GPs often have to report elderly patients who are no longer safe to drive to the DVLA. Columnist Dr David Turner says it’s time to change the way we see the driving licence
I stopped my father driving. He never knew that to his dying day.
He had been developing dementia, but had no insight into his condition. Especially in terms of how it was affecting his driving ability. After a few near misses on the road – reported to me in scarily graphic detail by my mother – we decided enough was enough.
I phoned his GP, explained the situation, and asked her to please advise him to voluntarily hand back his driving licence or, if he refused, that she would advise the Driver and Vehicle Licensing Agency (DVLA) on his behalf.
My father was a stubborn man. Having driven everything from an HGV to a motorbike, he refused to believe that he was no longer safe on the road. It took the GP writing to the DVLA about his medical conditions before his licence was revoked.
This is a problem we see very often as GPs. An elderly person who, for a variety of physical and cognitive reasons, is almost certainly no longer safe to drive but refuses to accept they are no longer fit to hold a licence. And often, it is a son or daughter who comes to see us on behalf of a parent to express concerns.
We live in a car-orientated society, and for many of us, four wheels are seen as freedom and independence. Public transport options in many parts of the UK are as good as non-existent, so the private car is the only way for some people to get around.
An article in the Times reported in March that a senior coroner had called for a driving-age limit following a 95-year-old driver killed a woman on a crossing.
Drivers over the age of 70 are currently required to apply for a licence every three years. There is no mandatory medical assessment, though; the decision to relicense the individual to drive is made on the basis of the individual’s own assessment of their fitness to hold a licence.
If private cars did not already exist and someone suggested today that we introduce them and only require people to pass a competency test once, as young as 17, which would then allow them to carry on driving into their nineties without further assessment, they would be called out as deranged.
The problem is that many see the driving licence as a right, not a privilege. Most people, quite rightly, expect professional drivers to undergo regular reassessments of their capability, yet many do not feel the same rigorous reassessment should apply to themselves.
On average, five people per day are killed on UK roads and 84 are seriously injured. If any medical treatment or intervention was killing and injuring people at this rate, can you imagine what the fall out would be?
My proposal would be to retest every driver – irrespective of age or health – every five years. Yes, a bit like revalidation. This could be done by using driving simulators so that it would not involve large numbers of driving assessors being trained. There would be banks of these simulators in out-of-town sites, and you book a slot online, turn up, put your credit card and driving licence in, and off you go.
You would either pass with advisory points, or fail with a need to have further instruction in a particular area of driving, such as distancing from other vehicles. You would pay for the retest yourself, so the whole scheme would fund itself with no need for the taxpayer’s money.
It goes without saying that if a GP was treating a patient and diagnosed them with a condition that could affect their driving capabilities, then they would advise the DVLA as they do now. But if everyone had a routine driving reassessment, it would take the burden of reporting unsafe drivers to the DVLA away from GPs.
It is time for a change, and for us to see the driving licence as something to be earned and retained on merit.
Dr David Turner is a GP in Hertfordshire. Read more of his blogs here
Until you get to the very elderly (86 year olds and above) the highest rate of car driver casualties by some considerable margin is in the 17-24 year old age group who have all recently passed their driving tests and the lowest rates are in the 66-70 year old group who haven’t been tested for decades. So the author’s proposal is illogical.
I’m sure we empathise with the situation you had and it sounds like you made a good decision for your dad; perhaps you had registered a power of attorney for his health and care so his GP could not simply dismiss your request on some sort of confidentiality basis. However generally and sadly, 26% of fatalities and 30% of casualties in UK in age group 17 to 29, while 19% of fatalities and 6% of casualties occur in those age 70 and over; so, even though, there is 2 years probationary driving for newly qualified drivers, perhaps the younger drivers need to be retested more often, not only for driving, but also tested periodically or randomly at the roadside, (or as targeted age group?) regarding cocaine use and other drugs which are on the increase (and which Police recognise have overtaken alcohol) as the main contributor to road accidents in UK. Dementia is still important too.
Young men drive like agressive dicks. That’s the problem although maybe retest every 10 or 15 years and certainly over 65 or so makes sense.
Often?
Young men are a bit mad but not all of them. This article is more about the health impacts on driving ability. I suspect the 2 biggest issues in elderly are cognitive decline and sight deterioration. Why they don’t make reporting by GP’s mandatory thus avoiding the telling a patient to tell the DVLA who may choose not to and then checking carefully to make sure you are not leaving yourself open to complaint. Simple law change would negate this barrier and dangerous hole in regulation. Also why not require an eyesight test result with the 3 year declaration post 70.
It appears that the author of the article is totally unaware that it does not require GP input to stop someone from driving.
If a family member thinks a relative is no longer safe to drive they can contact the DVLA directly. If needs be, anonymously. By all means, inform the GP that the family has taken that step, but don’t make it the GP’s problem. It risks damaging the doctor patient relationship unnecessarily and creates a huge amount of work.
@Stefan
Well said and I’m surprised nobody pointed this out sooner. If a relative contacts the surgery I tell them that – as the person with concerns – they are best placed to explain those concerns to the DVLA. As you say, it can be done anonymously.
The online service is at
https://contact.dvla.gov.uk/driver/capture_third_party_personal_information?locale=en
The former phone hotline 08444 5301118 seems no longer to function, so it might take some detective work to find a working one.
Dr Turner is absolutely right, a driving licence is not a right. I have Type 1 Diabetes and retinopathy and I quite rightly get tested by the DVLA every one to years, but only because they know about me.
The renewal of the licence at age 70 is a farce – all you have to do is tick the boxes to say you’re fine and away you go. What about all those older people driving around with cataracts? However the DVLA don’t know about them so aren’t concerned.
At the very least there should be a mandatory, self funded, eye test at age 70 and probably every 5 yrs prior to and after that.
Revalidation every five years was imposed in blanket form to all GPs and not just those known to pose a risk – why not the same for drivers, where I would suggest that the risk to life is probably even greater.