Road Safety is an area
demanding more attention due to increased vehicle usage, high speed of traffic
and ever increasing road network. There are large number of instances of
reported road accidents due to ever-increasing number of vehicles, good network
of rural roads constructed under PM Gram Sadak Yojna and sudden spurt in the cases
of road rage. As per Government of India statistics, during last three years
the number of accidents reported are about 5 lacs resulting into fatalities of
more than 1.3 lacs every year. In 2016 more than 1.5 lac people lost their
lives out of which about 92000 were killed in rural areas. Accidents carry high
economic and social costs, which are not easy to ascertain. Generally the cost
of road related injuries and accidents are assessed in terms of (a) medical
costs (b) other costs related to administrative, legal and police expenditure
(c) collateral damage in terms of damage to property and motor vehicle and (d)
loss due to income foregone arising out of absence from work or
impairment/disability or untimely death. Due to lack of sound social safety
net, accident survivors often live poor quality of life and have to live with
pain and suffering which are difficult to estimate. In developing countries
like India, where there is very little asset ownership and lack of social
support to families with impaired bread earner, accidents adversely impact the
welfare of accident victims and their dependents.
Paradoxically, higher speed vehicles
and better quality roads have their own contribution in increasing the number
of serious accidents. However, with better design of vehicles there is a
decline in fatalities vis-à-vis increase in number of vehicles. Even though length
of motorable road has increased significantly during last 46 years (1970-2016),
number accidents reported on every 10,000 kms of road have decreased
marginally. However it is worrying that the number of accidents has almost
doubled for every one lac population. It was 21.2 per one lac in 1070 but it
has gone up to 39.6 by 2016. Number of victims getting killed or seriously injured
in the accidents has also increased significantly for every one lac population.
During the same period, number of injured has gone up from 13 to 39 per one lac
of population. There are several causes of large number of accidents and
fatalities. Road design and upkeep is one technical reason about which the
engineering departments are already aware and initiate action as per the
availability of the funds. One area where a lot of attention is needed is to
train the drivers and road users about road safety. Generally advertising and
other road safety campaigns are launched to create awareness about road safety
but still a lot more is needed to be done. Road safety campaigns are primarily
focusing on road users and drivers in urban areas. Despite having a
significantly large road network in rural areas, huge number of vehicles
commuting in rural areas and on rural roads, not much training and education
efforts are made to train and educate the rural road users. With good network
of rural roads, speed of vehicles has increased and so is the risk of
accidents. Mixed vehicle use in rural areas and movement of animals on roads
also causes accidents. Road traffic
accidents kill more people around the world than malaria, and it is a big
killer of young people aged five to 29[i].
Further, the mechanism to take care of
road victims has not got the adequate attention. Often accident victims go
unattended because people are scared to help the victims lest they should get
involved in police case. These accident victims do not get timely medical
attention for lack of suitable transportation, inadequate medical facilities in
local hospitals and reluctance of the hospitals to admit them for want of
upfront fee payment. There is a need for overcoming all these bottlenecks and
integrating all these elements into a viable system that can provide a
sustainable solution to this hitherto largely unattended problem.
Road accident victims are not covered
under any immediate relief program/scheme of the government. Every case is
dealt in isolation and support extended by government to victims also varies
from case to case. In most of the cases, support reaches the victim only after
the critical first 24 hrs of medical attention is already over. Saving life in
an unfortunate happening of road accident by ensuring treatment in a state of
the art hospital has financial implications. In order to provide relief to the
victims, providing network of road side assistance helpline no. 108 is the
first step. It must be duly supported with linkages to hospitals mandated to
admit and treat the victims without bothering about payments to be received
from the victim. Network of state of the art hospitals alongside the roads is
the need of the hour. Empanelment of these
hospitals for treatment of road accident victims with robust mechanism to
monitor their performance in treating accident victims and facilitate
reimbursement of their claims carries a lot of importance to make system
sustainable in long run. Some projects in the county have made considerable
headway in initiating the ex-ante measures such as road accident reporting,
data analysis and engineering interventions. However, these measures have not
been incorporated as standard business procedure across the states to derive
maximum benefits from the learning. Furthermore, in the unfortunate
occurrence of a road accident, ex-post measures like timely rescue and
treatment of accident victims in an appropriate hospital equipped for handling
such accidents are not methodically integrated with a comprehensive road safety
strategy.
