Slightly alarmist reporting by the Daily Fail last week claimed that 1 million people with diabetes on insulin could lose their driving licences due to new EU legislation.
As with most stories, however, there is a grain of truth in this one, and here at ShootUp, we’re doing something about it. You can too.
What’s happening?
The DVLA (who are responsible for issuing your driving licence here in the UK) are looking to implement some new EU legislation around driving and diabetes in October 2011.
Is that good news or bad news?
Both. There are some positive things in the legislation for people with diabetes treated by insulin. For example, it will end the blanket ban on people on insulin driving Group 2 vehicles (heavy goods vehicles and public service vehicles eg buses). They’ll now be assessed against a criteria and reviewed annually. Much better than the current blanket ban.
However, there are also some areas of real concern. The proposal states that “Drivers experiencing recurrent severe hypoglycaemia shall not be issued a licence – ‘severe recurrent hypoglycaemia’ is now defined as ‘a second severe hypoglycaemia during a period of 12 months’”. As it stands, this could include night-time hypos. I struggle to see how having 2 severe night-time hypos a year has any impact on my safety at the wheel.
For the full, balanced story, without the tabloid overexcitement, try reading the Diabetes UK response to the proposals.
What can we do?
We need to make sure these regulations are implemented sensibly, with proper consideration given to the realities of diabetes, rather than abstract declarations about numbers of hypos, indiscriminate of timing or cause being a main feature. Diabetes UK responded to these proposals back in April, but as yet I’ve not seen anything that gives me hope that their concerns have been taken on board. Therefore, I’ve sent the letter below to my MP, and Tim has done similar to his MSP. Feel free to steal from it and amend it to write to your own MP. If we don’t take action on this now, we do risk our ability to drive being compromised (and as Tim’s only just passed his test, it’d be a shame for him to face problems so soon!).
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Dear xxx,
Diabetes & Driving changes – EU Regulations
The current proposal to amend the Driving License Standards for diabetes in light of EU regulations will be detrimental to the employment prospects and therefore the future health of your constituents who live with diabetes – unemployment is not conducive to maintaining good health with diabetes.
Approximately 1257 of your constituents, including me, have diabetes treated by insulin and will be affected by these proposed changes. On their behalf, could you please consider what actions you are able to take.
The current proposal from the DVLA is poorly defined and leaves the driving licences of people with diabetes on insulin subject to the vagaries of interpretation by those who are not subject matter experts. Diabetes UK, the charity for people with diabetes, have submitted their recommendations to the DVLA on amendments that should be made to the proposals, but to date I see no evidence of these recommendations being implemented.
Your immediate action would be very much appreciated.
A link to the relevant documentation is below, but if you need further information I’d be happy to discuss this with you.
Yours sincerely,
xxx
Address
Tel No
Diabetes UK recommendations: http://www.diabetes.org.uk/upload/About%20us/Consultations/Diabetes%20UK%20Response%20to%20Annex%203%20Consultation%2028April11.pdf
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You can find out who your MP/MSP/MLA is here. That will also give you an option to send them a message online. I always prefer to email my MP, it’s quicker.
Politicians are elected locally, so you need to be clear that this is an issue that will affect you and the people who vote for them. To give them the size of the problem locally, you can calculate the number of people on insulin in your area:
Diabetes UK say approximately 1 million people in the UK have diabetes treated by insulin (Type 1 & 2). The population of the UK is approximately 62million, so that means 1.6% of the population is on insulin.
You can find the number of people in your constituency here.
Calculate 1.6% of that figure eg there are 78,612 people in my constituency, so 78,612 multiplied by 0.016 gives you 1257 people with diabetes treated by insulin in my constituency.
Now get on with it and let us know how you get on.
Hi Alison,
I had a huge battle with the good folk in the DVLA this month. At first they refused to renew my licence, and then requested 90 days worth of bg tests, and picked up on one 2.4mmol/l hypo ten weeks ago. My licence was revoked immediately with a simple letter stating that I need to provide proof that I “have not been incapacitated more than three times, requiring the use of another person, whilst driving”. In 18 years of driving, I’ve never had an accident, and never required (thank goodness) assistance and test 8 or 10 times per day, and anytime before driving.
