HIGHWAY TRAFFIC AMENDMENT ACT, 1991 / LOI DE 1991 MODIFIANT LE CODE DE LA ROUTE
HEALTHCARE REHABILITATION CENTER
CONTENTS
Wednesday 11 December 1991
Highway Traffic Amendment Act, 1991, Bill 124 / Loi de 1991 modifiant le Code de la route, projet de loi 124
Trauma Association of Canada
Healthcare Rehabilitation Center.
Ann M de Fort-Menares
Selwyn Public School
Citizens for Safe Cycling
Alayne McGregor
East York Health Unit
Adjournment
STANDING COMMITTEE ON RESOURCES DEVELOPMENT
Chair: Kormos, Peter (Welland-Thorold NDP)
Vice-Chair: Waters, Daniel (Muskoka-Georgian Bay NDP)
Arnott, Ted (Wellington PC)
Cleary, John C. (Cornwall L)
Dadamo, George (Windsor-Sandwich NDP)
Huget, Bob (Sarnia NDP)
Jordan, Leo (Lanark-Renfrew PC)
Klopp, Paul (Huron NDP)
McGuinty, Dalton (Ottawa South L)
Murdock, Sharon (Sudbury NDP)
Ramsay, David (Timiskaming L)
Wood, Len (Cochrane North NDP)
Substitutions:
Brown, Michael A. (Algoma-Manitoulin L) for Mr McGuinty
Cunningham, Dianne E. (London North PC) for Mr Arnott
Fawcett, Joan M. (Northumberland L) for Mr Ramsay
Clerk pro tem: Manikel, Tannis
Staff: Luski, Lorraine, Research Officer, Legislative Research Service
The committee met at 1534 in committee room 1.
HIGHWAY TRAFFIC AMENDMENT ACT, 1991 / LOI DE 1991 MODIFIANT LE CODE DE LA ROUTE
Resuming consideration of Bill 124, An Act to amend the Highway Traffic Act / Projet de loi 124, Loi portant modification du Code de la route.
The Chair: It is 3:32 pm. We are ready to begin.
TRAUMA ASSOCIATION OF CANADA
The Chair: The first participant is the Trauma Association of Canada. Dr Michael Schwartz is president of the association. Please come forward and give us your comments. Try to end them about a quarter to the hour so that we have 15 minutes to engage in dialogue, questions and conversation.
Dr Schwartz: I can actually end more quickly than that. I would like to tell you first about some additional qualifications I have so that perhaps it will make my words a little more believable, or at least will provide you with some information about what you can ask me.
I am a neurosurgeon and the director of the neurotrauma program at the Sunnybrook regional trauma unit. I was on the Canadian Standards Association committee that set the standards for bicycle helmets for CSA approval. I guess most importantly, I am an enthusiastic cyclist. I came here by bicycle, wearing a helmet. I believe that helmets are important.
There is excellent evidence in the medical literature that shows helmets will mitigate the effects of falling off your bicycle and striking your head. They are designed to reduce the G-force administered to the brain when the head strikes the ground and they are likely effective if the person falls from the height the head is at when a person is cycling. If a cyclist is accelerated by a car, swept up on the hood of the vehicle, to a speed of, say, 40 or 50 kilometres per hour, then the helmet will not work and will not prevent a severe or even fatal head injury. So I think everybody should wear helmets but should have a realistic expectation about what they can or cannot do.
The other issue is whether the government is best served by a strategy of education or whether legislation is the best method. To be quite frank, I do not know what the answer to that is. I believe we are required by law to have a light on the bicycle between dusk and dawn and I will bet you that not 5% of cyclists do. In fact, very few of those people are stopped by the police. So if we are to have a law that requires people to use bicycle helmets, there should be enforcement of the law.
It may be a more effective strategy to have an excellent education program, the way, for example, seatbelts have been popularized with people. I think there is fairly good compliance because of education rather than because of legislation. Perhaps we need both. I think I would leave that to the government.
If you wish, I would be pleased to answer any questions about the mechanism of head injuries or about helmets or any other relevant thing.
The Chair: Thank you, Doctor. I should ask you, because a participant on Monday who rode his bicycle here expressed concern about the fact there was no place to conveniently park his bicycle and saw that as something of a disincentive on the part of Queen's Park to people bicycling.
Dr Schwartz: I found a bicycle rack at the east entrance to the Legislature, so it was convenient enough.
The Chair: Convenient enough? There is obviously a conflict of opinion because we are writing to the whip of the government caucus so that she can use all her powers and resources and all her high-priced staff to persuade the powers that be to make more bicycle racks, appropriate ones, to encourage more people to use bicycles, maybe even MPPs.
Dr Schwartz: I was a little bit uneasy that the bicycle rack did not seem to be fixed to the ground. If somebody wants to take the rack and my bicycle, it is physically possible.
The Chair: I suppose the good news is that the rack was still there.
Mr Waters: You mentioned that you were involved with the CSA.
Dr Schwartz: Yes.
Mr Waters: I have a concern because of the harmonization that is going to happen with those helmets. Is it going to make the helmet unsafe when we harmonize with the US standards? Is it going to downgrade it to the point where we should be concerned?
Dr Schwartz: There are some differences. First of all, there are two US standards. There is the American National Standards Institute one that perhaps is slightly less stringent than the CSA one, and there is the Snell criterion, which perhaps is slightly more stringent; but they have the same effect. The difference between CSA and the American standards is that CSA is actually enforced.
In order to keep CSA approval of a particular product, CSA will pick up samples of the product from time to time and test it in their own laboratories. In the US, the companies that have Snell-approved helmets or ANSI-approved helmets can submit those particular ones if they wish, but there is no after-the-fact testing. The standards are close enough, but I do not think we will lose anything if we harmonize with the US, provided the CSA keeps its policy of testing.
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Mr Waters: In your specialty, when you have someone who has suffered severe trauma to the head, being very blunt about it, is there a lot that you can do to help him or her? Or is it basically that if it is that severe, the good Lord heals, and what the good Lord does not heal, sorry.
Dr Schwartz: As neurosurgeons, we can treat some of the complications of head injuries. If the person has a blood clot on the surface of the brain, for example, we can remove it. What we cannot alter is the kind of injury that occurs diffusely through the brain that is caused right at the moment of impact. In fact, right at that initial bump, there is violent shaking of the brain, which has the consistency roughly of Jello; it fractures actually internally. If the person is badly enough injured, there is nothing at all we can do about that.
The way the helmet works is that it has a crushable lining of styrofoam. As the person strikes the ground, instead of stopping in an instant, it slows down over the distance that the styrofoam is crushed. So that will reduce the force applied to the brain considerably, and provided the person does not fall from too great a height or is not accelerated to too great a velocity, the helmet will be effective in preventing injury. Prevention is the only way. Our capacity to fix things after the fact is quite limited.
Mr Waters: You touched on the topic of a law versus education. I will go back to seatbelts, where the law was enacted along with a major education program. As I have said to other people on other days, our education system has done wonders. They have made monsters out of our children. If you do not wear your seatbelt, you do not move the car. They are better cops than the cops. I was wondering what your feelings are on doing the same things with helmets.
Dr Schwartz: I think that would be ideal. There is no question that those seatbelts were available before the law was passed and before people were educated about them. They were used far less frequently than after the law. In fact we know that mitigates injury. So that if a similar program could be developed including both legislation and education, that would be ideal.
Ms S. Murdock: On Monday one of the presenters brought in two helmets, one that had been in an accident, one that had not. I do not bicycle, but I was interested in the size of the helmets. One was an older one, so it was larger and so on. Would the helmets that are on the market now provide protection for all ages, or are there sizes to helmets and are there standards to those sizes?
Dr Schwartz: There are sizes, and provided the person buys it in a store where the salespeople are familiar with how they should be fitted, I presume that he or she will get the right size. I would think the smallest size that fits is the best, because it is less likely to slip down over your eyes or to fall off if you are thrown off the bicycle before you strike your head.
Ms S. Murdock: How about those carrier seats that little kids sit in? Are there bicycle helmets for that size of a child's head?
Dr Schwartz: That is a whole other issue. I think carrier seats are dangerous and should not be used. In fact we discussed this at the Canadian Standards Association, whether we should also make it standard for those carriers for children. There was considerable weight of opinion, although it was not unanimous, that they just should not be used, because they raise the centre of gravity of the bicycle, and unless the person is a very skilful cyclist or is lucky or whatever, the bike is more likely to turn over with a child on it. I think a child should not ride on a bicycle until he or she rides it himself or herself.
Ms S. Murdock: Having said that, are there helmets --
Dr Schwartz: Are there small helmets? Yes. There are two kinds of helmets, those with the hard shell on the outside and those which just have either plain styrofoam or some net over the top. I very much favour the ones with the hard shell, even though they are slightly heavier and perhaps provide slightly less efficient ventilation. But the fact is they will prevent any sharp object from penetrating, or at least will make it less likely that a sharp object will penetrate, and they also tend to diffuse the force. If a person falls on something irregular like a stone or a curb or whatever, the hard shell will diffuse the force rather than allowing the soft liner to split. I think the soft shelled helmets, which are generally the ones for small children, are inherently less safe than the others, but they exist. Anything is better than nothing.
Ms S. Murdock: The weight of the hard helmet would not --
Dr Schwartz: Make it more likely that a person would have a neck injury?
Ms S. Murdock: Yes. With little kids when they are --
Dr Schwartz: They are not that heavy. I think that, on balance, the hard shell is preferable.
Ms S. Murdock: And you would recommend wearing helmets on tricycles as well as bicycles?
Dr Schwartz: If a child is going to fall, a helmet will mitigate the effects of landing on the head. If we start the children out early enough, then it becomes a matter of pride, just as Mr Waters said. The children are more enthusiastic about using the safety devices than the police. If a child knows from the age of three that every time he or she gets on the tricycle that they must also be wearing a helmet, they just do it as a matter of course and they will refuse to ride the bike without it. My children, for example, just as you said, would not, when they were small, let anyone start the car if all the seatbelts were not fastened first.
The Chair: Mr Dadamo, and you can leave time for Mr Waters if you wish. He will be angry with you, not at me, if he is not allowed that one more question.
Mr Dadamo: How much time do I have?
The Chair: Go ahead.
Mr Dadamo: Doctor, "trauma" says it all, obviously. You work near and dear to this all the time. With all the expertise you have and the studies you have been through, should this legislation go through, would you be ready to help and see if is there any way we could possibly redesign the helmet to make it stronger maybe? Are there any flaws you see at this time that you could explain to us?
