I have been invited by the Editor of Call Sign to set out the Public Carriage Office position on diabetes and the possible impact on an individual's cab driver's licence if they develop the condition.
Before dealing with the diabetic issues specifically, it is probably useful to set out the position generally on medical fitness for cab drivers. In deciding whether an individual is fit to hold a cab driver's licence, the Licensing Authority requires to be assured of their physical and mental well-being. A London cabbie is a vocational driver, working in a densely populated urban environment with no legislative control over his hours or pattern of working. Consequently, a higher standard of medical fitness than that required for an ordinary motorist is necessary. The Licensing Authority has determined that the Public Carriage Office should be guided by the medical requirements laid down for DVLA Group 2 licence holders, ie large goods vehicles and passenger service vehicle drivers - the largest group of vocational drivers. (The adoption of this standard of medical fitness has the support of the 'Medical Commission on Accident Prevention', which recommends that Group 2 standards should be applied to taxi drivers as an occupational health policy.)
Turning now to the issues relating to diabetes. There are two main types of diabetes:
DIABETES
AND YOUR CAB
DRIVER LICENCE
Sandy Kennedy
Type 1:
This is where it is essential for the individual to have insulin to
sustain life. Without insulin, an individual would suffer hypoglycaemic attack,
followed by coma and ultimately death. This is insulin dependent diabetes.
Type 2:
This is where insulin may be being produced naturally but in insufficient
quantities. This type of diabetes can be treated in a number of ways, ie by
diet; diet and tablet; or insulin. Insulin treatment generally affords
effective control of the diabetes and helps protect the individual from some of
the long-term effects of the condition.
This is insulin created diabetes.
Diabetes Treated by Diet or Diet and Tablet
For cab drivers who have their diabetes treated in this way, the Public
Carriage Office follow the same rules as the DVLA, ie drivers will continue to
be licensed subject to their remaining in good health and that they do not
develop any condition which might affect their ability to drive safely and
competently.
The DVLA is required by law to revoke a Group 2 licence if the holder is treated with insulin for a diabetic condition. That legislation does not include licensed taxi drivers (although the EC directive which gave rise to the legislation recommended the inclusion of this group) and consequently, there is no automatic revocation of an individual's cab driver's licence if they are being treated with insulin. However, a strong medical case needs to be made if revocation of the licence is not to take place.
Each case is considered on its own merits, based upon the medical evidence presented by the driver's diabetic consultant which is then the subject of review by the Licensing Authority's own medical consultant. If the case is made, then the driver will be allowed to retain his cab driver's licence subject to annual certification from his diabetic consultant as to his continued well-being.
The Public Carriage Office recognise the impact the loss of a licence on medical grounds can have on a driver and his family and such a decision is not taken lightly. We seek to afford every possible opportunity for the individual to provide the necessary evidence that would allow retention, but this is not always possible. Our ultimate responsibility, as a regulating authority, is for the safety of the fare paying passenger and public at large and if this cannot be assured, then we will take the difficult decision to revoke, albeit regretfully.
Sandy Kennedy
Public Carriage Office
