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GPs should certify over-75s' fitness to drive every year, says Harriet Harman

GPs should certify whether their patients aged over 75 are fit to drive as part of an annual health check they’re entitled to under the GMS contract, according to senior Labour MP Harriet Harman.

In her column for constituency paper Southwark News, the Peckham and Camberwell MP said she had raised the possibility of GPs certifying older patients' fitness to drive with transport secretary Chris Grayling and the Commons Transport Select Committee.

The former leader of the Opposition said GP certification would also include an eyesight check and be ‘simple and straightforward'. 

But GP leaders said that any suggestion that GPs should routinely conduct a full medical examination, un-resourced and as part of the current contract was among the most ‘bonkers’ thing they had heard for some time.

Ms Harman says that the growing number of elderly drivers in the UK is a ‘safety issue that needs to be addressed’ with 1.2million drivers aged over 80, and 100,000 older than 90 according to the DVLA.

The situation now is that patients over the age of 70 must renew their driving licence every three years, and self-declare any medical conditions. The GP must also notify the DVLA of any concerns they have around any patient.   

But Ms Harman says authorities should make use of a stipulation in the GMS contract to allow for annual certification for elderly drivers.

The GP contract says that registered patients aged over-75 can request an annual health check-up, ‘in the course of which [the GP] shall make such inquiries and undertake such examinations as appear to it to be appropriate in all the circumstances.’

Ms Harman says: ‘Already, when you are over 75 you have a named GP and are entitled to an annual health check. It would be simple and straightforward for anyone over the age of 75 to have to get their GP, at their annual health check, to certify whether they are still fit to drive.

‘And without the annual recertification by the GP – who will have checked their eyesight as well – they would not be able to renew their driving licence.’

But the BMA’s contracts and regulation lead Dr Robert Morley said the presumed simplicity of this assessment showed ‘abysmal ignorance’ of the pressures on general practice.

Dr Morley told Pulse: ‘To suggest that GPs should be doing annual certification on all over-75s - which would require among other things a very detailed full medical examination - un-resourced and as part of the current contract is one of the most bonkers things I’ve heard from a politician in many years and that really is quite some achievement.

‘The workload implications would be huge. Who on earth does Harriet Harman think would be left to treat the sick?’

Ms Harman subsequently told Pulse: 'One of the things that I’ve proposed [to the transport secretary] is that people over the age of 75 should only be able to renew their licence if they can produce a GP certificate that shows they continue to be fit to drive – and if they don’t produce the certificate then their driving licence would lapse.'

She added this would have an additional advantage of promoting take-up of the over 75s health check, but 'of course GPs need to be properly resourced to do their existing work let alone take on any extra responsibilities.'

Ms Harman is campaigning on this issue on behalf of her constituent Benjamin Brooks-Dutton, whose wife, Desreen, and young son, Jackson, were killed by an 85 year old driver losing control and mounting the pavement.

A petition by Mr Brooks-Dutton calling for ‘compulsory retesting every three years’ for over 70s has received over 250,000 signatures.

Read Harriet Harman's full comments here

GP of all trades

Cuts to council and social care budgets have meant GPs are increasingly the default authority for assessing social need and there is growing recognition of the need to push back against this non-core work often extending well beyond fit notes and benefits support.

NHS England has pledged to work with the BMA to cut down on GPs being asked to pick up non-contractual work that should be completed by hospitals - although not a single sanction has been issued for reported breaches.

But it has also tasked GPs with prescribing hormone therapy and monitoring of patients needing specialist gender dysphoria care. and last month provoked GP ire by suggesting practices could lead fire safety checks for patients in high-rise buildings.

 Meanwhile wide ranging public health guidance from NICE in 2015 suggested GPs would be ideally placed to conduct temperature checks in elderly patients’ homes

And the Home Office requires GPs to check patients’ nationality as part of immigration and health tourism checks, and assess whether they can hold a firearms license.

Readers' comments (35)

  • A silly season should. Quite rare.

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  • MPs such as Harriet Harmen are best placed to certify their constituents safety to drive. Afterall they can see their electors any week in their "surgeries" and should do this public service for free. They are public servants afterall!

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  • Totally agree with Paul Cracknell

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  • The DVLA should do this for a small fee of course.GPs arnt best placed to do this we dont see them drive.

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  • Surely it wouldn't be difficult to devise a system where the over 75s keep a log diary of their driving (in a range of different environments) with reflection on their performance, including details of any near-miss incidents, to discuss with their driving instructor on an annual basis. Every 5 years they could apply for a certificate of competence from the HMG Driving School as long as they have done the mandatory training on tyre pressure checks and use of the in-car fire extinguisher. They could easily gather feedback from other road users.

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  • Just.....No!

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  • Pendoc - thanks for making me laugh.