The DVLA didnt weren’t interested in my pleas for leniency, and demanded my Endo’s details. By coincidence I had my four monthly check up today, and my Endo is amazing, and he’s currently assisting with the drafting of the new Irish driving guidelines for diabetics, and he said he had to deal with the DVLA for my licence renewal (I’m currently living in Ireland), and could not believe the ferosity of the guidelines imposed by the DVLA. Eventually, through sheer persistance, phone calls, emails and letters, got the renewal through, for 3 years anyway.
Got my A1c results today too, it’s 5.7% so take that DVLA *boldly sticks two fingers up and runs off*
I’ve sent my email…
Very concerning. Email sent.
Has anyone classified severe?
@jason What a nightmare, congrats on fighting it.
@seasiderdave Current proposal talks about “‘severe hypoglycaemia’ being where “the help of another person is required”. That’s far too open to interpretation for my liking. Part of the DUK recommendation is “Diabetes UK recommends that ‘Severe Hypoglycaemia’ is defined in guidance for drivers as “an event requiring assistance of another person to administer actively carbohydrate, glucagon or other resuscitative actions.” That’s at least a bit more specific.
Can I change my answer to the poll? From now on I won’t even ask my other half to pass the fruit pastilles if it counts against me.
I know, I have visions of having to argue that I was just lazy Gov’ner not severely hypo. Mind you, if we get the legislation right, it shouldn’t be an issue. Have you emailed your MP yet? 😉
Just to be different …
I’m not overly worried although I’d like to see the wording tightened up so that the requirements are clear which is what i’ll send to my local mp for her to ignore!
Personally though I would prefer the hospital consultant to have to send the dvla a letter stating no objections on a renewal & a legal requirement to test blood sugar before setting off with a strict sentence as I was shocked by the number at my hospital who dont!
I’d love to know the statistics on how many road accidents are caused by a hypo as opposed to undue care & attention, I’d estimate maybe 0.0005%.
@furrypaul I’ve submitted a Freedom of Information request to the DVLA asking them to provide me with the evidence they’re using to justify these changes.
At the moment, if the DVLA question your medical fitness, your consultant needs to give their opinion as you suggest. The issue is, if the guidelines the DVLA are working to are ridiculous – for example you may have perfect control but you’ve had 2 severe hypos requiring glucagon whilst asleep – your consultant’s letter is meaningless, because he’s bound by the guidelines.
IMHO this is all a result of woolly EU legislation, which is always very vaguely drafted. For example “severe” in the Directive is not properly or adequately defined. Compare this to – for example – the definition of theft in UK’s 1968 Theft Act which is – off the top of my head – “taking property belonging to another with the intention of permanently depriving the other of it”. It may sound like legalease, but in fact it *really* nails down what theft is. This legislation needs an equally good definition of “severe”, etc.
My view is that EU legislation is actually written in this woolly way so that member states have enough wiggle room to define it and enforce it however they like. Sometimes, subjectively, it seems the UK Parliament introduces this wooliness in ways in which aren’t much good. It reminds me of that episode of Yes Minister in which there’s a proposal to introduce a community-wide ID card:
Frank: “Won’t the other EEC countries object to carry identity papers too?”
Sir Humphrey: “No – the Germans will love it, the French will ignore it and the Italians and the Irish will be too chaotic to enforce it. Only the British will resent it.”
[See: http://www.thevervoid.com/media/yesminister_05.htm%5D
It’s the same with introducing this Directive – only the British will resent it. But what the hell do I know? 🙂
@Tim Spot on. I don’t mind them implementing it, I’d just like the DVLA to take the time and braincells to do it properly by applying some thought to it, rather than the current slap dash muddle of words proclaiming to be meaningful.
@Alison – precisely!
@tim with directives the individual country is supposed to take & implement in a manner in which it can be enforced & used the way it was intended. Change drive on the right for drive on the left for example.
Unfortunately they mainly seem to ignore that, give it a UK number & publish it in whatever state they got it in!
The definitions are one of the things which should be defined by member states so that there are no conflicts with existing legislation or practices. They like to conveniently forget that we pay the politicians wages to do this stuff (grumble, rant!)
Speaking of politicians……
Anyone got a reply yet?
I am a bit torn on this one. I definitely agree the regulations need to be clearly defined and not open to interpretation. Personally I would hate to lose my license, but I found out from discussing this issue that a friend of mines brother was killed in an accident by someone who was hypo at the wheel.
