Reporting alcoholism to DVLA
FoggyTown
am forming the impression that there is some kind of responsibility
for doctors to report to DVLA if a patient is a suspected or admitted
alcoholic. I got that impression from this part of the DVLA website.
http://www.dft.gov.uk/dvla/medical/ataglance.aspx (download the "at a
a glance" pdf file and then click on section 5 - "Drug and alcohol
misuse")
Is this really what it seems: a complete disregard for doctor-patient
confidentiality? It also makes it appear that an alcoholic has a
statutory duty to report themselves! What kind of wishful thinking is
that?
Note: I am NOT defending the rights of drunks to drive. Just
concerned about the ethics and the conflicting responsibilities of the
doctors.
Brimstone
What about the doctor's responsibility to the wider community, surely that
comes first?
Mr X
"FoggyTown" <fogg...@aol.com> wrote in message
news:92a878bc-3cc4-4744...@j39g2000yqh.googlegroups.com...
>I have been doing some research based on a relative's behaviour and I
> am forming the impression that there is some kind of responsibility
> for doctors to report to DVLA if a patient is a suspected or admitted
> alcoholic. I got that impression from this part of the DVLA website.
>
patient on a number of occasions not to drive and yet the doctor knows they
still are driving. They have to inform the patient that they will be
informing on them unless they stop driving.
It is thought that public safety takes priority over patient
confidentiality.
Big Les Wade
>
>"FoggyTown" <fogg...@aol.com> wrote in message
>news:92a878bc-3cc4-4744...@j39g2000yqh.googlegroups.com...
>>I have been doing some research based on a relative's behaviour and I
>> am forming the impression that there is some kind of responsibility
>> for doctors to report to DVLA if a patient is a suspected or admitted
>> alcoholic. I got that impression from this part of the DVLA website.
>>
>No. That only exists in extreme circumstances where the doctor has told the
>patient on a number of occasions not to drive and yet the doctor knows they
>still are driving. They have to inform the patient that they will be
>informing on them unless they stop driving.
But there is no *legal* duty on doctors to do this, only guidance from
the GMC:
http://www.gmc-uk.org/guidance/current/library/confidentiality_faq.asp#q1
7
which is in fact quoted in the DVLA "At a glance" booklet.
>It is thought that public safety takes priority over patient
>confidentiality.
The drawback, of course, is that once patients realise this, they will
no longer consult their doctors about the relevant medical conditions.
The outcome will be all bad: patients don't get cured, and the DVLA
don't get to cancel their licences.
--
Les
Conspiracy theory: A suspicion that officials sometimes mislead the public in
order to protect their own interests.
Just zis Guy, you know?
wrote:
>The drawback, of course, is that once patients realise this, they will
>no longer consult their doctors about the relevant medical conditions.
They often don't anyway. My sister refused point-blank to see a
doctor, turned away an ambulance and was eventually only admitted to
hospital when her organs had pretty much shut down.
Mr X
"Big Les Wade" <L...@nowhere.com> wrote in message
news:65uAVrcGx4pKFw$p...@obviously.invalid...
> But there is no *legal* duty on doctors to do this, only guidance from the
> GMC:
> http://www.gmc-uk.org/guidance/current/library/confidentiality_faq.asp#q1
> 7
> which is in fact quoted in the DVLA "At a glance" booklet.
>
>>It is thought that public safety takes priority over patient
>>confidentiality.
>
> The drawback, of course, is that once patients realise this, they will no
> longer consult their doctors about the relevant medical conditions. The
> outcome will be all bad: patients don't get cured, and the DVLA don't get
> to cancel their licences.
>
I doubt that will happen in any signifigent numbers. These rules have been
around for years.
Big Les Wade
>
>"Big Les Wade" <L...@nowhere.com> wrote in message
>news:65uAVrcGx4pKFw$p...@obviously.invalid...
>> But there is no *legal* duty on doctors to do this, only guidance from the
>> GMC:
>> http://www.gmc-uk.org/guidance/current/library/confidentiality_faq.asp#q1
>> 7
>> which is in fact quoted in the DVLA "At a glance" booklet.