Dr Schwartz: I have no concrete suggestions for improving helmets. It is always a compromise. You could make a helmet that would be far more efficient or far more likely to cushion the impact, but it would be bigger and heavier, and if you made it big enough and heavy enough nobody would wear it. There is always a tradeoff between size and convenience and effectiveness. Right now we are at some sort of level of convenience that still provides protection.
Mr Dadamo: I am hearing over and over again that the helmet is good for one impact?
Dr Schwartz: One bump, yes.
Mr Dadamo: One bump. I do not understand why they cannot make it more solid.
Dr Schwartz: It is not a question of being more solid. In being crushed, it slows the head down right at the moment of impact, so that once it has been crushed, unless it is made of a material that restitutes completely to the state it was, it cannot be used twice. It is much cheaper and equally effective to have a helmet that is only used once because then you are sure it is in mint condition until you bump it.
Mr Dadamo: So it is the inside that damages of course and not the outside?
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Dr Schwartz: Yes, that is right.
Mr Waters: My one question would be getting back to what Ms Murdock had asked about, the small children. I have been asking a lot of questions on this, and I thought of a new angle, and that is: As a doctor, as a cyclist and as a person who is involved with helmets, do you see any way that we can safely transport children at a very young age who can hardly hold their head up, some of them, on a bicycle? Is there a safe way of doing it? Could we create a better carrier or whatever?
Dr Schwartz: I think you would have to have either a tricycle, which will not tip over as easily, or I have seen trailers that are intended for carrying small children, although that makes me worry because they are not so easily visible; they are low and might be struck by a motor vehicle. But I think you have to have something that prevents the bicycle from tipping.
Mr Waters: But you do not see a means of putting on a two-wheel bicycle a safe means of carrying a child that size?
Dr Schwartz: No, I think not, because anything you put above the wheel raises the centre of gravity and makes it more likely to tip over.
Mrs Cunningham: Your reputation precedes you. I am going to ask you a couple of questions.
Dr Schwartz: Oh, I am not finished yet?
Mrs Cunningham: I am going to take advantage of your expertise.
Dr Schwartz: I see.
Mrs Cunningham: Others have tried to escape our questions from time to time, too.
You will not be surprised to know that the majority of people before the committee have been supporting the legislation, some with reservations, to the extent that they think the education program that should accompany this legislation should be fairly extensive. One of your predecessors before the committee said we have so many major health problems in Ontario that we can do nothing about. I mean, we wish we could do something about them, and here we have a health problem we can do something about. I thought that was rather profound. That seems to be the tenor of what we are getting here.
I am fairly satisfied with regard to helmets. As a matter of fact, I am quite excited about it because I think we have an opportunity over a period of time, if we give the public time, to manufacture here in Ontario and create more jobs, exciting jobs I think, for people. So that part I am fairly comfortable about. But I am wondering, given your experience, or the thinking you may have done with regard to the phasing in of this legislation, what seems to be the advice we are getting, if you have given that any thought?
Dr Schwartz: Exactly how to go about enforcing it?
Mrs Cunningham: We did not want the public to wake up some morning in March or April and realize that they have to have helmets in another month.
Dr Schwartz: You might begin by an education program saying that on a certain date you will be required to wear a helmet if you ride a bicycle on the road. Provided people knew the date was coming, that might serve to have them go out and buy helmets. Then I suppose after the legislation is enacted, a person might be given one warning and then, if they fail a second time, I guess a fine should be levied. How are seatbelts done? I do not know. Do you get fined if you do not wear a seatbelt?
The Chair: He was not eliciting confessions.
Mrs Cunningham: Actually, what you have said, I think, is just common sense and that is what the committee wants. Basically we are not experienced. We are looking for good advice. What we have looked to are precedents, most of us, like what happened in Maryland in -- I forget the name of the county.
Interjection: Howard.
Mrs Cunningham: Howard county in Maryland, where in fact they did phase dt in over a period of time and gave people, whether they be children or adults, a warning, and they had to produce their parent under some circumstances and their helmet under others. That is what we will struggle with. I think your first response was one of just common sense, and that is what we are going to try to do.
I should say too that there has been some opposition from cyclists themselves, who are concerned that from an environmental point of view they really would like to see more people cycling, and a helmet would be a deterrent. I am wondering if you could help us in what we should be saying to cyclists who tell us that a helmet is a deterrent. Mind you, they wear them.
Dr Schwartz: I cannot see how that would follow. I suppose it is an additional expense for the individual, but bicycles have gotten so expensive anyhow, that presumably the $60 or $70 that they would pay in addition for a helmet is not unreasonable. I would think that if more of them are made and used, the price would likely come down.
Mrs Cunningham: Their other argument is that it is an invasion of their rights.
Dr Schwartz: That is nonsense. It is an invasion of my rights if I have to get up in the middle of the night to operate on somebody who has done something really stupid and caused an accident or caused an injury. The rights argument does not work. People have argued that for motorcycle helmets. The fact is that a person does not have the right to expose himself or herself to risk if it produces expense and difficulty for the rest of us. I think that people who become disabled by foolishness are a burden for all of us and I do not see any harm in preventing them from doing that.
Mrs Cunningham: We are particularly concerned because Ontario is now struggling with a tremendous cost in rehabilitation for head injuries. Some of the families who have come before this committee are so concerned about having to send their young people out of their community. So the costing has to be made very real.
The Chair: Is there anybody else who had any closing remarks or questions of the doctor?
All of us on the committee thank you very much for the time you have taken to prepare this presentation, for your work on this matter and for appearing here today. We appreciate it. Mrs Cunningham, who is the sponsor of the bill, or Mr Dadamo, who is the parliamentary assistant to the minister, I am sure will be pleased to keep in contact with you. Keep in touch with either of them, and I am sure they will try to keep you updated on the progress of these matters. If you have any further things down the road, feel free to get in touch with us. Thank you. Take care, sir.
HEALTHCARE REHABILITATION CENTER
The Chair: We now have the Healthcare Rehabilitation Centre making a representation to us.
I should tell people that there is coffee and milk and juices there, some of them native Ontarian, some of them as a result of cross-border shopping. Orange juice at an Ontario government parliamentary committee is always a peculiar thing. In any event, make yourself at home, and it is there for you to consume.
Larry Donaldson, director, Canadian operations of the Healthcare Rehabilitation Center, would you please tell us what you want to tell us. Try to leave us the second 15 minutes at least for questions and conversations, sir.
Mr Donaldson: I am here today to present this brief to the members of this committee both as a professional involved in the treatment of children who have suffered the effects of traumatic brain injury and as a parent.
Many speakers before me have surely given the committee the statistical data surrounding the number of children and adults that suffer serious head injuries due to accidents involving bicycles. In Canada it has been recorded that yearly there are 5,000 children who visit emergency rooms as a result of a head trauma related to bicycle accidents, and 60 of these kids will die as a result of that injury. Within the general category of deaths related to bicycle accidents, 75% of them involve head injuries.
Of children who suffer brain insult and survive, it is estimated that between 190 and 310 per year will require some type of post-acute care rehabilitation. It is the costs associated with the acute medical treatment and the post-acute care rehabilitation that I would like to bring to the committee's attention today.
In today's health care system it is not unknown to have an acute care cost ranging from $1,500 to $2,000 per day. This will include all of the costs: bed costs, physicians, lab costs, medication, life support costs and all of the capital expenditures that would be involved in the support of an acute care bed. With all of these needs rolled into one figure, these high costs are not unreal. Should a patient require six weeks of acute care, these costs could range from $63,000 to $84,000 in acute care.
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In Ontario the problems that exist in the availability of post-acute care beds have created the bed-blocking problem that now exists. This can further escalate those acute care costs if a patient is stuck in an acute care bed, one of the most expensive beds in the province.
Within the present Ontario hospital system, there exists a limited number of acute care rehabilitation beds for patients that suffer brain insult. These beds operate at a cost of approximately $800 to $1,000 per day. Should a patient get treatment within our system, it would last from three to five months. This portion of the care would cost between $78,000 and $154,000. Unfortunately, there is an inadequate number of beds available in Ontario to service the population and patients have been utilizing rehab beds in the United States.
From this point on, I will speak to the costs of brain injury rehab within our US-based hospital system, as the services we offer our patients are currently unavailable in Ontario. Healthcare Rehab Center is a fully licensed brain injury rehab hospital located in Austin, Texas. Over the past 50 years we have been involved in the treatment of patients who have suffered neurological trauma. The cost of the acute care rehabilitation is roughly the same, $800 to $1,000 a day. Thus the costs for the acute care rehab portion will be the same as in Ontario, $78,000 to $154,000.
Following the acute care phase, patients who have suffered serious brain injury require further post-acute care rehab. These programs involve education, vocational rehabilitation, neuropsychological counselling, cognitive retraining, behavioural management -- one of the most challenging aspects of brain injury rehabilitation -- and community re-entry programs. Due to the broad nature of these programs, they take time. This phase of the treatment may last three to 12 months and cost an average of between $500 and $750 a day. Therefore the costs of this phase may run between $45,000 and $274,000.
The final place in which there are costs related to a simple bicycle accident resulting in brain injury is the area of long-term care. Should an individual require care for the rest of his or her life, the costs can through the ceiling. Just to give someone the absolute basic needs can cost over $100 a day. To give someone a place to live and grow to his full potential, to live his life to its fullest, you can expect costs to range between $170 to $270 a day. With an injured child of 10 years of age with an expected lifespan of 60 more years, you can look at costs in the neighbourhood of $5.9 million.
What we now have is an injury that has the potential to escalate into a $6.5 million dollar care bill. If this committee can help prevent these types of costs through prevention, ensuring the passage of this bill, I will be pleased. These costs are not going to go away; if anything they will escalate, and the demand for their being made available to Canadians will increase as parents and patients become more aware of the benefits of proper care.
In summary, I just want to go over those costs again. Acute care costs, $84,000; acute care rehab costs, $154,000; post-acute care rehab, $274,000; and long-term care, $5.9 million. Total potential costs -- and these are potential, it does not happen to everybody -- $6.4 million
These costs, of course, can and do vary from patient to patient. There are those lucky enough not to require anything more than a bandage in emergency and a comment to "take care" out there.
There are certainly patients who require a much higher level of care for their lifetimes and the costs can and do exceed the above estimates. It is clear that accidents involving bicycles are going to cost us money. If there is any way possible to save costs, both financial and personal costs, then we should make an effort to do so.
I am here today to point out the terrible costs of treating those who suffer potentially unnecessary injuries to the head. With treatment, some will recover to a point that enables them to live a full and productive life within society. With treatment, some will be able to live a life within society that will be tolerable. These treatments cost big dollars, as I have pointed out to you today. There is really no way out of the rehabilitation costs related to these injuries.
