Very illuminating and somewhat alarming letter from a retired GP in this months IAM mag.
He states that when he was practising he was advised by the Medical Defence Union that if he were to inform the DVLA that one of his patients was medically unfit to drive it would be considered a breach of doctor/patient confidentiality and he would be subject to disciplinary action by the GMC. The same would also apply if he informed the family of his patient of the same facts. All he was able to do was inform the patient that he should not drive a vehicle, but if the patient ignored him there was nothing he could do.
While one has to respect the right of an individual to have his medical records kept private, surely in a case where that condition proves a risk to the lives of others a GP should be duty bound to inform the nescessary authorities.
I wonder how many people, particularly those whose ability is deteriorating with age are continuing to drive knowing full well they shouldn't?
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I should have thought that non-disclosure of certain conditions would count against, too - not an enviable position! I'd be surprised if we'd come this far without any case law, though.
In any event, Doctors are routinely asked to confirm fitness to drive of recovering patients, to which the answer 'no' amounts the same thing, surely? Perhaps the point is that they have to be asked...
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JBJ,
As far as I understand it in order for a doctor to release a patints medical records the patient has to give written permission, or a court needs to have ordered it.
I am surprised that in a case of fitness to drive it has not been made a requirement for a GP to inform the DVLA if a persons condition makes them a danger on the roads.
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I'd also be surprised if it wasn't within a GPs bounds of duty. This also brings us back, though, doesn't it, to family members being duty-bound or not to report their loved ones who they know should not be driving?
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...interesting point Tom...but I would say that it is not within a GP\'s remit to know whether a patient drives or not unless it was specifically related to the condition they\'re presenting with
...a kind of get out clause, I know, but it\'s not really a GP\'s business whether or not a patient uses his own judgement on when to drive...Doctor\'s advise...not dictate
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Fortunately the IAM seems to have got this one wrong.
(I cut and pasted the text below from the dvla fitness to drive guidance for medical practitioners)
Notification to DVLA
It is the duty of the licence holder or licence applicant to notify DVLA of any medical condition, which may affect safe driving. On occasions however, there are circumstances in which the licence holder cannot, or will not do so.
The GMC has issued clear guidelines* applicable to such circumstances, which state:
"1. The DVLA is legally responsible for deciding if a person is medically unfit to drive. They need to know when driving licence holders have a condition, which may, now or in the future, affect their safety as a driver.
2. Therefore, where patients have such conditions, you should:
* Make sure that the patients understand that the condition may impair their ability to drive. If a patient is incapable of understanding this advice, for example because of dementia, you should inform the DVLA immediately.
* Explain to patients that they have a legal duty to inform the DVLA about the condition.
3. If the patients refuse to accept the diagnosis or the effect of the condition on their ability to drive, you can suggest that the patients seek a second opinion, and make appropriate arrangements for the patients to do so. You should advise patients not to drive until the second opinion has been obtained.
4 If patients continue to drive when they are not fit to do so, you should make every reasonable effort to persuade them to stop. This may include telling their next of kin.
Revised January 2003
5 If you do not manage to persuade patients to stop driving, or you are given or find evidence that a patient is continuing to drive contrary to advice, you should disclose relevant medical information immediately, in confidence, to the medical adviser at DVLA.
6 Before giving information to the DVLA you should inform the patient of your decision to do so. Once the DVLA has been informed, you should also write to the patient, to confirm that a disclosure has been made."
(*Reproduced with kind permission of the General Medical Council)
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