A recent incident involving a student who sustained a broken neck after being medically cleared for skydiving has sparked debate over the future of “fit to do” letters from NHS GPs. Dr. Tim Mercer has expressed concerns that these medical clearances may soon become obsolete.

Miriam Barker, a 21-year-old history and philosophy student at Southampton University, is seeking £15 million in damages after a skydiving accident left her paralyzed. Barker, who joined the university’s Skydiving Society in 2018, had received her doctor’s approval for her first jump in Devon.

Despite her parachute deploying correctly at 3,500 meters above Dunkeswell Airfield, Barker hit the ground with significant force, resulting in a catastrophic spinal cord injury. In a TikTok video, Dr. Mercer described the incident as a tragedy and suggested it might signal the end of GPs issuing “fit to do” letters.

Dr. Mercer acknowledged that he had previously issued such letters but now hesitates to declare anyone fit for certain activities. “I don’t feel qualified to certify someone as fit to skydive, handle a parachute, and land safely,” he said. “Similarly, I am not trained to assess fitness for scuba diving in shark-infested waters or climbing Mount Everest.”

While these may be extreme examples, Dr. Mercer highlighted Miriam Barker’s case, noting she allegedly paid £30 for the letter during a private consultation. Her pursuit of legal action could set a precedent, he argued, potentially reshaping the responsibilities and liabilities of medical practitioners.

Indeed, whilst those represent extreme cases, Dr Mercer argued that the situation of Miriam Barker, who he claims spent £30 for such a letter during a private consultation, is likely to establish a legal precedent given her intention to pursue litigation over her injuries.

“She’s now going after the GP for £15 million,” he continued. “The letter saying she was fit to jump out of a plane will cost about 30 quid and because it is private work, the likelihood is that the doctor is not indemnified and so they’re going to have some difficult in defending it.”

Consequently, Dr Mercer believes no GP will be prepared to sign such documents “ever again”. He elaborated with a theoretical scenario: “If you see your GP and you’ve done 500 marathons in your life and the Paris Marathon won’t let you run unless you have a form that says you can, your doctor is not going to sign it. If the runner has a heart attack and ends up suing for £15 million then that doctor is probably going to lose some sleep.”

Meanwhile, Dr Mercer noted that medical professionals can feel “backed into a corner” when signing these letters, especially if the patient plans to use it for charitable fundraising purposes. “But is your GP qualified to do this? No.”

Instead, the GP suggested that the NHS could take a leaf out of the DVLA’s book. “The DVLA is a great example of how this could be done,” he stated. “The DVLA doesn’t ask the doctor, ‘Is this person fit to drive?’ They simply request medical evidence and then their specially-trained assessor ultimately makes the decision about whether the person is medically fit to do the task.”

And referring back to the case of Miriam Barker, Dr Mercer admitted: “I don’t understand how someone can go to training, make a GP appointment and have them sign a form, then jump out of a plane and activate a parachute and at the point where you land and something tragic happens you suddenly become unfit to do it.”

He concluded by expressing that for doctors it really isn’t worth the “risk” and the days of signing letters are now “gone”. 

“Why would anyone sign a letter for 30 quid to say you are fit to do something when they could be sued for £15 million – when you could work an hour in out-of-hours and help people who really need your help and have the same money in your pocket?” Dr Mercer asked.

NHS England has been invited to respond.