Some parties sue in the courts and are able to recover damages. Society must ultimately pay these costs in higher insurance premiums. Others, unable to litigate, fight within the health care system to gain access to these treatments and benefit from them as much as possible. Here our society is once more burdened with these high costs. Some, unfortunately, for whatever reason, are unable to access suitable treatment and are left without. Without treatment, these patients ultimately cost the health care system even more money if they are funnelled into chronic, long-term care hospitals and/or psychiatric hospitals and, I might point out, jail.
The costs incurred by keeping patients within the health care system are well documented and will ultimately exceed the $6.5 million figure I have given you today. It is these exceptional care costs that are leading the current government towards a policy of redirection of long-term care and support services in Ontario.
In every way the province of Ontario loses each time a child or any person is seriously head-injured on a bike. I hope that by bringing to the attention of the committee the tremendous costs involved in each injury, I can push you to a speedy enactment of this bill. Any costs for its implementation and enforcement can certainly come from moneys saved in the health care system, moneys that will inevitably be spent as a result of, but preferably in the prevention of, bicycle accidents.
Thank you for taking the time to listen to my presentation, and I would be glad to answer any questions.
Mrs Cunningham: Mr Donaldson, thank you very much for being here today. I think it is interesting that somebody who is in the business of providing rehabilitation services -- by the way, that is not even a good word. It is extremely responsible that somebody in your position is coming down here to tell us to do something about it fast. One would argue, as a physician did yesterday, "Put me out of business." He actually said: "I do not want this job. I do not want to see children as damaged." You are saying the same thing, which is pretty profound and extremely responsible, so I really thank you for that. Perhaps when we solve this problem, we can go on to the long-term care problem right here in Ontario.
I wonder what you have learned from your work in rehabilitation that might help us, beyond what you told us today, in the phasing-in of this legislation. I think we are concerned about being criticized, first of all in not giving people time to adjust, those people who have not taken advantage of education programs that have been out there proliferately since the early 1970s; and the real issue of not looking cool in a helmet, which happens to be the one that most tell us about; down to the fact that we are pretty serious about trying to make this a business-in-Ontario issue. We would not have thought of that, by the way, until we had one of the representatives of the CSA standards committee on bicycle helmets. Do you remember who that was?
Interjection: Mr William Coffman.
Mrs Cunningham: Yes, Mr Coffman came and told us it was a possibility, probably within a year. So we are trying to be more realistic that these helmets could be manufactured, certainly by American companies, in Ontario. But we would like to see some initiative, as at Fanshawe College, where the students were doing prototypes and what not and are extremely interested in starting up their own small business. So if you can give us advice on phasing-in or education here at all, we would appreciate it.
Mr Donaldson: I think my response there would be, the sooner you can put me out of business the better. Regarding phasing-in, the longer you wait, the more injuries you are going to have. Phasing-in is one of your most difficult questions, along with enforcement. But as soon as possible it can only help. If the transition period is difficult for people as they are educated that they must wear helmets, then that is going to be a difficult time. Even with seatbelts now, there are people who refuse to wear them. I think you will always have non-compliance. Most parents, if told that they and their children have to wear helmets, will get them quickly.
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Mrs Cunningham: Thank you for underlining that.
Mr Jordan: Thank you, Mr Donaldson, for your excellent presentation and certainly for drawing to our attention the costs involved to everyone as a result of not having this regulation in effect. I think generally the members of the committee are really convinced of the need. I know personally that my real concern is how to implement the legislation.
I might throw out a suggestion that, instead of listening to parents being concerned about the costs of these helmets, they be issued through the schools along with an education program, and the parent-teachers associations and so on be educated on the use of them and the need to use them. If we do that for a period of time, even though the legislation is on the books, it would not necessarily have to be enforced with a penalty. Would you care to comment on that?
Mr Donaldson: Again, all I can say is as soon as possible, whichever way the committee and the enforcement bodies that are assigned with enforcement, the OPP, feel is the most feasible way to get people wearing helmets and just as quickly as possible. The whole idea that it is cool to wear a helmet has to be ingrained in the kids, like the seatbelts. You do not start the car until the seatbelt is on, and you do not get on the bike until the helmet is on. Whatever ways can be devised to get kids feeling that it is cool to wear a helmet, then get at it.
Mr Jordan: I think education is going to be the requirement to parents and children working together up, let's say, to the age of 12 or something like that, and then after that they could accept their responsibilities. Thank you very much
Mrs Fawcett: This is the first time I have been at this committee, and I find it extremely interesting. Further to what Mr Jordan was talking about on educating through the schools, that certainly is an excellent way. I was an elementary school teacher and that is definitely a place to start.
I can remember the days when hockey players did not wear helmets. I even played a little without a helmet. Now, it is just unheard of that a child does not wear a helmet. So obviously they found a secret. I am sure there must be some way we could incorporate the idea -- I realize that a child must wear one in order to be allowed on the ice -- whether we can somehow plan some way that a child does not get on a bicycle unless he or she has a helmet. Somewhere there must be something we can do.
Earlier, Ms Murdock mentioned babies or small children. To me, that is the place to start. If a child grows up almost right from birth with a helmet on, then it might be a way to make sure this campaign definitely goes forward. I think you are to be complimented in trying to put forward this legislation. To me, it is a must.
Mr Donaldson: Enlist some sporting stars, the Gretzkys of this world. I know that Jeremy Rempel was here and presented to the committee. There is a star who can get out there and show the community that helmets are a good idea. I think you need to develop that type of campaign of making it cool, that this is what you do, that if you do not do it, you are just strange, you are weird: "Why don't you have your helmet on?" You have got to start with the kids.
Mrs Fawcett: Cool first, until it becomes a habit.
Mr Donaldson: Exactly.
Ms S. Murdock: Actually, I am in favour of this, as I think my questions have indicated, but we have a couple of problems. I know Mrs Cunningham has mentioned some of the concerns that have been expressed here, but also that are expressed, I know, in my riding. I have had a couple who are not too thrilled about the idea.
One of the comments made to me is the personal preference of not wanting to wear it, which I think the former presenter, Dr Michael Schwartz, probably stated as clearly as anyone I have heard thus far. I appreciate that, because I intend to use his comments: the cost of providing the helmet, not so much in higher economic groups but in lower economic families, and the enforcement provisions. Right now there is a lack of compliance with existing legislation. Making more legislation does not necessarily mean there will be compliance, without the education.
The other thing is the Highway Traffic Act. We have ages here that are not going to be applied. So I am wondering if your recommendation is that the Highway Traffic Act be changed to include that the age limit be lowered for service of the offence, or whether it would go to the parent, and what your thoughts are on that.
In terms of your experience in rehab work -- I am asking a whole bunch of questions in one -- having dealt with the children and the parents,do the parents subsequently wear helmets after having seen what happens to their child? I do not believe we are going to have a problem in the long run, or even in the short run, of convincing kids with a good education program and getting some star to do it. Where we are going to have the problem is getting people who have ridden bikes for years and years and years without a helmet. Trying to convince them to wear it is going to be the problem. So I would like to hear what you have to say.
Mr Donaldson: It is interesting how people will not comply with this type of legislation, but they comply awfully quickly when it is their child or their niece or their nephew that all of a sudden gets a brain injury. That gets compliance really quickly. It is the whole idea that it will never happen to me. Inevitably, it does, or it happens to someone near and dear to you.
What I find sometimes disheartening is when children that have suffered very serious brain injuries have to wear a helmet for the rest of their life because their skull is at a point where any slight trauma will cause further damage. That hurts. That is not to say they may sustain that brain injury because of a bicycle accident, but certainly the helmet might have helped in the first place, and they have to go through the rest of their life with a helmet. It is tough.
I know the dilemma that is before you with the enforcement. How do you enforce a law with an eight-year-old kid who said, "My dad told me I didn't have to wear a helmet"? Dad is a fool, and a kid at eight years old is not responsible. So I would like to see parents be responsible for that and, however the law is written, to put the onus on the parents to comply.
Do you license all bicycles in the province so everybody has a plate on their bicycle? Then there is a registration system. From there, you know who the responsible adult is because of that licence plate. I do not know. That is your dilemma. That is why you guys are here.
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Ms S. Murdock: Mr Donaldson, I saw you nod when Dr Schwartz was talking about the carriers. I noticed that you were agreeing with him.
Mr Donaldson: Oh, yes, there is no question that cost is not an issue, because with volume, especially if we can get some manufacturing in Ontario, which would be wonderful -- do we not need some? -- it will get the prices down. What is the Canadian Tire price now? Seventeen dollars? You can get a helmet with their coupon rebate in that neighbourhood. You could see that coming down to $12. If somebody can go out and pay $200 or $300 for a bike, what is $12 or $15 more to save a life or at least to improve a life if there is an accident? I think it is meaningless.
Mr Wood: My feeling is that I support helmets that are going to prevent a lot of injuries, but my concern is along the same kind of question that Sharon and Leo Jordan had. There must be quite a few thousand children out there of any age that are probably coming from single families. Maybe they have single-parent families. Maybe they have one bike between three or four or five children that is shared back and forth, or they share it with the neighbours from different communities. I am just wondering how we deal with that. If we say that legislation is coming in effective 18 months from now, how do we deal with situations of that kind?
I was going to say there are probably a million children throughout the province that are not as wealthy as other ones are that live under those conditions. I am just wondering if there are any ways and means of maybe making sure that helmets are available in the schools. The question is, if you put a $20 fine on a person whose mother does not have food for the children at home to begin with, and then you have got the helmet beside that -- I just wanted to see if you had any ideas or thoughts on that.
Mr Donaldson: I do not know. I know that under the Highway Traffic Act it is a given right to operate a motor vehicle and that can be taken away from us by non-compliance with the statutes under that act. You could get as rough as to say that if you do not comply with the bicycle helmet, then you do not have the right to operate a bicycle. That may be rough and tough to deal with. But kids walking and not sustaining head injuries beats kids riding bikes without helmets and getting head injuries. I mean, it is rough, it is tough. It is not going to be easy for those people, I agree with you, but I think you get the education and you get the kids so that when they graduate from that tricycle and have those training wheels behind the bicycle, they know to ask, "Where's my helmet? I need to get fitted for my helmet." You go from there.
Mr Wood: I have a grandson who will be three on February 9. I am proud of the fact that I see his mom and dad take him out to the skating rink.
Mr Donaldson: He has a helmet.
Mr Wood: He has a helmet on the ice. I am hoping that is going to follow through with bicycles into years to come. But I know, from my own experience, when I was born and raised in a poor family in a farming area, you maybe had one or two bicycles between 10 families. It has changed a lot now, but those helmets are going to be exchanged from one kid to the other. "I am going to put it on just because I do not want the cops to stop me," or this and that. It is a concern that goes through my mind. How do we deal with it?