One possible ex-post measure that could be attempted is to create a Fund
for treatment of road accident victims. The revenue streams for the medical treatment in this Road
Safety Fund would primarily comprise of inflows from Motor Accident
Compensation Tribunal (MACT) claims, which are paid to the victims by the
insurance companies. There would still be a gap between the Funds required for
medical treatment and the claims given by the insurance company. This viability
gap has to be funded by the Government. It can do so by making budgetary
provisions in the annual budget. Money spent on this will have positive impact
on economy by bringing down the casualties and reducing the number of impaired
workers due to accidents. A small fraction of tax collected on fuel may be ear
marked for this purpose. In this direction, Road Accident Fund of South Africa[ii]
is a good model to follow. In India also, the proceeds from the small part of
tax imposed on fuel can straight way flow into the Road Safety Fund. Apart from
this receipt, other stream of receipts would not reach to fund in time. Receipts
coming from MACT or insurance companies would realize much later whereas the
expenditure incurred on accident benefits happens immediately after the
accident. While the medical expenses have to be paid up-front, there is a
considerable delay in settlement of accident claims by the tribunals. This Fund could pay upfront for accident
victims’ treatment in an appropriate and empanelled hospital, equipped for
treating such cases, with recoupment to the Fund from the MACT award at a
subsequent date. Asset management to make the Fund viable and sustainable,
verification of claims of hospitals and mechanism to release payments to
hospitals in a time bound manner is necessary to make this process effective.
In order to handle the
issue of road safety in rural areas, it is desired to have a multi-pronged strategy based on 4 ‘E’s viz. Education, Engineering
(both of roads and vehicles), Enforcement and Emergency Care. In this direction
following need to be
addressed and taken forward:
1.
Rural road design and identification
of black spots in rural roads: Rural roads constitute more than 61% of total road network of the country.
Rural roads, in many cases have been constructed by upgrading the mud roads or
kuccha narrow pathways constructed in the village to facilitate movement of
animals and people to farms and back to their homes. Utility of such roads was
very different from the roads now constructed. Such roads, when get converted
into bitumen or RCC roads with very good motorabilty, the vehicle movement on
such roads are facilitated significantly. Speed goes up and so are the chances
of accidents. Many roads have alignment issue, many are not designed to handle
speed of more than 40-50 kms due to presence of blind turns, narrow culverts,
animal movements etc. Most of the roads are designed to handle light vehicles
where as heavy vehicles have started using these roads due to their better riding
quality and less traffic. This not only causes extensive damage to the life and
surface of the road but increases the chances of road accidents on these roads.
Large number of rural roads has been constructed with a lot of focus on quality
of material and riding comfort. Road safety has not got the commensurate
attention, it deserves. Further no comprehensive study has been conducted to
assess the black spots in rural roads, conduct road safety audit and work on
them to improve road safety standards of these roads. For the existing roads,
comprehensive road safety audit shall be done and alignment and other changes
be effected in a phased and planned manner. Currently road safety audit is at
nascent stage and that too only a small stretch of highways have been covered. For
new roads, design of roads must be prepared keeping in mind the connectivity to
village and growth in high speed vehicles, road safety concerns etc.
2.
Awareness about road use, signage,
speed and safety: Creating awareness is
the best way to increase road safety. For road safety awareness among the
general public, the Government and civil society has been undertaking various
measures “in the form of telecasting/broadcasting of T.V. spots/Radio jingles,
display of cinema slides, hoardings, organizing Road Safety Week, seminars,
exhibitions, all India essay competition on road safety, printing of
handbills/stickers, posters, etc., containing road safety messages for various
segments of road users viz. Pedestrians, cyclists, school children, heavy
vehicle drivers, etc. , painting on road railings on themes of road safety,
road safety games, calendars depicting road safety messages, etc.”[iii]
Efforts of creating awareness have inherent bias in favor of urban areas, even
though large number of accidents is happening in rural areas. There are fatal
accidents happening in rural areas and many accidents take place due to
unacceptable behavior of the drivers or the road users.
Rural
Road accident statistics of 2016
|
|
Number of
accidents in rural roads
|
216,638
|
Number of
persons killed
|
56,643
|
Number of
persons injured
|
220,868
|
Source: Ministry of Road Transport and Highways, Government of India
These accidents may definitely
be brought down by imparting elementary level of awareness about basics of road
safety to rural road users. There is a need to engage rural populace in this
exercise to have maximum impact on road safety.
