that have been looked at?

Dr. Declan Bedford

There is no particular problem there because the equipment used at present can detect 20 mg. That is not a problem at all.

Is there technology available within a car that means that one cannot start the car if they have drink on board?

Dr. Declan Bedford

Yes, the Senator is talking about alcolocks. They tend to work for people who really have drink problems, but as soon as they stop using them, they are back drinking and driving again. These are people who have serious problems and are repeat offenders. The evidence is that they work because the car will not start but, when they are taken out again after a period, those people seem to drift back again to their old faults.

I believe that technology should be used more. Is there a need to extend the use of alcolocks? Gardaí should be visible but they could be doing better things. It may help reduce the Garda presence if we had alcolocks or some other technology. We have speed cameras which are helping to reduce deaths on the road and the obligation for gardaí to be standing by the side of a road. Is there a role for technology there?

Dr. Declan Bedford

There have been many advances in technology and it may be the case in the future but I do not know if there have been any major trials in big populations. I believe that they have only been tried with people who have problems. There is obviously an expense associated with them as well. Random breath tests and that sort of thing are supposed to be a deterrent to stop people from drink-driving in the first place. They are not designed to catch people. I read an article many years ago about a young police officer in Australia who was taken out to his first random breath test check point. He came back that night and had not caught anybody, and was very disappointed until a senior officer told him that that was a good night and that their job was to stop people by letting them know that the police were present, which stopped them from drinking and driving. I believe in highly visible enforcement.

I welcome Dr. Bedford. What process did Dr. Bedford have to go through to be appointed to his position? Had he to go through an interview process?

Dr. Declan Bedford

No, I did not. I was asked to go on the board a couple of years ago. With regards to the chairmanship, the last chairperson was Professor Cecily Kelleher. Her term finished earlier in the year and no appointment had been made. A Department official asked me if I would consider being chairperson if I was offered the position and I said that I would do it for the rest of my term. My term ends next March or April.

On the issue of alcohol impaired driving, there is a proposal to change the legislation. It has not gone through the Dáil itself yet. If there is no change, and given the witness's views, would he feel that his position has been compromised?

Dr. Declan Bedford

Would what be compromised?

At the moment there is a proposal for what is essentially a zero tolerance policy in which all those caught with between 50 mg and 80 mg of alcohol in their systems would be put off the road. If it does not get through, would Dr. Bedford's position be compromised, given that he is an advocate of a zero alcohol approach?

Dr. Declan Bedford

No, I do not think so. I have to be practical at the same time. Whatever legislation is brought in has to be acceptable. As this is a democracy, I have no particular problem. I do believe that, in any case, whatever the level is, the key is highly visible enforcement. Without that, nothing works. That is my own personal view on that. Of course 20 mg would be a good limit. It would make it clear to everybody. When we see people out at night-time some think they are fine with a glass of wine or a beer or two and believe they are below the limit and are obeying the law but one cannot be sure. Alcohol affects everybody differently. If the limit was down at 20 mg, people would know they definitely could not drink and drive. That would clear it up and they would forget about having the one or two drinks. That might happen.

The witness hit the nail on the head. Some people are not too sure what they can drink. I put the question to the Department of Justice and Equality. This legislation is arising out of the fact that the Minister for Transport, Tourism and Sport, Deputy Ross, stated that it was being abused by some who were just getting fixed penalty points as opposed to being put off the road. He felt that the system was being abused but, at the same time, no one can give us figures to say that people have gone back on the road and been caught again within the same legislation. As Dr. Bedford said himself, perhaps people are not too sure if one glass is okay or not. They might learn their lesson. Why give them a hard penalty the first time when they might be innocent of the fact? People might be able to have the one drink and be able to drive with good care and within the rules of the road, but is it too harsh to put them off the road straight away?