Mr Donaldson: On the farm you would not have worn a hockey helmet, but go back to that same rink you were skating around on and all the little rink rats are going to have helmets on now, I hope.
Mr Dadamo: There are two of us who want to ask questions and about four minutes left, so I will be very brief. I want more to make a comment than I want to solicit an answer from you, if that is okay. Alluding to what Mrs Cunningham was saying earlier to someone else when we were talking about having to educate the public and having to take some time to systematically tell them or prove to them that wearing a helmet is going to be good for them -- and if you do not have an answer now, that is okay -- but what we ask you and others is, when you walk away from this committee after making this presentation, if you would be so kind as to keep in touch with us. If you would come up with something at 3 o'clock in the morning that you think is good for us, let us know by letter.
Mr Donaldson: My best time.
Mr Dadamo: The one thing we are all in agreement with here is that it seems to make sense that a helmet will save us a lot of money, a lot of pain, etc. We need probably about 18 months to two years' lead time to make people familiar with the cause and also for manufacturers to build the helmets, because obviously if we made the law tomorrow morning at 9 o'clock we would catch everybody off guard and we would not have enough helmets on the market.
That is my comment for what it is worth. If you should come up with something, with all the people you talk with and the expertise you have available at your fingertips, please let us know.
Mr Donaldson: I will give you a call.
Mr Jordan: Just a quick reference to the education part of it we were discussing and the cost of these helmets and who is going to have them. As Len pointed out, in some larger families they are going to be interchanged among the children, and we do not have control over that and no act of the department of highways would have control over that, so a helmet being worn that does not fit may not be giving the protection we assume it is. I would like to stress that this should be an issue that is really educational, that it should be properly fitted to each child through our education system. I do not think we should ask the parents to take that on.
Mr Donaldson: It might be a challenge to the manufacturing sector to come up with a helmet that is capable of fitting within two or three sizes. That would be a good industrial design project for Fanshawe College or any of them.
Mrs Cunningham: I am not sure whether you have been following the hearings, but in the enforcement part, I keep referring to Howard county in Maryland, just because I thought it was interesting. There, normally, for persons younger than 16, there is a first offence and a second offence, and it is $25 to $50 for a first, and the second offence would be $50 to $100. But, interestingly enough, it says that if the person who has been given the penalty shows up between the date of the violation and the court appearance with a purchased helmet, it can be waived, which I think is a progressive way of doing things.
It goes on to say that members -- they refer to their enforcement officers here as members, I guess of the enforcement -- will make immediate notification to parents of children under seven and inform them of the unsafe circumstances. I think this piece of legislation is really public education, at least initially, for young children.
They go on to say that everybody who has violated will get a pamphlet. You have to give them a safety pamphlet and you have to give them the violation form and tell them about the statistics. And they did have a grace period.
I think it is rather innovative, and they tell us it is working fairly well. It is a beginning for us anyway. It is not that we are sitting here without some precedents. That one, for us, seems to be a fairly comfortable one, and it is a form of legislation where the enforcement becomes part of the public education as well. I just thought you would be interested in that.
Mr Donaldson: Yes, that is great.
The Vice-Chair: I wish to thank you very much for coming and appearing before us, Mr Donaldson. It has been great meeting you, and I understand you and I will meet in the near future, hopefully. Thank you again for your presentation.
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ANNE M. DE FORT-MENARES
The Vice-Chair: Anne M. de Fort-Menares, welcome to the committee. At your leisure you can start your comments, and then I would ask that you try to leave a few moments so that we can have some exchange.
Ms de Fort-Menares: Thank you for receiving me this afternoon. I do not represent anybody except myself, and the public constituency, presumably.
I am appearing partly to seek clarification, and to raise some concerns I have about the legislation and get your responses to that. My points pertain to the wording of the bill and to the procedure you are following, or the way that the amendment to the act is being done, which I will come to. I have highlighted most of my points on what you have in front of you and I will go through them.
I am operating on certain assumptions, which I have put right up top, because they are in forming my opinion.
The first assumption, and my most important one, is that cycling is an egalitarian activity. If you learn to bike, you can do it. You do not need money to do it, you do not really need money to maintain the bike, you do not have to go through any procedure to do it, bikes are transferrable -- all of those issues. People of any age or financial background can do it and that gives them control over their transportation, which I think is an important issue.
Cycling is a viable means of alternative transportation. Despite what a lot of people say, you can cycle 12 months of the year in Toronto, and there are people who cycle every day in Toronto, and that goes for most of Ontario.
Ms S. Murdock: Come to Sudbury.
Ms de Fort-Menares: Well, in Ottawa there are people who cycle through the snow.
But my second main presumption is that cycling is beneficial to the whole community because of the reduction in noise pollution, air pollution, wear and tear on infrastructure, parking issues, production of bicycles, the longevity of bicycles -- all kinds of things. The whole cycle of the bicycle is fairly environmentally friendly and, because of that, I think it should be promoted and encouraged.
Third, I am assuming that everybody benefits from understanding what safe cycling is about. Motorists tend not to understand what cyclists are doing, and cyclists also are frequently criticized for doing things that agitate motorists, so education programs aimed at everybody who uses the roads benefit everybody equally, I think.
Those are my assumptions. You may differ from those, and you can let me know.
With the wording of the bill as it is proposed, the definition of "bicycle" includes tricycles and unicycles. I gather from the foregoing presentation that you intend to impose the helmet legislation on everybody on a bicycle under this definition.
The second point about wording is that the present definition of "helmet" under the Highway Traffic Act requires this hard, smooth outer shell. I also wonder about the so-called "no-shell" types. They seem to be excluded from the definition presently in the act, even though they do apparently have Snell and ANSI approvals.
The Vice-Chair: We have someone here from the Ministry of Transportation who can answer those particular parts of that question for you, so you would be aware.
Ms de Fort-Menares: Do they want to answer it now?
Mr Weir: You would like me to answer it now, Mr Chair?
The Vice-Chair: Yes, while it is fresh in everyone's mind.
Ms de Fort-Menares: The first question was the definition of "bicycle."
Mr Weir: The present definition of "bicycle" does include tricycle and unicycle, so that is correct. On your second point, a helmet as defined under regulation 482 as it now reads pertains to motorcycles, so there would be a requirement to develop a new regulation. The section of the act being proposed to be amended talks about the user having to wear a helmet that complies with that regulation, which only talks to motorcycle helmets and helmets for motor-assisted bicycles.
Ms de Fort-Menares: Will this be revised?
Mr Weir: It would need to be revised, yes, to make that section apply to bicycles.
The Vice-Chair: The intent is that although we are amending the act, there will also be amendments to the regulations that will take into consideration the special needs of cyclists.
Mr Weir: That is right.
The Vice-Chair: So I am anticipating that there would be an amendment to the helmet regulation put forward that would allow for a bicycle-type helmet to fit within the act or the regulations thereof.
Ms de Fort-Menares: Is that all looked after by MTC staff, or what used to be MTC?
The Vice-Chair: I do not know how they are normally done, but there will be a list of those recommendations going with the bill to MOT and we will jointly develop the regulations that will go with the act, should the act pass.
Mr Weir: Yes, that is correct. Otherwise, the way the bill is presently proposed, cyclists would have to wear a motorcycle helmet, so a new regulation would have to be developed.
Ms de Fort-Menares: Is your intent also that people on tricycles wear helmets, or have you not thought that implication through?
Mr Weir: I would hope it would cover that, but it has not been decided yet. I recall when I have gone to visit my mother-in-law who winters in Florida, she rides a tricycle that has 26-inch wheels and 10 speeds, and she goes to town shopping, so in reality she is out on the road.
Ms S. Murdock: Just in relation to that question, we have had presenters come before us who have stated that just getting on their bicycles, they fall. They have not even gone anywhere and they have not even gotten up on it and they hit their head and they end up in serious trouble in the hospital. Then somebody today said that on a tricycle the same situation occurs when they fall. Unfortunately it is a fact that you are raised off of the ground so your centre of gravity is different, and when you fall you do not have control of how your head is going to land, so a helmet would cushion the fall. Just so you know where I am coming from, if we are going forward with a law, you would not put it in partially, you would cover it all. The enforcement part of that is going to be the problem. I mean, how do you take a two-year-old and charge him with a ticket?
The Vice-Chair: We can now allow you to go forward with your presentation.
Ms de Fort-Menares: Thanks. It is not much of a presentation.
Ms S. Murdock: No, it is good.
Ms de Fort-Menares: My main concerns tend to be negative and not entirely in support of your legislation.
There is a certain problem in what I am talking about because my experience is in Toronto. We are all sitting in Toronto but there is a whole province out there where the situation is a little different. I am aware of that and in some ways I think that as well comes into consideration of the legislation.
Bikes are free and cheap and all of this stuff and good for the environment. There are four main reasons people use bicycles: for pleasure, for convenience, for sport and for transportation. I think that two of those areas are already really completely wearing helmets. Sports people and most transportation people, especially people like bicycle couriers and so on, are wearing helmets already. You are dealing with the converted.
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I think the pleasure and convenience groups will be adversely affected by the proposed legislation. I think they will be hard-hit and I do not know if you have considered that. I wanted to bring what I think is relevant to your attention. There is this issue of the financial burden, especially with the cost of helmets now.
What I think comes into play here is that cycling should be promoted as alternative transportation. It is transportation for people who may not have any other means, and this is something I have seen in Toronto and other cities all over the world. You may not be able to walk two blocks, but you can get on a bike and go two blocks and do your shopping and socializing. You may not have a licence, you may not have a car, but the bike makes it possible. I see older people all along Bloor and Danforth who do that. They are often on the sidewalk too, which is a problem. Anyway, they are there on their bikes doing things that I do not think they could do if they did not have a bike.
Now, if you have this helmet legislation, I think what will probably happen is that they will either not wear the helmet, because they will not get one, or they will not go out. So I see this whole quiet, almost invisible constituency of cycle users getting cut out of their means of transportation and of movement getting to places.
The other group is kids and people financially affected. There are people who I think will not see the point of the helmet because they go two blocks on their residential street to get down to the store or the bank or whatever. And there are people of course who cannot afford it. Forty dollars is a meaningful expenditure for a lot of people, especially people with more than one kid. It is where education makes it something that is just ingrained. Punitive legislation is a different kind of problem, I think, imposing that on people. "You have to spend the money or you can't ride the bike," I think becomes a real difficulty.
