Opinion: Medically unfit drivers put all road users at risk

By John Kushnick, legal operations director at National Accident Helpline

More than two million motorists with impaired vision could still be driving on UK roads, according to recent data.

Under current regulations, the UK relies on a self-reporting system, which requires drivers to notify the Driver and Vehicle Licensing Agency (DVLA) if they have any eyesight condition that could affect their driving.

However, this self-reporting approach to determining driving fitness creates significant dangers on our roads.

Most drivers prioritise their personal needs and convenience over safety concerns, operating under the assumption that nothing will go wrong.

Many older drivers make misleading claims like “I've driven for 60 years without an accident,” failing to recognise that past performance doesn’t predict future safety, especially as physical and cognitive deterioration naturally occurs with age.

These changes typically happen gradually, making them difficult for individuals to notice in themselves.

Meanwhile, health professionals juggle numerous considerations and don’t consistently evaluate driving ability during routine visits, creating opportunities for drivers to misrepresent their conditions.

Perhaps most concerning is that cognitively impaired drivers often lack the awareness to recognise their unfitness to drive, putting themselves and others at risk.

When it’s time, families must step in

Families play a crucial role in ensuring the safety of both their loved ones and others on the road.

Close family and friends are typically most aware when a driver becomes unfit, observing their decline and experiencing their deteriorating driving firsthand.

However, many mistakenly believe they must either allow continued driving for the sake of “independence” or secure the driver’s consent to stop – prioritising the driver’s short-term interests over public safety.

As such, family members frequently remain silent about concerns to avoid conflicts, hoping nothing serious will happen.

They may also incorrectly assume that medical professionals would have intervened if genuine safety issues existed.

People must take stronger stands to prevent unfit individuals from driving, despite the personal discomfort this may cause.

As difficult as these conversations may be, an awkward family dinner is vastly preferable to an emergency room visit or funeral.

How victims’ families can seek justice

Medically unfit drivers don’t just endanger themselves – they pose serious risks to everyone around them.

When their impairment leads to a tragic accident, the consequences can be devastating for innocent victims and their families. In such cases, feelings of grief are often compounded by a deep sense of injustice – and families have every right to seek accountability.

For families seeking justice when loved ones are harmed by medically unfit drivers, the claims process resembles standard procedures but may involve additional complications if insurers revoke policies due to non-disclosure.

Claims remain possible but often progress more slowly with less cooperation, potentially requiring the inclusion of insurance companies in legal proceedings. Families can also advocate for police prosecution of responsible parties.

Legal reforms needed to better protect the public

The goal should be prevention to avoid these tragedies in the first place. Several reforms could enhance road safety.

Implementing automatic retesting after age 70, followed by periodic retests every two or three years, would help identify declining abilities.

These tests should focus specifically on eyesight and cognitive function, including risk identification similar to, or the same as, those faced by new drivers.

It’s illogical to maintain lower standards for existing drivers experiencing natural decline than for those just beginning.

Medical practitioners should also be required to consider how patients’ conditions might affect driving ability, regardless of whether or not they know the person drives.

This approach should include a straightforward process for reporting concerns to licensing authorities, with clearly defined levels ranging from “must stop driving immediately” to “minor concerns, recommend retesting but may continue driving”.

Finally, the system should simplify the process for family members to report concerns, either through general practitioners acting as gatekeepers or directly to licensing authorities, though the latter approach might invite unwarranted complaints.

Cost of ignoring the signs

Preventing tragedies caused by medically unfit drivers requires both individual awareness and meaningful reform.

Families, healthcare professionals and policymakers all have a critical role in recognising when someone is no longer fit to drive – and in taking action before lives are lost.

However, until more efficient measures are taken, the burden of responsibility falls on the driver.

Beyond the ethical failure of ignoring medical advice, unfit drivers must remember they face serious consequences on two fronts.

Criminally, they risk prosecution and potential imprisonment, even for first-time offences.

Financially, ignoring medical advice invalidates their car insurance, preventing them from claiming for personal losses.

While their insurers must initially cover claimants’ costs, they can recover all expenses from the non-compliant driver – potentially running into hundreds of thousands or millions of pounds and resulting in bankruptcy.