Professor Denis Cusack:

I am not speaking for the Medical Bureau of Road Safety, but I will touch on some of the points Deputy Fitzmaurice raised. I do not know if it will be of help to the committee, but there is a provision in the Safety, Health and Welfare at Work Act 2005, section 13(1)(b), which puts responsibilities on the employee not to be intoxicated and put others at risk. I believe this is a theme. It is about shared responsibility and it is not all on the employer nor all on the employee. I do not know if this is a help and it might cross-reference with different legislation.

On Deputy Harrington's question, my response was to Deputy Ellis, who was asking how drugs are tested for and how they go into the body, the Deputies are quite right that it is more complex, but that is simply in terms of how we test what we are looking for. There are many variables and it is more complicated than alcohol, but perhaps I can reassure the committee by simplifying the variables. In terms of road safety and impaired driving, it comes down to whether the drug disappears from the system in 24 hours or three hours and whether we can test it by one method or another. They are the complexities we have to deal with. When it comes to the safety of driving the simple variables are whether there is an active substance in the bloodstream at the time of driving which is known to impair driving and make it more dangerous, and how we find that substance. One can take all the variables and reduce them to just that moment in time.

One might also consider all the things for which we cannot test. This is why I go back to the opening statement. It is important to know what is happening elsewhere. From all of the literature, we know that the classes of drugs picked up in the majority of impaired drivers are drugs such as cannabis, benzodiazepine or valium-type drugs, cocaine, opiates, methadone, amphetamine and methamphetamine. Members are right that it is not 100%, but if we were to not to do anything until we can find everything, then we would be putting lives at risk. This is a very comprehensive start. I will give the committee an example. When we checked the blood and urine samples of drivers arrested by gardaí on suspicion of driving while intoxicated, but who were found to be under the limit for alcohol, approximately 75% of samples turn out to be positive for drugs. That is a very good start. It is not perfect; it is more complicated.

There is a discrepancy between the number certified as definitely having drugs in the bloodstream versus the number of prosecutions. I brought this up with previous Ministers Michael McDowell and the late Séamus Brennan, which illustrates how long ago it was. Part of the reason was the difficulty in bringing evidence that would satisfy. One of the important things in our democracy is that nobody should be found guilty of an offence unless there is evidence beyond reasonable doubt. Taking away a person's driving licence is a very big step. We are trying to balance that with road safety.

Since November 2014 there has been impairment testing which is fairer to the driver and assists the Garda in bringing forward better and fairer evidence. The roadside chemical testing is adding to that. We hope that this course is progress. I remind members that it took decades to get the roadside mandatory alcohol testing. It is a significant step, but it will take time. We take our job seriously to make sure that what is out there is fair, accurate and practical for gardaí. For example, can they use these devices in the pouring rain? Even though the gardaí and the devices came in dripping wet, we found they could be used. I wish to reassure the committee that, despite all the complexities, we are trying to make sure this is a simple and fair system.

I thank Deputy Fitzmaurice for discussing drivers with diabetes. In another life my specialty training here and abroad was diabetes. I will mention the medical fitness to drive guidelines. What the Deputy has said is exactly what we want to ensure - that people are reassured. I hope, since the Deputy brought it up, he does not mind me replying in a personal way. This is about making sure that the Deputy remains healthy and fit to drive and to support him in that. I am a member of the fitness to drive group, which has representatives of both patients and specialists in diabetes. I do not know if members have had the opportunity to read the medical fitness to drive guidelines, Sláinte agus Tiomáint. They are probably not light reading. Up to a few years ago we were relying on very skimpy 1980s guidelines from what was then the Department of the Environment. We actually had to refer doctors to the UK guidelines. Chapter four of Sláinte agus Tiomáint deals with diabetes mellitus. The thing about medical fitness to drive is that the aim is not to stop people driving but to facilitate people with medical conditions to be in the best health possible and to make sure they are not precluded from driving because of a medical condition, whether it is epilepsy, heart disease or diabetes. The chapter of the guidelines dealing with diabetes mellitus contains a number of appendices to help doctors and their patients ensure that the patients, as drivers, remain fit and healthy and do not run foul of the regulations. It is very positive and we need to get the message out that somebody taking insulin or an oral hypoglycemic is not going to run foul of roadside drug testing. It is a very important message and I thank the Deputy for bringing it up. Road traffic legislation deals with the penal and criminal, but instead of linking it to misuse of drugs and criminality, as a doctor I am trying to link it to where it belongs - road safety and medical fitness to drive. Rather than trying to have prosecution, why not try to get people to realise that all we are trying to do is make sure that drivers are driving safely for themselves, their families and other road users. I hope this reassures members about medical fitness to drive. The Deputy himself is probably an expert on diabetes.