Introduce 20mph limits and GDL to improve child health: RCPCH

12.00 | 20 November 2014 | | 36 comments

A leading children’s health organisation is calling for the next Government to introduce a national 20mph zone across residential areas and graduated licensing for novice drivers of all ages, as part of a suite of measures to improve the state of child health.

The Royal College of Paediatrics and Child Health (RCPCH) says Britain faces “serious consequences” unless politicians “value our children as much as the elderly”.

In its manifesto ‘Vision2015’, launched earlier this week, RCPCH challenges all political parties to commit to a series of measures that it says will radically improve the state of child health in the UK.

The report says the UK’s child mortality rate is the second worst in Western Europe and that Britain is dubbed ‘the fat man of Europe’ – with a third of children overweight or obese by the age of nine years.

Writing in the foreword, Dr Hilary Cass, RCPCH president, says there will be ‘serious consequences’ for inaction on improving children and young people’s health given that half of the top 10 risk factors for the total burden of disease are initiated or shaped in adolescence.

Dr Cass says: “The main focus of health and social care policy from successive Government has been on meeting the needs of an ageing population. Many of the big ticket policies  – such as pension increases, winter fuel allowances and free TV licences – have made a welcome difference to many older people. We now want to see equal focus given to our younger population.”

One of the recommendations to tackle the UK’s poor childhood mortality rate is to “reduce the national speed limit in built up areas to 20mph to reduce the number of deaths by road traffic accidents”.

It is also lobbying for the introduction of graduated licensing schemes for novice drivers of all ages “which has been shown to reduce road related deaths in countries that have applied it”.

Other measures the Royal College is calling for include restricting advertising that encourages unhealthy eating and preventing children from having cheap access to alcohol.

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    Eric
    I am rather surprised at your comment. The definitions are not “mine” but simply pulled from various dictionaries from a Google search.

    Your comment about me not referencing the effectiveness of road safety interventions is even more bizarre. The title of the Fred Wegman paper I referenced is “Improving the effectiveness of road safety campaigns: Current and new practices”. It gives a very good overview of this exact issue.

    Your constructed “unintended consequences” are not fact but merely your own theories. The “toxic mix” is a product of your imagination.

    Your talk of 1960’s housing also misses the mark. Many would say that today’s housing crisis is the outcome of libertarian, market forces displacing the planned development of public sector social housing.

    You miss the point of the 20/30mph impact speed issue. Most people, councilors and RSPs recognise that the real issue is about a 20mph prevailing speeds near miss compared to a 30mph injury, and of all the wider societal benefits beyond casualty reduction.

    If there is a scandal it is the constant call from those who can drive, those who do have spacial and visual acuity, the fit, the healthy to deride those who don’t for daring to be using the roads at all.

    I celebrate the fact that we are developing a new social consensus about how we share those public spaces between houses that we call streets for all rather than just a privileged few. And yes that is ruffling a few feathers and uncosying a few vested interests. But that is the stuff of social development and progress.


    Rod King, 20’s Plenty for Us
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    Rod
    I note that none of your definitions, or your other text, include a measure of how effective the teaching, or methods aimed at risk reduction, actually are in terms of reducing collisions or casualties.

    I don’t doubt that the 20’s Plenty campaign began with the best of intentions, but the unintended consequences (pedestrians taking less care, speeds on some roads increasing, drivers with lower concentration through driving at unnaturally slow speeds – altogether a toxic mix) have exposed the flaws in the 20mph approach in terms of effects on casualties and collisions. At last year’s Conference I compared your solution-based campaign to the building of high-rise blocks in the 1960s to solve the housing crisis – that has since been discredited, and I’m confident that 20mph will be in due course. I suspect that analogy partly explained the swing in support among the delegates away from you in favour of me.

    The fact that councils have been persuaded to spend millions on implementing 20mph zones and limits, and some health professionals have swallowed the “hitting people at slower speeds kills fewer of them” argument, is a national scandal.


