Doctors have a duty to inform the DVLA if a patient is not fit to drive, according to new guidance prompted by medics’ concerns following the Glasgow bin lorry crash.
Harry Clarke, the driver who killed six people when he apparently lost consciousness at the wheel three days before Christmas last year, had failed to disclose a history of dizzy spells and fainting, it emerged at a fatal accident inquiry this summer.
Now draft guidance from the General Medical Council advises that while the main responsibility to disclose still lies with the patient, if the individual carries on driving and cannot be persuaded to stop, the doctor has a duty of public protection and the balance falls in favour of disclosure.
The GMC guidance reflects feedback from doctors who were anxious about balancing their duty of confidentiality with public safety.
Niall Dickson, the GMC chief executive, 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 behind the wheel of a car.
“A confidential medical service is a public good and trust is an essential part of the doctor-patient relationship. But 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 guidance emphasises that when doctors diagnose a patient, or provide treatment, they should keep the patient’s ability to drive at the forefront of their minds.
In October, Clarke was arrested after he was allegedly seen driving a car despite having had his licence suspended on medical grounds.
The fatal accident inquiry heard that Clarke fainted at the wheel of a bus in April 2010. While his managers at the time knew about the incident, his subsequent employer, Glasgow council, and the DVLA did not. Clarke told his GP that he had fainted in a hot canteen rather than at the wheel, with no warning signs.
While the new guidance may not have avoided the tragedy, it is likely to be welcomed by the victims’ relatives who have consistently criticised the response of the authorities to the accident, most recently questioning in a BBC documentary whether the Crown Office was aware of all the evidence when they made the decision not to prosecute Clarke.