For other people who use bikes really casually, once or twice a year, I do not think the outlay on the helmet will necessarily be seen as having any return for the use of the bike. People who use bikes once or twice a year are good candidates for getting them to switch over to cycling, if they perceived it as a safe thing. Most people do not perceive it as safe in Toronto, and it has nothing to do with helmets. It has to do with where you have to bike on the road.
There is this large thing about who is getting affected, who uses bikes, why, and how they are getting affected by the proposed legislation and what it will mean for them in their daily lives. The issue of enforcement I think removes people's choice. If you do not want to wear your seatbelt that is your choice. You can ride down the street in your car and maybe they will not see you; you accept that. If you are on a bike without a helmet you can be seen six blocks away and then it becomes a selective issue of enforcement.
There are a lot of problems with community relations with the police in Toronto, and who is it who is going to have helmet things enforced? Young males presumably, who are probably already high targets for harassment from police. Whatever, it becomes I think a real problem about who is going by without a helmet and getting stopped and who is not.
My last point is about amending the Highway Traffic Act only for helmets. One, I think the Highway Traffic Act should be completely and comprehensively revised with regard to bicycles altogether. I think the question of whether bicycles should be in the Highway Traffic Act should be considered, how they are defined. They have basically got all the restrictions of the act and no benefits or protections whatsoever. I think things like priorities should be sorted out. The longest paragraph in my submission addresses this basic issue about why there are deterrents to cyclists. It is because the whole system is set up for cars. I mention some of the articles in the act that I think are particularly problematic.
In summary, I think the proposed legislation threatens to reduce the availability and encouragement of cycling, which I think should be encouraged.
The Vice-Chair: I am going to allow for only one quick question from each caucus because of time, and because we have another time problem that is going to rapidly take place here and infringe upon people presenting later. I will ask Ms Cunningham to start off.
Ms de Fort-Menares: If I can just restate the position, it is not that I am opposed to wearing helmets; I am opposed to punitive legislation. It gives no other benefits to cyclists.
Mrs Cunningham: Thank you for being here today because I do not think there has been a witness before us, no matter what his or her position, who has not given us some ideas on what we ought to do with this legislation. I do not think there has been anybody, a committee member or an observer in the audience, who has not gone away from these meetings being tremendously enlightened as to the problem we are trying to solve. This is a health care problem that can be dealt with, as opposed to some of the health care problems we see in our neighbourhoods every day that cannot. Today, were you able to be here for the first couple of presentations?
Ms de Fort-Menares: No.
Mrs Cunningham: We asked a question of Dr Michael Schwartz, a neurosurgeon in Toronto at Sunnybrook Medical Centre, an expert in the field. We are very concerned about imposing something like this on people's lives, and his response to us was that he resented the fact that people did not wear helmets, got into trouble and he had to get up in the middle of the night and spend -- you heard the previous presentation by Larry Donaldson from the Healthcare Rehabilitation Center, who told us about the tremendous cost, millions of dollars, for an individual who has a brain injury. We have been pretty well warned by people who appear before the committee and who work with trauma units, and parents.
One of the most poignant presentations yesterday with regard to costs was a mother, Trish Woodworth, who described the loss of her 21-year-old daughter this year -- she died this fall. She was a law student, and her mother was told in the intensive care unit that if her daughter had been wearing a helmet she would have lived. This woman was a single parent. She phoned me today and said, "Don't let cost -- $20 to me, or $40 or $60 I would have given any day to save the life of my daughter."
Ms de Fort-Menares: Anybody does, retrospectively.
Mrs Cunningham: It does, but when we came to this committee many of us had the same concerns you have, and we still do to a point. We are trying to be responsible, but as for being restrictive, I think we have asked that question. Two people have told us they feel restricted having to pay so many dollars for health care, and the quality of people's lives.
We have been totally convinced that these helmets can be produced for $20 and probably here in Ontario. Even if we enacted this law within a year we were told we could come up with millions of helmets. The workforce is ready to move on and do it. I will stop, but I just want you to know I am in favour of cycling and wish we would have more people cycling. We do not know if this will be restrictive.
Mrs Fawcett: Ms Cunningham did touch on what I -- I wondered if you had heard the presentations, especially by the doctor, and I know in retrospect we would definitely pay the money. Is there a figure you think people might be able to afford?
Ms de Fort-Menares: I cannot speak for other people's finances, but I think probably under $40.
Mrs Fawcett: Under $40, right. I agree with you. I think, presented with the alternatives -- I think it is a whole education process. We were just discussing here how we brought in the seatbelt legislation. I do not think we came in with the seatbelt and the penalty, we tried to get people to do it voluntarily before the penalties, and possibly that is a way. Thank you very much for your presentation.
Mr Klopp: I appreciate your coming forward. A lot of people, when they have negative comments, do not bother coming. Your comments are ones we all generally share. We all feel we should have some form of helmet. I come from a rural, area and whether it is pleasure or going to work, an accident is an accident if you fall.
We really believe, especially on this side, that promoting conditions for safe, responsible cycling goes hand in glove with this project. This is not a case of, "Oh, you are going to pass a law." We have to look at the whole procedure.
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I remember getting my licence a few years ago, and bicycling and tricycling was never brought into it. I feel ashamed. Coming from rural Ontario, I never really realized it, but moving down here for a few months I recognize it, even back in good old Huron county.
Your points are taken very seriously on this side. We are going to look at them and we generally feel we should be moving forward. It is getting down to between $17 and $20 for a helmet; a case of beer is $25. What is more important?
The Chair: Ms de Fort-Menares, on behalf of the committee I want to thank you for taking the time to come here and present your views and engage in the conversation with committee members. We trust you will keep in touch with Ms Cunningham, the author and sponsor of the bill, or with Mr Dadamo, the parliamentary assistant to the Minister of Transportation, or whichever MPP you wish. They similarly, I trust, will keep you advised of the progress of this matter.
We appreciate your coming, taking the time out of your schedule. We invite you to return on other issues or on this one when it reaches other stages of its development. Of course, as Ms Cunningham points out, you are welcome to stay. Some people view that as a form of punishment. I invite you to stay, either here in the committee room and hear other submissions, or visit the assembly while you are here in the building.
Mrs Cunningham: That is the punishment. Stay here.
Ms de Fort-Menares: Not that it is necessarily punishment, but I am afraid I am late on several projects. Thank you very much for having me.
SELWYN PUBLIC SCHOOL
The Chair: The next presenter is Allan Cobb. Mr Cobb, please come up here and be seated. We have a written submission from you which will now be part of the record, an exhibit in this exercise. I am going to tell you, and others who are present, that at 5:45 there is a vote in the House to which all members will be aggressively whipped. That is not quite as it sounds, but it is remarkably close. That means we are going to have to try to compress the balance of submissions into the remaining time frame. As I say, we have your written submission. Please spend a short time elaborating on that and leave us some time for questions and commentary, sir.
Mr Cobb: I will, and I will be finished way before then. I am the principal of Selwyn Public School in the borough of East York. Our school has children from four to 10 years of age.
Last year we were one of four schools in East York which participated in the Be Bike-Smart bicycle helmet education intervention program sponsored by the Hospital for Sick Children and Kiwanis International. The East York health unit provided leadership for this pilot program at our school. They will be presenting later on this afternoon.
At the beginning of the program, our community health nurse made presentations to our staff and to the executive of our home and school association. Both groups were very enthusiastic about the prospect of encouraging children to wear a proper helmet when riding a bicycle and therefore cutting down the number of head injuries.
A school planning team, comprised of the principal, teachers, parents and students, examined means of promoting the use of bicycle helmets. Assemblies were held in the school for both the primary division and the junior division. The intent of the assemblies was to provide further information with respect to the need for wearing a helmet while riding a bicycle. Laura Robinson, a former Canadian Olympic cyclist, was a guest speaker for both assemblies.
One of the activities developed by the committee was a school-wide contest to design posters encouraging children to wear bicycle helmets. This was a very successful activity. Prizes for the contest were provided by our home and school association and Kiwanis.
Our final activity in April was designed as a parent information night and a helmet-fitting and sale session. The first 40 families were given a $5 rebate coupon, which could be traded in for cash once a proof of purchase was provided for a new bicycle helmet for their son or daughter.
Dr Pat Parkin provided the parents with information with respect to the potential injuries sustained when the individual was not wearing a helmet, and the benefits of wearing helmets. Eighty parents attended along with many children.
During the campaign a grade 4 student was involved in a bicycle mishap over the weekend. Jason, who was not wearing a helmet, collided with the curb and was unconscious for a short time. His younger brother was able to summon help. Fortunately, Jason only received bruising about the head. Back at school, Jason was able to dramatically point out the disadvantages of not wearing a helmet. However, his mother was not convinced that a helmet would have made a difference. Had Jason been wearing a helmet it would have made a positive difference. Adult role models with respect to wearing helmets are few and far between.
The educational process will produce positive results over a given amount of time. Usage at our school increased from 3.5% to 16% over the period of one year. But can we afford to wait for better results given the serious injuries that occur with youngsters and bicycles? Statistically, it can be shown that when children put on a helmet while riding a bicycle fewer head injuries occur.
It would be much easier if youth in great numbers started wearing bicycle helmets on a consistent basis. But, like motorcycle helmets, restrained baby seats in cars and seatbelts in cars, the state sometimes must protect those who do not protect themselves. I speak in favour of the bill which will require bicyclists to wear helmets when riding our roadways. I view this proposed legislation as an extremely important measure of preventive medicine.
Yes, there will be resistance; yes, there will be difficulties enforcing the law, but if the bill is able to reduce the number of head injuries and deaths associated with youth and bicycles, it will be well worth it.
The Chair: Thank you, sir. We are going to look to members of this caucus for any brief questions or commentary.
Ms S. Murdock: I want to thank you for coming here. Actually, I think the Hospital for Sick Kids used your school in one of the examples on Monday's presentation. I am really impressed with the differential from the 3.5% to the 16%. I think that says a lot for the education idea and the education system in conjunction with the legislation. It is important that both go hand in hand.
I just wanted to make a comment. The member of provincial Parliament I worked for four years ago was a man by the name of Elie Martel who has been a strong proponent in the area of head and neck injuries for years and years. In fact, I think after he resigned he wanted to get the government of Ontario of the day to set up, I think it was, a sports injuries committee. What people do not realize is that head and neck injuries in this province are so much more prevalent than -- they think they are car accidents more than anything else. They do not have the idea that, for instance, diving accidents, hockey accidents and bicycle accidents cause so much injury and so much cost to our medical system. I really commend you. I am glad you came and thank you very much.
Mrs Fawcett: Have you noticed that the 16% you reached for -- I assume that is students wearing helmets after the program.
Mr Cobb: Yes.
