Department for Transport
Central Government
Noted
The Department for Transport explains the current driver licensing arrangements, emphasizing the legal requirement for drivers to report medical conditions to the DVLA and that the DVLA can only act on information received from licence holders and/or healthcare professionals about known medical conditions. They mention a Call for Evidence to gather views on the legislative framework that governs driver licensing for people with medical conditions. (AI summary)
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Dear Mr Wade,
Thank you for your report of 12 April 2024 made under paragraph 7, Schedule 5, of the Coroners and Justice Act 2009 and regulations 28 and 29 of the Coroners (Investigations) Regulations 2013, following the investigation you conducted into the death of James Ferris Baxter.
I was very sorry to learn of the circumstances of Mr Baxter’s death and would like to express my sincere condolences to his family.
I have considered your report and its recommendations carefully and I can assure you that the Department takes such matters very seriously.
The current driver licensing arrangements are underpinned by a legal requirement that all drivers, of any age, must inform the Driver and Vehicle Licensing Agency (DVLA) at any time if they develop a medical condition that may affect safe driving. All drivers must meet the appropriate medical standards for driving and a licence will only be issued to those who meet those standards. These arrangements are designed to be balanced and proportionate for all drivers, balancing road safety and the mobility of individuals.
The medical standards relating to fitness to drive are set out in the DVLA’s guidance: Assessing fitness to drive: a guide for medical professionals. The guidance is based on both domestic legislation and advice from the Secretary of State for Transport’s Honorary Medical Advisory Panels. The guidance advises members of the medical profession on the medical standards that need to be met by individuals to hold licences to drive various categories of vehicles. The health standards for drivers of lorries and buses are From the Secretary of State Rt. Hon Louise Haigh MP
Great Minster House 33 Horseferry Road London SW1P 4DR
Tel: 0300 330 3000 E-Mail:
Web site: www.gov.uk/dft
Our Ref:
substantially higher than for drivers of cars and motorcycles due to the size and weight of the vehicle and the length of time a professional driver typically spends at the wheel. The medical panels provide the DVLA with expert medical advice about relevant medical conditions and their impact on driving.
Drivers of lorries and buses are required to renew their driving entitlement every five years from the age of 45 and then annually from the age of 65. When renewing their licence, a driver must make a declaration regarding their health and submit a D4 medical report following an examination which must be carried out by a doctor. The DVLA recommends that drivers ask their own GP to complete the D4 medical report, given that the GP will have access to the medical records and could provide medical information that may be required. However, there is no obligation for drivers to see their own GP and to make it a requirement may have impacts on drivers and the transport industry in terms of time and costs. In addition, a number of private companies offer this service to drivers and where this is the case, the examining doctor should be satisfied that they have sufficient information about a driver’s medical history and should not sign a D4 where there is any doubt.
After the age of 45, and in accordance with the requirements for lorry and bus licensing, Mr Baxter submitted several D4 medical reports which were completed by his own GP. The only medical conditions declared on these reports were diabetes treated with low-risk medication, and hypertension. At no point was the DVLA advised that Mr Baxter had ischaemic heart disease.
In November 2020 Mr Baxter applied to renew his lorry and bus entitlement. He submitted a D4 medical report which was completed by a doctor other than his GP. On this occasion the doctor completing the D4 notified DVLA of Mr Baxter’s diabetes and added that Mr Baxter was not on anti-hypertensive treatment but was taking two other types of medication, one for renal protection and one for hypercholesterolaemia (high cholesterol). The additional information supplied was unrelated to his diabetes.
The DVLA most recently issued a driving licence to Mr Baxter in December 2021, around nine months before the incident. The application and D4 submitted at that time which again was completed by a doctor other than his GP detailed that all medication remained the same except with the addition of medication for prostate issues which was unrelated to his diabetes. Based on all the evidence available at the time, Mr Baxter was relicensed by the DVLA.
The information provided to the DVLA on Mr Baxter’s D4 medical reports did not raise any health concerns which would have required the DVLA to conduct further medical investigations into his fitness to drive. Mr Baxter’s D4 medical reports provided information about the medication he was taking, but it was only the medication used to treat diabetes that was relevant in terms of assessing his fitness to drive.
I have noted your suggestions regarding the possibility of adding Hbac1 and cholesterol readings as standard to the D4 forms, as a way of screening for risk of heart-related conditions. Currently, the DVLA can only act on information received from licence holders and/or healthcare professionals about known medical conditions.
The DVLA issued a Call for Evidence late last year to gather views on the legislative framework that governs driver licensing for people with medical conditions. There were 486 responses in total which are currently being examined.
