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IN TOUCH – Safety: On the Streets & Early Health Screenings

TX:Ìý 20.09.2022Ìý 2040-2100

PRESENTER:Ìý ÌýÌýÌýÌýÌýÌýÌýÌý PETER WHITE

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PRODUCER:Ìý ÌýÌýÌýÌýÌýÌýÌýÌýÌý BETH HEMMINGS

White

Good evening. ÌýTonight, safety is our watchword – safety on the roads; safety on the pavements, where there are still any left and safety from avoidable illness, are blind and partially sighted people getting the information they need to identify potentially dangerous symptoms?

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But first, for more than a decade now there’s been a feeling amongst many visually impaired people that getting around is becoming more difficult and that policies which could make the streets safer for blind and partially sighted people have been taking a back seat.Ìý In particular the increased prevalence of so-called shared spaces, where vehicles, cyclists and pedestrians are expected to mingle have proved controversial and unpopular with many blind people.Ìý Well now, the High Court has given permission for a judicial review brought by a visually impaired woman over the Department of Transport’s guidance on tactile paving.Ìý The argument hinges on the height of pavements and the extent to which they give blind walkers a clear demarcation between relatively safe pavements and the potentially dangerous road.Ìý

The woman in question is Sarah Leadbetter and she joins me.Ìý Sarah, before you spell out your quarrel with the Department of Transport, tell me about the incident which gave rise to your bringing your case.

Leadbetter

Me and my two friends was in Manchester with my guide dog Nelly, we had to go to one of the shops, Primark, we went to cross the road, there was no kerb, there was no tactile paving, there was no control crossing box or rotating cone and one of my friends is completely blind, he didn’t realise that he’d gone into the road and also my guide dog, her paws, was in the road too.Ìý But the other thing was we had to get over just not that room but tram tracks as well.Ìý And luckily for us, there was a member of the public that said – come along, we will help you cross the road.Ìý But we didn’t know that we’d gone from the pavement into the road because there was no kerb there to stop us or to warn us and it was very dangerous for us.

White

Now I think the judicial review is not specifically about shared spaces, so can you explain precisely what it is you say the Department of Transport has failed to do?

Leadbetter

Not putting the minimum of 60-millimetre kerbs.Ìý In the tactile paving guidance, there is only like a small kerb, like most places will have a very tiny lip and a lot of people are tripping over that, they don’t even know they exist, they can injure themselves and really a 60-millimetre kerb is the minimum because a long white cane user or a guide dog user will know that there’s a kerb there – oh yes, that’s the stop of the pavement and you’re about to go into the road.Ìý And because the pavements, everywhere we go, are completely flat we’re just walking straight into the road, it’s dangerous and this is the part that I am actually very keen that they actually rectify by having the judicial review.

White

Now I suspect that quite a lot of people will understand why this is crucial for someone using a cane, you’ve explained it really clearly, you locate the substantial drop with your cane and if there isn’t one there you miss it.Ìý What’s the problem, specifically, for a guide dog user?

Leadbetter

What it is, the guide dog from a young age they are taught to go from one kerb, walk a straight line either to the edge of the pavement nearest to the road or in the middle and what you do is go to the next kerb, they know that kerb is there to keep you safe and they stop.Ìý If there’s no kerb there whatsoever that dog doesn’t know and it’ll just walk straight into the road.Ìý So, it’s crucial really because their training includes kerbs.

White

Isn’t part of the idea of lower gentler pavement drops to make them easier to negotiate for wheelchair users?

Leadbetter

Exactly but what we still want is the actual 60-millimetre kerb at one side and then at the side of it the gentle drop, like you’ve just been talking about for the wheelchairs too.Ìý So, it is helping and it’s not hindering wheelchair users because they can’t get out on to the road and across the road in their wheelchair.Ìý But also, we, at the same time, need that kerb to keep us safe.

White

Okay, well we did approach the Department for Transport about this, they said they were unable to comment on an ongoing legal case.Ìý We are joined, though, by Andrew Hodgson, who’s President of the National Federation of the Blind in the UK.

Andrew, your argument, I believe, or your concern is that there has been consultation with the federation over this but that your recommendations have been ignored in the department’s access guidance.Ìý I mean what did you advise?

Hodgson

We advised that there should be a 60-millimetre kerb as a minimum and that seems to have been ignored, so that is why we’re very pleased that Sarah’s taking the case out on our behalf.Ìý There are other aspects of the legislation that we don’t like as well but it’s not the legislation, it’s the guidance, that we don’t like but in due course we might be taking up that but for the moment we’ve been advised that this is the issue that we should take up.

White

What is it you’re saying is the overall effect of this on blind people’s attitude to negotiating the streets?

Hodgson

I think the overall effect is that we’re going to, I believe, be coming on the issue of e-scooters shortly as well…

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White

We are, yeah.