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  • Cobblers

    Hold on a moment. If I recall the stats correctly the worst ages for drivers and serious accidents are males aged 17-25yrs. Head and shoulders above 75+yrs group.

    Does Ms Harperson want medicals on them too?

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  • £150 a time sound about right?

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  • No doubt the BMA can negotiate that down to £10 however.

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  • AlanAlmond

    Don't worry..in the future this will all be done by pharmacists.

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  • The Government does not pay an adequate capitation fee for the over 75s to fund these annual health checks we seem to be signed up to.

    If Harriet Harman's idea came to pass I would tender my resignation that day. It would be my line in the sand, just like bringing back out of hours.

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  • Moron

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  • Dear All,
    Has Ms Harman every had any issues with driving?
    Goose et ganderii.
    Regards
    Paul C

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  • No problem. My private rates for work with medicolegal risk (as we would undoubtedly be sued by insurance companies when an over75 causes an accident) are approaching £500 an hour.

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  • GPs are not driving instructors.

    GPs are not opticians.

    Perhaps we need a #GPsAreNot campaign!

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  • So the trend is for anyonebutGP to deliver healthcare yet driving fitness and fire safety needs a trained GP.

    #ClassicNHS

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  • that's a lovely idea. well done, Harriet.
    now.. what else been in the news lately- oh, cyclists!
    I wander if GPs could be nice enough to go around checking front wheel breaks during their admin time/home visits?

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  • we did this in Canada 160CAD for the form in addition to the 40 to 130 for the visit.

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  • i think we should start selling fresh fruit and veg in our waiting rooms too and make all the elderly a hot water bottle at night with there GP going round to make them a hot chocolate for bedtime

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  • The greatest concern is yet another example of how detached from reality our political leaders are, from both sides of the divide. The damage this could do to precious Dr/patient relationships is incalculable, and the potential medico-lagal backlash appalling.

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  • Now now boys and girls don't be negative about our leaders! You may end up on a naughty list 😂

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  • I have a better idea, since elections are aplenty, I would like to certify MPs' eligibility to stand for election; and at a small fee, I will also throw in a brain MRI!

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  • National Hopeless Service

    Opticians do eye checks not GPs. What these people need is a driving test not a GPs best guess whether they have the faculties to drive or not. Something else to increase our indemnity fees. I am struggling with todays workload and dont need any more funded or not. Driving Mobility centres have been around for years who can do these assessments in a true driving environment and I have told several patients to attend.

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  • Ye £150 is what some doctors charge for hgv

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  • Even better idea. Get these guys to do it. I send my punters here is there's any doubt. http://www.eastangliandriveability.org.uk/

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  • Vinci Ho

    Here is a good one:
    Certifying over 75s' fitness to have sex(I try to avoid the f word today) every year by GPs.

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  • My son asked me what is going on in my job and why are we (GPs) being mentioned in the news every day?

    Completely speechless. Cannot answer him anymore. It is beyond a joke now. So very, very sad. Not sure this is the job any of us signed up to and worked so hard to do. Will there be any time to actually do Doctoring looking ahead? Oh to rewind the clocks 20yrs and make some very different career choices…...

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  • Pendoc,
    Congratulations, best suggestion of the day!

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  • Send them to optician for eye check and make sure they bring report from optician saying if their vision is adequate for dvla.
    then charge them for checkup, fee should be 200 because in elderly you have to read all hospital letters and do proper examination from mini cog to physical health- it may involve ecg or 24 hr tape

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  • If a cognitively impaired senior does go driving, e.g. Up wrong side of road undeterred by any family/friends,how are they going to get to grips with a compulsory exam certificate appointment plus the fees? We refer people to Drivability and they rarely seem to take steps to book the appointment and drive on anyway.It certainly is not a simple exam as anyone trying to wade through dvla guide to do a dvla/ category 2 report knows. On that subject can anyone signpost me to the section of dvla guidance that covers 'a blackout that the cardiologist said was neurological and the neurologist said was cardiac ' ?

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  • Oh please!

    Would someone explain how this proposed check would have prevented the reported incident?

    http://www.bbc.com/news/uk-england-london-30578887

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  • 7:15. Genius

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  • Over here patients pay for a driving medical exam, which is much more straightforward than the UK one, and utilises the same form for HGV,PSV and all vehicles. If you are unsure you can recommend an Occupational Health assessment where the patient has to book a driving session with an OT for driving to assess their functioning behind the wheel and makes a recommendation. This is then submitted with the licence application.

    It may be that they are adv not to go above 50KMH ever and not to drive outside their local area and this is then endorsed on their licence. If they break that, the licence is revoked. It is much simpler.

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  • Fitness to drive means eye sight , mental and physical capacity. it is non gms and in elderly it should be done at cost of £200 minimum. just saying every thing is part of normal health check is bonkers.

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