This query came via Twitter (which I confess I don’t really understand or follow, so it’s not a good way to try to contact me but it worked this time).  The question is:

Do HCP’s have a duty of care or obligation to report drivers who may have caused an accident causing injury to roads & traffic authority?

I asked for clarification as to what they had in mind.  My correspondent gave this example (edited from twitter speak into English):

An elderly person with eye problems hits the patient that you are attending and causes him to be hospitalised. I’m curious about Doctors, paramedics and nurses.

There can’t be any obligation to ‘report’ the driver to the licensing authority.  First, the appropriate body to report the matter to would be the police as they would be investigating the accident to determine what happened and if any criminal offences had been committed.

Putting that aside, what could the doctor or nurse or paramedic report?  In this context it doesn’t actually matter whether the patient had eye problems or just can’t drive.  If your treating the person that was hit, rather than the driver, you’re not in a position to assess the driver’s situation or what actually happened.  You may have one side of the story but that is all.  The HCP certainly can’t, without examining and entering into a therapeutic relationship, make a determination as to whether the other driver is medically fit to drive, or not.

If you have relevant evidence as to what happened (and see here Lithgow Council v Jackson [2011] HCA 36) then you could give a statement to the police but no-one is under any obligation to assist police with their inquiries so you are under a duty to report what you know, but you may chose to.  (There are offences such as ‘Concealing serious indictable offence’ (Crimes Act 1900 (NSW) s 316) but, without going through it in detail, that’s not going to apply here.  Here the suggestion is reporting a person for being unfit to drive not that they committed a serious indictable offence.  Further if they have committed an offence it’s hardly concealed if it’s a road traffic accident with ambulance in attendance, the police know about it, so the sections not relevant).

One would have to be careful though to ensure that one didn’t breach any confidence.  If, for example, a paramedic asks the driver if they had been taking any drugs and that question was asked for therapeutic reasons (ie to facilitate treatment) and the driver gives an honest answer, there is no obligation to tell that to police. There may even be an obligation not to answer a police officer’s question if the officer asks ‘what did the driver say?’ as there is the need to protect patient confidence.  That would be even stronger in the case of a registered health professional where the ethical duty to keep information confidential is supported by standards of professional practice and established legal privileges.  The answer should however be recorded on the case notes as it forms part of the relevant history and those records must be produced in response to a search warrant or subpoena.

In terms of ‘duty of care’ that refers to the common law of negligence but to whom would the duty be owed? Not the patient you are treating as they’re already injured, reporting that the other driver appears to be unfit to drive will do nothing to protect injuries to your patient.  There is no duty of care to the world at large, that is the unidentified class of people who could possibly be exposed to danger if the other driver is allowed to continue.

So in the context of the question asked, where a health professional is treating someone who was injured in a motor vehicle accident and believes that the accident was caused by another driver (for whatever reason) there is no obligation or power to report to the RTA – who wouldn’t know what to do with the report anyway.  They couldn’t act on it as the report isn’t coming from the person’s treating doctor, it would be just unsubstantiated gossip.   I’m sure anyone would, rightly, object if they got asked to ‘show cause’ why they should keep their licence just because someone reported that, in their view, they were not fit to drive. Nor is there any obligation to report one’s suspicions to police.   You could and perhaps should give a statement to police that sets out what one saw and observed but one should be careful to ensure that professional standards, in particular with regard to protecting patient confidentiality, are maintained.