Hodgson

…people, especially those who aren’t that confident, are afraid to go out or nervous to go out.Ìý In years gone by, going out was relatively easy when you didn’t have so many pavement obstacles and there were standard kerbs and so on.Ìý And we realise, of course, that there have to be changes to make the environment more accessible for wheelchair users.Ìý But, nevertheless, we feel that the legislation that was brought in for safer streets on the outset of the pandemic was not that well thought through.Ìý The pavements were widened, there’s less space for cars and the vendors – the cafés – have spilt out onto the pavements and are taking up more space, this too is a hazard for visually impaired people.

White

Let me go quickly back to Sarah.Ìý What’s the timescale on your judicial review, when’s the case going to be heard?

Leadbetter

We’re now going to be waiting for a date in January of next year.

White

Okay, well stay with us, both of you because this hasn’t been the only development which has been seen as creating more hazardous roads, as Andrew mentioned.Ìý The increasingly visible or for blind people invisible presence of the e-scooter on our roads, and even more alarmingly on our pavements, has also been causing great concern.Ìý Now the government has been running trials in a number of towns and cities because they see the e-scooter as a cheap and non-polluting alternative to the car.Ìý But there are signs that the e-scooter might be about to take a backward role, as it were.Ìý Kent County Council is the latest local authority to decide to discontinue the government’s pilot scheme after being offered the chance to extend it to 2024.Ìý Well, KCC’s cabinet member for transport, Councillor David Brazier, said he’d decided to truncate the scheme before someone was seriously hurt and he told Michelle Hussain, on the Today programme, why they’d initially adopted it.

Brazier

The agreement from us to permit the scheme, that’s to say allow these scooters on the roads around Canterbury, was taken after the DFT – the Department for Transport – approached us and said is there a good place for a trial and we said Canterbury, there are two universities there, lots of young people who are likely to be customers.Ìý On the other hand, of course, there are hundreds of illegal scooters in Canterbury and the existence of both categories, if you like, become conflated.Ìý We have almost from the outset been constantly bombarded by members of the public who have had frights from scooters and then after a series of minor accidents a retired librarian, Mrs Sarah Carter, was knocked over by one of the scheme scooters, which should not have been on the pavement, and she was quite badly injured.Ìý She was elderly and she could have been killed.Ìý So, finally, recognising that the country council serves the public, the residents of Kent, I decided that enough was enough.

White

That was Councillor David Brazier.Ìý

Sarah Leadbetter’s still with us.Ìý We should stress that lady herself wasn’t visually impaired, certainly as far as we know, but have you had any brushes with e-scooters?

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Leadbetter

Oh yes, definitely.Ìý When – well at the time I was doing some filming in Birmingham and I was stood with my retired guide dog on one side of the pavement and the person on the e-scooter was on the other side of the pavement and knew we were there and just came straight at us, at the last minute he did veer off but he slightly clipped Kiki.Ìý But all he wanted to do was go behind us and put the actual e-scooter in the rack behind me.

White

Right.

Leadbetter

On the pavement.

White

Andrew Hodgson, of the National Federation, new technology always takes a time to bed in and requires the right forms of controls to be developed.Ìý I mean so it was with the motor car, although some would say we never got that under control, is there a danger that blind people could be seen as the kind of luddites of the 21st century in these kinds of debates?

Hodgson
I think there are wider points to these.Ìý These scooters are actually unfit for purpose structurally in any case, they’re such a danger to the riders.Ìý The companies that are organising these trials, together with the councils, haven’t come up with proper ways for these scooters to be parked.

White

So, what would you like to see so far as the e-scooter is concerned?Ìý Are you suggesting that they shouldn’t be on the roads at all?

Hodgson

I think we’re suggesting that, yes.Ìý

White

And Sarah?

Leadbetter

Even if there’s new technology and like you’ve said, there’s people that are on them and riding them who will not stop riding all over the pavement, people don’t know they’re coming at them or from behind them and they’re also laid down on the floor, they’ve just been left all over the place and people can injure themselves or have accidents and it’s not safe, so yes, the trials need to be stopped and also curbing the buying of the ones from the shops too.

White

Sarah Leadbetter, Andrew Hodgson, thank you both very much indeed.

Ìý

Now, still on safety but of a rather different kind.Ìý We’re always inviting you to put questions to us but I have to say that when GP Katie Elliott got in touch with us, to ask how visually impaired people got their information about important health screening programmes, we rather turned the tables on her.Ìý Katie is also Clinical Director at the Northern Cancer Alliance and therefore the perfect person to ask what we should know, she agreed.Ìý

So, my first question was:Ìý What are the main cancer screening programmes that we should be aware of?

Elliott

The three main cancer screening programmes and that’s the breast cancer, cervical cancer and bowel cancer screening programmes and there are also some newer programmes in development, so that’s the targeted lung health checks that some people might have come across or been invited to.

White

And how are people actually meant to get information about these programmes?

