A SENIOR doctor in Scotland has urged GPs to pass on information about patients whose ability to drive safely could be impaired by medical conditions such as fainting episodes, collapses and alcohol dependency.
Professor Andrew Collier, a consultant physician in Ayrshire, said the case of Harry Clarke, the driver who blacked out at the wheel of his lorry in Glasgow last Christmas, killing six people, highlighted the need for family doctors to divulge patients’ medical problems to the DVLA licensing body if they felt it could affect their ability to control a vehicle.
Collier, who is based at University Hospital Ayr, said that under General Medical Council (GMC) rules, the onus is on the patient to self-report but doctors can breach patient confidentiality where the patient or others are likely to be in danger.
In reality, said Collier, many doctors are unaware of the GMC guidelines and others who are rarely blow the whistle for fear of being branded untrustworthy and losing patients.
A fatal accident inquiry into the bin lorry tragedy has heard how Clarke saw his doctor more than 300 times in 30 years.
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He complained repeatedly of dizziness, vertigo, stress, tension headaches, anxiety and depression.
Records showed Clarke had two vertigo incidents in 1977 and a vasovagal [fainting] attack in 1989 when he drove articulated lorries. He reported dizziness in 1994, “upset balance” in 1999 and was advised not to drive after dizziness in 2003 when working as an oil tanker driver.
Dr Daniel Rutherford, who compiled a report on behalf of the family of Jacqueline Morton, one of the victims, said Clarke’s medical history suggested he was not fit enough to drive a car, let alone a 26-tonne council refuse lorry, and that had he been Clarke’s GP, he would have told him to notify the DVLA. Collier, who published a paper last year highlighting the worrying number of people in Scotland who drink alcohol excessively yet routinely drive, said that if Clarke had refused to self-report, then doctors would have been within their rights to go to them with their concerns. It is almost certain that the DVLA would have banned Clarke from driving.
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“It’s quite clear that GPs have a duty of care to notify the DVLA if they have concerns that a patient could pose a risk because of a medical condition. I think many doctors are unaware of this and it needs to be highlighted,” said Collier.
The GMC’s guidelines state that doctors “should contact the DVLA immediately” if a patient cannot be persuaded to stop driving or if a doctor discovers they are continuing to drive against medical advice.
Collier said he has tipped off the DVLA about patients who got behind the wheel after he explicitly warned them against doing that.
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Meanwhile, the crown’s handling of the case has been described as a “shambles”.
Brian McConnachie QC, a former senior prosecutor, said he could not understand why the crown announced in February that Clarke would not be prosecuted. It means the crown cannot reverse its decision.
“The crown are usually very reluctant to tell people that they’re not going to be prosecuted and I cannot fathom why a prosecution in this case was swiftly rejected.”
McConnachie also said it was “remarkable” that the prospect of private prosecutions by the victims’ families was allowed to be made public. “That is why Clarke has refused to answer questions at the inquiry,” he said. “Otherwise, he would have been compelled to comply more fully. It’s a shambles.”
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Erin McQuade, 18, and her grandparents, Jack Sweeney, 68, and Lorraine Sweeney, 69, from Dumbarton, West Dunbartonshire, died from multiple injuries after being hit by the bin lorry.
Stephenie Tait, 29, and Morton, 51, both from Glasgow, and Gillian Ewing, 52, from Edinburgh, were also killed in the incident.
A Crown Office spokesman said that since Clarke was unconscious at the time of the tragedy he was not in control of his actions and did not have the necessary criminal state of mind required for a criminal prosecution.
“In addition the crown could not prove that it was foreseeable to the driver that driving on that day would result in a loss of consciousness. This still remains the case and all the relevant evidence regarding these points was known to crown counsel at the time the decision to take no proceedings was made.”