Motorists will face a range of new health checks to determine whether they are fit to drive under the most comprehensive reform of the driving licence system in decades.
Drivers will have to declare every 10 years whether they are medically able to get behind the wheel, according to proposals to be set out early in the new year.
For the first time, the Driver and Vehicle Licensing Agency (DVLA) will issue a series of minimum physical and mental requirements motorists must fulfil including eyesight performance and reaction times.
Tests, costing up to £80, will be offered to drivers to check whether they are fit to drive.
Anyone who chooses not to take the tests but declares themselves able to take to the roads will be committing a criminal offence if they fail to meet the established standards.
The move is designed to weed out tens of thousands of motorists – many of them elderly – who use their cars while suffering from conditions which could make them a danger to themselves or others.
"We are trying to improve road safety and help drivers fulfil their obligations. What we have now doesn't work," said a Whitehall source.
"At the moment the DVLA is sifting through a large number of medical records and simply ends up giving people their licences back.
"The DVLA is not getting at those drivers who should be letting it know about their medical conditions. We really want people to take responsibility."
Underpinning the review is the number of older drivers on the country's roads, which has increased dramatically since the laws governing health requirements for drivers were last changed in the 1970s.
By 2021, there will be an estimated 3 million over-70s driving on the country's roads.
The Association of British Insurers has found that this age group is three times more likely to be killed or seriously injured on the road than those aged 40-65.
Currently, drivers with traditional paper licences are not obliged to confirm the state of their health until they reach the age of 70.
However, all motorists are told to inform the DVLA if they believe they may suffer from a condition that could affect their driving.w
After this they are expected to complete a medical questionnaire, again using their own judgment as to the extent of their driving impairment.
This is considered by officials at the DVLA, which can order the driver to take a new driving test or undertake a formal assessment.
In 2006 the DVLA dealt with 600,000 motorists whose physical ability to drive had to be re-certified, a 20 per cent rise on the previous year.
The Department for Transport hopes to use the introduction of photocard licences, which will need to be renewed every 10 years, to change the system.
All motorists are expected to have the new licences within a few years.
When applying for the licence, motorists would be expected to declare that they are fit to drive.
To check, they will be offered voluntary tests.
The new tests would include an eye examination to determine whether a driver can still read a number plate from 67 feet and a series of cognitive checks measuring reaction times.
They could also be used to determine what alterations need to be made to a car used by a driver who has lost partial or total use of a limb.
The proposals were welcomed by Motability, an organisation which helps the disabled.
"It must be a good thing for people to be tested, even for their own peace of mind," a spokesman said.
But Andrew Howard, the head of road safety at the AA, expressed concern over the plight of older drivers.
He said: "It is quite possible that many drivers would decide to give up driving rather than travel a considerable distance to a strange town to do a test.
"Many would feel that asking for a test to be moved because they didn't feel happy driving to it would be tantamount to an admission that they should not be driving."
Should the changes be adopted, other reforms are likely.
They could include the issuing of daylight driving licences for motorists suffering from the condition night blindness.
They could also lead to more licences being issued for a shorter period than the current 10 years.
But curtailing the rights and mobility of the elderly is politically sensitive, so the Government has backed away from initial suggestions that the elderly should face regular mandatory checks on their driving ability.
A Department for Transport spokesman said that an overhaul was needed. "The demands on the driver licensing system are very different to those of 30 years ago," he said.