Mrs Fawcett: Is that continuing? Are you holding it? Has it worn off or are you continuing to drill and review, the old adage in teaching?
Mr Cobb: It is hard to tell. This is part of a project, but what I can say is we will be into our second annual program like this in the spring. I am sure if they do some measuring then the percentage will increase.
Mrs Fawcett: What kind of feedback did you get from the children? Were they really excited to participate? Were there are a lot of renegers?
Mr Cobb: We had a lot of enthusiasm from the children and there were a lot of purchases made at the time. But I guess the reason I used the example of the individual is that -- we can say the educational process is very important and it is, but what children hear at home from their parents sometimes can --
Mrs Fawcett: You only have them a few hours.
Mr Cobb: You lose part of that impact.
Mrs Cunningham: Here we have a school principal taking the time in his busy life to come down here. I think he is a credit to his profession. Mr Cobb, I thank you for the work you have done in your own school and for coming here and giving us a living example of what can happen in part of the implementation process which we feel very strongly about, the education part. We will probably be in touch for your help and guidance.
Mr Cobb: Thank you.
The Chair: Sir, on behalf of the committee, I thank you. Mrs Cunningham pointed out the time it took to prepare this and we appreciate that. I should tell you that either Mrs Cunningham or Mr Dadamo, as the parliamentary assistant to the Minister of Transportation, or any other people, would probably be pleased to participate in your next program dealing with the educational exercise you spoke of. They would appreciate an invite, I am confident of that. Say hello to your school. Bring your students by at some point in the near future. They are welcome here too and it is always an interesting exercise for your students. Thank you very much, sir.
Mrs Fawcett: Just quickly, are there other classes that are going to do this? Are there other classes or other schools that are going to take part?
Mr Cobb: We have an offer from our unit that it will implement this type of program in as many schools as are interested next year.
Mrs Fawcett: Thank you. Good news.
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CITIZENS FOR SAFE CYCLING
The Chair: The Citizens for Safe Cycling. There have been several pieces of material distributed. Please sir, tell us who you are and proceed with your comments.
Mr James: I am Peter James. I am representing Citizens for Safe Cycling. First, I will do some background on myself and our group.
I have been cycling for recreation and as a mode of transportation for over 25 years. I occupy the legislation chair for Citizens for Safe Cycling and I am qualified in cycling instruction by the Canadian Cycling Association. I have given the Canadian Cycling Association education courses with adults and children, and I recently taught the police bicycle patrol officers in both Ottawa and Nepean. I have two pre-teen sons, both of whom cycle regularly.
Citizens for Safe Cycling is an independent association based in Ottawa-Carleton. It was formed in 1984 by a group of concerned cyclists in response to seven cyclist deaths within a one-year period. The issue of cyclist safety has therefore always been a prime driving force behind our activities. We realized early on that proper education was an important component in promoting cycling as a viable, safe and efficient mode of transportation.
Our activities are currently supported by over 1,400 local cyclists. Since 1984, we have worked for better cycling education, for improvements in the design and construction of roads and other cycling facilities, for changes in cycling-related legislation and for proper enforcement of existing legislation. We have promoted the wearing of helmets and encouraged non-cyclists to use bicycles whenever possible as a mode of transportation.
Our achievements since 1984 have included regional funding for a bicycle education and safety co-ordinator and the creation of cycling advisory committees in the four largest Ottawa-Carleton municipalities. We also persuaded local police forces to use bicycles for policing operations. This year, we conducted a helmet promotion campaign which was funded by MTO to the tune of $5,000.
At the provincial level, we have worked for several years to obtain a review of the outdated provincial bicycle policy. We submitted papers describing existing problems and we recommended changes that would ensure that cycling would be treated equally with other modes of transportation as far as funding is concerned for cycling-related road improvements and legislation that was applicable to cyclists. The results of this review are now awaiting ministerial approval.
From the very beginning, we have encouraged both experienced cyclists and less experienced cyclists to take the Canadian Cycling Association's Can-Bike courses, and we have actively promoted the use of helmets at all times. It is part of the course material to discuss the effects of helmets and their benefits in regard to cycling accidents. Several of our executive members are qualified instructors. We teach at schools, further education institutions and workplaces, and, as I mentioned before, I taught the Ottawa and Nepean police bicycle officers.
The issue of bicycle accidents is an aspect of cycling that concerns us greatly. It is what our constituency is bringing to us as one of the problems they see. We receive many reports of cycling accidents, and several of our members have joined us after an accident to learn more about and to promote the safe operation of bicycles.
You will note that I have used the word "accident," not "injury." I want to make a deliberate distinction between the accident, which is the cause of the injury, and the injury, which is one of the symptoms of the accident.
Bicycle accident surveys show that cyclist behaviour is a significant contributory factor to many cycling accidents. This behaviour is often the result of an almost complete lack of cycling education.
At school, our children do not receive any cycling education from anyone who is knowledgeable and qualified to teach cycling. They may receive misguided advice from non-cycling teachers or police officers to keep out of the way of cars, but they are not taught how to interact with other road users. Compare this to swimming. In Ottawa, all grade 4 and 5 students take Red Cross courses given by qualified instructors. As a result, these children have good basic swimming abilities. More important, they are taught to follow safety precautions such as never swimming alone, using the buddy system, and not entering unknown water without checking that water first.
As adults, many cyclists, who by this age probably know the rules of the road, do not obey those rules when they are riding their bicycles. Why is this? One reason is that because of their earlier lack of education, many cyclists do not think of the bicycle as a vehicle and therefore do not consider that the rules of the road are really applicable. This same lack of education causes such a misunderstanding of the risks that many cyclists, in an effort to reduce those imagined or misunderstood risks, actually increase their real risks.
For example, bicycle accident studies show that very few cyclists are ever hit by a motor vehicle from behind. This does happen more at night, but this is often because the cyclists do not have adequate lights. But many cyclists are so frightened of this perceived danger that they go to such lengths to avoid it -- by, for example, riding facing traffic -- that they create a significantly greater risk of being involved in an accident. Their presence is now not able to be anticipated by other road users who are thinking in terms of the regular rules of the road.
One of our objectives in cycling education is to remove these misconceptions and to establish an understanding of the real risks so that accident avoidance can be concentrated on those accidents which are actually likely to occur. As a result, the properly educated cyclist feels a great deal safer on the road and the accident rates of these cyclists are much lower than those of typical uneducated cyclists.
Looking at this particular piece of legislation, if it is enacted, will it be enforced? It is an unfortunate reality that police officers do not see the enforcement of legislation against cyclists as being a major priority. Together with other cycling groups, we have tried hard to change this, but with limited success.
Can we expect this attitude is going to change for helmet legislation? As an example, there is legislation in place which requires that cyclists have lights and reflectors on their bicycles at night. By making cyclists more visible, this legislation both increases the safety of cyclists and makes it easier for other road users to see the cyclists.
Enforcing this legislation is relatively simple. It is easy to detect that the cyclist is not obeying the law. There can be no argument as to whether the cyclist has the required lights on his bicycle, but enforcement is almost non-existent. This was clearly shown in Ottawa-Carleton this September as local police forces undertook a bicyle lights campaign. At the end of a week, fewer than 10 charges had been laid and fewer than 10 warnings had been issued.
It would therefore appear that additional funding will be required to enforce this legislation. Otherwise, helmet-law enforcement will have to be at the expense of the enforcement of some other cycling legislation. There is funding that could be made available. We have not been told that it will be. We heard this week that the OPP is so short of funds that calls are going unanswered and almost no overtime is being worked. Municipal budget cuts can be expected to have the same effect on the operations of local police forces.
If the legislation is not enforced, there will be many cyclists who probably will not wear helmets, and the law will be brought into disrespect. This will also reflect unfairly on those cyclists who are law-abiding, and the task of obtaining fair and equal treatment for cyclists will become that much more difficult.
I have heard a lot of discussion that one of the biggest issues is of children and injuries to children, but it does not seem to have been resolved as to how the legislation is to be enforced against children. Is a police officer in a cruiser going to swoop down on a group of children playing in the street and write out tickets for each one? Will the officer escort the children home and chastise their parents? Some of the children will probably run away. Is the officer going to chase them in his car? It will not take long for children to realize this legislation is not likely to be seriously enforced, causing them to be unprotected, disrespectful of the law and disrespectful of police officers as well.
I also want to address the issue of promotion and encouragement of helmet wearing. It is all very well to pass a law that requires everyone to wear helmets, but we do not yet have a consensus among the general cycling public that helmet wearing is necessary or effective. The law by itself will not change this.
The experience of other jurisdictions is that a concentrated promotion campaign is essential and that significant voluntary compliance should be achieved first. Studies that have been undertaken by Dr Cushman in Ottawa have shown a significant increase in helmet-wearing rates over the last three years. We have already achieved levels of about 25% for elementary school children. As well-designed helmets become more available, these wearing rates can be expected to increase, and 1991 was the first year when approved helmets that were reasonably affordable -- let's say less than $30 -- were widely available.
There are promotion campaigns at the present time, but many are not well co-ordinated and they do not send out a consistent message. It is essential that education on safe and proper riding techniques be included in these campaigns. The campaign should not just address the need to wear a helmet. It should look at the reason why you are wearing a helmet and what other measures can be taken to avoid accidents. We know the MTO has made a good start in this direction, but funding and support for a properly co-ordinated campaign must be maintained.
In summary, we are extremely concerned that the helmet bill is taking a very narrow approach to the serious problem of bicycle accidents and injuries by seeking to prevent the injuries without addressing any of the causes of cycling accidents. We acknowledge that many members are concerned, very concerned, about the incidence of cycling injuries, particularly to children. We urge you not to choose a quick-fix solution that will prevent some injuries but will not prevent any accidents. We ask you to take time to consider all aspects of the problem and we request that you look at this bill and decide whether it is sufficiently effective in its present form.
We further request that you provide positive support for measures to improve and expand cyclist and motorist education and to undertake effective helmet promotion campaigns that will increase helmet-wearing rates without ignoring other means of reducing cycling accidents.
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Mr Dadamo: We have talked about many things with the groups we have had the opportunity to talk to. Cost has come up, and we talked about the health burden on our society. We talked about using parents for role models.
As a politician, you find out very quickly that you cannot please everybody, that you offend somebody. What we are trying to do is to find some common ground and possibly legislate something, at least looking at this piece of legislation, that will make everybody happy. What I would like to find out from you is how we are going to, in your mind, enforce this from a law perspective.
Mr James: We have wondered what the answer to that question is in respect of, let's say, bicycle lighting. We have lobbied as hard as we can to get proper enforcement of that. We have attempted to encourage local police forces and have provided them with material to permit them to undertake lighting enforcement campaigns, yet it just does not seem to happen. Clearly it would seem that the police need more encouragement than just that of groups such as ourselves to get them to enforce a particular piece of legislation.
