Driving licenses: How they pass under the radars of age limits

•  The Greek paradoxes: In Attica, the Region is responsible for the driving licenses. The competence for the control of doctors lies with the AMA. Patoulis, that is, is both controller and audited…

• In Canada, the hospitals are directly linked to the competent licensing authorities. In case of serious illness, the driver’s license is automatically canceled.

• Where did the investigation into the activities of the illegal license-issuing ring of illegal driving licenses lead us.

  By Aris Hadjigeorgiou

Although in recent years, road accidents have received less and less media attention, there is one category of “blood on the tarmac” that increasingly causes horror: Those in which the protagonist is an old or very old driver with obvious signs of helplessness that “scatters death”.

The elderly, over 80 or even 85 years old, persist in driving with impaired perception and without any organized system to prevent them. The result? Getting reversed on expressways, violating red lights, stop signs, and basic traffic rules without even realizing that they are endangering the lives of other people who could be their children or grandchildren.

The incidents are frequent in Greece, given the lack of simple traffic controls in our country, but the problem is of wider concern to the European Union, where a debate has been opened on the forced application of restrictive measures. On March 1, 2023, a consultation was launched ahead of the adoption of a mandatory directive that will force those over the age of 70 to undergo a re-test to retain their driving license.

The paradox is that in Greece, mandatory medical re-testing earlier than the age that Europe is discussing has been in place for many years. Specifically, for those who obtained a license before 2013, a medical check-up (pathologist, ophthalmologist) is imposed at 65 years of age every three years, and after 80 years by more specialties (neurologist and ENT are added) with a maximum renewal limit of 2 years. However, while there is often talk of doctors giving a certificate of competence without a prior examination, no disciplinary sanction has ever been imposed, as a responsible party told Data Journalists.

“I don’t recall in my 16 years on the Board of Directors of the Athens Medical Association and then as chairman of its Disciplinary Council that a complaint for such serious misconduct has ever been received,” surgeon Achilleas Rentis tells us. Mr. Rentis was a member of the Board of Directors of the AΜA from 2002 to 2018 and was then elected Chairman of the Disciplinary Board until he resigned for health reasons. He explains to us that the penalties imposed by the Disciplinary Board are very severe and reach up to the withdrawal of the professional license.

“I’ve also heard that there are cases of “deals” with doctors – such as “take the money and let me drive”. But it seems inconceivable to me that a colleague would break his oath for a few euros,” the surgeon stresses. However, he admits that the whole process has several “filters”:

• – First, there must be a complaint to the Athens Medical Association (the same applies to all local Associations).
• – The complaint is not referred directly to the Disciplinary Council. It must first reach the Board of Directors of the Association (the Board of Directors of the AMA has 17 members) and they must decide.
• – Each Board obviously does not have the means and resources to investigate the content of the complaint in depth and members usually judge based on their experience. “Obviously, the many acquaintances between doctors can also play a role,” Rentis says.
• – If the board decides, then the complaint is referred to the disciplinary board. That of the AMA is a seven-member body and each member has to substantiate his/her opinion and minutes are kept.
• – There is also the possibility of appeal to the Secondary Disciplinary Council of the Panhellenic Medical Association, in which judges also participate.

However, regardless of the “filters” and “loopholes” allowed by any control system, it is particularly weighty the testimony of Mr. Rentis that no complaint about a doctor who is being bribed or issues health certificates to elderly people to renew their license has ever reached for control.

Of course, in the case of Attica, we must point out another paradox: The fact that the Region of Attica is responsible for driving licenses and that it has been headed for the last four years by George Patoulis, who is also President of the Athens Medical Association.

At the same time, a circuit of illegal issuing of licenses, involving officials of the Region, driving instructors, and doctors, came to light after an investigation by law enforcement authorities. The activity of the circuit, for which elements of the case file were leaked to the press, extends over the period 2017-2018. Indeed, at that time, the then leadership of the Ministry of Transport under Christos Spirtzis planned to implement a new system by subjecting drivers over 74 years old not only to a medical examination but to a regular review of skills every three years.

