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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)

  • oh boo hoo! Drs are actually been asked to be brave and make a descision, in the public interest.WHAT IS YOUR PROBLEM?!
    here we are as trusted and respected public servants being asked to help out fellow public servants, who actually wear body armour to protect themselves from psychopaths and the rest of the mostly sane but criminal underclass,in order to protect the rest of us.
    we earn more in a day than most police earn in a week.
    i am not particularly interested in the perverse thinking on anti hunt/gun/toff champagne socialists that seem to be inflicting politics and political correctness on medical professionals. this sort of information is a public duty to provide in the interests of public protection and we for our sins are better placed than anyone else to provide it.
    if you know a patient with a gun would be a threat to the public then you would clearly be negligent if you did not say so. fee or no fee.
    what goes around comes around. refuse/ obstruct or protest, and you shoot yourself in the foot...

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  • Given that data is extracted on a regular basis from our computer software systems, a possible solution would be:
    In applying for a gun licence, person gives consent for aspects of their medical record to be downloaded on a regular basis. A code is entered on the patient's record that acts as a trigger for the regular extraction for the duration of the licence. The extracted data pertains only to information that is deemed a potential risk for owning a gun. Independent police/medical experts review the data and decide whether it is appropriate the person to continue holding the licence or as appropriate call the person in for a re-assessment. A regular extraction of data would be far more accurate than hard-pushed GPs trying to add something else to their never-ending list of things we "should" be doing. Everyone happy. GPs not involved apart from entering one code. Gun holders get to hold their licences. A more robust system for cross-checking unstable gun-holders is in place. A far more useful purpose for GPES than most of the other things it is used for.

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  • Being paid a fair sum for leafing through a set of notes which is not an insignificant task, on top of what is now unmanageable clinical workload, is not unreasonable.

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  • 'Guns' have many purposes, many of which will not be obvious to urban-dwellers...yes, there is a significant 'leisure' use for sport (such as Olympic) but even the weekend pheasant shooter has a very important role in rural economies. Then there are the stalkers, essential to controlling deer populations so that forests and other landscapes, properties and even roads are safe from the destructive capabilities of these species that may have been introduces centuries ago as alien species (especially islands). Plus the contribution of humanely raised (free-range, no antibiotics), low-fat foods into the food chain. Then the game-keepers whose jobs would be impossible without firearms today, including in their conservation roles, and roles in the rural economy. And the farmers who need to protect the crops and livestock that provide YOUR EVERYDAY FOOD.
    The guns that are being licensed have all good reasoning. The ones that shoot dead in cities are more often unlicensed.
    The government need to take the same responsibility as with driving licenses. We (GPs) MUST NOT become the court's and press' fall guys for a very flawed and biased system based on layers of bullying (by judiciary, police, BASC) that constantly pass the buck.
    BMA- take the responsibility that your members pay you for. Advocate for what is RIGHT, not what is easiest.

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  • Jonathan Pywell | GP Partner17 Nov 2016 10:37pm

    Bravo. Spot on

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  • The main issue with this is that the police issue the license whether or not we reply. This means that effectively we cannot charge for this non-contracted service. I believe this is extremely dangerous as a GP who knows a complicated patient well could be on a fortnight's leave when the letter arrives. The police should increase the fee to enable them to pay GPs for the report, or they should stop issuing licenses automatically

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  • Unfortunately, Philip Wilson, the police will not issue the license without the initial reply from the GP, as a friend (gamekeeper) recently found out as the letter of refusal came the day before his renewal date, stating that the license could not be renewed as the GP declined to issue a report (as was the BMA guidance in the Summer!)

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