Lights on bicycles not only reduce injuries, they reduce accidents as well. If you can reduce accidents, you are going to reduce those injuries right away. So it is proactive in that sense. It has an obvious benefit, but we have been unsuccessful in real terms in getting that enforced.
Mrs Cunningham: I think that when you put this brief together -- I am assuming this is the one that you put together for us?
Mr James: Yes, that is our written brief.
Mrs Cunningham: The questions you are asking are the same questions we had at the beginning of the hearings. Some of them, in my view, have been answered as we go along, and I think you would probably be pleased to know that we share all of your concerns.
With regard to the helmet standards, we intend to put those into the legislation, and anything you would give us with regard to what you think ought to be there as part of either the legislation or regulations, whatever is appropriate, we would appreciate hearing from you. I am giving you about four things to respond to now.
With regard to the enforcement of the law against children, we have talked about other precedents. We just today talked about the Maryland experience, where in fact there are two levels of fines. I am not sure you were here for that. You have been here for a little while? You heard that?
Mr James: Yes, I have been here all day.
Mrs Cunningham: Then you will know that I made a statement about that, and you might want to respond to it. The implementation program is one that we are very concerned about, and perhaps you could give us a time frame that you think would be fair.
With regard to "MTO's support not stated," I was hoping, personally, that nobody would talk about their support or otherwise until we had the public hearings, because what we were looking for were ideas on how this whole thing could happen, if indeed it was appropriate at this time in Ontario.
So what we have been looking for is good advice around enforcement. Rather than telling the whole world what we are going to do and getting them angry, we have taken a different approach. We all feel pretty secure about some of the things; for example, are helmets available? We think that question has been answered. The phasing-in period: we think we have an idea about what we would like to do there. But there are some that we would like to hear from you on, and I have given you four.
Mr James: On the issue of helmet standards, I am well aware that the motorcycle regulation specifies ANSI, Snell, CSI and CSA, and I would expect that a comparable regulation would be written with respect to bicycle helmets. But those helmet standards do not address children under five. There are no standards for helmets for children under five. It is difficult to see how legislation can be enforced if a regulation is attached to the legislation and the standard which is referenced in the regulation does not apply.
Mrs Cunningham: What would your recommendation be, given what you said?
Mr James: If you are going to quote a standard in a regulation it has to be relevant in some way to the people who have been enforcing it, unless the regulation would exempt children under five from having to comply with the particular standard.
Mrs Cunningham: That would be my guess too. Is that your recommendation, given what we all know right now today on children under five?
Mr James: You leave it very open then that a parent could put a child in any helmet, and it may not even be a cycling helmet. There are problems with using non-cycling helmets for cycling use.
Mrs Cunningham: We would not do that, given the evidence we have here. You are an expert, so I am asking, what would you say to us, what would your recommendation be? We do not know what the answer to the question is. What would you say in the regulations with regard to children under five? That is a very difficult question we are asking you.
Mr James: The regulation would have to be written in a manner that would identify what a bicycle helmet is without referring to a standard, because there is not a standard that identifies what a bicycle helmet is for a child. We certainly would not recommend that any helmet could be worn by a child. Hockey helmets, for example, have lots of protrusions on them and they are not suitable for cycling. The recommendation would be that a bicycle helmet has to be identified without referring to a standard. Now whether or not that is a logistical nightmare is beyond my experience. It is certainly not as easy as referring to a Canadian standard, because that can be done in one line -- everyone knows what a Canadian standard is.
The Chair: Mr James, on behalf of the committee, I have to say thank you very much for taking the time to present this material and your comments. Obviously there is great interest in what you have had to say. Mr Dadamo, from the Ministry of Transportation and parliamentary assistant to the minister, and Mrs Cunningham, the sponsor of the bill, will undoubtedly be keeping in touch with you. Please keep in touch with us. If there is more you want to say, feel free and feel comfortable contacting us. Take care, sir.
ALAYNE MCGREGOR
The Chair: Ms Alayne McGregor, good afternoon and be seated. Please tell us what you want to tell us. Try to give us some time to talk to you. Please use several minutes to address us and then leave us some time to question you.
Ms McGregor: My name is Alayne McGregor. I am a member of the city of Ottawa Cycling Advisory Group and Citizens for Safe Cycling, but I am speaking here as an individual. For the last four years, for eight months of the year, I have been cycle-commuting to work. I also use my bicycle as my main means of transportation. I always wear a bicycle helmet and I urge my family and friends to wear bicycle helmets as well.
The reason I am here today is to talk about bicycle accidents and why they happen. I guess I am a bit of an expert on that because I seem to have this horrible tendency to have one bicycle fall a year, to my great chagrin. But contrary to the stereotypes, none of these bicycle accidents has ever involved a car. In fact, in general what they have been is falls. Normally what they have been caused by is the road surface itself. I should also note that in every case I was able to ride away from that fall.
For instance, in the spring of 1989 I was cycling along a road in Kingston. I had to move out into the road because there was a parked car, so I did a shoulder-check as is proper practice and because of that I missed seeing a parallel crack in the road. What happened was my front bicycle wheel go caught in the crack and I went over the handle bars and I landed right here on my head.
Luckily, I was wearing a helmet. I am going to pass the helmet around. If you look at the left side where the strap is, you will notice how the foam was completely compressed at that point. That is where I hit and I am very glad I was wearing a helmet, because as the doctor at Kingston General Hospital told me it probably saved my life.
I would like to jump ahead to the summer of 1990. It was a beautiful clear day in Ottawa and I was late for an appointment so I was taking a corner pretty fast. It was a corner I had gone through lots of times before and I knew how fast to take that corner, except what I did not know at that point was that there was two inches of sand on the corner left by some blankety-blank city workmen. What happened was that I took that corner fast and my bicycle went like this and I landed here and here, and boy, did I land hard because of the sand.
I am going to pass around a picture taken of me five days after the accident occurred. You can see the injuries from that particular accident. I did not hit my head in the slightest in that accident. My head did not touch the ground. The only thing that touched was my arm and my leg, but at the same time the doctor told me I had one of the worse cases of haematoma, which is a fancy name for a bruise, that he had ever seen.
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I would like to contrast the two accidents. Both of them caused me considerable pain and suffering for several weeks afterwards, and both of them were primarily caused by improper maintenance of the road, but in only one case was my helmet of any use.
I have also had the clerk pass around an article from the Ottawa Citizen about a local Ottawa cyclist named Marc Lamarre who was cycling down a local road and happened to collide with some other cyclists who were doing bizarre things on the road. Mr Lamarre was wearing a helmet, but his helmet did not help him at all because what happened was that he managed to break a couple of ribs and shatter some bones in his leg, and now he is not going to be able to cycle any more. Again, what I am trying to say is that you can have serious accidents on your bike and the helmet is not going to be the cure-all.
Clearly, helmets reduce the severity of certain types of accidents and that is why I wear a helmet and that is why I think they are a darn good thing to have. But they do not prevent accidents, and that is why I am worried about this bill. I am worried that a mandatory helmet requirement is going to be seen as the solution to bicycle injuries. I am worried that helmets, which lessen the effect of one type of injury, albeit the most serious injuries, will be seen as the magic bullet that prevents bicycle accidents. They cannot.
Bicycle accidents occur for a whole bunch of reasons: bad road surfaces, unleashed dogs, law-breaking cyclists, law-breaking motorists, carelessness, mechanical failures and all sorts of things. The way you are going to address these is by proper law enforcement and education campaigns. I can speak for that myself. I have taken a Can-Bike skills course, which is the Canadian Cycling Association's course, last year after my accident and I found that it did help me. It did not help me in terms of learning how to avoid cracks, how to dodge rocks or stuff like that. I think I have managed to avoid a bunch of accidents since then.
But if this government spends the money it is going to spend to promote the mandatory helmet bill and to educate the public about the mandatory helmet bill, I am worried that there is going to be at some point a resources crunch, that we are going to say, "Okay, we do not have enough both to promote this mandatory helmet bill and do the other types of education to educate people on how to prevent accidents and to educate motorists and cyclists how to share the road."
I am all in favour of helmet promotion. I think the government should continue the campaign it is doing now to promote helmets, but there is an additional cost on top of that for the mandatory campaign. I am just wondering where that money is going to come from. I have a prejudice in favour of preventing accidents rather than minimizing their effects afterwards. That is what is worrying me about it.
I would also like to mention a second concern with Bill 124: the standards, which we have talked a little bit about before. As I am sure you have been told, hockey helmets will not work, but I suspect we are going to see a lot of them if this bill actually happens.
For example, last summer I was coming out of a local park and I saw this family come along. There was a mother and father and two little boys on their bicycles. The two little boys were wearing hockey helmets and the hockey helmets were not even clasped up. So if those kids had gone off their bicycles, the helmet would have been over here and they would have been over there. They would have been absolutely useless, but this family was obviously firmly convinced, "Well, I am protecting my kids because I have got them to wear a helmet," even though the helmet would have been useless. I think you can have a big campaign in order to educate Ontarians about what type of helmets are needed, how to wear them and how to wear them properly.
This is my current helmet. I did not finally figure out until this fall how to properly adjust the straps so that the helmet did not fall back. I kept having to push it back and push it back and then finally a friend of mine told me what I should do. Yet I am an experienced cyclist. But there was nothing in the information that came with my helmet to tell me what I have to do to adjust this helmet properly. None of the people in the bicycle stores told me how to adjust it properly. So I am saying that there are real concerns there.
If this helmet bill is going to actually protect Ontarians, it is going to take a careful setting of helmet standards and a massive educational campaign. It must be combined with measures that actually prevent accidents rather than just minimize the injuries. I hope as much as you do to reduce cycling deaths and injuries, but this bill is not going to be enough on its own.
The Chair: Thank you for an enlightened and speedy commentary on the legislation.
Mrs Cunningham: I enjoyed it. I enjoyed it because the concerns you have raised are the concerns the general public raises. Three weeks ago most of us would have done it, I think, almost the same way you did today. Now we have had the privilege of having people like yourself come before the committee to raise questions it is our responsibility to get the answers to, and have experts come before the committee to answer those questions.
The reason I introduced Bill 124 was with regard to prevention, that is, to prevent head injuries, to prevent the unnecessary loss of life or quality of life, to prevent taxpayers' dollars being spent on rehabilitation, and to prevent a neurosurgeon who sat here earlier today having to get up in the middle of the night and do something that he wished he never had to do; he wished he did not have the job.