>>
>It is unwise for them to go against what the GMC says.
I do not think there are any specific penalties or liabilities.
>>>It is thought that public safety takes priority over patient
>>>confidentiality.
>>
>> The drawback, of course, is that once patients realise this, they will no
>> longer consult their doctors about the relevant medical conditions. The
>> outcome will be all bad: patients don't get cured, and the DVLA don't get
>> to cancel their licences.
>>
>I doubt that will happen in any signifigent numbers. These rules have been
>around for years.
Actually they have changed relatively recently. But you are right in so
far as patients generally do not realise that consulting a doctor may
result in their driving licence being withdrawn later on.
Mr X
> I do not think there are any specific penalties or liabilities.
>
could make a complaint to the GMC who could take action against the doctor.
> Actually they have changed relatively recently. But you are right in so
> far as patients generally do not realise that consulting a doctor may
> result in their driving licence being withdrawn later on.
>
What else do you propose? That unfit people continue to drive illegally?
Bob Ferguson
"FoggyTown" <fogg...@aol.com> wrote in message
news:92a878bc-3cc4-4744...@j39g2000yqh.googlegroups.com...
> am forming the impression that there is some kind of responsibility
> for doctors to report to DVLA if a patient is a suspected or admitted
> alcoholic. I got that impression from this part of the DVLA website.
>
> http://www.dft.gov.uk/dvla/medical/ataglance.aspx (download the "at a
> a glance" pdf file and then click on section 5 - "Drug and alcohol
> misuse")
>
> Is this really what it seems: a complete disregard for doctor-patient
> confidentiality? It also makes it appear that an alcoholic has a
> statutory duty to report themselves! What kind of wishful thinking is
> that?
>
The concept of confidentiality was one of the first things abandoned by
Nu-labour. Your medical records are now stored on a central computer for
any government Tom Dick or Harry to peruse.
Big Les Wade
>
>"Big Les Wade" <L...@nowhere.com> wrote in message
>news:YrGoRtfni6pKFw7$@obviously.invalid...
>> I do not think there are any specific penalties or liabilities.
>>
>If someone was injured as a result of the driver being on the roads they
>could make a complaint to the GMC who could take action against the doctor.
They could try. It would be interesting to know whether it ever has been
and what came of it.
>> Actually they have changed relatively recently. But you are right in so
>> far as patients generally do not realise that consulting a doctor may
>> result in their driving licence being withdrawn later on.
>>
>What else do you propose? That unfit people continue to drive illegally?
That happens all the time anyway. I see them everywhere. One just went
down my street, although his unfitness was due to his selfishness and
stupidity rather than any medical condition.
I do not know what percentage of RTA damage is caused by drivers'
medical unfitness. I'd want to know more about that, before deciding the
problem is important enough to justify frightening people away from
consulting their doctor.
Big K
GPs hand out Diazepam like sweets yet don't report their patients.
Big K
Including full details of all those cosy chats you had with your nice
friendly psychiatrist and social worker.
kkm
<L...@nowhere.com> writes
>The drawback, of course, is that once patients realise this, they will
>no longer consult their doctors about the relevant medical conditions.
>The outcome will be all bad: patients don't get cured, and the DVLA
>don't get to cancel their licences.
>
Or just tell the GP they no longer regularly drive. In urban communities
atleast, GPs are very unlikely to have contact with their patients out
of surgery hours, in rural communities it might be more likely.
On visiting the surgery they can just park a couple of streets away.
--
Kevin
Mr X
"Bob Ferguson" <robert....@google.co.uk> wrote in message
news:4aa7b...@glkas0286.greenlnk.net...
Judith M Smith
wrote:
>I have been doing some research based on a relative's behaviour and I
>am forming the impression that there is some kind of responsibility
>for doctors to report to DVLA if a patient is a suspected or admitted
>alcoholic. I got that impression from this part of the DVLA website.
>
>http://www.dft.gov.uk/dvla/medical/ataglance.aspx (download the "at a
>a glance" pdf file and then click on section 5 - "Drug and alcohol
>misuse")
>
>Is this really what it seems: a complete disregard for doctor-patient
>confidentiality?
