Driving (Persons with Dementia)

Rachel Maclean Excerpts

1st reading: House of Commons
Tuesday 4th June 2019 Commons Chamber

[Rachel Maclean (Redditch) (Con)]

I beg to move,

That leave be given to bring in a Bill to require doctors to inform the appropriate driver licensing agency of a diagnosis of dementia; to require drivers diagnosed with dementia to undertake a supplementary driving assessment; and for connected purposes.

This Bill is born out of my personal experience, but I know many other people have similar stories to tell. My Bill sets out to better address just one area of daily life that is impacted for the 850,000 people in the UK currently living with dementia. That number is expected to rise to 1 million by 2025 and to 2 million by 2050. Many families and carers are concerned for their loved one’s safety while driving with the condition, and I am pleased to have received support from many of them.

It is important to say from the word go that this Bill does not seek to prevent those diagnosed with dementia from driving if they can do so safely. Indeed, one in three people with earlier-stage dementia still drives, and it is critical for those diagnosed with dementia to maintain their quality of life and dignity. Driving truly is at the heart of a person’s independence, and it can be hugely difficult to come to terms with its loss. Yet, at the same time, carers and families may have serious concerns about the safety of their loved one and of road users in the neighbourhood, particularly if their loved one lives alone or far from the main family member or carer.

This Bill seeks to make the mechanism for assessing fitness to drive with a dementia diagnosis fairer to both the person with dementia and their family, carers and the local community. Of course, driving is dangerous at the best of times and is not without risk, especially when one is diagnosed with a condition that affects cognitive ability. Although, of course, every individual is different, statistics show an increased risk of dementia patients being involved in road traffic accidents. I do not believe that the current system strikes the right balance in mitigating the risk, and at the moment it only adds to the very difficult process for families trying to help their loved ones make the transition. My Bill seeks to start a conversation about how we can support a person with dementia more compassionately as they come to terms with the impact of such a devastating condition.

The status quo is that the licence holder—the person with the diagnosis—is responsible for notifying the Driver and Vehicle Licensing Agency or Driver and Vehicle Agency. But some people diagnosed with dementia do not necessarily want to start a process that might ultimately lead to their licence being revoked. It is common for the person with dementia to lack insight into their own loss of capacity. It is also the case that GPs may not be prepared to notify the DVLA, for the same well-intentioned reasons. A GP does not always see their patient behind the wheel, and if they have known the person for years, it is a difficult and unwelcome conversation for them to have, especially given the pressures that we all know frontline GPs work under. I have heard anecdotal stories from GPs who were not prepared to take steps on the driving issue until a dementia patient actually drove into their car in the surgery car park.

My Bill would recognise that a person with dementia might be safe to drive, and would establish a simple mechanism for an assessment to take place. It would therefore become the norm for the DVLA to be notified and for a supplementary test to take place at an appropriate interval following the diagnosis. That would present the patient with the opportunity to actually demonstrate to their carers and the community that they were in fact safe to drive, which would be a welcome outcome for everyone. Should the person be found unsafe to drive, it would be a natural opportunity to help them access the many excellent local transport options, whether Rural Wheels or other services in their community. An end to driving does not necessarily mean an end to an independent, fulfilled life, and I warmly welcome the work that volunteers and local authorities do to provide vital services.

It is a common misconception that the driving test that dementia patients are required to take is the same as the full driving test and, of course, most of us—even if we have been driving for years—would probably not be able to pass the test, let alone someone who is a little older. The supplementary driving assessment looks at the overall impact that dementia is having. It is done in a supportive way and makes some allowances for the bad habits that drivers might have developed. The outcome of the test might suggest modifications to the vehicle or driving behaviour that could extend the period someone could drive safely following a diagnosis.

Under the simple system proposed in the Bill, the clinician or doctor would be required to notify the DVLA automatically, which would then require the person to take the driving assessment at an appropriate juncture. If that were part of the normal process following a diagnosis, it need not be feared. It is only one small practical step, but it would present a wonderful opportunity to talk about how we, as a society more generally, can not only continue to support vital research work to eventually find a treatment for all forms of dementia, but ensure that services are properly resourced in the future.

As we come to the end of the parliamentary Session, I am delighted to have been able to use this opportunity to raise awareness of dementia. Of course, other conditions can have similar impacts on one’s ability to drive and I do not believe other disabilities should be treated differently from dementia in this regard, but given my personal experience I wanted to raise this specific issue in my Bill. I am pleased to have secured the support of Alzheimer’s Research UK, which has been invaluable in supporting me with the Bill, and I am also delighted that colleagues from across the House are supporting me, including the chair of the all-party parliamentary group on dementia.

I hope the Bill will encourage a conversation about how we can better support those with dementia and address the wider impacts on our society. This is one small part of the jigsaw, but it is a real issue that many families face every day. Such impacts might not necessarily come immediately to mind, but are emotionally just as painful as others. The Bill seeks first and foremost to encourage that conversation, and I commend it to the House.

Question put and agreed to.

Ordered,

That Rachel Maclean, Antoinette Sandbach, Sir David Amess, Eddie Hughes, Anne-Marie Trevelyan, Vicky Ford, Simon Hoare, Jack Brereton, Jack Dromey, Nic Dakin, Jim Fitzpatrick, and Debbie Abrahams present the Bill.

Rachel Maclean accordingly presented the Bill.

Bill read the First time; to be read a Second time tomorrow, and to be printed (Bill 394).