Road Safety Bill [HL]

I have tabled Amendment No. 114 in this group. These are extremely important amendments. I am grateful to my noble friend Lord Hanningfield for moving his amendment and to other noble Lords who have spoken. I agree with most of what my noble friend has said, but I have a slightly different approach. All noble Lords agree that we have an opportunity for improvement. We know that the Minister is probably not keen on introducing a major first-aid test into the driving test. The Driving Standards Agency—the DSA—should be employing driving examiners, not first-aid examiners. However, we could require either a first-aid certificate or evidence of first-aid training. Another difficulty with the approach is that youngsters taking their driving test have enough on their plates at that point in their lives. In addition, they will do only the bare minimum of study and then forget what they have learnt. We have a life-skill problem, which I hope that many of us will pursue, particularly when we debate education and health matters. After Second Reading, mindful of the Minister’s anxieties about new tests, I sought a high-quality briefing on the matter and I was lucky enough to be briefed by a senior emergency medicine consultant. I circulated a report of my meeting to many Members who were present at the start of the Committee. Aside from the general discussion on first aid, he was at pains to emphasise that the casualty would die in four minutes, as my noble friend Lord Hanningfield pointed out, if three key life-saving actions were not taken immediately: procure an airwave; immobilise the neck; and detect and control external bleeding. A casualty is very lucky if he has a competent first aider attend him in the first few minutes, but that is all it takes to die if the immediate action drill is not carried out. However, he would be unlucky if he did not have a competent first aider in seven or eight minutes. The logic is as follows: the casualty will die in about four minutes if his airway remains blocked. Therefore, if the casualty is unconscious, the head needs to be carefully brought back and the jaw pushed forward: that opens the airway. If the casualty is speaking or trying to do so, there is not a breathing problem or an airway problem. The neck must be kept immobilised because the spine could be severely damaged: if one does not know, play it safe. The casualty should not be moved from the vehicle unnecessarily. Lastly, there needs to be a check for bleeding. The casualty can bleed to death in a few minutes from external wounds, but normally it can be stopped simply by applying pressure using anything, not just a sterile dressing. The casualty might be bleeding internally, but additional external bleeding will reduce the chances of survival. If we did decide to introduce some element of testing, what should be done—especially if we want the DSA to employ driving instructors, not first aid testers? It is very simple. All that is needed is for the candidate to demonstrate at the test centre attempting to communicate with the casualty—““Hello mate. How are you doing?””—procuring an airway by carefully tilting the head back and pushing the jaw forward if necessary, and immobilising the neck and holding it still until more skilled help arrives. The candidate should then state the need to the examiner to search for bleeding and demonstrate applying pressure to the wound to stop the bleeding. It is as simple as that. Those are the three things that must be carried out immediately, in the first four minutes. There are a number of obvious advantages to this approach. It is a drill involving almost no diagnosis and no specialist skills are required to train or test it. Young drivers would find it easy to explain among themselves how easy the drill is, which means that they will not forget it. There is also a hidden advantage. Passing the driving test is not easy and a certain amount of bottle is required. If the examiner is able to tell the candidate that he has passed part of the test, it is bound to help the candidate’s confidence. The Minister could increase the number of first aid questions in the theory test, but the problem with such an approach is that unless a full-blown first aid course underpins the candidate’s knowledge, he or she will quickly forget. At Second Reading the Minister mentioned the difficulty of candidates who are squeamish. While the drill I have described will cover most cases, it might be sensible to provide for some exemptions with a doctor’s certificate. It would be far better to dispense with all the theory questions and go for a very quick practical assessment that tests only the ability to procure an airway, immobilise the neck, and detect and control bleeding. It would mean about 30 seconds’ worth of practical testing with a dummy. Finally, I should like to remind the Committee that this is not my interpretation of first aid requirements at road traffic accidents; it is derived from a briefing by a senior emergency medicine consultant.