Let me be blunt. We have a problem. That problem is a result of placing cars at the centre of planning over the past 60 years - we’ve built our society around the car to such an extent, we can’t see beyond them anymore.
People are in love with them and politicians are afraid of them. As far as our transport system is concerned, we place a higher value on an individual’s time than we do on their health, or on our health for that matter.
We’ve become car blind
We are an obese nation and we’re getting fatter. Our children are likely to have a lower life expectancy than us because of poor health related to physical inactivity.
About 10% of the NHS budget for England and Wales is spent on diabetes – that’s £1.5m an hour. Nearly all of that money is spent on treating the complications of type 2 diabetes, from amputations to kidney failure, heart disease and stroke. This is literally the elephant in the room - £25,000 every minute on type 2 diabetes, an entirely preventable disease caused by obesity .
We’re blind to the damage cars cause to us and our environment. In 2014 (the latest year full statistics are available), more than 194,000 people were killed or injured in reported road accidents on UK roads. Of those nearly 23,000 people were seriously injured – these people had life changing injuries and relied on the NHS to pick up the pieces – and 1,775 were killed .
Yet, if we look at our rail network, the last passenger fatality was in 2006 at Grayrigg in Cumbria. There was widespread media coverage. There was an inquiry. We’ve managed to engineer out passenger fatalities on the rail network by managing risk appropriately. Imagine if were to take the same approach to road-based transport. Across the UK, we currently have five equivalents of Grayrigg every day on our roads and most of these don’t make the papers or the evening news. It’s because we’re car blind.
Let’s take air quality. Nearly 40,000 premature deaths are attributable to air pollution each year in the UK  and road transport is responsible for 80% of the pollution where legal limits are being broken . It’s the invisible killer but traffic is still the cause. What’s worse is the negative impacts are often felt by the poorest, the youngest and the oldest in society. It’s a real inequality issue that we’ve sleep walked into and we’re simply not addressing. We’ve become very good at monitoring air quality but we’re only just beginning to understand the scale of the impact.
So what can we do about it?
Cycling and walking are an important part of the solution alongside shifting to cleaner vehicles. We have evolved to move and it’s clear we’re doing less and less of that, so we need to design and build the environment around us to encourage us to move more. Presenting people with opportunities not to use the car is key. We need to redress the balance away from private motor traffic, towards high-quality public transport and a network of safe, attractive walking and cycling routes. We need to end our love affair with the car.
But we need to go further still. We need to think about our transport system as a public health issue and concentrate on prevention rather than continuing to mop up the impact. If we are to reduce air pollution to safe limits, ambitious targets for increasing the number of people walking, cycling and using public transport must be set and underpinned by significant investment. Furthermore, we must take measures to reduce levels of motor traffic, while incentivising cleaner vehicles for essential journeys which cannot be shifted. Put simply, we need to manage risk appropriately.
We need to start addressing these problems head-on. How can we stop our transport system being one that tries to deal with cures and to transform it to one that focuses on preventions? We know that building active travel into our daily routines can address many of the issues we face, from congestion to better air quality and health improvements. Our task is such, that we can't afford not to act. Ignoring the need for investment in active travel is not an option.
 Department for Environment, Food and Rural Affairs (2015) Improving air quality in the UK: tackling nitrogen dioxide in our towns and cities, UK Overview Document, December 2015
 Royal College of Physicians (2016) Every breath we take: the lifelong impact of air pollution. Report of a working party. London: RCP.