Regarding standards, you are absolutely right. You used the word "careful." We promise, and we will take your advice on that. Massive education, you are absolutely right. We do not have the answer to that, but, boy, we are going to get it before we deal with this legislation, because it would be irresponsible to do otherwise. As for road safety, most of the cyclists who have been here have all complained about that.
So I would like to thank you very much. You have given us more challenges. My compliments are to Ottawa, though, for setting a standard that has been quoted lots before this committee with regard to the 25% compliance with the cyclists who wear helmets. That is something to be proud of.
The Chair: Quite right. Thank you, Mrs Cunningham.
Mrs Fawcett: Ms McGregor, I just wanted to say that I think your expertise and knowledge in this has provided us with a lot of very valuable information. Thank you for coming.
Mr Klopp: I really do believe we are just here passing a law. I would not be as excited about it. I think it is only the beginning of the end. Your comments about education are bang on. Do we have enough money as government? Well, there is never enough. But in fact many of the groups have realized that government is not some fictitious thing, that it is their money, and they have come forward and said, "You put in legislation, and that will be our plus, and we will do a lot of the work," instead of the reverse model, which in the good old days people have taken. These tougher times have maybe made us all more aware of that. So I take your comments seriously, but I think we do need to get on with it.
The Chair: Ms McGregor, all of us thank you for taking the time to come here, for your interest and your organization's interest. We appreciate you are here in your own and your organization's interest as well. The interest of avid and enthusiastic bicyclists in this issue is impressive, and we are pleased to see people like you coming from communities across Ontario showing an interest in their government and in this legislation. Mrs Cunningham is the sponsor of the bill. She would be pleased to hear from you down the road, as would Mr Dadamo, who is the parliamentary assistant, or any other member -- your own member, for instance, among those. Thank you. Have a safe and comfortable trip back home.
EAST YORK HEALTH UNIT
The Chair: The East York Health Unit has braved and endured difficult traffic conditions. Sorry about the timing, people. To make you come during this time of the afternoon was indeed cruel, but perhaps it is the propensity of government to impose that sort of hardship on the electorate. Would you please tell us who you are and highlight your submission so that we have some time. Perhaps you could spend five or six minutes on your submissions and then give us some time to ask you questions.
Mrs Shortt: I am Linda Shortt, director of adolescent health at the East York Health Unit. With me are Peggy Howorth and Tish Willekes, who are two community health nurses who co-chair a helmet promotion committee in East York and who have been involved in helmet education, and Gail Nyberg, who is a member of our board of health and a trustee on the board of education for the borough of East York.
I just want to say one thing, and that is that we are here to speak from our perspective, which is an educational one. I think you have heard a lot about the statistics about injury and hospitalization, but we do not intend to go over those. We want to talk a little bit about what education can achieve and what it cannot achieve. We are here from a public health perspective, which is that of preventing injury and looking at the most efficacious way of doing that.
Mrs Willekes: I am going to spend a brief few minutes describing the program we implemented in four of the East York schools in April, 1991. When we started our planning we realized we had three major factors to address in our programming. One was that we felt the majority of parents had absolutely no idea of the statistics concerning injuries and death of children in bicycle accidents. Second, we were very concerned around the whole issue of the cost of helmets and how we were going to address that, because two of these schools were of low-income families. The third concern was how we were going to convince the older students, when peer pressure was stating that to wear a helmet was not considered a cool thing to be doing.
The programs were all school-based, but we tried to reach into the community and include parents who were motivated and interested in the cause to try to personalize the programs in each of these communities. The program was more or less the same in all four schools. There were three main components. We offered a parent information night when parents had an opportunity to learn the facts, the statistics, how helmets would protect one's head in the event of a bicycle accident. We also brought in people who knew all the dos and don'ts about helmets, how they should be fitted and so on. Our main message to parents was that we felt they had to serve as role models for their children.
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During schooltime there were student assemblies and these were totally student-run. We had students perform skits and rap songs and lip-sync groups, all selling the message that helmets were cool and should be used at all times. We were fortunate in finding a female athlete who is a cyclist, and she served as our role model and gave her testimony on how a helmet had saved her life on more than one occasion.
We also had helmet-fitting nights, and we were first of all offering this as a convenience for parents. They could come to the school and in a short period of time outfit themselves and their children with a recommended helmet. We also had retailers that were prepared to sell helmets at a discount at these times as well.
Because two of the schools were of low-income families, we were fortunate in that we had some money given to us by the Kiwanis in support of this campaign and we gave a large sum of money to these schools. The principals decided to structure a rebate-type of coupon that families, on proof of purchase of a bicycle helmet, could get a sum of money back.
The survey, as written in the brief before you, shows that we were very successful. The helmet use went from 3% to 16% after the educational program. As East York nurses, we are committed to continue this education program. We still have a lot of concerns about how long this is going to take to convince everyone that this is the safe way to ride. The statistics basically are saying 16%. We know that most of those heads are small children. We still find it difficult to convince the older children in grades 7 and 8, never mind the high-school ages, that they need to consider this something for them to do.
In terms of moving into certain school communities, we have some problems in that some schools do not have a strong parent involvement. We also have principals who do not allow any cycling to occur on the school property and there are no bicycles that come to school. So it is hard for us as nurses to convince that school body to allow an educational program to happen in that particular school. We feel we need the support of legislation to help us to convince children, especially the older child.
Mrs Howorth: I am not going to speak to you as an educator, although I am very involved in an education program and I really believe in the education program we are doing. I am speaking as the mother of a teenage son who last October became one of these statistics you are hearing aobut. My son was riding his mountain bike down a really steep hill. His brakes failed, he flew off his bike, and the way he stopped was when his head hit a tree. I spent a week in and out of Sunnybrook Medical Centre with this child who was very ill, and I am convinced that if he had been wearing a helmet, he would have had a sore neck maybe and a sore head, but that is all.
Fortunately, my son in the long-term is going to be all right, but what really brought home to me the message that we need mandatory legislation is the fact that this fairly rational teenager, at the time he was lying in the hospital throwing up and feeling really horrible, agreed that, yes, he should wear a helmet, but now that he is feeling okay he is having second thoughts about wearing a helmet.
My son owns two helmets. He knows all the risks of riding without a helmet but his stand is that it is an infringement on his personal liberty to be forced to wear a helmet. I am convinced we need legislation to help protect this age group, these teenagers. I am not saying they have no sense, I am saying that over this issue they are a little bit difficult to convince. I think what this legislation will do is help us protect these kids, because I know how much helmets do protect them, and they do save lives. I also think it is going to help parents like me who are very involved with this issue. I could talk to this child until I am blue in the face and not have any effect on him. So that is why I am here today. I realize that there are difficulties with enforcing legislation, but I know it has been done in other places and I think it can happen here and I think it is what we need to do.
Mrs Nyberg: I am part of the political arm of the board of health and the board of education, but I am heremore to speak to you as a mother of three teenage sons. They have helmets and what they need from you is the permission to wear them. There are peers, and as you all know, peers are the most important thing at the teenage level, no matter what they do. They have them, they put them on their head, they round the corner, they do not wear them. They need the permission from you to wear them.
Mrs Cunningham: This is not what we expected to hear from you -- it is even better. Most of us in this room are parents and we really relate to what you just said. Even in my home where I have a head-injured son, I have to tell you that his friends suffered with him for seven years, the ones who were able to stay with him, visit him and be part of his life to the very small extent they could, and even today some of them do not wear seatbelts, although they lived through the agony of this kid's life -- even with the law. But I will tell you that the greatest excuse of all, when I asked him about it, is that they are terribly afraid of having to spend money and pay the fine and getting caught and having points and all these things. I guess that is my story. It never ceases to amaze me after what they have been through, that even with the law -- but of course the seatbelt legislation has been so successful.
I can only thank you for everything you have done, and certainly for the active role you have played in the program in those four schools. I am warning you that we will be back to you. Because I think what this committee will feel fairly strongly about, and I have been listening to my colleagues in this non-partisan issue, are ideas on how we can get a community like yourselves to help us with the education part. You have heard the previous presenter talk about the real need for education. Your presentation has been compelling for me. Sometimes you think you are alone as a mother or as parents. Thanks.
Mr Waters: Earlier on in the hearings someone had come in and said we should put about $800,000 to $1million a year into education for people riding bicycles. After the principal was talking, I thought maybe our money might be better spent if we cut down on that and allowed our schools to do a lot of the education with what is now available, and let people such as yourself maybe take some of that money and put it towards helmets for those who cannot afford them. I would like your opinion on that comment.
Mrs Shortt: That is a difficult one. We are a health unit that has chosen to make injury prevention one of our priorities. By doing that it means that we are choosing not to do other things. We often lay education on the school system -- mandatory AIDS education and mandatory this education and that, and sometimes it is effectively done that way. I think what we need is a coalition of people who agree that this needs to be done, and that perhaps education can work with health to create the kind of education that is needed.
But we have more than one target here. We have kids and we also have parents who have to be convinced. I think the issue for younger children is very different than the issue for older children. With education we are probably going to get helmets on beginning riders. I think it would take a long time to get helmets on adolescents and frankly we are confounded about how to do that. I think we need legislation to get helmets on the group of kids who have the highest injury rate, those 13-, 14- and 15-year-olds. They can know the facts and own helmets, but do not wear them because it gives them helmet-head, or whatever it is they call it. So as Gail says, I think we need the legislation to give them permission to wear their helmets.
Ms S. Murdock: Actually a concerned group coalition is probably not a bad idea. I noticed in your enforcement issues in your submission you have a year phase-in period with a province-wide educational campaign. By a year phase-in period you mean what?
Mrs Shortt: A year after the legislation is passed it becomes effective, so that people have a year to gear up and get their helmets and we have a year to really push with education.
Ms S. Murdock: The other thing is -
The Chair: Thank you, Ms Murdock.
Ms S. Murdock: No, I have to ask -
The Chair: Ms Murdock, I am telling you. Mrs Fawcett.
Mr Waters: Ms Murdock, there are four minutes on the bell.
Mrs Cunningham: Four minutes and we are locked out.
Mrs Fawcett: I really appreciate your coming, and I agree with you totally. I do not know what happens to teenagers. Some of them seem to go brain-dead, the fully intelligent people, and yes, we need to help them.
The Chair: I want to thank you on behalf of the whole committee for your interest, for coming here this afternoon. Please keep in touch with Mrs Cunningham, who is the sponsor of the bill, and Mr Dadamo, who is the parliamentary assistant to the Minister of Transportation. Have a safe trip back home. Thank you, people.
Thank you to the committee for its co-operation this afternoon. We will be back on Monday at 3:30 pm.
The committee adjourned at 1743.