    Eric Bridgstock, Independent Road Safety Researcher, St Albans
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    Eric

    “Road Safety” is defined variously as :-
    “teaching people how to behave safely when driving or crossing the road:”

    “the avoidance of danger on the road”

    “methods and measures for reducing the risk of a person using the road network being killed or seriously injured.”

    and Fred Wegman says :-
    “Road safety campaigns can be defined as purposeful attempts to inform, persuade, and motivate a population (or sub-group of a population) to change its attitudes and/or behaviours to improve road safety, using organised communications involving specific media channels within a given time period [2].”
    See http://www.sciencedirect.com/science/article/pii/S0386111211000045

    Personally I prefer to use the term “Road Danger Reduction”.

    So, yes, 20’s Plenty for Us does play a part in reducing road danger and increasing road safety. And, of course, I am very proud to have been awarded an MBE for “services to road safety”.


    Rod King, 20’s Plenty for Us
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    Eric:
    Re-your statement “Such careless behaviour can be seen in every area where limits have been reduced from 30mph to 20mph…”

    Is that based on ‘research’ you have carried out yourself having travelled around the country visiting all these areas and spending time at each one observing such behaviour?
    Mind you, why waste time researching something when you can simply conjour up a desired scenario?


    Hugh Jones, Cheshire
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    Perhaps if Eric calls himself an Independent Road Safety Research…er then that’s different but what’s in a name? I think this is going off thread of the article

    What’s obvious to me and no doubt many others is that there appears to be a great divide between the 20 is plenty brigade and supporters and those that don’t. A lot depends to a great extent on evidence although one would have thought that evidence should already be available as some towns/cities have had areas with 20 mph limits for quite a few years and yet there is no empirical evidence either way.

    What I do see to my mind is from time to time supporting reports from authorities or paid for by authorities supporting their (authorities) previous decision to make some roads into 20 mph areas. As a retired police officer I am in no doubt that those in power, no matter what power they have, will ever do a U turn so I don’t expect any changes in the meat of those reports. We can in the future expect every LA to report benefits to 20 is plenty as with Bristol it was at a cost to taxpayers of 2.5 million.

    Only an independent authority or body with no axe to grind and no political masters would ever be able to satisfy the criteria required to make a comprehensive and credible report.


    bob craven Lancs
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    Rod
    I note that you do not answer my points just toss back your own questions.
    Empirical: “depending upon experience or observation alone, without using scientific method or theory, especially as in medicine”.

    Such careless behaviour can be seen in every area where limits have been reduced from 30mph to 20mph, and where vulnerable road users have been encouraged to feel safer. You remain in a state of denial about the unintended negative effects of the path you have chosen to pursue.

    Now please address the question – is 20’s Plenty a road safety organisation, and on what basis?

    I do not set out to mislead readers and so have added two letters to my sign-off.


    Eric Bridgstock, Independent Road Safety Researcher, St Albans
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    Eric
    So where exactly is this “wealth of emperical evidence” that 20mph limits are factor in children “walking into roads without looking”? If you could provide the links to the reports and sources then I would be interested.


    Rod King, 20’s Plenty for Us
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    Eric:
    I’m sure nobody is doubting that you’re ‘independent’ in the sense you describe. I am ‘independent’ as well as, no doubt, are many other contributors – it’s not that big a deal. However, to be fair, ‘Independent Road Safety Research’ to the uninitiated does sound like some official body or organisation and not just somebody’s hobby. To use that title does suggest impartiality, objectivity, specialist knowledge and practical experience of the subject and not just somebody with a personal gripe about speed management.


    Hugh Jones, Cheshire
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    For the record, referring to one of Rod King’s earlier comments, I have no theories that “faster is safer”. What I have found is that slower does not automatically equate to safer, and that speed management activity can introduce hazards which more than negate any casualty/collision reduction benefits expected from them.