Not as far as I can see - what exactly are you objecting to?
Judith M Smith
wrote:
Rubbish : would you rather have unfit people driving on the roads. It
would have to be extreme case for the doctor to tell the DVLA after
they have followed the guidance - it is a very, very last resort as
you will see if you read:
-------------------------------------------------------------------------------------------------------------------
The DVLA is legally responsible for deciding if a person is medically
unfit to drive. The Agency needs to know when driving licence holders
have a condition which may now, or in the future, affect their safety
as a driver.
Where patients have such conditions you should:
a. Make sure that 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.
b. Explain to patients that they have a legal duty to inform the
DVLA about the condition.
If 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.
If patients continue to drive when they may not be fit to do so, you
should make every reasonable effort to persuade them to stop. This may
include telling their next of kin, if they agree you may do so.
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 the DVLA.
Before giving information to the DVLA you should try to 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.
Big Les Wade
>>no longer consult their doctors about the relevant medical conditions.
>>The outcome will be all bad: patients don't get cured, and the DVLA
>>don't get to cancel their licences.
>
>Rubbish : would you rather have unfit people driving on the roads.
As I patiently explained, it is not a matter of "Would you rather do
option A which solves the problem entirely, or option B which doesn't
solve it at all?"
*Both* the doctor's options - to keep quiet or to break confidence -
will leave unfit people driving on the roads. Keeping quiet allows this
particular patient to remain an immediate danger. Breaking confidence
neutralises that immediate danger, but will also discourage some future
patients from disclosing their illnesses, so that they will not only
remain ill but also they will continue to drive (because no-one will
know they are ill).
The question is, which option leads to the worse result?
Liz Bonn - I'm from Portugal
"Big Les Wade" <L...@nowhere.com> wrote in message
news:65uAVrcGx4pKFw$p...@obviously.invalid...
> But there is no *legal* duty on doctors to do this, only guidance from the
> GMC:
> http://www.gmc-uk.org/guidance/current/library/confidentiality_faq.asp#q1
My sister, when her epilepsy was confirmed, was told by her GP to report the
matter to DVLA and also told her that he would be "completing and forwarding
the necessary paperwork".
I did wonder at the time how that squared with the whole confidentiality
thing.....
Judith M Smith
wrote:
>Judith M Smith <judith...@live.co.uk> posted
>>On Wed, 9 Sep 2009 12:06:46 +0100, Big Les Wade <L...@nowhere.com>
>>wrote:
>>>
>>>The drawback, of course, is that once patients realise this, they will
>>>no longer consult their doctors about the relevant medical conditions.
>>>The outcome will be all bad: patients don't get cured, and the DVLA
>>>don't get to cancel their licences.
>>
>>Rubbish : would you rather have unfit people driving on the roads.
<snip non argument>
have you actually read the article suggested?
http://www.dft.gov.uk/dvla/medical/ataglance.aspx (download the "at a
a glance" pdf file and then click on section 5 - "Drug and alcohol
misuse")
Please point out the bit which is causing you concern?
Does it say that a doctor must report an alcoholic to the DVLA as a
matter of course?
Bob Ferguson
"Mr X" <inv...@invalid.com> wrote in message
news:h88hl3$sb$1...@frank-exchange-of-views.oucs.ox.ac.uk...
Nope because they were stored at your doctor's surgery and they were
protected by confidentiality at that time.
Jethro
> "Mr X" <inva...@invalid.com> wrote in message
>
> news:h88hl3$sb$1...@frank-exchange-of-views.oucs.ox.ac.uk...
>
>
>
>
>
>
>
> > "Bob Ferguson" <robert.fergu...@google.co.uk> wrote in message
> >news:4aa7b...@glkas0286.greenlnk.net...
>
> >> "FoggyTown" <foggyt...@aol.com> wrote in message
> >>news:92a878bc-3cc4-4744...@j39g2000yqh.googlegroups.com...
> >>>I have been doing some research based on a relative's behaviour and I
> >>> am forming the impression that there is some kind of responsibility
> >>> for doctors to report to DVLA if a patient is a suspected or admitted
> >>> alcoholic. I got that impression from this part of the DVLA website.
