Legislative Reform (Provision of Information etc. Relating to Disabilities) Order 2022

Baroness Randerson Excerpts

Tuesday 12th July 2022 Grand Committee

[The Parliamentary Under-Secretary of State, Department for Transport (Baroness Vere of Norbiton) (Con)]

My Lords, this is a short but important order that amends Section 94 of the Road Traffic Act 1988. It will allow a wider group of healthcare professionals to provide the important medical information that the Driver and Vehicle Licensing Agency needs to assess whether someone can meet the appropriate health standards for driving. This will reduce a burden that currently rests only with doctors.

This change will directly support the Department of Health and Social Care’s agenda to reduce bureaucracy in general practice. The Government recognise that we should be using the skills and expertise of other healthcare professionals, where appropriate. This in turn frees up time for doctors to focus on patient care.

The measure meets the tests set out in the Legislative and Regulatory Reform Act 2006 and has been approved by the Delegated Powers and Regulatory Reform Committee of your Lordships’ House, and the Business, Energy and Industrial Strategy Committee in the other place, as being appropriate for a legislative reform order with the affirmative procedure.

I will give a bit of background. The DVLA is responsible for deciding whether a driving licence holder or applicant meets the appropriate health standards for driving in Great Britain. The DVLA does this by assessing information about the individual’s health against medical criteria. This order does not change the DVLA’s responsibility for making driver licensing decisions.

All drivers and licence applicants have a legal obligation to notify the DVLA of a medical condition that may affect safe driving. In some cases, the DVLA can make a decision with the information provided by the driver. However, in many cases, additional information is required. By far the largest source of medical information is gathered from questionnaires that are completed by doctors from information held on the driver’s medical records. This service is provided outside NHS contracts; it is private work for which the DVLA pays doctors a standard fee.

Currently, the Road Traffic Act requires a driver to authorise a doctor who has previously given medical advice to them to provide information to the DVLA. In practical terms, this means that the DVLA can accept medical questionnaires only from a doctor. This is an unnecessary burden in this day and age, because not only doctors but many other qualified healthcare professionals are able to provide this information. Between 2016 and 2021, an average of 267,080 questionnaires were completed each year by doctors. It is estimated that each questionnaire takes 20 minutes, so I am sure noble Lords can appreciate that a substantial amount of time is taken up by those tasks.

I turn to the content of the order before your Lordships today. The current law was made in 1988 and does not really reflect current clinical practices. Often healthcare professionals other than a doctor may be primarily responsible for managing certain medical conditions. The term “registered healthcare professional” is used to describe a range of clinicians, including doctors and nurses. Changing the wording of the legislation from “registered medical practitioner” to “registered healthcare professional” will ensure that information can be provided directly by the most appropriate person.

The DVLA will take a phased approach and will initially ask for details of the driver’s doctor. The DVLA will write to the driver’s doctor, who will be able to pass the questionnaire to another healthcare professional for completion if they wish to do so. However, this change means that longer term, when a driver knows that their care is provided mainly by another healthcare professional, the driver will be able to authorise that healthcare professional to provide the information required by the DVLA. This will allow questionnaires to be sent directly to other healthcare professionals and will remove the need to include a doctor in the administration of the questionnaire. Before the DVLA begins to send questionnaires directly to other healthcare professionals, the department will write to the BEIS Committee with a review of the new process. This will provide reassurance to the committee that there are sufficient safeguards in place.

We have heard some concerns that healthcare professionals other than doctors may not have the knowledge to complete the DVLA’s medical questionnaires, but we are content that that is not the case. The DVLA recognises that a person’s medical history can be complex, but in many cases healthcare professionals other than doctors will be more than capable of providing the information needed. It is important to recognise that in this day and age many healthcare professionals are specialist practitioners—for example, diabetes nurse practitioners. Although some may feel that the GP’s overview of health is important, it should be noted that the DVLA’s questionnaire is about a specific medical condition and not about the person’s general health. It is about one condition and whether that may affect their driving. If that person has several conditions, there will be several questionnaires that will investigate whether that person is able to continue driving. The request is for the information, and then the DVLA makes that decision.

The order also removes the necessity for the person authorised to have personally given medical advice to the driver. This will address situations where the named doctor no longer has access to the information required, because the advice and attention was from many years ago, or the doctor has retired or moved to a different practice. We will amend the law to remove that requirement.

The DVLA consulted on this proposal. There were 411 responses to the consultation from the public, medical and healthcare professionals, and road safety groups. Almost 82% of those 411 people or groups who responded agreed with the proposal.

The aim of this measure is to update an outdated piece of legislation that does not reflect the way modern healthcare works today. We also see that it relieves a burden on doctors, which is why we have been able to use the legislative reform order route. Those doctors will be able to spend more time on patient care.

As I have noted, the measure will allow the most appropriate healthcare professional to provide the information, but I reiterate that it remains up to the DVLA and its doctors and medical experts, who will review that information, to make a decision about a driving licence application. I beg to move.

[Baroness Randerson (LD)]

I thank the Minister for her very clear explanation. This seems a sensible streamlining of the legislation in accordance with the modernisation of clinical practice. It is welcome, because there are stories of drivers having to wait for excessively long periods for GPs to give their signature and hence their permission. That delay is undoubtedly largely because of the grave and worsening shortage of GPs in Britain. It is therefore really important that we use them in the most effective way.

I was pleased to see that the widespread response to the public consultation was overwhelmingly positive, and that the Secondary Legislation Scrutiny Committee agreed that the appropriate processes had been followed. However, I have two short questions for the Minister. First, what checks are there to ensure there are no abuses of this system? What will be done to review it? Whenever you introduce a new system, you need to look at it in the light of experience in case there is a weakness. Some respondents were concerned not just about abuse of the system but about the level of qualification of some of those healthcare professionals. That might be totally unjustified, but it is important that the review takes place.

Secondly, the DLVA is UK-wide, but healthcare is devolved. There are different approaches to the use of certain healthcare professionals across the nations of Britain. There are some areas where GPs are relied on more than in others, and the breadth of healthcare professionals used is greater in some nations. What consultation was there with the devolved Administrations about this to ensure that the legislation matches their approach to the use of a broader spectrum of healthcare professionals in the system?