I am very grateful for you bringing your concerns to my attention. Please be assured that my department takes road safety very seriously and we are focused on ensuring that only those who are fit to drive are granted a licence to do so.
Thank you for your report of 12 April 2024 made under paragraph 7, Schedule 5, of the Coroners and Justice Act 2009 and regulations 28 and 29 of the Coroners (Investigations) Regulations 2013, following the investigation you conducted into the death of James Ferris Baxter.
I was very sorry to learn of the circumstances of Mr Baxter’s death and would like to express my sincere condolences to his family.
I have considered your report and its recommendations carefully and I can assure you that the Department takes such matters very seriously.
The current driver licensing arrangements are underpinned by a legal requirement that all drivers, of any age, must inform the Driver and Vehicle Licensing Agency (DVLA) at any time if they develop a medical condition that may affect safe driving. All drivers must meet the appropriate medical standards for driving and a licence will only be issued to those who meet those standards. These arrangements are designed to be balanced and proportionate for all drivers, balancing road safety and the mobility of individuals.
The medical standards relating to fitness to drive are set out in the DVLA’s guidance: Assessing fitness to drive: a guide for medical professionals. The guidance is based on both domestic legislation and advice from the Secretary of State for Transport’s Honorary Medical Advisory Panels. The guidance advises members of the medical profession on the medical standards that need to be met by individuals to hold licences to drive various categories of vehicles. The health standards for drivers of lorries and buses are From the Secretary of State Rt. Hon Louise Haigh MP
Great Minster House 33 Horseferry Road London SW1P 4DR
Tel: 0300 330 3000 E-Mail:
Web site: www.gov.uk/dft
Our Ref:
substantially higher than for drivers of cars and motorcycles due to the size and weight of the vehicle and the length of time a professional driver typically spends at the wheel. The medical panels provide the DVLA with expert medical advice about relevant medical conditions and their impact on driving.
Drivers of lorries and buses are required to renew their driving entitlement every five years from the age of 45 and then annually from the age of 65. When renewing their licence, a driver must make a declaration regarding their health and submit a D4 medical report following an examination which must be carried out by a doctor. The DVLA recommends that drivers ask their own GP to complete the D4 medical report, given that the GP will have access to the medical records and could provide medical information that may be required. However, there is no obligation for drivers to see their own GP and to make it a requirement may have impacts on drivers and the transport industry in terms of time and costs. In addition, a number of private companies offer this service to drivers and where this is the case, the examining doctor should be satisfied that they have sufficient information about a driver’s medical history and should not sign a D4 where there is any doubt.
After the age of 45, and in accordance with the requirements for lorry and bus licensing, Mr Baxter submitted several D4 medical reports which were completed by his own GP. The only medical conditions declared on these reports were diabetes treated with low-risk medication, and hypertension. At no point was the DVLA advised that Mr Baxter had ischaemic heart disease.
In November 2020 Mr Baxter applied to renew his lorry and bus entitlement. He submitted a D4 medical report which was completed by a doctor other than his GP. On this occasion the doctor completing the D4 notified DVLA of Mr Baxter’s diabetes and added that Mr Baxter was not on anti-hypertensive treatment but was taking two other types of medication, one for renal protection and one for hypercholesterolaemia (high cholesterol). The additional information supplied was unrelated to his diabetes.
The DVLA most recently issued a driving licence to Mr Baxter in December 2021, around nine months before the incident. The application and D4 submitted at that time which again was completed by a doctor other than his GP detailed that all medication remained the same except with the addition of medication for prostate issues which was unrelated to his diabetes. Based on all the evidence available at the time, Mr Baxter was relicensed by the DVLA.
The information provided to the DVLA on Mr Baxter’s D4 medical reports did not raise any health concerns which would have required the DVLA to conduct further medical investigations into his fitness to drive. Mr Baxter’s D4 medical reports provided information about the medication he was taking, but it was only the medication used to treat diabetes that was relevant in terms of assessing his fitness to drive.
I have noted your suggestions regarding the possibility of adding Hbac1 and cholesterol readings as standard to the D4 forms, as a way of screening for risk of heart-related conditions. Currently, the DVLA can only act on information received from licence holders and/or healthcare professionals about known medical conditions.
The DVLA issued a Call for Evidence late last year to gather views on the legislative framework that governs driver licensing for people with medical conditions. There were 486 responses in total which are currently being examined.
I am very grateful for you bringing your concerns to my attention. Please be assured that my department takes road safety very seriously and we are focused on ensuring that only those who are fit to drive are granted a licence to do so.