Doctors to be told to inform on unfit drivers
New guidelines from the General Medical Council (GMC), the statutory body with which all UK doctors must be registered, are likely to oblige GPs to report patients who are medically unfit to drive to the Driver & Vehicle Licensing Agency (DVLA), or the Driver & Vehicle Agency (DVA), the equivalent body in Northern Ireland.
The draft guidelines, which are out to consultation until February, have been issued in the wake of several high-profile accidents involving commercial vehicles, in which driver health has been identified as a potential contributory factor.
The current rules already allow doctors to inform the DVLA or DVA without consent where a patient has continued to drive without medical advice. But the new guidelines strengthen this position by emphasising that doctors have a duty to report such cases.
“If you conclude that a patient’s refusal to give consent [for you to disclose relevant information to the DVLA or DVA] leaves others exposed to a risk of death or serious harm, you should contact the DVLA or DVA immediately and disclose any relevant medical information, in confidence, to the medical adviser,” the draft GMC guidelines state.
“Before contacting the DVLA or DVA, you should try to inform the patient of your decision to disclose personal information. You should then also inform the patient in writing once you have done so.”
Drivers themselves are legally obliged to report any relevant medical conditions to the DVLA, with potential fines of up to £1,000 should they fail to do so. But critics of the status quo point out that, particularly for those who drive professionally for a living, there are potentially strong financial disincentives for doing so.
Niall Dickson, chief executive of the General Medical Council, said: “This is difficult territory – most patients will do the sensible thing but the truth is that a few will not and may not have the insight to realise that they are a risk to others…
“Confidentiality is not absolute and doctors can play an important part in keeping the wider public safe if a patient is not safe to drive… We are clear that doctors carrying out their duty will not face any sanction – and this new guidance makes clear that we will support those who are faced with these difficult decisions.”
The Freight Transport Association (FTA), which has been calling for fleet operators to get access to medical decisions which indicate a lack of fitness to drive, called the move “a step in the right direction” – but said more needed to be done.
Ian Gallagher, FTA’s lead on DVLA, said: “We’re in a ridiculous situation that the employer is completely reliant on the individual to notify them that they have a medical condition. In some cases it’s the employer’s own checks that actually highlight that entitlement has been suspended or revoked on medical grounds.
“Employers have no right to access medical records. Patients can even veto doctors’ letters if they don’t agree with what’s been written.”
He continued: “FTA believes that GPs should seriously consider the draft guidance and put what’s written into practice and notify DVLA if they know patients are driving against their advice, but, this doesn’t go far enough. We need a process that involves the employers that provides access to necessary medical information, which could ultimately save lives.”
The road safety charity Brake welcomed the move, meanwhile, saying it had “long called for greater clarity from the GMC.”
Gary Rae, director of communications and campaigns for Brake, said: “This is a positive move by the GMC, which will clarify the responsibilities and duties of both doctor and patient. We do recognise that, previously, doctors have been in a difficult position regarding confidentiality of their patients but the guidance makes it clear that this confidentiality is not absolute.”
He added: “I would appeal to all drivers to ensure that they do declare any medical conditions that could prevent them from driving safely to the DVLA/DVA. If they fail to do so, they will pose a continuing risk to themselves and other road users.”
FTA said its chief executive, David Wells, had recently attended a meeting to discuss access to medical records with transport minister Lord Ahmad.
““I urged the department to consider ways to speed up the process for employers to have better access to medical information so they can manage the risk to all road users appropriately,” Mr Wells said. “The industry takes this seriously and needs appropriate tools to manage drivers while respecting individuals’ privacy and data.”