The new system was implemented for a few months but caused a huge backlash from those involved. The reports of the time, just before the 2019 elections, recorded protests from 95-year-olds who came to be tested in their cars, examiners who refused to participate because the examination vehicle had no pedals in case of…misalignment, and from local Medical Associations. Seniors are cut off and many insist on coming for re-examination as driving at these ages is sometimes equated with “affirmation of life”.

Mobilizations and walkouts by examiners begin, waiting lists grow long with tens of thousands of candidates, the ministry insists and promises to look into a solution but after the elections, the New Democracy government freezes the re-examination of seniors and later abolishes it. It also abolishes the list of contracted doctors to whom one had to go in order to get the medical certificate.

Any doctor could now sign the certificate, either through the electronic prescription system or manually. Many people continued to prefer the handwritten certificate of competence, especially in cases where the electronic one would appear next to the prescription of medicines for serious illnesses related to perceptual capacity. But let’s return to the 2017-2018 period.

That is when the circuit was operating in Attica, which was identified to secure driving licenses without even examinations and with a fee ranging between 2000 and 3500 euros. The trial was originally scheduled for last April and was postponed until December, while parts of the file leaked to the press describe the ways in which the procedures and “obstacles” were circumvented, with the biggest bribes involving the issuance of professional licenses. Telephone interceptions carried out to identify members of the ring were also revealed.

However, intercepted conversations were published on the newsauto.gr website that include dialogues with doctors in order to obtain a certificate of competence:

– “Is the order ready?” “It is ready, I’m wrapping it now”…

– “Are you ready, Doctor?”… “I’m wrapping it now”… “Now?”… “Now? You f@ck@d us, man… When should I come?”… “In half an hour…”.

– “I’ve sent two more to the cell phone…”. “Do you want to sit down for a while and I’ll prepare them quickly?”.

-“Good morning. Are they ready yet?”… “Yes, I’ve prepared everything you sent…”.

-“Where are you? Did you drown in Oropos? “I’m still here… I’ll be back tomorrow.” “I’ve got everything ready… See you tomorrow…”

In other cases, the conversation is between a driving school owner and customers:

-“…Your license has expired… Well, we’ll fix it… The cost is around 220 euros… with the doctors and everything included… If it hadn’t expired it would have cost you around 100 euros….

-“… All included, 250 euros… And you’re not going anywhere. Not even doctors… I’ll write down that you completed the mandatory hours…”.

-“… I came two, three times and I couldn’t find you. My license expires today. “Take a picture… get your ID and license and come by the office and we’ll fix it. All together 320 euros…” “… It’s too expensive…” “I know, but what can I do? There are four doctors… I can’t do something else honestly”… “I’ll pay you in two instalments…” “Okay… Okay…”

– “Can we renew my father-in-law’s license? What do we have to do?” “How old is he? Is he in good shape?” “He’s 73, he has no issues…”. “Bring a passport-type photo, his ID card, and a photocopy of his driver’s license… oh and his social security number… The cost is 180 euros to avoid going to doctors, and not do anything else…”.

The most recent of the horrific car accidents involving an elderly driver occurred on July 19, 2023. An 88-year-old woman driver of a private car ran a red light and rammed two cars on Marathonos Avenue near Rafina. As a result, a 49-year-old Navy lieutenant, father of two children, lost his life and a 23-year-old sailor was seriously injured.

A long list, however, is formed by a specific category of incidents, with a common feature the movement in the opposite traffic flow, especially on closed motorways where high speeds are reached and the last thing anyone expects is to see another vehicle coming towards them:

In October 2022, an elderly couple set out in their car to return from their holiday home in Kineta. The 83-year-old driver, however, reversed at the junction of the highway and after driving for a kilometer moving in oncoming traffic, collided with a motorbike, resulting in the death of the rider and the two passengers of the vehicle.

Similar incidents with vehicles entering oncoming traffic were also recorded in September 2020 on the Schimatari-Chalkida motorway, three times in spring 2021 on the Northern Road Axis of Crete (BOAK), and in September of the same year on the Larissa-Volos section.

