A fatal accident inquiry has recommended changes to the law after a toddler was killed by a woman who continued to drive despite suffering from dementia.

Three-year-old Xander was killed in June 2020 when a car driven by 91-year-old Edith Duncan, who died before she could face trial, came off the road and hit him and his mother on Morningside Road in Edinburgh.

A Fatal Accident Inquiry was ordered into the death of the toddler, with the findings released on Monday.

It found that the cause of the accident was "entirely" the fact Mrs Duncan could not "perform safely what would otherwise have been a routine turning manoeuvre".

Read More:

The pensioner was "suffering significantly impaired cognitive ability as a result of frontotemporal dementia and was unfit to drive or hold a driving licence".

There is currently no upper age limit for holding a driving licence in the UK, with those over 70 self-certifying every three years that they remain able to drive.

On the morning in question, Tuesday June 30, Xander and his mother Victoria were walking down Morningside Road as Edith Duncan attempted a u-turn in her red Kia Picanto.

As she did so she accidentally accelerated violently, mounting the kerb with enough force to burst the trye and hitting the pair without at any point trying to brake.

The car had no relevant defects and there were no other contributing factors, with the report stating "the collision was entirely caused by dangerous driving by Ms Duncan".

Following the crash, the 91-year-old "looked confused" and appeared unclear as to how the car had come to a stop, telling police that her foot must have slipped on the accelerator.

A witness, Clare Kavanagh, said Ms Duncan did not appear to realise what she had done, and worried the eggs she had bought might have been smashed.

At a subsequent police interview she "gave a nonsensical description of how the collision occurred" and could not remember having cancelled her insurance several months before. She appeared to be unaware that it was illegal to drive without insurance, having previously renewed her policy regularly.

She was unaware that she was suffering from dementia, and her GPs failed to diagnose her "because her presentation was such as to disguise her underlying cognitive impairment".

A doctor who examined her initially "had no concerns" due to "an excellent command of English" but then asked Ms Duncan to complete a cognitive test.

On the test, which is scored out of 100, a score below 83 is considered indicative of dementia and the 91-year-old scored 66, having particularly poor results for memory and attention.

There was, the FAI concludes, "no means of the DVLA becoming aware of her diminished ability to drive" as it would have required cognitive testing, with Ms Duncan likely "not aware of her own deteriorating cognitive condition".

The inquiry concluded that formal testing would have identified Ms Duncan's condition in advance, which would have seen her licence revoked and meant she would not have been driving on the day in question.

It said there was "an inherent and obvious flaw" in self-reported results, especially given there is powerful social pressure not to relinquish a licence.

Around half a million people are diagnosed with dementia in Britain, but DVLA records have only around 30,000 on the books and many may not even appreciate they have a problem.

The system "allows drivers to self-certify fitness to drive", "does not monitor the answers" and has no limit in age, making it "ineffective in identifying drivers with dementia".

As a result unfit drivers are left in charge of vehicles on the road and "the public is unavoidably at risk".

Recommendations made included revoking the current system of self-certification to drive after the age of 70, with that to be limited to only those drivers under the age of 80.

Any application for renewal by a driver aged 80 or older should not be granted unless the applicant driver has successfully undertaken a short initial cognitive assessment. Failure to pass that assessment should result in both the application for renewal, and any current licence, being suspended pending further
assessment.

That would have to be enacted by the UK Government, as the relevant law is reserved.

In the meantime, further relevant questions should be included on the current self-certification form to include questions such as whether drivers had been involved in an accident in the last two years which was partly or mostly their fault, or whether anyone had told them they are concerned about their ability to drive.