At midnight on 31 January 1983 legislation was introduced to make the wearing of seat belts compulsory. Only 40% of the population were wearing them at the point and the change in the law was met with howls of indignation. But now if you or I get into a car the use of a seat belt is reflex. Not wearing one almost feels like nakedness.

This is a beautiful example of a behaviour change leading to a mass attitude change and social progress is filled with similar examples of enlightened leadership. If you are in any doubt about this try and find some film of people smoking on aeroplanes and gauge your response!

So it is rather sad to read the government’s muted and timid reaction to Lord North’s excellent report. The report advises that the current blood alcohol limit of 80 mg/100 ml (17.4 mmol/l) be reduced to 50 mg/100 ml (10.9 mmol/l), that random breath testing of drivers be introduced, and that a lower limit of 20 mg/100 ml be considered for younger drivers.  I suspect that the government are fearful of appearing authoritarian or agents of a nanny state. I don’t think that they need be.

Although governments should defend individual liberties they should also articulate and facilitate the social responsibility that we all owe each other. Achieving a balance between these competing poles should involve the regular redrawing of lines in a dynamic healthy society, Road safety is currently in this spotlight and mass attitude change seems possible.

The evidence of benefit for the lowering of speed limits in built up areas is growing(?) and seems to me to be overwhelming, and if you live in Portsmouth, Oxford, Newcastle, or Islington you will already have noticed an increase in 20 mph zones. I think many more of us will be experiencing this soon.

The proposals in Lord North’s report are similarly convincing. His honest appraisal of the evidence and his clear sighted awareness and willingness to face up to possible objections certainly convinces. If you are sceptical now- read his report – you won’t be when you get to the end of it.

The government should recognise that the acceptance of the current levels of death and injury on our roads will in time seem as ridiculous (and outrageous) as smoking on planes. They should be bold, get abreast of the curve and demonstrate some leadership

One of the difficulties about making your mind up about road safety is that it all can seem very remote. You can drive for 30 years without its significance really impinging on you. But the statistics are there and as advocates of public health Doctors should be aware of them.

I recently wrote about my experience of a child running out in front of my car, and among the internet response was an article in a rather militant cyclist’s blog. After a long exposition about the general wickedness of all drivers it concluded with a comment on my awareness of road safety: “(Dr Foreman’s) consciousness has developed but … there is room for improvement.”

So. How is your consciousness doing?

Nick Foreman is a general practitioner in Rickmansworth.