GPs should refuse all firearms licence requests, says BMA in U-turn
The BMA has advised GPs to reject all firearms licence requests from the police due to a lack of funding, signalling a change in its original position.
Since April, GPs have been required to provide police with information about patients wishing to own a gun, but the BMA's previous advice had been vague as to whether GPs can charge a fee.
However, the BMA has now said that GPs should reject all requests it receives from the police, after the British Association for Shooting and Conservation (BASC) advised their members to refuse to pay a fee to the GP for this process.
The BMA says that GPs should ‘return the letter to the police without delay’, telling them they are unable to do the work due to a ‘lack of funding or for a conscientious objection to gun ownership’.
This is the latest controversy since the new process of firearms licences was brought in from April.
The new regulations - which were agreed with the BMA - require GPs to inform the police whether they have any concerns about the patient receiving a firearms licence, whether the patient has any relevant medical conditions (such as depression or dementia) and to put a firearm reminder code on the patient record.
Previously, policeonly contacted an individual’s GP before the issue of a firearm certificate if an applicant has declared a relevant medical condition.
But GPs criticised the regulations after they were announced, pointing out that there is no provision for them to be paid for the work, which is outside the GMS contract.
Devon LMC issued a template letter for GPs to refuse to participate in the firearms licensing process, stating that GPs are not suitably qualified to give an opinion on whether there are concerns about a patient.
Both the LMC conference in May and the recent BMA Annual Representatives Meeting voted for changes to the firearms licensing process.
Now the BMA has told GPs that this is ‘work that is not a condition of the GP contract and therefore a fee can be charged.’
It says: 'We are now advising GPs to return the letter to the police without delay explaining they are unable to undertake the work due to a lack of funding or for a conscientious objection to gun ownership.’
The BMA guidance emphasises that GPs should return the letter as soon as possible, because if GPs delay or disregard the letter they could place themselves ‘at professional risk’.
Dr Paul Roblin, chief executive of Berkshire, Buckinghamshire and Oxfordshire LMCs, has been campaigning on the issue since it was introduced.
He said: 'My view is that the belief that the amount of information in the initial GP response does not justify a charge is wrong. The NHS should not be subsidising non-NHS work, and the cost of GP input should be funded by a proportion of the application fee covering GP time and input
'The GP has to review the notes, looking through summary pages, many years of consultations, A&E attendances & letters to check for the conditions & history listed. Only once this work has been done can a box be ticked.
'This judgement carries medico-legal implications, so care must be taken even at the first response stage.'
The BASC said it was ‘disappointed that some doctors are now demanding payment for a matter that affects public safety and in opposition to the agreement reached by the BMA’ and ‘advises applicants to refuse to pay any fee demanded’.
Paul Dale, BASC firearms officer said: ‘After all the work that the representatives of all interests put into the agreement on medical involvement I am deeply disappointed that some doctors see the process as yet another chance to make money. Public safety should mean more to them than a fee.’
However, this may mean that GPs do not take part in the firearms licensing process at all.
The BMA says: ‘Although our change in position will mean the majority of GPs will withdraw from participating in the process, it is still important to inform members how the current process works for those who choose to participate or where applicants are happy to pay the fee.’
This initial letter from the police is currently sent after the applicant has received a licence, but is being changed to be sent before the licence is granted.
The BMA’s advice only applies to the initial letter from the police - BASC is still advising members to pay for a full medical report if the police request one, which they may do if the GP says they have concerns.