Panchayati Raj
Institutions (PRIs) to be involved in conducting training for driving licenses
and road safety: PRIs are the ideal institutions
to train rural people about road safety. Unless learning comes from grass root
level, its propagation will be slow and fatal accidents would keep happening in
large numbers. PRIs have enormous potential to create awareness among the
villages and this must be exploited in a professional manner. Panchayats may
play a very important role in convincing two wheeler drivers and riders to wear
helmet and not use mobile while driving. This will bring down fatalities in
road accidents in rural areas. If standard procedure of road safety training is
made available to GPs and it is included in the regular transaction of activities
of the GPs, it would get ingrained in the culture of villages. PRIs should be
provided with funds and functionaries to create awareness. Further, apart from
creating awareness and imparting education about road safety, it may be
considered to delegate the powers to PRIs to issue temporary driving licenses
for driving agricultural vehicles such as carts, tractors and non-motorised
vehicles, e-rickshaws as well as two wheelers. To begin with, even a different
category of diving license may be considered eg. learner’s license valid in the
district of PRI and valid for select types of vehicles popularly used in rural
areas. Transfer of this function will definitely empower panchayats and enhance
their revenue generation potential. Gradually, it may be considered to delegate
the powers to panchayats to impose penalty and fines on non-compliance of
traffic rules, including provisions related to upkeep of vehicles. Further, if
panchayats will have the power to issue license, it would definitely create
awareness about traffic rules among the elected representatives and
functionaries working in the panchayats.
Table: Main causes of serious
accidents in India
Cause of Accident
|
Number of
accidents (% age)
|
Number of people Killed (% age)
|
Number of people injured (% age)
|
Fault
of Driver of motor vehicle
|
4,03,598
(84.0)
|
1,21,126
(80.3)
|
4,14,785
(83.9)
|
Fault
of Driver of non-motorized vehicle
|
6,546
(1.4)
|
2,250
(1.5)
|
7,620
(1.5)
|
Fault
of Pedestrian
|
8,298
(1.7)
|
3,091
(2.0)
|
7,465
(1.5)
|
Fault
of Passenger
|
5,200
(1.1)
|
2,181
(1.4)
|
4,535
(0.9)
|
Mechanical
Defect in motor vehicle
|
6,688
(1.4)
|
2,823
(1.9)
|
6,956
(1.4)
|
Engineering/
Designing fault of Roads
|
1,289
(0.3)
|
589
(0.4)
|
1,217
(0.2)
|
Defect
in road condition (surface of roads/surface condition of roads)
|
7,158
(1.5)
|
2,983
(2.0)
|
6,579
(1.3)
|
Stray
Animal
|
1,604
(0.3)
|
629
(0.5)
|
1,307
(0.3)
|
Poor
light condition
|
3,833
(0.8)
|
1,631
(1.1)
|
4,477
(1.0)
|
Other
causes
|
20,858
(4.3)
|
7,312
(4.8)
|
23,380
(4.7)
|
Causes
not known
|
15,580
(3.2)
|
6,170
(4.1)
|
16,303
(3.3)
|
Total
|
4,80,652
|
1,50,785
|
4,94,624
|
Source: Ministry of Road
Transport and Highways, Government of India
Common causes of accidents are
negligence or fault of drivers, fault of pedestrian, stray animals, fault of non-motorised
vehicles etc. It is evident that most of the reasons of accident are common and
more pronounced in rural areas than in urban areas. It may also be noted that
all accident cases of rural areas are not reported. Only accidents with
fatality or grievous injuries get reported. Hence, data of accidents are not
very exhaustive. It is certainly on the lower side at least for the rural
areas. Good training of drivers at entry level (when they start learning to
drive in villages and try their hands on motorcycles and tractors). If PRIs may
be given the resources to conduct training and delegated power to issue
learners’ licenses for the residents within their jurisdiction, it would create
awareness and produce responsible drivers.
