Hi Brian,
The two points you cited from Dr. Fowler are most interesting. The first one about accident rates for those with vision impairments not being higher than other groups has also been documented by doctors here in the U.S. In fact some have said they have less accidents because of the rigorous screening and driver training. My low vision specialist, Dr. William Park has written papers on the matterr based on his experences and he seems to come to the same conclusion. Unfortunately, I am not able to find these papers at the moment to quote specifics.
Although I do not use bioptics, I found the second item interesting as Dr. Fowler makes a good point about there being no need nowadays for trying to spot signs soley for directions because of advances in GPS technology.
I believe that efforts need to be made to change how driver's licenses are issued so that it is fair and done just as Dr. Fowler says by use of real world simulators or behind the wheel road tests instead of relying on some arbitrary vision standard that doesn't really mean much. Thankfully states such as Maryland have taken steps in the right direction by allowing those with up to 20/100 vision to be considered for a driver's license based on an extensive visual, mental and physical evaluation. The process is fair and has varying degrees of driving restrictions based on each persons abilities.
Perhaps it might prove beneficial for law-makers and vision specialists in the UK to look at Maryland's program and see if they can implement some of it.
All the best.