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All GPs must help patients obtain firearms licences if requested, BMA says

GPs who refuse to deal with firearms licensing requests because of conscientious objection have to help patients find another doctor, says updated BMA guidance.

The new guidance says GPs ‘must engage in the process of firearms licensing when requested to do so’ and if GPs refuse to engage with the process based on conscientious objection they have to put in place alternative options for the patient.

Since April this year, GPs have been expected to keep a record of all patients who own a gun – and to inform police if anybody develops a mental health problem such as depression.

Previous BMA advice said that GPs may be able to refuse based on conscientious objection to gun ownership but the updated guidance says this refusal would have to be undertaken in line with GMC guidance.

This requires GPs to notify patients of this objection in advance, and if the service is not easily available from another doctor, ‘the GP that objects has a professional duty to put in place alternative arrangements for the provision of the relevant services or procedures without delay'.

The new guidance replaces previous guidance that stated that GPs should refuse all firearms requests after the British Association for Shooting and Conservation (BASC) advised its members to refuse to pay a fee to the GP for this process.

But after discussions with the BASC, the Home Office and taking external legal advice, the BMA has now said that the new guidance ‘takes account of the regulatory obligations on the part of GPs and specifically the requirement to “comply with all relevant legislation”’.

The advice goes onto say that this ‘obliges GPs to cooperate with and agree to facilitate statutory processes in which they have a prescribed role or function’.

The guidance still allows for GPs to charge for firearms licences, saying: ‘However, it is also clear that where a fee for the relevant services has not been provided within the terms of the GMS contract, it may be demanded and that the GP can withhold such services until such time as the fee has been paid.‘

It later says: 'The demand for a fee may form a condition, which if not fulfilled, means the GP can refuse to engage in the firearms certification process.’

The guidance re-emphasises that GPs cannot simply ignore the letter from the police or delay a reply as this places them at professional risk.

This advice only applies to the initial letter from the police, which asks if GPs have any concerns about the patient applying for the firearms licence. BASC still advises any licence applicants to pay if a medical report is requested as part of the licensing process.

Dr John Canning, GPC professional fees and regulation subcommittee chair, said it is 'unacceptable' for GPs 'to take no action at all' when they receive a request.

He told Pulse: 'If someone comes in and says, "I’m a gamekeeper, I’m very depressed and I’ve got a gun and I’m thinking of using it" and I do nothing about it then I’m in grave danger of having to explain myself.'

It comes as GPs received letters from firearms licensing bodies suggesting they could not refuse requests.

The Firearms and Explosives Licensing Department of Hampshire Constabulary wrote that it 'will regard you as having a part to play in the duty of care to prevent harm and loss of life and the management of risk around licence holders'.

Tony Hill, firearms licensing manager at the constabulary, said they 'regard the GP as having shared responsibility with us for the prevention of harm through the use, or threat of use, of licensed firearms'.

He said that if GPs don't engage with the process 'there is a danger that medical conditions that might affect the suitability of a person to possess firearms may go unreported to us'.

He added: 'The possible consequences of this for the patient or others are clearly severe, and it is for this reason that we point out the potential ramifications for these doctors.'




Readers' comments (57)

  • Such dictatorial proclamations / commands from the BMA is exactly why I am now happily practicing medicine in South Australia.

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  • Joint responsibility for ensuring safe gun ownership?? I've not read that for them a. If that's the case write back saying that we have a blanket policy that no gun ownership is safe. Here are the patients medical records that he/she has allowed us to release. Here is our fee. If the patient has a new problem you would like us to inform you about we can send you his updated records as long as the patient agrees... And for another fee of course. Alternatively you could leave us alone and decide yourselves who you hand out your guns to.

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  • ED: Thank you for using a far more appropriate photograph at the top of this story. Shotguns are all about rural life.

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  • This comment has been removed by the moderator.

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    Due to the increase in sore bottoms due to inadequate wiping post-defaecation particularly in overweight and elderly patients it is now advised that after opening bowels patients book an urgent appointment with their GP to be checked for any faecal remnants and to have them removed by an expert (GP).

    Sounds ridiculous but you never know where the responsibility of GPs will end when patients have virtually no responsibility themselves.

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  • The patient this morning told me flat : Can you please check my bp today because in two days I'll be seeing my proper doctor - o yes, the last time they had the MDT meeting in hospital there were two doctors and one GP. Ahem, message taken, GPs are not proper doctors but we are happy to the excreta is cleared.

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  • If this comes into force (monitor firearms for a potential deterioration and take the blame for an incident if occurs) I'm resigning as a partner.

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  • The GPC has done us a disservice in seemingly negotiating this extra bit of work and responsibility for no fee.

    Please join me in writing to your local firearms service and insisting that GPs are paid a fee by the firearms authority (not the patient).

    The argument runs like this:
    1) Providing reports to the police is not part of our contractual responsibility.
    2) The police charge members of the public for administering their shotgun application -around £120 currently.
    3) The police feel that they need to tighten their policy and want us to search through medical records and generate a report to them.
    4) This request for a report comes from the police (not the patient) and is sent to the police therefore they have to incorporate the costs for this service in the fees they already charge for administering the scheme.
    5) Incidentally I have also made it clear that the practice has not agreed a timescale with them, that they cannot assume that if we have not replied within a certain timescale that we have made a check and that we have no concerns, and to stop making requests for reports until a framework has been agreed.
    6) I also point out that the read codes that we use on patient records are nothing to do with the police, and form part of the medical records. Likewise we would have no jurisdiction requesting that the police enter data on patients criminal or police records.
    7) I point out that as good citizens we will continue to report concerns to them as we always have.

    If local groups can negotiate we have a chance with not being totally stitched up on this one.
    Clearly GPs will get drawn into the next Dunblane event medicolegally, and we need to be compensated for taking this additional risk on.

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  • Totally agree Dr Greenway.
    This is a good template which local LMCs should apply to each police force. A request should generate the above automated reply, and when they have paid appropriately then the work will be undertaken. As you point out the Police are already being paid for this

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  • I hope the few dwindling members of the BMA can finally put the nail in the coffin and should leave.
    It just goes to show the BMA needs scrapping and a new organisation founded.

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