Chart: Major reasons of accidents in
India in 2016
Cause of Accident
|
Number of
accidents (% age)
|
Number of people Killed (% age)
|
Number of people injured (% age)
|
Fault
of Driver of motor vehicle
|
4,03,598
(84.0)
|
1,21,126
(80.3)
|
4,14,785
(83.9)
|
Fault
of Driver of non-motorized vehicle
|
6,546
(1.4)
|
2,250
(1.5)
|
7,620
(1.5)
|
Fault
of Pedestrian
|
8,298
(1.7)
|
3,091
(2.0)
|
7,465
(1.5)
|
Fault
of Passenger
|
5,200
(1.1)
|
2,181
(1.4)
|
4,535
(0.9)
|
Mechanical
Defect in motor vehicle
|
6,688
(1.4)
|
2,823
(1.9)
|
6,956
(1.4)
|
Engineering/
Designing fault of Roads
|
1,289
(0.3)
|
589
(0.4)
|
1,217
(0.2)
|
Defect
in road condition (surface of roads/surface condition of roads)
|
7,158
(1.5)
|
2,983
(2.0)
|
6,579
(1.3)
|
Stray
Animal
|
1,604
(0.3)
|
629
(0.5)
|
1,307
(0.3)
|
Poor
light condition
|
3,833
(0.8)
|
1,631
(1.1)
|
4,477
(1.0)
|
Other
causes
|
20,858
(4.3)
|
7,312
(4.8)
|
23,380
(4.7)
|
Causes
not known
|
15,580
(3.2)
|
6,170
(4.1)
|
16,303
(3.3)
|
Total
|
4,80,652
|
1,50,785
|
4,94,624
|
3.
Communication System: It is often noticed that road
accidents’ victims suffer most during the golden period of their survival due
to lack of communication facilities. A mechanism to facilitate communication
with victims of road accidents needs to be developed. One method could be to
develop linkages with mobile operators to extend the emergency contact facility
to control rooms of patrol vehicles and ambulance in the region. A system may
be developed whereby the victim presses the emergency contact button and the
message may get flashed to the nearest control room of traffic management
setup. From there, based on the location of the victim (which may be identified
through the location of the mobile) ambulance may be deployed by road safety
setup, if the call is related to road accident. Now there are control rooms in
place and good number of ambulances has also been provided atleast in cities
and on highways. Once the ambulance moves to accident site message may be
electronically flashed to nearby hospitals about the possible accident victims
approaching the hospital. This information will provide ample time to the
hospital to take advance action to treat the accident victim. Ambulance, after
picking up the victim may report to the control room or road safety setup,
which may then log the accident status with police authorities and road safety
Fund. Thus, through electronic methods, inter-linkages may be developed and
advantages of technology may be derived to provide treatment to accident
victims. In order to facilitate this inter-linkage, mobile/telephone operators
need to be taken on board and connectivity be mapped with road safety setup.
4.
Hospital System: Ministry of Road Transport has done a
comprehensive study of the system of road safety after Supreme Court directed
it to handle the insurance and other road safety issues in a judgment passed on
a PIL. Study highlighted that there is a need to lay down guidelines for
establishing and upgrading trauma care systems at all levels including district
hospitals and tertiary care medical college hospitals and creating a grid of
medical, allied medical and rehabilitation facilities to provide first aid,
care during transportation, emergency care in the hospital and rehabilitation. The hospitals providing medical
treatment for accident victims should be empanelled based on the facilities
that they possess. There should be comprehensive and transparent criteria for
empanelment of these hospitals specifying thresholds in terms of bed capacity,
medical/surgical facilities, medical/paramedical staff strength, diagnostics
and radiological capacities. These hospitals should agree to cost of packages
for each identified medical/surgical intervention/procedure as approved under
the scheme. An MOU may be signed with the empanelled hospitals to treat the
road victims through cashless settlement mechanism. The Fund may utilize the
services of Third Party Administrators (TPAs) which may be traditional TPA or
any other institution assigned the task of managing claims on behalf of road
safety set up for claims processing.
5.
Claim Settlement System: Once the accident victim is admitted
in the hospital, system should be enabled in a manner whereby the hospital would
provide cashless treatment. The details of the beneficiary and the treatment
given would be recorded in the hospital database. Demographic details,
including adhar no. will be captured and identity of the victim shall be
established in due course. The hospital would periodically upload beneficiary
details and complete transaction details to TPA server. Claims would be
processed in TPAs office and statement would be prepared and sent to the Fund at
a regular interval. Based on this statement, the Fund would make payment to
TPA. The TPA would settle the claim of the empanelled hospital. If treatment is
not covered within the pre-defined packages, pre-authorization is obtained from
the TPA by the hospital before proceeding with the treatment.