In November 2022, a similar accident occurred on Vouliagmeni Avenue, in Voula. The 80-year-old driver was driving for 1.5 km in the opposite direction, resulting in a head-on collision with the 40-year-old driver’s car, fortunately without any casualties.

In June 2022, on the highway outside Chania, between Mournies and Souda, an elderly man was found driving for five minutes in the opposite direction causing terror to drivers who were driving normally.

In another case, an 80-year-old driver drove 10 kilometers in the opposite traffic flow on the Corinth-Patras motorway, between Ancient Corinth and Isthmus, and was stopped after a huge mobilization of the Traffic Police.

In April 2019, an elderly man drove in the opposite traffic flow on the Ionian Road at Filippiada and another vehicle that tried to avoid him hit the divider, resulting in the injury of its passenger.

Another incident in March 2018 caused great disruption to traffic but without causing injury when an elderly man drove his car 40 kilometers in the middle of the night in the opposite traffic flow of the Thessaloniki-Neon Moudania highway. The police had to stop traffic at junctions he was passing through but, judging by the distance of 40 kilometers, it was difficult enough to stop the elderly man.

Whenever such an incident occurs, even if it does not involve deaths and serious injuries, officials involved in issuing licenses admit the loopholes in procedures to prevent physically challenged drivers from driving. In many cases, there are also those who, “with their backs to the camera”, testify that they have been asked for money to avoid a medical check.

However, people familiar with the situation point out that the most serious “loopholes” are not so much the medical check every two or three years but the lack of daily checks by the traffic police. If these were carried out intensively, they would simply prevent people with problems from driving “from the very beginning”.

On the other hand, in organized countries such as Canada, there is a system of direct linkage between hospitals and the directorates that issue the licenses. Thus, if someone is admitted to a hospital, for example for a stroke, their driving license is automatically “frozen”.

As we have already mentioned, since last March, a detailed debate has been underway at the European Union level on measures to reduce road accidents and the number of victims they cause. In the Member States, there are great inequalities and disagreements about restrictive measures for older people, as it is considered that a horizontal measure would be an obstacle to their social activity. Some of the key findings included in the relevant studies:

• –   >Between 2001 and 2021, road traffic deaths fell by 61.5% from 51,400 to 19,800 per year. In 2022, however, there was a 3% increase compared to 2021 but this is attributed to the increase in traffic following the pandemic.
• –   >The largest decreases, of more than 30%, were recorded in Lithuania and Poland, while Denmark also saw a 23% decrease. In contrast, over the last three years, the number of road traffic deaths in countries such as Ireland, Spain, France, Italy, the Netherlands, and Sweden remained relatively stable or increased.
• –   >Between 5% and 15% of road accidents are related to the mental state of the driver. In Finland, 16% of fatal road accidents are attributed to the driver’s illness, while in France 4% are attributed to the driver’s medication. Research in Denmark revealed that 9% of road accidents are linked to the physical condition of the driver and 1% to the driver’s mental balance.
• –   >20% of road deaths are caused by drivers over 60 years of age. However, this age group includes 30% of driving license holders.
• –   >A survey of representatives of national authorities showed that 36% of those who responded considered poor medical checks of drivers to be an important issue, while 18% considered it to be unrelated to road safety. On the other hand, Member States express the view that there is a lack of clear scientific criteria and consider that limits should not be related to the age of drivers but to the functional requirements of driving.
• –   >Among the Member States, France and Germany are the most opposed as they consider that more frequent medical checks for older drivers are not necessary and that it would affect their right to mobility – but they remain open to the application of specific restrictions such as night driving or mileage restrictions.
• –   >The age limits for compulsory medical checks vary from country to country and the implementation of the horizontal limit of 70 years is also treated differently as governments even measure the impact of the financial cost of carrying them out. A reduction in these costs, however, is expected for Greece and also for Italy-Spain where the 65 age limit is currently in force.