    Further, I have never claimed that “Independent Road Safety Research” is an organisation – it is what I do in my spare time, entirely independent research into road safety, entirely self-funded and with no vested commercial interest or other undue influences. My work is founded on safety engineering principles rather than emotion.

    Perhaps Mr King would confirm that he still considers “20’s Plenty” to be a road safety organisation when he has no evidence of any casualty/collision reduction attributable to a reduction of a speed limit to 20mph, and accumulating evidence that 20mph is bad for road safety?

    Finally, he has not responded to my suggestion that the 20mph could have been a factor in the boy walking in the road without looking. I suggest that he cannot rule it out any more than I can categorically state that it was (but there is a wealth of empirical evidence that that is the case).


    Eric Bridgstock, Independent Road Safety Research, St Albans
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    I agree entirely Hugh as no doubt you are aware I was pointing out that the slower the movement of the vehicle the greater the risk. A risk that a pedestrian will not be seen and will therefore be at a greater risk to life and limb.

    From my own knowledge of Blackpool (over 50years of it) when the illuminations are on and traffic is tightly packed and travelling at less than the 20 mph speed limit pedestrians take chances of crossing. As they are so close to the vehicles in motion they will or may not even be seen in the peripheral vision of the driver who at that time is concentrating heavily on the vehicle in front and not what is going on at his nearside. It may be the case that he may have previously seen them and they may be aware that he is there but sometimes as a driver one doesn’t believe that anyone could be such an idiot to run out in front of or into the side of a moving car no matter what slow speed they may be doing. Bad lighting and the brightness of brake lights at a close distance don’t help as they create glare. That’s mainly the pedestrian’s fault and that’s why we need the Green Man back.

    Therefore, and this is my argument…..if more space is given between vehicles it enables the driver to take more time to look and see around him and identify more potential dangers and react to alleviate or mitigate any danger that may present itself.


    Bobn Craven Lancs GIVE SPACE NOT SPEED CAMPAIGN
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    That’s fine Bob if we’re only concerned with vehicles only ever hitting the one in front, but the 20s are primarily for the benefit of pedestrians who may suddenly enter into the path of a vehicle from the side, so whilst maintaining a safe stopping distance is still valid, it needs to be also with respect to that part of the road ahead where a pedestrian may suddenly appear – typically from between parked vehicles. For those drivers who do not anticipate or think about this possibility, the slower we can get them to go, the better chance they will have to stop in time.


    Hugh Jones, Cheshire
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    I agree with Derek but also from experience and observations I would say that if you look at heavy traffic vehicles they are in fact travelling at 20 mph or even below. The gap gets less and less to the point that everyone is dangerously tailgating. It’s not just the relevant speed that is the danger, the other consideration has to be distance. In many circumstances vehicles can drive giving further distance, it’s just that they don’t. They also believe wrongly that if the vehicle in front applies its brakes that they can easily adopt the same braking and stay behind that vehicle. Not so when the vehicle in front has a collision and no brakes are used. No amount of braking can stop a rear end collision if too close.

    It’s not speed, it’s distance relative to that speed is the main problem. If vehicles were far enough away there would be fewer accidents. Drivers could see more and respond quicker to any approaching danger and they will be seen sooner by other road users.


    bob craven Lancs
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    To continually counter a question with another question shows a lack of belief in one’s own sincerity or research. As much as 20’s plenty would appear to be a logical step towards safer roads, it fails to show any improvement, not least due to the fact that as drivers slow, they are more distracted. As traffic slows pedestrians also become more blasé to its proximity. One does not need to be a scientist or qualified researcher to understand the basics of road safety, simple logic and experience is all that is needed. It’s not rocket science.


    Derek Reynolds, Salop.
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    True Duncan
    Anyone can stop at a known and given point and so does not require the thinking distance. Just the braking distance which is only one part of the equation.