I am not sure what the answer is apart from widespread use of CGMs. Even the first hypo whilst driving is one too many.
My other half, got a reply via the DVLA, stating that the letter he sent to his MP, is being looked at immediately with a HIGH priority (I’m not sure what that means exactly! I’m not holding my breath!) I haven’t received anything back as yet unfortunately. Has anyone else had any joy?
Nothing back for me yet from either DVLA or my MP.
I think its reasonable to give people 2 weeks to respond to a letter/email. Tomorrow is the 2 week deadline, at which point I’m going to write directly to the Secretary of State for Transport Philip Hammond, and copy my MP to make sure he’s aware.
Yeah, I’m in the thank goodness and about time group. I know several diabetic who drive who should never be behind a wheel. I know diabetics who have had accidents and have never been questioned as to why. I know why.
No doubt i will hear howls of protest, but I was diabetic for a long time before I lost my warning signs, and know just how easy it is to become hypo, testing or not. I think no matter how small the likelihood is, no diabetic should be allowed to drive.
Unsurprisingly Lizz, I disagree with you 🙂 The legislation as it stands is clear enough to deal with the examples you quoted of idiots who drive without being fit to do so. The issue is that it isn’t adequately enforced. That can be solved without implementing vague and poorly written new laws.
I’m intrigued when you say you know diabetics who have had accidents and have never been questioned and you know why. Why? If I’m found at the wheel of a car with a low blood sugar, I expect to be prosecuted and lose my licence, just as I’d expect the same if I was stupid enough to drink and drive. If that isn’t happening, we have an enforcement issue, not a legislative issue.
If we decide to make most people with diabetes unemployable by implementing your blanket driving ban because of a very small risk (research is inconclusive and shows that diabetics are either at less risk of having accidents, the same risk or worst case, a slightly, but not statistically significant increased risk – http://ec.europa.eu/transport/road_safety/behavior/doc/diabetes_and_driving_in_europe_final_1_en.pdf ) I assume we’re also going to apply a blanket ban to all people who are overweight as they’re at increased risk of having a heart attack, all people with high blood pressure because they may have a stroke and all older people because you never know when they’re going to randomly drop dead?
Driving is a dangerous activity and it needs policing properly. But poorly defined, ill informed blanket legislation is not the way to do it.
In the past I have known two diabetic people who admitted to being low when driving, both of whom had accidents. in fact further back than that, as a young thing, I knew a diabetic young man who had a scarred face from driving into a wall while hypo. I think any risk is too much – just because we want to drive, need to drive, and are pretty sure we are a very small risk, doesn’t seem good enough to me.
I’m fairly certain that someone with low blood sugar who didn’t react in time could raise their blood sugar by the time any police arrived. Who would know? They wouldn’t be in the statistics would they?
Are you saying that on a long journey by car on a motorway you could always be sure your blood sugar wasn’t going to fall without you realising? What about rising? Because high blood sugar also causes lack of coordination – Tim didn’t know he was 15 while testing in your video.
I am absolutely sure that a lot more diabetics are not safe to drive than say they are – we are supposed to be self-reporting but human nature means we don’t. How else can this sort of thing be controlled except by making sure no-one drives who has diabetes? Because we are self-testing Drs rely on OUR reporting of our own control and that is too easily, and very easily abused.
@alison – I’m with you. Why should the irresponsible or unfortunate actions of a minority be allowed to tar us all? Should my husband be prevented from driving in case he might have an asthma attack whilst at the wheel (and if one comes on suddenly, he could well lose control). No (they arent). Should people with heart problems who are well controlled under drug therapy be prevented from driving in case they have a heart attack? No (they arent, provided they are well controlled). So why should those diabetics who are adequately controlled be penalised because of an irresponsible few?
Thanks for the template letter Alison, I keep sharing and encouraging people to sign the petition and contact their MP.
Well, I got a response. My MP has obviously looked at the government policy on the situation (he does mention several of the buzzwords) but all he really says is ‘More people will be able to drive, if you have recurrent sever hypos your licence will be taken away, once you stop having hypos you’ll get it back, we have very safe roads.’
