Medical tests for older drivers
Fitness to drive a motor vehicle can be a complicated and sensitive issue, with challenges for doctors and patients. The AMA has a national position statement on the Role of the Medical Practitioner in Assessing Fitness to Drive which outlines some of the key principles of the Association in this area.
Although the AMA does not believe that there should be a mandatory requirement that doctors inform appropriate authorities if they consider a person unfit to drive, it is so in some states, and all medical practitioners need to be aware of what the legal requirements are in their state.
In South Australia, under the Motor Vehicles Act 1959 the two clauses relating to licence holders and health professionals are:
98AAF—Duty on holder of licence or learner's permit to notify illness etc
The holder of a licence or learner's permit who, during the term of the licence or permit, suffers any illness or injury that may impair his or her competence to drive a motor vehicle without danger to the public must, within a reasonable time after the occurrence of the illness or injury, notify the Registrar in writing of that fact. Maximum penalty: $750.
148—Duty of health professionals
(1) Where a health professional [a legally qualified medical practitioner, a registered optometrist or a registered physiotherapist] has reasonable cause to believe that—
(a) a person whom he or she has examined holds a driver's licence or a learner's permit; and
(b) that person is suffering from a physical or mental illness, disability or deficiency such that, if the person drove a motor vehicle, he or she would be likely to endanger the public,
the health professional is under a duty to inform the Registrar in writing of the name and address of that person, and of the nature of the illness, disability or deficiency from which the person is believed to be suffering.
(2) Where a health professional furnishes information to the Registrar in pursuance of subsection (1), he or she must notify the person to whom the information relates of that fact and of the nature of the information furnished.
(3) A person incurs no civil or criminal liability in carrying out his or her duty under subsection (1).
It is important to be clear that it is the driver licensing authority (Department of Planning, Transport and Infrastructure/Registrar of Motor Vehicles) that makes licence decisions. The AMA(SA) would emphasise that it is the patient's responsibility to ensure they are fit to drive. This is true both for short-term events that can affect a person briefly (eg tiredness, consumption of alcohol, hand injury, or a longer-term condition such as a paralysing stroke).
If a driver has a health condition that could affect their ability it is wise for them to discuss this with their doctor. If someone has a condition that does affect driving the driver licensing authority (DPTI) will take the appropriate action. This may include asking for medical confirmation of severity of the condition and whether the person has the "medical fitness to drive" according to Australia-wide standards (under the Assessing Fitness to Drive medical standards for licensing and clinical management guidelines).
With this information, among other information, the authority grants licences. Somepeople may be granted a license with conditions and some who do not fit the criteria of holding a licence may not be granted a license or may have it suspended. Any imposed conditions and length of license and review is the licensing authority's decision.
It is important that patients and the broader community understand that just as the doctor does not 'give' patients their health condition, neither do they give or remove licences - they are only reporters as to the severity of the condition and the known issues regarding if this could affect driving.
The AMA(SA) has received the below advice from the Registrar of Motor Vehicles on 27 August 2014 regarding changes from 1 September 2014.
Older drivers and medical testing: Changes from 1 September
For some drivers 70 years and older, changes to medical fitness to drive assessment requirements will come into effect on Monday, 1 September 2014. From this date, drivers who hold a car (C class) driver's licence only and do not have a medical condition will no longer be required to have an annual medical assessment completed by their doctor.
The Department (DPTI) has advised us that other fitness to drive requirements have not changed, including:
- Drivers are required to submit an annual medical assessment to retain a Motorcycle (R or R-date), Light Rigid (LR), Medium Rigid (MR) or Heavy Vehicle driver’s licence from the age of 70 years, due to the increased road safety risks driving these vehicles poses.
- Drivers with a medical condition recorded against their licence, irrespective of their age, will still need to submit a medical assessment in accordance with the review period outlined in the National Transport Commission Fitness to Drive Guidelines.
- All drivers, regardless of age, are required by law to report any medical condition that could affect their ability to drive safely.
- Health professionals are required to notify the Registrar of Motor Vehicles when a patient is diagnosed with a medical condition that requires regular medical assessment which may affect their ability to drive
The Department of Planning, Transport and Infrastructure is in the process of communicating these changes to affected licence holders as well as the wider community. From 1 September 2014 those people who are no longer required to submit a medical assessment will not be sent a Certificate of Fitness form to complete. If a patient attends a medical practice with a Certificate of Fitness they have received in the mail, it must be completed and returned to Service SA, GPO Box 1533, Adelaide SA 5001.
The Minister for Road Safety is continuing to consider future measures to ensure road safety is not eroded by the changes that come into effect on 1 September.
If you require further information regarding these changes please visit the DPTI website.
27 August 2014