It is commonly thought that a Doctor and other healthcare professionals have an unimpeachable and overriding duty of patient confidentiality in every circumstance. However when it comes to a patient’s fitness to drive and reporting to the DVLA this is not the case.
In law, it is the duty of the licence holder or applicant to notify the DVLA of any medical condition that may affect safe driving. The obligation in the first instance is for the driving licence holder to
■ notify the DVLA of any injury or illness that would have a likely impact on safe driving ability
■ respond fully and accurately to any requests for information from either the DVLA or healthcare professionals
■ comply with the requirements of the issued licence, including any periodic medical reviews indicated by the DVLA.
Doctors and other healthcare professionals, when they become aware of any medical condition that may impact their ability to drive, should:
■ advise the individual on the impact of their medical condition for safe driving ability
■ advise the individual on their legal requirement to notify the DVLA of any relevant condition
■ treat, manage and monitor the individual’s condition with ongoing consideration of their fitness to drive
■ notify the DVLA when fitness to drive requires notification but an individual cannot or will not notify the DVLA themselves.
The last obligation may pose a challenge to issues of consent and the confidential relationship between patient and healthcare professional.
Both the GMC and The College of Optometrists offer guidance upon when confidentiality can be breached – where the guidance is met, the DVLA should be contacted immediately and disclosures of the drivers medical issues made if there is concern for the safety of both the individual and the wider public.
Once the DVLA becomes aware of the relevant medical condition it will undertake an investigation to consider all ‘relevant medical information’. This can include a review by a DVLA appointed Doctor.
Unless the driver is deemed a ‘High Risk Offender’ (having a previous disqualification for drink or drug driving) the licence holder is usually entitled to continue driving under section 88 of the Road Traffic Act 1988 although any such driver would be well advised to carefully check the terms and conditions of their policy of motor insurance before continuing to drive.
The DVLA have the final decision upon whether a driving licence should be refused or revoked. Ultimately the licence holder can then appeal to the Magistrates Court under section 100 of the Road Traffic Act 1988 where they believe that the decision was wrong. This will invariably involve an application to the Court and calling medical evidence to suggest that the licence holder is in fact fit to drive.
The risk of losing the application could prove expensive as the DVLA are likely to request that any costs incurred in opposing the the application are paid by the licence holder. An experienced motoring solicitor will be able to advise and represent in these circumstances, including entering into negotiations with the DVLA before an application is issued to the Court.
Notifying the DVLA of driving licence holders that pose a ‘very real risk of danger to the public or themselves’ is one of the very limited examples therefore of a Doctor of other health care professional having a duty to breach patient confidentially.