Elliott

So, anyone who’s registered with their GP would automatically be invited when they become eligible and it’s based on certain age groups that are eligible for each programme.Ìý So, as long as you’re registered with a GP, you’ll get an invitation.Ìý And you’re able to let the screening teams know if you need that information in a different format, in an accessible format.

White

Well, this is what goes to the heart, in a way, of your inquiry to us because I suppose my question, in a way, is how will you initially get that information, particularly if you haven’t got round to telling your GP how you want information.Ìý I mean if you don’t go regularly to the doctor’s, you don’t see the adverts up when there’s a campaign on, you could easily get missed, couldn’t you?

Elliott

Yeah, so I think it all does come down to getting that initial appointment.Ìý So, the first thing, absolutely you have to be registered with a GP and then if the GP knows about accessibility information, then, with your permission, we can then pass it on to the screening team or you can directly contact the screening team.Ìý But I think it’s about that general knowledge, as well, for people to know about screening programmes and that’s why I was really keen to make that we help people to feel aware and confident about accessing the screening programmes.

White

How much is this at the discretion of individual GP surgeries – who does get access to these screening programmes and how they’re told?

Elliott

The invitations for the screening programmes actually come out centrally from the National Screening team.Ìý So, the GPs don’t do the invitations for that at all.Ìý If individuals contact the screening team to let them know about their accessibility needs, then they can make a permanent record on their screening record to make sure that invitations do come out in a format that the person has specified.Ìý The GP part of it, we follow up if people haven’t taken part in screening and that’s where there’s probably some variability.Ìý So, every GP practice is incentivised to get really good uptake of the cervical screening programme and that is something that GP practices do on site.Ìý Whereas the other screening programmes happen somewhere else.Ìý So, breast screening, you have to go to the unit for the breast screening and the bowel screening people have to do at home, I think that’s one of the particularly more challenging screening programmes.

White

And, of course, the problem is that the rules about all these screenings are slightly different, aren’t they – the ages at which you’re entitled to get them, the ages at which they’ll stop.Ìý So, there’s quite a lot of room, isn’t there, for slippage, if you like?

Elliott

Yes.Ìý So, I think it’s for women to know that as they come around their 25th birthday that they’ll be invited and that that screening programme runs till their 60 but there’s a bit of variability as well.Ìý So, initially, the first part of the screening programme’s every three years until you’re 50 and then it’s every five years after that.Ìý And then for the breast screening programme that that actually starts when people are 50, between 50 and 70.Ìý So, it’s things like that that some of those things people won’t generally know about.

White

No.Ìý There are now rules, aren’t there, originally introduced just a few years ago, about people having information in the format that suits them best.Ìý For blind people that could be audio, it could be braille, it could be large print, it could be email, could be text.Ìý Do you think these rules are actually being applied?

Elliott

I think when people make their preferences known that I think quite a lot has been done to try and accommodate that.Ìý But there’s a bit of a mismatch, at the moment, still, Peter, with the communication between the different systems as well.Ìý So, for instance, just because you’ve told your GP about your accessibility needs, it doesn’t mean that the screening programme automatically know, those two systems don’t talk to each other.Ìý There’s a lot of work going on around a national reasonable adjustments flag, which would apply to any kind of additional needs that somebody might have and that will work across the systems but it’s not quite there yet, it’s not quite in place.

White

For a lot of blind people now email is by far the easiest way to do things and yet I’m still hearing, we’re still hearing, about surgeries who say – oh we don’t do email.Ìý And often the reason given is confidentiality but nothing can be less confidential than a print letter that you have to get somebody to read to you.

Elliott

Yeah.Ìý There are definitely challenges and variability in some places and I think if you’re not happy with the service you get from your GP, then I would encourage everybody to ask around for recommendations of surgeries where they are doing it well because everybody should be working towards that.

Ìý

White

Can you trigger access to a screening programme just because you want it?

Elliott

Only if you’re in the eligible age group.Ìý The reason that people can’t just have screening outside of that age group is because the age ranges are set up based on the balance of risk of the disease versus risks of over investigation or doing harm.Ìý But I think the really important thing, as well, about what we’re talking about, is that if people have symptoms they must get in touch with their GP and discuss their symptoms.Ìý The screening programmes are for people who are asymptomatic, they’re not for people who are experiencing symptoms.

White

Katie Elliott.Ìý And if you have any information about using screening programmes, as a blind or partially sighted person, that you’d like to pass on to Katie, so that it could perhaps be shared with others, do let us know and if you prefer to give that information anonymously, because it’s quite personal, that, of course, will be respected.Ìý You can email intouch@bbc.co.uk, you can leave voice messages on 0161 8361338 or go to our website bbc.co.uk/intouch.Ìý

From me, Peter White, producer Beth Hemmings and studio managers, Sue Stonestreet and Amy Brennan, stay safe, goodbye.