Dr. Declan Bedford

One could say that, and I have no difficulty in understanding that, but the idea of having the big deterrent and having highly visible enforcement is to stop it in the first place. We do not want to see anybody up there. The consequences are not just being put off the road because of the penalty points. It might affect one's job as well, if driving was important to it. Of course, one could still have an accident. The evidence is very clear that for every little bit of extra alcohol a person's judgment might just be slowed down enough so that he or she will not react in time if somebody runs out on the road or if a car comes around the corner. As an advocate for safe driving, I would always be going for the lower limit and the high deterrent in the hope that nobody will be caught at all and that everybody will decide not to drink and drive.

Does the witness think that drugs have been a big factor in crashes or in bad driving?

Dr. Declan Bedford

Yes, and the legislation has come in now, so it is going to be very interesting to see how many people are caught. It is a bit early yet to see what the trend is and how many people get caught and how much safer the roads get when people understand that they are going to be caught. However, we know from the population studies that a fair number of people are taking drugs. There are many people taking cannabis, benzodiazepines and other drugs. They do impair driving, and at a population level that means there will be more crashes.

If the legislation is implemented in a visible manner, people might take account of it and decide not to take drugs and drive.

Has the witness come across situations where, following a post mortem, the gardaí might have pointed to both drug and alcohol use?

Dr. Declan Bedford

Yes. I cannot give the Deputy the exact figure as I cannot remember.

Dr. Declan Bedford

There have been such situations. I have looked at more than 900 results for people killed in car crashes. I have looked at the Garda files and the post mortem results and a good proportion of people had both. The biggest by far, however, was alcohol. Alcohol was way out there on its own, mainly in men rather than in women, unfortunately, especially younger men. That is the way it is. Drugs have become more common in the world in the last few years, however.

I thank the witness and the Chair.

Does any other member wish to ask a question?

I have a number of questions, though the witness has just answered one of them. With regard to the Road Traffic Act, I wanted to ask if Dr. Bedford has any statistics thus far or even a progress report on the new legislation on drug testing. He has just stated, however, that it is too early to say.

Dr. Declan Bedford

I do not have any up-to-date feedback on that yet as it has only just been introduced. Anything at this stage would be a bit skewed. I would say, however, that at the end of this year we should have a reasonable start. I have nothing at present.

I am also curious as to what kind of relationship the witness has with the Garda in his role as chairman designate of the Medical Bureau of Road Safety, particularly with regard to road safety figures and breath testing. What is his opinion on the recent breath test episode?

Dr. Declan Bedford

I have had no personal contact with the Garda, either in my role as chairman designate or as a board member. The senior staff in the Medical Bureau of Road Safety have operational meetings with the Garda and are also involved with providing them with training. They meet them then, but that is an executive matter and I have no dealings with the Garda at all. In response to the Deputy's question about the discrepancies in breath testing, our director, Professor Denis Cusack, gave a detailed reply on that matter to the Chairman of the Oireachtas Joint Committee on Justice and Equality, Deputy Caoimhghín Ó Caoláin, either last year or earlier this year. I cannot remember when exactly. We supply all of the necessary supplies to An Garda Síochána, including the mouth pieces and the various other aspects. We had not had to order any in for a while so our staff checked with the Garda as to whether more were needed. It said no, that it had enough. Questions were eventually raised about this, I think originally in 2014 or 2015, and the question of an audit arose. I know that our board staff helped the Garda complete the audit showing that there was a discrepancy.

Dr. Declan Bedford

It is not our function to measure or exactly quantify what the gardaí are doing. Our functions are very strictly stated in the relevant Acts. Checking out or reporting on returns made by the Garda is not one of them.

I was just curious about the relationship, given the breath testing scandal.

Dr. Declan Bedford

The staff and the senior staff work with the Garda. They go out to check the equipment, provide training, offer feedback and that kind of thing. That is their role.

Was Dr. Bedford shocked by the figures?

Dr. Declan Bedford

They were very disappointing to hear. It undermines credibility. Road traffic legislation regarding alcohol and so forth is one of the most challenged matters before the courts, so anything that leads to a lack of confidence in the system produces more challenges and more confusion for drivers. Drivers might feel that they can get away with things because everything is in disarray. It certainly does not help.