    All the info yet collected and understood puts the thinking distance at 20 mph as 20 feet being 2/3rds of a second (vehicle travelling at 30 feet per sec.) then comes the braking distance understood to be 22 ft. A total of 42 ft. and not the 32ft or 10 metres as described in the article.


    bob craven Lancs
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    Rod and others
    Have you considered why “a young boy stepped out from between two parked cars in Cotham Road” and whether the road being a 20mph limit may have led him (or his parents?) into a false sense of security/safety? As is so often the case in safety matters, the law of unintended consequences can rear its ugly head.


    Eric Bridgstock, Independent Road Safety Research, St Albans
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    On the contrary, Tau were one one of my favourite bands of the ’80s – who can forget ‘China In Your Hands’.


    Hugh Jones, Cheshire
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    When Hugh says that that the lower the speed, the more time there is for seeing, reacting and stopping (under control) he is not taking into account the Tau of the precipitating event that would cause us to stop in the first place.


    Duncan MacKillop, Stratford on Avon
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    Bob:
    I tried it when I was out this morning – level road, slightly damp, trailing throttle – it is possible to stop in 10 feet from a steady 20mph. Obviously we don’t know what the gentleman was driving, or his usual driving style and reaction times etc and there may have been some embellishment for the purpoes of a news story, but the principle remains the same, that the lower the speed, the more time for seeing, reacting and stopping (under control).


    Hugh Jones, Cheshire
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    Bob
    No demeaning is intended, merely a clarification of what those “research credentials” are. When someone labels themselves as a “research body” then it seems reasonable to ask what research has been done and whether that has been peer reviewed or accepted by any recognised journal. I will leave others to judge on any such information that is forthcoming.


    Rod King, 20’s Plenty for Us
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    Rod:
    Twice now you have requested or should I say called into doubt a person’s credentials. Presumably because you do not believe that they share the same views as yourself. This is not the first occasion that you fallen back to this ploy. I assume therefore that you believe that you cannot win an argument without demeaning the other party. That is only an assumption on my part and not based on any fact at all so you can discredit it as you no doubt will.


    bob craven Lancs
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    Rod
    Going back to the link from Bristol Post etc. I would have though that you or your researchers would have thought twice in quoting that in defence of your programme.

    The 20 mph limit was implemented a short while ago by the mayor, and before then and subsequently it has been constantly attacked by the Conservative group. This is reported in that paper. The author of your example story is a developer and restaurenteur who by all accounts is not unknown to the mayor and some say they are both Directors of a company together. That might be hearsay but it’s what some locals believe.

    As regards to his avoided incident at 20 mph it would take 42 ft to stop and yet he stopped in 10 foot less. That’s amazing by anyone’s standards, so it does draw doubt upon the veracity of the report you quote.


    bob craven Lancs
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    It is clear that Public Health professionals are taking an increasing interest in the aspects of transport policies that effect public health. Often the “bigger picture” and wider opportunities for engagement can enable them to have a very positive influence on transport. For a PH perspective then I would recommend the “Essential Evidence” pages of Dr Adrian Davis of Bristol. This may be seen at http://www.travelwest.info/evidence


    Rod King, 20’s Plenty for Us
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    Eric
    My mention of “research” was only because “research” is what it says on “your tin”. Surely a reputable “research” organisation would be interested in uncovering such stories, especially if their like would be so important in you contemplating your theories of “faster being safer” and whether they are true in the “real world”. As a “research” organisation perhaps you could point to any research paper you have had peer reviewed and published. This would enable everyone to gain a better understanding of your research credentials.


    Rod King, 20’s Plenty for Us
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    Idris
    I will leave Nick to defend whether his report was meaningless or not. But turning attention to your “report” on Portsmouth.

    Did you take into account that there were a core of 20mph zones which were not included in the 20mph implementation report but were included in your figures for post report periods. Note that Stats 19 does not differentiate between the core zones and the limits! Did you compare to the national trend for all roads (including A/B roads and motorways) or just urban roads? Did you compare any peer cities such as Southampton which is of similar size with the same Stats 19 reporting constabulary? Did you consider tthat KSI’s (as you so often mention in other comments) are a poor indication of road danger due to their smaller numbers at local authority levels?