So I have taken him to task regarding the UKs decision to include night-time hypos in the count. We’ll see if he responds again…
I understand the comments made by lizz and as an argument goes it is very compelling but I fear I must disagree. When I was first diagnosed last year at the ripe old age of 43 my first thought was that I would lose my motorbike license, q major disaster for me! Luckily it never happened but as a more vulnerable road user through being a biker I am fastidious in testing. Prior to going out, no more than an hour on the bike and then test again its the only way I know I will be safe. I do similar in the car. I’m not sure we can tar all diabetic car drivers with such a broad brush. Sure, throw the key away on the negligent ones but try to help the rest of us surely?
I guess my experience has been to meet some diabetics who are definitely not safe. Going on the law of averages, I can’t help feeling there must be more than a ‘few’ out there, and this worries me. I don’t think a law can possibly cover it.
Any posts on diabetes forums which mention loss of hypo warning signs for instance produce an avalanche of replies. How many of these people have stopped driving, or reported this to the DVLA?
I can understand that you might feel unfairly treated if you take huge care over tests etc and have never had a problem, but I still don’t think an asthma sufferer or heart patient is as much of a risk. For one thing, most people with a heart complaint, and most asthma sufferers, if they felt the slightest bit wonky or whatever would stop the car. The whole point of a hypo is that your brain is NOT taking sensible decisions. Far from it in fact!
Who is to say who is negligent? I knew of someone who has Addisons and diabetes – sudden crashing hypos and no waning symptoms, but they still drove. Did their GP stop them? No. They should have done. My own GP, when I had to get a letter to say i couldn’t drive, said, i can’t write that, of course you can drive. I pointed out I have no warning symptoms, and that i have frequent hypos. That’s ok, just do lots of tests. They wouldn’t write a letter. My Consultant did in the end. It says in the info when you apply for a license that any hypo unawareness means you cannot apply, and if you have a licence you must report yuor loss and stop driving until the situation resolves.
I would be very interested to know the percentage of people who have lost symptoms and the percentage of people who have self reported. And the number of GPs who have reported patients as now unable to drive.
@lizz Subjective comments eg ‘….some diabetics who are definitely not safe’ wrt diabetes and driving are not a credible means of making such an important decision for a significant sector of the popluation.
The Diabetes and Driving in Europe – A Report of the Second European Working Group on Diabetes and Driving, an advisory board to the Driving Licence Committee of the European Union provides objective information. The relevant summary is below.
http://ec.europa.eu/transport/road_safety/behavior/doc/diabetes_and_driving_in_europe_final_1_en.pdf
‘IN SUMMARY FOR GROUP 1:
The results of the studies of crash risk and diabetes are conflicting: some show a slightly higher risk, some no difference, and some a slightly lower risk. The differences are small, compared with the differences in crash risk that we see in the general population (eg influence of gender or age: see fig 1), and seems therefore acceptable.’
The important words are ‘… seems therefore acceptable.’ So why the need for more restriction?
I think what i said explains what I mean – the statistics will be based on reporting based on evidence, and evidence can be swayed by diabetics themselves.
I am stating my opinion based on diabetics I know – I have never known that many diabetics personally, but if the report you quote is to be believed, the ones that I have known have numbered among them a disproportionate number that should not be driving, but still are.
Plus, have the effects of high blood sugar on reactions whilst driving ever been studied? I suspect not. I also suspect that the effects of very high BS rare similar to those of low blood sugar.
Very willing to hear that they have been studied and that reactions are fine. But I know how slow/clumsy I am when high – and have read how some diabetics ‘run high’ to be ‘safe’ when driving.
@lizz The Report can most certainly be believed – it’s included in Annex C of the DVLA consultation papers. Reports don’t come with a much better pedigree than that.
http://www.dft.gov.uk/dvla/consultations/~/media/pdf/consultations/Proposals%20to%20amend%20Driving%20Licence%20Standards.ashx
Which of course begs the question – why are DVLA wasting public money on consultations and attempting to amend legislation when their own objective evidence clearly shows the current system to be satisfactory?
Read it and it seems jolly sensible to me.
Just caught the end of a question on today’s Prime Minister Question Time…
An MP asked for reassurance re- new driving regs for people with diabetes. The PM says the DLVA are going back to the European Commission to check its understanding of the interpretation of the minimum standards of this directive… he says as we all know, on too many occasions departments gold plate directives and it can’t be said too often they should stop it!
Well that’s reassuring… NOT!