Does it undermine the work of the witness's own organisation, for example, or that or of the Road Safety Authority in getting the message across to people of the importance of not drinking and driving? Given the scandal around the figures-----

Dr. Declan Bedford

It takes away from the core message. We want everybody to be clear at all times that they should not drink and drive. Drinking and driving kills and causes injuries. That is a very simple message, but it can be clouded up by other controversies. From that point of view then, yes.

Does Deputy Barry wish to raise any questions? No. Senator Feighan wants to come in again. I will then move on to my own questions.

In the last months this committee has discussed the question of reducing the drink driving limit to zero. This has been controversial. Part of the job of the committee is to try to tease out information from all sides. Do we want the limit drilled down? The Road Safety Authority could not give the information to us because of data protection issues and we were quite disappointed at this. We all want to ensure that people are safer, but this was information that should, we felt, have been made available. We took legal opinion on this and were told that the RSA was within its rights. We are talking about legislation, however, that we as a committee and a committee Chair cannot get because of data protection.

Senator Munster rightly mentioned the Garda figures. Could it now be an issue that the Garda figures were also wrong? We are talking about legislation that we cannot get drilled down because of data protection. We are now dealing with this Garda scandal over figures that were effectively falsified, for want of a better word. What is Dr. Bedford's view on that?

Dr. Declan Bedford

Those figures are obviously not dependable. There are, however, data available annually from the Medical Bureau of Road Safety. Our reports are published on our website and these give our findings. Research has also been carried out on this. My own research looked at 900 deaths and I was able to see the actual blood levels of the people killed in each of those crashes, both passengers and drivers. I know that the Medical Bureau of Road Safety and others have done other research over the years. Those figures are reliable because they are based on actual blood tests rather than any improper recording of them. There are data out there. At the same time, however, it seems only logical that if data are being collected on a yearly basis by whatever authority, be it the Road Safety Authority or the Garda, they should be reliable and could be used to measure trends and assess whether the legislation is working or whether it needs to be adapted.

What is Dr. Bedford's views on a committee that is just trying to drill down legislation and is being told that the data needed by us to make decisions on legislation are unavailable because of data protection? No names are mentioned, or anything like that. To me, it is absurd.

Dr. Declan Bedford

I am not fully sure-----

To be helpful and to be fair to everybody here, I think that the Data Protection Commissioner should be able to provide clarity on any data protection issues or replies that the Senator is unhappy with. To be fair to Dr.Bedford, I do not know if he wishes to answer that. I appreciate that the Senator wants to get the facts.

Dr. Declan Bedford

I am not fully sure as to what data the Senator cannot get his hands on.

I wanted to drill down on the number of deaths, year by year, from 2012 to 2017. That information could not be made available to the Chair or to the committee because of a data protection issue. I was very surprised.

Dr. Declan Bedford

I cannot answer that. I do not know.

If Dr. Bedford wishes to come back in, he can do so afterwards. I have a question myself but I will let the Vice Chair, Deputy O'Keeffe, in first.

Senator Feighan asked earlier about the status of immobilisers in vehicles. What is Dr. Bedford's personal view on this? If we make breathalyser test equipment available to public houses, then maybe customers might test themselves before going out the door. Does Dr. Bedford have a view on this?

Dr. Declan Bedford

People can buy breathalyser-type machines themselves; however, the difficulty is whether we can depend on them. Are they calibrated? The machines that the Medical Bureau of Road Safety give out to the Garda are checked at least twice a year and tests are done to make sure that they are correct. The difficulty here is whether we could depend on breathalysers that customers might use in the pub themselves. For starters, if somebody had just finished a drink the machine would be likely to give a higher result straight away. It might also not be calibrated correctly and give a false negative. Somebody getting a false negative and then heading out in the car would produce a very bad situation. A positive might be fine and might lead someone to decide not to drink and drive. There is a risk, however.

I do not know of any studies done at a population level to state whether it works.

Could it be tried out? Dr. Bedford mentioned supervision and calibration. Could it be calibrated like weights and measures? The Revenue Commissioners could visit the pubs and check the drink measurements.

