BMA votes for cycle helmet compulsion

BikeBiz.com watched the live BMA webcast of this morning’s "cycle" debate. Docs voted by a small margin to argue for cycle helmet compulsion.

David Sinclair, the main proponent of the cycle helmet compulsion debate went against his BMA division’s advice ("sorry, Fife," he said) and argued for compulsion. How did he illustrate this? With a melon strapped into a helmet…

Sinclair called those who oppose cycle helmet compulsion "Lycra-clad freedom fighters."

At close of the debate, Sam Everington, deputy chair of the BMA’s council said: "We’ve had an enormous amount of letters about serious injuries caused by not using helmets."

Odd, but he appeared not to have time to mention the March letter sent to the BMA by 45 doctors and PhDs, urging the BMA to reconsider its helmet compulsion "position", now made into policy by today’s vote.

The list of docs on the letter included many experts, including a senior lecturer in paediatric pathology, a professor of medical statistics, a professor of medicine and metabolism, a consultant psychiatrist, a consultant in emergency medicine, and a consultant in public health.

The non-medical docs included a Fellow in system safety engineering, a PhD in risk assessment and a materials engineer.

TRANSCRIPT OF DEBATE

DAVID SINCLAIR, Fife division, FOR THE MOTION

"I have to declare a competing interest, I sit on the Board of Science.

"I was thinking of dropping this, it’s a water melon, on the floor, to show how effective a helmet is but health and safety suggested that if the melon does splatter I’ve got problems…

"My division was divided on this motion and I’ve been told by my division to propose this motion in as neutral way as possible. [Laugh from audience].

"Cycling helmets, we all know, are effective cheap devices that save lives and cycling accidents.

"This is incontrovertible.

"The motion recognises we need to move along the road to compulsion some time in the future.

"This debate is about the rights and responsibilities of our society versus the rights and responsibilities of the cyclist in our society.

"It includes the loss of the cyclists’ freedom if he is forced to wear a helmet versus the real risk of death or permanent brain injury if he doesn’t.

"And the effect on friends and family and, indeed, doctors and healthcare workers who come face to face with the aftermath.

"I hope in the debate we do not get many nanny-state jibes from well-intentioned Lycra-clad freedom fighters.

"Remember, remember, the compulsory use of seatbelts was made law in 1981. As part of a caring profession you wouldn’t want that law repealed.

"I also hope we’re not told by jobbing career politician [doctors] of the surveys around the world showing accident reduction [sic] after helmets were introduced.

"Believe me, after the time this motion went in, I’ve been scouring the net and all the surveys are flawed in some way or another, mainly by confounding factors.

"In my summing up I will tell you how I am going to vote, for the adults for I am truly undecided on this point, but in all honesty I cannot remain neutral in the case of children, so, sorry, Fife.

"I firmly believe we have a duty, in the public interest, to try to ensure the safe arrival of our cycling children into normal adulthood.

"Our society accepts children are unable to give informed consent so we legislate for them in various ways. For example, we force them to go to school, we force them not to have sex, we force them not to have the vote. I shall vote for the compulsion of helmets for children because they have not the power or informed reason and because of their soft, developing brains and squashy skull."

RICHARD KEATINGE, North West Wales division, AGAINST

"Compared to the huge health benefits of cycling this motion may seem trivial, After all there are relatively few deaths or injuries to cyclists. It may seem harmless, after all how much harm one centimetre of expanded polystyrene actually do? It may seem a useful protection, it’s been described as uncontroversial.

"None of these things is true.

"Cycling is the best buy in health. Cyclists have a death rate about 40 percent lower than non cyclists. Obese cyclists are rare.

"Helmet laws – wear a lid or get off your bike – powerfully discourage cycling, especially amoing teenagers.

"Every enforced helmet law has been followed by a steep drop, of about 30 percent, in cycling.

"Helmet laws are a grave threat to health.

"Danger? Well, it’s real. The hourly rate of injury is about the same for cycling as pedestrians and motorists. That’s about one serious injury per 3000 years of cycljng. Serious injuries are not that common and the majority of them are due to motor vehicles.

"One centimetre of polystyrene won’t do you much good if you get hit by an HGV.

"No helmet law has shown any effect on the proportion of head injuries to cyclists.

"Helmets laws actually don’t work.

"After all, we’re talking about one centimetre of polystyrene intended to be crushed and absorb the energy of a one metre fall. This is hardly relevant to most serious injuries.

"I’ve been shown broken helmets with the comment, ‘This helmet has saved a life.’ In most cases the foam wasn’t even crushed. Helmets are far more fragile than even children’s heads. Most broken helmets have simply failed.

