Driving license: should a medical examination be required every 15 years?

When you obtain the B license, it’s for life. But that could change. This week, the European Parliament must vote on a bill aimed at establishing a medical examination every 15 years, conditioning the renewal of a driving license. This is already the case for heavy goods vehicle or public transport drivers, who must regularly pass medical tests. The objective of this measure is, logically, to reduce the number of victims of road accidents. If this law is adopted, member states would have just over two years to put it in place. But this proposal, formulated by Green MP Karima Delli (president of the European Union Transport Committee), is not unanimous among road safety professionals.

“There are around 48 million B permit holders in France. This would mean that general practitioners would have to provide a little more than 3 million additional visits each year,” assesses Dr Philippe Lauwick, doctor approved for monitoring medical fitness to drive. “When we see that the French already have difficulty making an appointment with their GP when they are sick, I doubt that this measure can be easily implemented,” he believes, emphasizing that general practitioners are “not neither trained in this sometimes complex exercise, nor particularly eager to do it.” The content of this examination has not been specified.

Along with Germany and Poland, France is one of the last European countries where a lifetime license is still the norm. Some have already chosen to impose a regular examination every 10 years, upon obtaining the license. This is the case of Belgium and Romania. Other countries have established an age limit beyond which a regular medical examination is obligatory. This is the case of the Netherlands (for those over 75 every 5 years), Denmark and Finland (for those over 70 every 5 years), but also of Spain, Greece , Italy and Portugal, where the rules are even stricter.

According to the specialists we interviewed, not only would such a measure be difficult to apply in the current context, but there is no proof that it is truly useful. “Studies have shown that these systematic medical visits are not effective in reducing the frequency of road accidents,” says Anne Lavaud, general delegate of the Road Safety Association, citing a report from the European Transport Safety Council. This is confirmed by the National Road Safety Council in France. “Countries that have chosen to systematize medical examinations for all drivers have not had tangible gains in terms of road safety,” we read in a June 2023 report. Not to mention that there could be unexpected side effects. “This risks leading to an avoidance strategy among people who, for fear of seeing their license revoked, no longer go to their doctor,” points out Anne Lavaud.

It is not difficult to see that this proposed law targets older drivers. “However, contrary to popular belief, they are not the main culprits in road accidents,” defends Anne Lavaud. These are in fact young drivers (18-24 years old), as noted in the latest ministerial report. In 2022, 18-24 year olds counted 78 drivers responsible for accidents per 1 million inhabitants in this age group, compared to 41 among those aged 75 and over. The identified causes of accidents are, in order: excessive speed, alcohol and - equally - inattention and drugs.

“These figures are quite telling and yet it is accidents involving seniors that are most often the subject of intensive media coverage,” notes Anne Lavaud. It should be noted, however, that while older people are less likely to cause road accidents than young people, they are more often involved in fatal accidents (64% of cases compared to 56% for other age groups). And they cause more accidents per kilometer traveled than all other drivers. “However, we refuse the stigmatization of this population, especially since in terms of road safety, elderly people are the first victims of accidents as pedestrians.” Thus, of the 302 pedestrians killed in the city in 2022, half were 75 years old or over.

In practice, all the data seems to show that it is not age, but specific health problems that are decisive for driving ability (although the two are often closely linked). “Studies have concluded that drug addiction, mental disorders, epilepsy and diabetes are more important factors than age,” says a report from the European Transport Safety Council. A systematic medical examination could even unfairly deprive elderly people of their autonomy, even though they would still be able to drive short journeys during the day. “A risk factor for deterioration of health and premature entry into a retirement home,” underlines the report. The challenge is therefore to find the right balance for society between security and preservation of mobility. What older people do willingly spontaneously. “Contrary to what we imagine, they are more likely to spontaneously stop driving – even if their health still allows them to do so – rather than to continue,” notes Dr. Lauwick.

The doctor says he is against the idea of ​​a systematic medical examination for everyone. “It would be more profitable to carry out targeted tests on people whose health is really in question,” he believes. A device that... already exists in France! A medical examination is obligatory following certain offenses or in the event of illness. There is even a very precise list of pathologies which require a medical visit, inventoried by a decree of March 2022.

Heart failure, hearing impairment, balance disorders, epilepsy, psychiatric disorders, onset of Alzheimer's disease... As soon as a driver receives one of these diagnoses, he must theoretically be seen by a doctor "approved for driving license” before being able to get behind the wheel again. There are around 4000 across France, but no directory lists them. In any case, this control visit is rarely carried out in practice. “Almost no one is aware of these devices, including health professionals,” regrets Dr. Lauwick. “There is no need to make a new law, it would be enough to make known and apply the one that already exists to improve the situation!”