>
> >>>http://www.dft.gov.uk/dvla/medical/ataglance.aspx (download the "at a
> >>> a glance" pdf file and then click on section 5 - "Drug and alcohol
> >>> misuse")
>
> >>> Is this really what it seems: a complete disregard for doctor-patient
> >>> confidentiality? It also makes it appear that an alcoholic has a
> >>> statutory duty to report themselves! What kind of wishful thinking is
> >>> that?
>
> >> The concept of confidentiality was one of the first things abandoned by
> >> Nu-labour. Your medical records are now stored on a central computer for
> >> any government Tom Dick or Harry to peruse.
>
> > And they could never have looked at the paper records before if they
> > wanted.
>
> Nope because they were stored at your doctor's surgery and they were
>
> - Show quoted text -
a confidentiality which had no standing in law.
Mr X
>
> Nope because they were stored at your doctor's surgery and they were
> protected by confidentiality at that time.
>
kkm
<inv...@invalid.com> writes
>
>And they could never have looked at the paper records before if they wanted.
>
They probably could, but you can't search 30,000 paper records for the
keyword alcoholic in quite the same way as you can a database.
--
Kevin
Mr X
"kkm" <k...@w3.to> wrote in message
news:B9LzEKAb...@cntl-prk.demon.co.uk...
Big Les Wade
They aren't doing it at the moment because the database doesn't exist
yet. You may remember press reports of certain little local difficulties
with building it.
But when it's built, they will ultimately begin to search it. First for
the words "paedophile" and "terrorist"; only paedophiles and terrorist
could object to that. A little later they'll look for "heroin", then
"cannabis", and not long after that, "alcoholic".
It's the way they work. Even some people on uk.legal believe the age-old
right of medical confidentiality is a mere bagatelle compared with the
urgent necessity of taking away people's driving licences. You can bet
that if uk.legal has some of those then government departments must be
busting at the seams with them.
Big Les Wade
>On 10 Sep, 09:15, "Bob Ferguson" <robert.fergu...@google.co.uk> wrote:
>> Nope because they were stored at your doctor's surgery and they were
>> protected by confidentiality at that time.- Hide quoted text -
>
What do you mean? Of course it did. GPs are under no obligation to
produce identifiable medical records except to certain specified people
under closely defined circumstances, usually involving a court order or
a notice from the Secretary of State.
Mr X
"Big Les Wade" <L...@nowhere.com> wrote in message
news:zI6SZCGa...@obviously.invalid...
> It's the way they work. Even some people on uk.legal believe the age-old
> right of medical confidentiality is a mere bagatelle compared with the
> urgent necessity of taking away people's driving licences. You can bet
> that if uk.legal has some of those then government departments must be
> busting at the seams with them.
>
unusual for confidentiality to be over-ridden under those circumstances.
Jethro
> Jethro <jethro...@hotmail.com> posted
What *penalties* exists in *criminal* law for a doctor who divulges
confidential patient data, above and beyond the penalties surrounding
data protection ?
There was a recent court case where the HoL held that patients have no
right to confidentiality in their dealings with doctors, nor people
dealing with lawyers (legal privilege doesn't exist either) ...
Ukblonde
> I have been doing some research based on a relative's behaviour and I
> am forming the impression that there is some kind of responsibility
> for doctors to report to DVLA if a patient is a suspected or admitted
> alcoholic. I got that impression from this part of the DVLA website.
>
> http://www.dft.gov.uk/dvla/medical/ataglance.aspx (download the "at
> a
> a glance" pdf file and then click on section 5 - "Drug and alcohol
> misuse")
>
> Is this really what it seems: a complete disregard for doctor-patient
> confidentiality? It also makes it appear that an alcoholic has a
> statutory duty to report themselves! What kind of wishful thinking
> is
> that?
>
> The concept of confidentiality was one of the first things abandoned
> by
> Nu-labour. Your medical records are now stored on a central computer
> for
> any government Tom Dick or Harry to peruse.