    With regard to your comments on fuel emission then did you take into account the views of DfT who say that emission and fuel use reduces with 20mph unless an unnecessarily high gear is used? Did you take into account Peter De Nayer who found that for many cars 20mph is the most economic speed? See http://www.telegraph.co.uk/news/2109539/Fuel-prices-Slower-driving-can-save-motorists-500-a-year.html

    Did you take into account the work of Imperial College , London who concluded that “It is concluded that it would be incorrect to assume a 20mph speed restriction would be
    detrimental to ambient local air quality, as the effects on vehicle emissions are mixed”. They made particular note of 20mph drive cycles having a beneficial effect in reducing diesel emissions compared to 30mph.

    See http://www.cityoflondon.gov.uk/business/environmental-health/environmental-protection/air-quality/Documents/speed-restriction-air-quality-report-2013-for-web.pdf


    Rod King, 20’s Plenty for Us
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    The RSGB article from which Rod extracted his reference lists all the things it did not consider, making its results all but meaningless. In particular, it failed to differentiate between all collisions/injuries and fatal/serious injuries. As I have mentioned here before and as confirmed in detail on my web site, Portsmouth data shows a steadily worsening KSI trend compared to elsewhere, by the 4th year 50% higher than had it followed national KSI trend.

    To be fair, the article emphazised the lack of meaningful data and its implications. I agree with that, and with the call for a long-overdue competent, unbiased and thorough analysis of the evidence, much of which must be available in Stats19 data even if it has not yet been collated as it needs to be. Until then, all claims of benefit are no more than wishful thinking.

    Another point – whatever the medical skills of the doctors involved, I very much doubt that they know much at all about road casualty statistics, or for that matter that engines put out more harmful emissions at 20mph than 30mph, or that catalytic converters run too cold at low speed to be effective.


    Idris Francis Fight Back With Facts Petersfield
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    Eric:
    If the ‘bad driver’ hadn’t been restrained by the ’20’ limit and a KSI had resulted, I think you would be shouting it from the rooftops as ‘evidence’ that the 20s are ineffective. Put your prejudices to one side and show that you’re genuinely concerned about road safety and acknowledge that a child fatality/injury DID NOT HAPPEN (to borrow your upper case emphatic proclamation) when it might otherwise have done.


    Hugh Jones, Cheshire
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    Rod
    There are so many things wrong with that story, it would never count as “research”. I asked for an accident (a collision) that would credibly not have happened had a 20mph previously been implemented.

    Your link is an incident that DID NOT HAPPEN and it is no more than the driver’s assertion that “when a young boy stepped out from between two parked cars in Cotham Road he says he is “absolutely sure” he would have hit him if had he been driving any faster than 20mph”. Essentially, this is an admission that he considers himself a bad driver.

    But the comments below the story lead to various pieces of evidence that the driver is a businessman who is a friend of the Mayor, who has been pushing the 20mph scheme. There are many reasons why he may wish to publicly praise the Mayor but they do not constitute evidence of a benefit of 20mph.


    Eric Bridgstock, Independent Road Safety Research, St Albans
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    Eric
    I thought you were a “research” organisation. How come you haven’t found this :-
    http://www.bristolpost.co.uk/20mph-speed-limit-stopped-running-child/story-23286248-detail/story.html


    Rod King 20’s Plenty for Us
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    Readers may find it useful to see the full article from which Rod extracted his RSGB reference:
    http://www.roadsafetygb.org.uk/news/3161.html

    The article comprises a summary of analysis of before and after casualty data from 10 areas where a 20mph scheme had been implemented.


    Nick Rawlings, editor, Road Safety News
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    I recognise Rod’s RSGB quote and challenged it at last year’s Conference as follows…

    Let’s suppose that the 20mph limit was responsible for the reduced collisions/casualties – how could that have happened?

