Relative risk of death per kilometre travelled by age group in South Australia (source: Transport SA)

Radio National’s Background Briefing program ran a story on Sunday, At the end of the road, about the growing number of older drivers. It looked at the evidence for compulsory licence retesting of older drivers and the social impact of forcing them off the road.

NSW is the only state with mandatory age-related driver testing. From the age of 85, drivers must either sit a bi-annual driving test or opt for a restricted licence that limits their driving e.g. only during daylight hours; or within a restricted radius of their home (1).

The case for testing is that the number of elderly drivers is increasing and they’re over-represented in casualties.

The number of drivers aged over 85 in NSW increased 94% in the five years up to June 2011. There were just 2,492 drives aged 90 and older in 2005; now there are 8,406.

Fatalities and serious injuries for all drivers declined 14% in NSW over the last 10 years. However according to the NSW Centre for Accident Safety, older drivers fared far worse. There was a 50% increase for drivers aged 75-plus. For drivers aged 85-plus the increase was 111%.

Older drivers are under-represented in crashes because on average they drive less but they’re over-represented in casualties. Their greater frailty means they’re more likely to be killed or seriously injured in the event of a crash.

When allowance is made for the fact they drive less, the fatality rate per kilometre for drivers aged 70 years and older is comparable to that of drivers aged 17-25 years (see exhibit).

Given these numbers, the key issue is whether or not mandatory testing makes a difference. Victoria has neither compulsory age-related driver testing nor compulsory medical checks, yet casualty rates for elderly drivers are claimed to be no higher than in other States.

Why that’s the case isn’t clear (2). Perhaps it has something to do with different driving conditions in Victoria. Or it might be that Victorian GPs are particularly persuasive in advising patients who’re unfit to drive to give up.

I’d like to see some reliable data on the relative contributions to crash/casualty outcomes of driving tests vs medical tests/advice. If most of the benefit is coming from the latter, then requiring elderly drivers to sit a driving test every two years is an unnecessary burden.

Consideration of these sorts of issues isn’t helped by the NSW Government’s refusal to release the report of its Older Drivers Taskforce. It was set up in 2011 to determine if the testing rules for older drivers should be revised.

The Taskforce concluded its deliberations in September this year and recommended no change to the current regime. However some members didn’t see the final report. The Government’s reluctance to release what should be an essentially technical study invites the suspicion that the evidence doesn’t support the policy (3).

However it comes about, the number of elderly persons who give up driving is set to increase dramatically. As I’ve noted before (see Are older drivers a danger to others?), this will lead to a significantly lower quality of life for many people.

For one thing, the elderly are more at risk of casualty as pedestrians than they are as drivers. For another, rates of depression are higher for older persons who can no longer drive. Many have lost partners and live alone, so they value opportunities for social contact.

And managing the basics of life such as shopping and doctor’s appointments without a car is hard for someone whose mobility is impaired. People who suffer age-related problems like incontinence value the privacy of a car and might be reluctant to use public transport.

The ‘non-driving elderly’ is an issue that’s already here. An expansion of home services will be a big part of the solution, but maintaining a reasonable level of mobility outside the home will be much harder.

Big investments in new train lines and suchlike won’t help. Further improvements to the accessibility of existing public transport services for those with restricted abilities would be much more sensible.

The most useful solutions though will be based around cars because they’re private, operate door-to-door, and involve no waiting and transfers. These are important attributes for those whose mobility is restricted.

There’s plenty of scope for innovation around the way taxis are deployed. There’s an enormous fleet of private cars and drivers that could be mobilised too given the right regulatory incentives.

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  1. In NSW, drivers older than 75 must also pass an annual medical test. In S.A., drivers over 70 years must pass an annual medical test.
  2. It’s not helped by staff of the Monash Injury Research Institute publishing research in gated journals.
  3. The report was taken to Cabinet so it’s not accessible under FOI either. Background Briefing reports that the responsible Minister, Duncan Gay, declined to discuss the matter.