> And they could never have looked at the paper records before if they
>
> Nope because they were stored at your doctor's surgery and they were
> protected by confidentiality at that time.
I've asked a Dr this question, and so long as they know you aren't
causing any danger they are not obliged to report. Many alcoholics are
well aware of their condition, try and get help as well as making sure
they don't drive drunk. Thousands of people drink-drive every weekend
and not all of them alcoholics, many are people who don't think or
don't have a problem.
DVLA may ask for a report if say they think there is a problem i.e. a
person is caught drink-driving with a very high reading on the
breathalyser. Then they may write to your Dr and arrange a medical with
one of their Drs in order to assess the risk.
--
Ukblonde
Big Les Wade
>On 10 Sep, 13:37, Big Les Wade <L...@nowhere.com> wrote:
>> Jethro <jethro...@hotmail.com> posted
>>
>> >On 10 Sep, 09:15, "Bob Ferguson" <robert.fergu...@google.co.uk> wrote:
>> >> Nope because they were stored at your doctor's surgery and they were
>> >> protected by confidentiality at that time.- Hide quoted text -
>>
>> >a confidentiality which had no standing in law.
>>
>> What do you mean? Of course it did. GPs are under no obligation to
>> produce identifiable medical records except to certain specified people
>> under closely defined circumstances, usually involving a court order or
>> a notice from the Secretary of State.
>
>confidential patient data, above and beyond the penalties surrounding
>data protection ?
Probably none, but that's not the same as saying that medical
confidentiality "has no standing in law". It *does* have standing - the
standing that no third party has the right to demand sight of an
individual's medical history.[*] Together with professional ethics, that
was usually enough.
[*]except for a very few exceptions.
And I am glad you recognise that the DPA does provide criminal sanctions
against disclosure of personal medical information.
onearm
[snip]
> Is this really what it seems: a complete disregard for doctor-patient
> confidentiality? It also makes it appear that an alcoholic has a
> statutory duty to report themselves! What kind of wishful thinking is
> that?
Doctors have a duty of care to their patient, and also to society at
large. A doctor who does not report a patient that poses a significant
risk (for example, an alcoholic who says they often drive while drunk,
and have no intention of stopping) leaves themselves open to legal action.
Note that if your doctor advises you not to drive and you continue to do
so that you're probably driving un-insured.
The real shocker isn't that doctors are expected to do this, or that so
few doctors actually do so, but that so few doctors think to mention to
patients that perhaps driving is a bad idea.
Big Les Wade
>Doctors have a duty of care to their patient, and also to society at
>large. A doctor who does not report a patient that poses a significant
>risk (for example, an alcoholic who says they often drive while drunk,
>and have no intention of stopping) leaves themselves open to legal action.
Can you give an explicit statement of the law that makes the doctor
liable, or any precedents for such actions that have been won in the
past?
>Note that if your doctor advises you not to drive and you continue to do
>so that you're probably driving un-insured.
Nonsense. If a motor insurance company accepts your proposal, then they
are obliged to cover you, at least for third party.
>The real shocker isn't that doctors are expected to do this, or that so
>few doctors actually do so, but that so few doctors think to mention to
>patients that perhaps driving is a bad idea.
How would you go about collecting information on the number of doctors
that do this, given that doctors' advice to patients is very rarely
disclosed to anyone else?
Mr X
"Big Les Wade" <L...@nowhere.com> wrote in message
news:vrxlhIAw...@obviously.invalid...
> onearm <one...@example.com> posted
>>Doctors have a duty of care to their patient, and also to society at
>>large. A doctor who does not report a patient that poses a significant
>>risk (for example, an alcoholic who says they often drive while drunk,
>>and have no intention of stopping) leaves themselves open to legal action.
>
> Can you give an explicit statement of the law that makes the doctor
> liable, or any precedents for such actions that have been won in the past?
>
party were to make a complaint I would say they have a good chance of it
being upheld as the doctor would have breached GMC regulations.
> How would you go about collecting information on the number of doctors
> that do this, given that doctors' advice to patients is very rarely
> disclosed to anyone else?
>
I expect you could do an anonmyised survey.
