Fitness to the drive in the Netherlands Ruud

Fitness to the drive in the Netherlands Ruud Bredewoud, MD chief medical advisor CBR Brussels November 25 th 2005

Driving licenses » Mayor of place of residence – driving license » CBR – medical certificate of fitness to drive

Medical certificate » Group 1 categories – at 1 st issue – above 70 yrs every 5 years » Group 2 categories – at 1 st issue – every 10 years – above 70 yrs every 5 years

Application for group 1 » Under 70 years – personal declaration (€ 19) • questionnaire » 70 years of age or older – personal declaration (€ 19) – medical examination (€ 75)

Contents » Visual acuity & field » Blood pressure » Urine (glucose) » Limbs and spinal column » Mental condition » Physical condition

Three party system » Minimal requirements – Minister of transport / Dutch Health Council » Medical examination – any doctor » Decision on fitness to drive – medical advisor of CBR

Further investigation » Specialist (€ 45 - € 125) – ophthalmologist, neurologist, psychiatrist, cardiologist etc. » On road test (for free) – expert on practical fitness to drive

On road test » “Because there are no scales to define fitness to drive, the meaning of the medical report is to inform the CBR on the impairments. The outcome of the on road test will provide the final conclusion” » Dutch health council 2001

Diagnoses vs impairment » Minimal requirements – Diagnoses based • examination decisive • for example abuse of alcohol – Impairment based • on road test decisive • for example visual field, cognitive

Some figures » Applicants 70 yrs and older – 2004: 137. 000 – refused: 4. 300 (3, 2%) – restrictions: 5. 300 (3, 9%) – shorter validity: 8. 100 (5, 9%)

Decision by CBR » Fit for a limited period » Fit under restrictions » Unfit

The End