    In a case where the limit was reduced from 30mph to 20mph, the implication is that some incidents, which would otherwise have happened, have been prevented by the 20mph limit. These must be attributable to law-abiding drivers, who are now travelling at or below 20mph. As those same law-abiding drivers would presumably have been driving within the previous [30mph] limit, they must have been having accidents that were caused by them driving at inappropriate speeds within that limit. The numbers of such incidents would be, I suggest, very small, and I would welcome an example of an accident where that was the case and where, therefore, it could be credibly be claimed that the incident would not have happened if 20mph had previously been implemented.
    Without such an example, and I doubt that one exists, there is no reason to believe that the 20mph limit was responsible for any falls in collisions or casualties.
    Reductions better than local/national trend will have been brought about by engineering changes, changes in traffic volume, regression to the mean, etc.


    Eric Bridgstock, Independent Road Safety Research, St Albans
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    Derek
    I once heard a story about someone observing a child crossing the road in Switzerland. The child stopped at the side of the road and first a car stopped from one direction and then from another. He then crossed the road.

    Of course in this country we teach children and drivers that the child must wait until either their are no cars (sometimes a long wait given our dependency on cars) or judge the time when there is a large enough gap to cross safely. Of course the latter has the problem that most children under high school age do not have the capacity to judge car speeds reliably.

    Given that UK is about 16th from best in the World league of child pedestrian deaths per head of population then there is every benefit from developing a far more tolerant consensus among drivers with regard to vulnerable road users such as children, elderly, disabled, pedestrians and cyclists.

    And if I can quote from Road Safety GB:

    • Having said that, in half of the 20mph schemes we looked at, casualties and/or collisions were significantly lower than would otherwise have been expected – and in only one of the schemes were collisions higher than would otherwise have been expected.

    • While not suggesting that the 20mph schemes are the only reason for these reductions, it is perhaps reasonable to assume they have played a part in this.


    Rod King 20’s Plenty for Us
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    It’s too general a statement and too tenuous a link to say that lower speed limits will benefit children’s health generally – no doubt what they meant to imply – in the road safety context – is that sometime, somewhere, a child (or even more than one child) will not be hit by a vehicle because its driver will have been going slower than otherwise would have been the case, because of a lower speed limit and most importantly, one that was actually being complied with. In that sense yes, they could say that there is a direct link.

    Doesn’t have to be limited to children either – the elderly; disabled; deaf; partially sighted – all are vulnerable when crossing roads.


    Hugh Jones, Cheshire
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    The Royal College is concerned with child health care to a greater degree than road safety, placing obesity high on their list of concerns. That 20mph limits are mentioned equates to an assumption that they are in fact beneficial to road safety, when no such evidence is available. There is a definitely positive effect that teaching young people basic road crossing lessons is beneficial to their well being – or is this being brought into doubt? Perhaps we can benefit from Rod King’s opinion on that.


    Derek Reynolds, Salop.
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    Unusual that a Doctor should recommend an intervention that’s not based on the results of a double blind trial. Maybe the good Doctor should apply the same reasoning to the licencing of new drugs as without all that tiresome testing, it would make them much cheaper.


    Duncan MacKillop, Stratford on Avon
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    Steve
    You said “I wonder if their manifesto actually suggests teaching the green cross code again, that would have a bigger impact than more speed limits.”

    You can read the whole manifesto by clicking on the link that is on the article. Surely something that would be useful before you comment.

    Regarding your judgement regarding Green Cross Code, do you have a reference to your assertion or is that simply your opinion?

    And if it is your opinion, perhaps you can state any credentials so that a value can be put on that opinion!


    Rod King, 20’s Plenty for Us
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    Sorry, that article seems to have nothing to do with road safety. 20 mph limits seem only to be mentioned to get the article on this site, amongst many other things that will have bigger impact on child health. I wonder if their manifesto actually suggests teaching the green cross code again, that would have a bigger impact than more speed limits.


    Steve, Watford
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