Unfitness to Drive on Medical Grounds (Hansard, 12 July 1994)

§ Mr. George Howarth (Knowsley, North)

I beg to move, That leave be given to bring in a Bill to require medical practitioners to inform the Driver and Vehicle Licensing Agency in cases where they consider that their patients are unfit to drive on medical grounds. The Bill's purpose is direct and simple. It would place a statutory obligation on medical practitioners, whether hospital based or in general practice, to report to the Driver and Vehicle Licensing Agency any cases in which they consider a patient to be medically unfit to drive.

I took up this case because one of my young constituents, Paul Scarisbrick, was killed in an incident on the M62 in circumstances which, had the Bill been in force, would not have occurred. To put it bluntly, if the doctors involved in treating the man responsible for causing the incident had reported his condition to the DVLA, he would almost certainly not have been allowed to continue driving, and Paul Scarisbrick would still be alive today.

Let me explain the circumstances. Two years earlier, the elderly gentleman involved in the incident, whom I will not name here, had been advised by a consultant psychiatrist not to continue driving, as he was suffering from the progressive disorder commonly known as Alzheimer's disease. However, as there was no statutory requirement to take the matter further, neither the consultant nor the GP who was also aware of the situation saw fit to communicate that information to any third party. The man accordingly ignored the medical advice, and the result was that which I have already described.

Why did not the doctors involved take the matter further? They claim that the requirement for confidentiality between a doctor and a patient prevents them from passing on such information. Interestingly, in a letter to Mr. and Mrs. Scarisbrick's solicitor, the Liverpool district coroner, Mr. S.R. Barter MBE, said: I am in no doubt in my own mind that the existing law should be changed by statute. Once a doctor has made a clinical judgement, following full investigation, that a patient is suffering from a disease which makes him a danger to himself and the public if he continues to drive, then he should be under a statutory obligation to inform the DVLA of his opinion. Coming from such an experienced and distinguished source, that is proof positive of the need for a change in the law along the lines that I am proposing.

I also have a letter from the director general of the Association of British Insurers, Mr. Mark Boléat, in which he says unequivocally: ABI agrees with the purpose of your Bill to require medical practitioners to report to the DVLA a case where they consider a 834 patient unfit to drive, either for physical or mental health reasons. Once again, that shows support from an important body.

The medical profession, through its professional body, the British Medical Association, is opposed to the Bill. It is jealous, perhaps understandably, of the doctor-patient relationship with regard to confidentiality. I shall make two points on that: first, to some extent, doctors already breach that particular requirement with, for example, the reporting of notifiable infectious diseases; and, secondly, such confidences should, in my opinion and that of many others, be subjected to a simple but overriding test—that the wider public interest should be taken into account.

A motor vehicle in the wrong hands is a potentially lethal weapon. It is much more lethal than a gun, for example, yet the rules governing the licensing of guns are rightly much more stringent, and require proper medical certification. Although I realise that I am not entirely comparing like with like, I feel that it is nevertheless a useful analogy to compare not a gun with a car but a potential gun user with a potential car user.

Finally, some people have objected to the Bill on the ground that it is the thin end of the wedge—a bridgehead towards the compulsory re-testing of elderly people. It is not. Different people respond in different ways to the aging process. I know many people well into their 70s and beyond who are fully capable of living a full life, including driving a car. As a forty-something myself, however, I sometimes feel that I have already started to disintegrate, so there is no clear comparison between people at different ages.

Far from being the thin end of the wedge, the Bill could halt the movement towards compulsory re-testing in its tracks, as it would deal with many of the problems by medical means, rather than by the remorseless march of the calender. I am convinced that public interest and public safety now require that we legislate to ensure as far as is reasonably possible that those whom we license to drive are medically fit to do so. It is a small measure, which could have a giant effect.