South Australia's coroner has recommended learner drivers obtain a medical certificate before they get their licence, after a 2020 crash that killed a family of three.
The recommendation comes after an inquiry into a November 2020 crash at Suttontown, on the outskirts of Mount Gambier, that killed husband and wife Ned Walker, 80, and Nan Walker, 70, as well as their daughter Sue Skeer, 55.
Mr and Mrs Walker and Ms Skeer, of Millicent, were killed instantly in a collision between their Ford Territory and a Toyota LandCruiser driven by a 16-year-old boy and travelling in the other direction on the Princes Highway.
The inquest heard the boy, named TB in the deputy coroner's report, had momentarily lost concentration and veered into the right-hand lane, which caused Mrs Walker to move into the opposite lane to avoid a crash.
TB then corrected the Toyota into the left lane, causing the head-on collision.
The boy, who cannot be named for legal reasons because he was under 18 at the time of the crash, was later found guilty of three counts of aggravated driving without due care causing death and one count of aggravated driving without due care causing harm.
Self-reporting concerns
The coroner's inquiry looked into whether the boy's diagnosis of autism spectrum disorder, ADHD, Tourette's Syndrome, behavioural problems and developmental delays should have stopped him from obtaining a licence.
In her findings, deputy state coroner Naomi Kereru said TB failed to disclose any of his medical conditions on his application form when applying for his learner's permit.
TB and his mother had applied for the learner's permit together and the mother had formed the view that TB's medical conditions had no effect on his ability to drive.
The coroner found TB's medical conditions should have been disclosed and it was "unwise" to determine it was unnecessary to disclose his conditions without medical advice.
Ms Kereru found the application form for a learner's permit relied on applicants self-reporting their medical issues, and may promote people to not disclose them if they thought it would negatively affect their application.
She recommended all first-time applicants for a learner's permit be required to obtain a certificate from a medical practitioner that answered the medical condition questions included on the application form.
The doctor would then submit this form directly to the Registrar of Motor Vehicles.
"The fact that one person's momentary health episode can so easily claim the lives of three other people demonstrates the value in a health certificate step being added to the licence qualification process," Ms Kereru said.
Disclosure would lead to test
Ms Kereru found that if TB had disclosed his medical conditions on the application form, the Registrar of Motor Vehicles likely would have ordered further testing of his driving ability.
However, she noted it was unknown whether this testing would have disqualified TB from obtaining a licence.
She said TB's mother had been trying to support her son and had confidence in his ability to drive safely through prior experience on their farm.
"She clearly had no intention that her own family or anyone else's would be involved in a catastrophic incident," Ms Kereru wrote.
"She placed reliance on her own faith in her son instead of allowing the process to play itself out and independent advice to decide whether he ought to be driving or not."
After the deputy coroner's report was handed down, a statement from the family of Mr and Mrs Walker and Ms Skeer said the findings "laid bare a truth that is as devastating as it is infuriating".
"Our families did not just lose three cherished individuals; we lost the pillars of our lives in a cruel, preventable tragedy," a statement said.
"Reading the details of how a combination of severe, diagnosed neurological conditions was simply allowed to go unchecked has reopened our wounds, leaving us with an overwhelming sense of disappointment and sorrow.
"What compounds our grief is the glaring exposure of a broken system."
The statement called for quick legislative change to address the recommendations.
SA Transport Minister Joe Szakacs said the crash was a "tragic set of circumstances" and the government would consider the recommendation.
"We'll take a really close look at this. We'll take our time. This is a really important part of people gaining their licence and retaining their licence," he said.
"We'll do a full analysis. We'll look at what other states are doing as well."
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