Big Les Wade
>
>"Big Les Wade" <L...@nowhere.com> wrote in message
>news:vrxlhIAw...@obviously.invalid...
>> onearm <one...@example.com> posted
>>>Doctors have a duty of care to their patient, and also to society at
>>>large. A doctor who does not report a patient that poses a significant
>>>risk (for example, an alcoholic who says they often drive while drunk,
>>>and have no intention of stopping) leaves themselves open to legal action.
>>
>> Can you give an explicit statement of the law that makes the doctor
>> liable, or any precedents for such actions that have been won in the past?
>>
>I don't believe that the GMC publishes all results. However, if an injured
>party were to make a complaint I would say they have a good chance of it
>being upheld as the doctor would have breached GMC regulations.
We're talking about litigation, not GMC disciplinary panels.
>> How would you go about collecting information on the number of doctors
>> that do this, given that doctors' advice to patients is very rarely
>> disclosed to anyone else?
>>
>I expect you could do an anonmyised survey.
The OP claims to know the figures, so perhaps he could point us to the
relevant publication.
Mr X
> Mr X <inv...@invalid.com> posted
>>
>>"Big Les Wade" <L...@nowhere.com> wrote in message
>>news:vrxlhIAw...@obviously.invalid...
>>> onearm <one...@example.com> posted
>>>>Doctors have a duty of care to their patient, and also to society at
>>>>large. A doctor who does not report a patient that poses a significant
>>>>risk (for example, an alcoholic who says they often drive while drunk,
>>>>and have no intention of stopping) leaves themselves open to legal
>>>>action.
>>>
>>> Can you give an explicit statement of the law that makes the doctor
>>> liable, or any precedents for such actions that have been won in the
>>> past?
>>>
>>I don't believe that the GMC publishes all results. However, if an
>>injured
>>party were to make a complaint I would say they have a good chance of it
>>being upheld as the doctor would have breached GMC regulations.
>
> We're talking about litigation, not GMC disciplinary panels.
>
onearm
> onearm <one...@example.com> posted
>>Doctors have a duty of care to their patient, and also to society at
>>large. A doctor who does not report a patient that poses a significant
>>risk (for example, an alcoholic who says they often drive while drunk,
>>and have no intention of stopping) leaves themselves open to legal
>>action.
>
> Can you give an explicit statement of the law that makes the doctor
> liable, or any precedents for such actions that have been won in the
> past?
There is a precedent, I'm trying to find it.
http://emj.bmj.com/cgi/content/abstract/23/2/103
http://emj.bmj.com/cgi/content/abstract/20/6/526
http://www.cks.nhs.uk/patient_information_leaflet/epilepsy_driving_eruk
http://pb.rcpsych.org/cgi/content/full/29/3/90
http://www.thepractitioner.co.uk/story.asp?
storyCode=4113739§ioncode=45
http://ukpmc.ac.uk/articlerender.cgi?artid=532303
http://ukpmc.ac.uk/articlerender.cgi?artid=988171
etc etc etc.
The Warwick research group have useful information, as they were asked to
do DfT work about medical practitioners giving advice for fitness to
drive.
>>Note that if your doctor advises you not to drive and you continue to do
>>so that you're probably driving un-insured.
>
> Nonsense.
Hang on. If you have a medical condition that you must report to the
DVLA, and you do not do so, you're committing an offence. If you have a
medical condition that you should have reported to the dvla, but haven't
done so, you're probably driving unlicenced, which would invalidate any
insurance.
> If a motor insurance company accepts your proposal, then they
> are obliged to cover you, at least for third party.
Other people can answer this. I'm not convinced it's correct.
>>The real shocker isn't that doctors are expected to do this, or that so
>>few doctors actually do so, but that so few doctors think to mention to
>>patients that perhaps driving is a bad idea.
>
> How would you go about collecting information on the number of doctors
> that do this, given that doctors' advice to patients is very rarely
> disclosed to anyone else?
There are a number of ways.
You ask doctors what they would say to hypothetical patients
You ask doctors what they have said to real, but anonymised, patients
You ask patients what their doctors have said to them