Dr. Declan Bedford

They do.

Could we have that type of system put in place? Could that suggestion be looked at?

Dr. Declan Bedford

I suppose it might be worth a try, but I do not know that there is evidence anywhere to say that system works. It would only be speculation if I may say so. I am sure some individuals might use it, but they might get a false negative or a false low reading and then they would be in greater trouble when they go out, thinking that they were fine. If they did not have that reading, they might not have driven at all in the first place.

That is the key point: one should not drink and drive. That is it.

That is a matter of opinion, Chairman. May I ask one more question? There has been a knee-jerk reaction in regard to the culture of the breath test kits not being used and an exaggeration of fears. One can see checkpoints in the afternoon. I was intercepted one afternoon at 4 p.m. when I was coming out of a local town. There was a queue of cars, with the drivers waiting to be breath tested. I asked the garda what was happening and he told me they were conducting a mandatory checkpoint. Are we gathering figures for the sake of building up figures? Now there will be 2 millions tests conducted and most of them will be okay.

Dr. Declan Bedford

The drink driving offences and the crashes are at night time, but there are peaks in the afternoon as well, particularly on Sundays. There are data available, if memory serves me right, to show the peaks on Sundays. There is one other advantage of having an occasional breath check apart from that in the afternoon or at other times because it creates awareness: people will say that they are testing for drinking and driving. Many people would be reassured by that. They will say that, if they are doing it in the daytime, they will definitely be doing it at night-time as well. Several years ago I spoke to gardaí at the introduction of the random breath testing and said it was a matter of getting the message out there, without causing grief. If gardaí set up a road traffic check point on the verge of a motorway on a Monday morning and a big sign stating "random breath testing check" and they took all their equipment, all the cars would be sneaking by the first time before they have set up. They are thanking God they had passed it. All you would have to do is take it down straight away and those who would see it would thank God they had arrived too late. They did not have to stop anybody but the message is getting out. I know they have done that elsewhere. The message is getting out that gardaí are doing checks in the morning and a person would want to watch what they drink on Sunday night. There is a problem that some people do not realise how much they drink on a Sunday night. When they are driving to work at 6.30 a.m. or 7 a.m. on a Monday, they are over the limit. Crashes occur and people get injured.

I thank Dr. Bedford for answering the questions fully and frankly. I compliment him on his commitment to this, his lifetime work in this area. I have one question. European countries have different standards. Are we working towards a base standard? Is there international or European co-operation to have the same standard across all of Europe?

Dr. Declan Bedford

No. Some European countries have the zero or 20 mg per 100 ml as the limit. The UK has a higher limit at 80 mg per 100 ml but the majority are down to 50 mg per 100 ml. Several countries have 20 mg per 100 ml already. When we reduced the level from 80 mg to 50 mg per 100 ml, there were only three countries, the UK, Malta and ourselves, at that higher limit. The United Kingdom is still the same.

Is there a move to lowering the limit?

Dr. Declan Bedford

Yes. The evidence has become clearer over time. If one looks at what has happened in the past 30 to 40 years, the move is downwards.

The levels are reducing downwards. When people are on holidays in a different country, they might be confused about the drink driving limit. That is a problem if they are caught. Tomorrow, the 21 September, is a day when it is hoped there will be no fatality on our roads across the European Union. I welcome that initiative. I welcome countries working together. I would like to think that perhaps we might set the standard in terms of pushing for a standard lowest possible limit across Europe. I know that each individual country makes up its own mind, but the evidence is very clear - one should not drink and drive.

Dr. Declan Bedford

That is correct and that is the message we are giving to people who will be driving when on their holidays abroad. The message is to not drink and drive. The risks probably are rising because they drive on the wrong side of the road compared to us. Our message would have to be to not drink and drive when on holidays. It would be helpful if there was a standard level across Europe so that people would know the rule.

I thank Dr. Bedford.

Sitting suspended at 4.55 p.m. and resumed at 4.56 p.m.