6.
Mechanism for audit of claims: There should be an elaborate system of
auditing medical claims raised by the hospitals. The basic purpose of the
claims’ audit is to investigate potential mis-billings, frauds and analysis.
The idea is to (i) ascertain the credentials of the accident victims and
corroboration of accident details with the information available in the ICT
systems, (ii) verify that the services charged have actually been rendered,
(ii) see the pattern and nature of accidental injuries and claims thereof and
(iii) analyse and then assess the expenditure as per demographic profile of the
victims. This would mean that there is comprehensive systems of
records/documentation which is regularly cross-checked by independent auditors
and advises are received for further improvement in the system. It should also
ensure that pre-authorization has already been taken in case services beyond
the approved packages have been rendered.
7.
Mechanism for insurance claim cases: Individuals in many cases may not be
very keen on pursuing the case as the treatment has been provided by the Fund.
Hence, it is imperative for the fund management to take up the insurance claim
cases and follow them up till the award is delivered and Fund is recouped. For
this purpose, the Fund management could utilize the services of reputed law
firms on commission basis.
8.
Fund flow assessment: The Fund would receive periodic
returns from TPAs regarding hospital claims. It will also receive regular
returns regarding insurance reimbursements. Based on these, there would be
continuous assessment of Fund flow. The projections of deficit in the Fund so
arrived at, would form the basis for raising demand with the State/ Centre for
recoupment of the Fund.
9.
Administrative arrangements: An SPV needs to be constituted for
operating the fund and for carrying out the functions of coordination with
various stakeholders like hospitals, TPAs, auditors, legal firms and Government
bodies. There will be a Fund Manager who will be responsible for the fund
management, which will include deployment of surplus funds, cash flow
management, fund projections and advising on mechanism of raising funds.
10. Legal and Policy
matters: In order to make this
system operational there may be a requirement to carry out amendments in Motor
Vehicle Act, Laws and Rules related to Insurance of motor vehicles and road
accident victims. Changes required in the legal and policy matters affecting
the above mechanism have to be studied in detail and revamped law need to be
passed for the benefits of the road users.
It is high time that rural India is accorded importance in
road safety bring down casualties and loss of bread earners. A comprehensive approach
to handle road safety, both ex ante and ex post facto is needed with rural
focus. Most of the drivers come from villages. Unless they are trained and made
aware of road safety and trained to become responsible road users, number of
accidents in the country would not come down. People in the cities are much
aware of road safety due to continuous campaign launches in different media and
presence of police and imposition of fines on traffic violations also brings in
coercive learning measures. In rural areas, people don’t get these many
opportunities of learning and drivers are generally thrown on highways to learn
the trick of road safety while driving and experimenting. Such approach is very
unprofessional and undesirable. A professional approach to handle this issue
needed to bring down casualties in India in the decade (2011-20) of Action on
road safety declared by the United Nations.
[1] Article by
Mr.Ajay S Singh, ICAS. Mr.Singh is currently working as Chief Controller of
Accounts for Ministry of Rural Development, Ministry of Panchayati Raj and
Ministry of Drinking Water and Sanitation of Government of India.
[i] Global status
report on road safety 2015, World Health Organisation (WHO),
http://www.who.int/violence_injury_prevention/road_safety_status/2015/en/
[ii]
https://www.raf.co.za/Product-and-Services/Pages/Road-Safety.aspx
[iii] Road
Accidents in India-2016, report of Ministry of Road Transport and Highways,
Government of India
Bibliography:
1.
Global Plan for the
Decade of Action for Road Safety, 2011–2020. Geneva, World Health Organization,
2011 (www.who.int/ roadsafety/decade_of_action/plan/plan_english.pdf, accessed
24 January 2013).
2.
Global status
report on road safety: time for action. Geneva, World Health Organization, 2009
)www.who.int/violence_injury_ prevention/road_safety_status/2009/en/index.html,
accessed 25 January 2013).
3.
Global status
report on road safety 2015, World Health Organisation (WHO), http://www.who.int/violence_injury_prevention/road_safety_status/2015/en/
