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Heart of the matter
Page 34
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Drivers who suffer from a heart condition can face a long struggle to prove they are fit to drive again. Sally Nash reviews two case histories to see how the regulations have been applied.
What do you do if the Driver and Vehicle Licensing Agency (DVLA) refuses to renew your HGV licence because you have suffered a minor heart attack, even though your GP and cardiologist both think you are fit to drive?
This is the situation facing one driver working for a livestock haulier in County Durham. He prefers to remain anonymous because he has just lodged an appeal in court against the decision not to renew his licence and has approached his local MP about his case.
His wife, who works with him and has supported him in his battle with the DVLA, explains that her husband suffered a slight heart attack in September 2001. On his discharge from hospital his consultant told him the condition would be stabilised with medication and that if he continued to take this and not smoke he was "as much at risk of having another attack as the next man". Theconsultant also told the driver to get on with his life "as though he had not suffered any attack at all".
So far, so good. The much relieved driver contacted the DVLA to inform them about the situation and was told they could not prevent him from driving. After a break from driving due to the foot-and-mouth outbreak he resumed in February 2002 there have been no signs of any symptoms of a heart condition since his discharge from hospital.
Time for a medical
In February this year his licence became due for renewal and his GP carried out the statutory medical, complimenting him on his current state of health "for a man with his condition".
However, when the DVLA asked him to carry out an exercise tolerance test using a treadmill in April it indicated a problem and the agency refused to renew the licence.
During a consultation with a local cardiologist it was agreed that the driver be referred for angiography.This took place in July and the GP appeared pleased with the outcome.The driver was found to have one small occlusion on an artery. He was told that he didn't have to have treatment for it, but if he wanted his licence back he needed to have a `stent implant' (a mesh tube inserted into an artery to hold it open). If he had the implant he could have another attempt at the treadmill test.To have it done privately would have cost nearly £9,000, so the driver decided to go on the NHS waiting list. He had just been given a date for treatment as CM went to press.
But the driver is annoyed that, despite having the treatment, there is no guarantee that the stent implant will lead to a positive treadmill test. Meanwhile, his wife is frustrated with the lack of communication from the DVLA and the emphasis that is put on the exercise test.
"He's as fit as a flea," she says, "Both our GP and the local cardiologist agree that, the test aside, he is fit enough to drive our vehicle safely —the likelihood of a further heart attack is very remote. Surely the opinion of our own GP has some bearing on this,especially when, of all the doctors concerned, he knows him best."
However, drivers can take encouragement from another case history Rod Collett,a technical trainer with a Class 1 HGV licence,suffered two minor heart attacks within two years. The second time an angiogram revealed that the right-hand main artery had "gone soft". He had treatment for it and has now got his licence back.
Collett believes the DVLA strict assessment for licence renewal is fair, although he recognises that a decision to refuse a licence means the loss of livelihood for many drivers. "If you are behind a 40-tonner you can't have any heart problems because you have a responsibility," he adds."The job can be quite stressful and you have to think of the safety aspect."