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.
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