Swedish Road Administration

1
Swedish Road Administration

• Sven Hultman
• Stina Stenback
  
• Brussels 25 Nov 2005

2
The obligatory medical testing for category B
drivers in Sweden

• contains
• a self declaration of health, and
• an eyesight test
• When there is need for it, a doctors certificate
  will be ordered by the county administration

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Content of the medical test

• Self declaration regarding all the different
  diseases in our regulations with the medical
  requirements for driving licence holders
• Visual acuity
• Field of vision

4
The obligatory eyesight test is carried out by

• a general practitioner,
• an optician, or
• a trained person at a driving school with special
  equipment

5
Doctors do not make any formal decisions
regarding possession of driving licences Their
certificates should however be considered by the
responsible official at the county administration
6
Those who apply for a learners driving permit
will get a decision with

• refusal if the medical requirements are not met,
• approval if the medical requirements are met, or
• approval with conditions to give in new
  certificates within a certain period if the
  medical conditions are met but there is a need to
  follow-up the medical status

7
Those who already possess a learners driving
permit or a driving licence that has been
questioned will get a decision with

• revocation (withdrawal), or
• requirement to submit new certificates within a
  certain period

8
Appeal

• County decisions to refuse or revoke a learners
  driving permit and to revoke a driving licence
  may be appealed in an administrative court

9
Reports from doctors to the county
administration

• Reports from the police
• Reports from the criminal courts

10
In 1982 the mandatory doctors certificate was
abolished for those who apply for a learners
driving permit or a driving licence category B

• The reason was that an official study had found
  that those check-ups did not provide any new
  information that was not mentioned in the
  applicants health declarations, and that the
  medical profession should be used for better
  purposes.

11
In 1953 the Swedish doctors were
recommended to provide the county administration
with relevant information when their patients did
not fulfil the medical requirements for driving
licences but it was still voluntary

• In 1972 they were told that they ought to do so
• Since 1981 the law says that they shall do so

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How to identify drivers and associated
medical problems
13
Since 1981

• All medical doctors are responsible for INFORMING
  THE ADMINISTRATION AUTHORITY of any medical
  impairment concerning driving capability
• It is also possible to reach a doctor patient
  agreement (as long as the doctor trusts the
  patient) that the patient shall abstain from
  driving

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• The physician who is duty bound to report usually
  knows his patient well
• Its cheap. Medical check-ups every 10 years,
  drivers aged 45 years or more, will be expensive.
  More than 3 milion drivers should need a medical
  examination during the next 10 years
• Quick medical examinations do not always identify
  medical impairment. In our country since 1998 C
  and D drivers aged 45 years or more undergo
  medical tests every 10 years and thereafter.
  Reports indicate that only very few medical
  problems are identified in these tests.

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• Check-ups do not seem to increase skills of the
  doctors. 1998 comparing 3000 GP in Finland and
  Sweden, physicians in Finland did not show more
  activity or knowledge with regard to
  fitness-to-drive.
• Drivers sometimes have to wait a long time before
  they can see a doctor which might cause problems
  related to work.
• Better information and education encouraged
  doctors to inform the authorities.

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• Reporting to the authorities will obstruct
  patient doctor relations
• Physicians do not know when to report
• If there are no apparent medical impairments
  what to do when the doctors need to make sure
  that driving capacity is still good enough? Maybe
  the patient refuses further examination. Mild
  dementia, post stroke etc
• Some drivers will never see a doctor

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The Swedish Road Administration suggests

• Physicians are obliged to report medical
  impairment
• Guidelines will make it easier to understand the
  regulations
• Traffic Medical Centres to which doctors can
  refer patients to see neuropsychologists, work
  therapists, doctors, driving examiners etc.
  Research, simulator, computers

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The Swedish Road Administration suggests

• 4. Traffic Medical Units at existing units like
  Geriatric wards
• Education in medical schools, postgraduate
• information
• 6. Mandatory self health declaration when
  renewing the driving license every 10 years