"To repeat, helmet laws don’t work, for either adults or children.

"This motion calls for an intervention which fails to reduce head injuries, which gravely harms health by reducing cycling and which even strangles a few children on their own helmet straps.

"We have not had a thorough review of the evidence. Until we do, we as a scientific association, I suggest, have no business passing this motion.

"If we do pass it, we will be faced with loud and well reasoned opposition from organisations which should be our friends.

ANDREW WEST, no constituency listed, FOR

"I’ve been working in emergency medicine for 20 years. I’ve lost count of the amount of times I’ve had to repair head and forehead lacerations and abrasions.

"I think two or three times I’d had to refer the patient to the plastic surgeons to find some way of covering the exposed bone. These are all patients who have come off their bikes one way or the other.

"I feel that, I take that, I accept that injury to the brain, depends how you define head injuries but injuries to the brain not affected a great deal by helmets but helmets do protect the shredding of the scalp. I feel that we should support this motion as it protects the scalp even if it doesn’t protect much else.

DAVID DEAN, medical students committee, AGAINST

"I always wear a helmet but wear it correctly. Most children and adults I see wearing helmets, wear them like this [helmet is pushed back off Dean’s head]. This motion should be addressing educating people how to wear a helmet so that those who choose to wear a helmet wear it correctly.

"Focus on benefits of cycling not forcing punitive measures on cyclists which will discourage cycling and which don’t address the real issue and that’s that car drivers need to be more considerate of cyclists.

SIMON MINCOFF, JVC, FOR

"Cycling can be dangerous. Personally, I want to protect the contents of my bonce and that’s why I wear a helmet and I wear it properly, over my forehead. I don’t want to be an organ donor.

"I know I look like a wally with my cycle helmet on, we all do, but as I say I’m cycling for my health and I want to look after myself. Please support this motion."

PETER WARD, Gateshead, AGAINST

"Most people in this room will not be regular cyclists. The Transport Research Laboratory’s research has found that cycle helmets are much more highly regarded amongst motorists than cyclists. And only 22 percent of cyclists wear them regularly.

"Every single vulnerable road user lobbying group, including RoSPA, every single cycling group in Britain, and in Europe, oppose a cycle [helmet] law. If the BMA would like to project an image of being anti-cycling, go ahead and pass this.

"Cycle helmets are designed to absorb impacts similar to a fall from one metre at 13mph. They are not designed to protect against collision with vehicles.

"The biggest contribution the BMA could do with this is to support cycling, join with cyclist’s lobbying groups and help us increase cycling.

"The BMA’s own position on this should be ‘if a helmet gets you cycling, wear one. If a helmet puts you off, don’t wear one.’ Here’s for a pro-choice BMA."

PROFESSOR SIR CHARLES GEORGE, chairman of the committee, FOR

"Er, the first point is in 2002, 594 children and 1801 adults were killed in road related traffic accidents. The second point is that actually there are controlled-trial studies that were reviewed by the Cochrane Colloboration and they reckoned the reduction in brain injury was by 65 to 88 percent.

"Of course, the Board of Science continues to lobby for other ways of protecting children and adults from injury by safer cycling environments and so on."

[EDITORIAL NOTE: Why did Sir Charles list ALL deaths from all traffic cause and not just the small number of deaths from cycle accidents? Here’s what anti-compulsion campaigner Guy Chapman has to say about the 88 percent stat: "I suggest the following litmus test: any submission which advances an efficacy figure of 85% or 88% should be discounted. These figures come from a single study and were revised downwards in 1996. Continued use of the higher figure indicates either insufficient research or a deliberate attempt to mislead."]

SAM EVERINGTON, Deputy Chair of Council, FOR

"Two things I want to add. We’ve had an enormous amount of letters about serious injuries caused by not using helmets.

"The second thing I wanted to add, to mention, was the parallel to the boxing ban. The thing that really put the issue of brain damage caused by boxing on the agenda was a call for us to ban boxing. That has enormous power in terms of generating interest in the whole issue of these sort of injuries. So the point I would like to make, keep in mind the strength of calling for some sort of compulsory use of helmets on the impact that will have of bringing the whole issue of cycling and cycling safety to the public. I would possibly suggest to you that it wasn’t until we generated this debate that this hit the headlines."

VOTE

Cards waved in air. Looks too close to call but both motions carried with statement from platform there had been a "reasonable majority." At this there’s murmuring from the floor. "Yes, it is carried," said disembodied voice from platform. Earlier in the day, motions with close votes had been put to an electronic vote, not so for helmet compulsion.