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GPC to seek change to firearms licensing procedure following GP outrage

GP leaders will attempt to renegotiate with the Home Office on the firearms licensing procedure, following a vote of GPC members yesterday.

GPs should not to be responsible for 'the interpretation of medical evidence' for the police to decide whether to grant a fiirearms license or a shotgun certificate, said the motion passed at yesterday's meeting.

The GPC will argue that the GP's role should solely be to ‘provide access to the applicant’s full medical record, in line with statutory legislation’, with the reconsideration following an outpouring of discontent among grassroots GPs.

It will call for the interpretation to instead be ‘undertaken by an appropriately qualified medical practitioner who is not the patient’s GP'.

The vote comes after Pulse revealed earlier this week that the BMA's updated guidance on firearms licensing said GPs cannot refuse to engage with licensing authorities.

The current system, brought in from April, means that GPs are sent a letter by police when a patient applies for a firearms licence asking if there are any recorded medical facts that could give rise to concerns if a licence is granted. GPs should also put a firearms reminder code on the patient’s medical record.

GPC deputy chair Dr Richard Vautrey told Pulse that the GPC executive and the BMA professional fees committee - which had agreed to the original arrangement - would now contact the Home Office to seek to change the procedure so GPs are not involved.

He said: 'We are going to be writing and seeking a meeting with the Home Office to try and change this situation so that GPs don’t feel that they’re being put in a situation where they are being asked to make judgements which they don’t feel that they have the necessary competence to do.

'I think we’re going to be looking again at what information we can provide to GPs but more importantly wanting to seek a better system than is currently in place,' he added.

This comes after BMA guidance was updated this week to take account of the 'regulatory obligations' on GPs and says that if GPs decline to help with a gun licence due to conscientious objection, they should find another option for the patient.

This was a change from their previous stance that GPs should refuse firearms requests straightaway. This provoked outrage on social media and among Pulse commentators, and campaign group GP Survival called the system ‘absolutely unacceptable in every possible way'.

BMA guidance has always stated that GPs can charge a fee for this work, at odds with the BASC position that GPs should reply to the initial letter to police for free.

If a medical report is required as part of the licensing process, everyone agrees that a GP can charge a fee.

The motion in full:

a) That the interpretation of medical evidence to assist the Chief Constable in their decision regarding the grant or renewal of a firearms or shotgun certificate should be undertaken by an appropriately qualified medical practitioner who is not the patient’s General Practitioner

b) That the role of the GP is to continue to provide access to the applicant’s full medical record, in line with statutory legislation;

and

GPCE mandates the GPCE Executive to negotiate arrangements to reflect the above, in collaboration with the BMA’s Professional Fees Committee.

Source: BMA

Readers' comments (14)

  • Anybody who requires a gun license in order to do their job should have their suitability for this assessed by an occupational health physician, as it is an occupational requirement; any request for an assessment for a gun license for occupational purposes should be paid for by the employer (or by the individual, as a business expense, if self-employed).

    I still, however, view part b) of the motion passed yesterday to have been ill-considered.

    Sharing a patient's full health record - even with consent - may breach DPA and confidentiality rules if information shared is not objectively needed by the party with whom it is shared. The onus should be on the patient to share information about their medical history with the doctor assessing them. With criminal sanctions for anybody who obtains - or retains - a firearms license by witholding medical information. And, as with DVLA, the onus should be on patients to report their illnesses to whoever controls their license.

    Any risk that information might be shared, against the wishes (if not contrary to their consent) of the patient would risk them not sharing that information with their GP, and thereby risks a patient failing to disclose signes or symptoms that would lead to a diagnosis and successful treatment, thereby harming the patient, as a result of compromising the GP-patient relationship.

    Thus for ethical reasons (possibly supported by the DPA and confidentiality rules) GPs should NOT, IMO, share patient's medical records with the physician doing an assessment for a firearms certificate.

    IF there is an agreement that data must be shared (and I reiterate, I would oppose agreeing to this) there must first be objective, evidence-based criteria for deciding what information needs to be passed on.

    Given that looking after sick patients and preventing illness must take a priority over non-NHS discretional matters such as firearms licensing, we need to find a way to keep the workload to a minimum, and must ensure that any such information-sharing requires only an automated search of the patient record, looking for Read codes for the necessary information; with no manual trawling of the records.

    Alternatively, patients should be asked to request a copy of their records from the GP and share them with the licensing authorities. This gives the patients the responsibility for deciding whether they are willing to share the information. If they choose not to, they can withdraw their license application (or risk prosecution for witholding information).

    If GPs are expected to maintain a register of gun-owners and report any illnesses that give concerns (and as I've said, I think patients should be made responsible for reminding their GP that they have a license, and for reporting such concerns, analogous to the DVLA requirements) then there must be an annual retainer fee for doing so, for as long as the patient holds the license.

    Furthermore... The GMC rules on conscientious objection relate to those situation where a doctor has an objection to a medical procedure (such as termination of pregnancy). They only relate to occasions when a practitioner does not wish to refer a patient for a particular medical procedures. They do not relate to other things patients may request, so they should not relate to this. I do not believe there is a GMC duty to refer a patient on to another doctor in this instance.

    I also stand by previous comments that a doctor (or a practice) should be able to inform the local Chief Constable that they will not be undertaking any firearms assessments, will not be replying to any requests to do so, and that not receiving a reply does not mean there are no concerns, just that the CC will have to find another way to get that individual assessed.

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  • Sorry Peter.
    That's all just far too sensible.
    You get my vote but there'll be enough Sir Humphrey's around to make sure that it won't fly.

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  • Write too much in the comments, people don't bother reading it.

    Just sayin'

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  • How come the GPC was so detached from reality that it agreed to the new process, and is only now objecting after real GPS rise up in anger. What a totally incompetent bunch

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  • "Will attempt to renegotiate".

    And there's the problem.

    "Dear Mrs Rudd, We aren't doing this dogs breakfast stuff anymore, and only agreed in the first place because that's our default setting."

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  • Dear All,
    Yes its a dogs dinner but lets keep one fact clear, the GPC did not "agree" to the new arrangements. They were implemented unilaterally. We advised them and expressed concerns and my committee made it very clear to them that GPs would not like their proposals. They then went away and came back with a slightly different process but still not what we advised. If you read the Home Office Guidance it says a fee is not expected. The use of this word is quite specific, we told them that GPs were entitled to a fee, they accepted this, the very powerful shooting lobby told them they would simply refuse to pay, so they came up with "no expectation" of a fee. So yes its a dogs dinner but not because GPC agreed to it. I would accept that our response so far has not been great and rather chaotic and for that i apologise; as a GPC member, as one of the team who worked with the HO and as holder of firearms and shotgun certificates.
    Regards
    Paul C

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  • Vinci Ho

    Sigh...
    Perhaps , I have some 'baggages' about BMA/GPC as our LMC secretary (a good friend) is still in BMA council. I honestly have never thought of cancelling BMA membership but carried on reading BMJ every week (which in my opinion shot its own foot when Agent Hunt used its study report to claim the weekend effect of higher mortalities in NHS hospitals).
    This is a unique point of time in world ,as well our NHS ,history . As I always believe , 'heroes' only arise in time of chaos(call that sensationalism if you want) and we do not need to look any further than this moment of time .
    As I wrote in other comments , the last string of hope probably only resides in the likely forthcoming parliamentary debates of Supreme Court consolidated the verdict that Brexit must pass through the parliamentary debates for new legislations and our representatives must fight for the prerequisite of ensuring NHS(hence GP) funding to sustain in terms and conditions for Brexit.(whether one would call the promise, of giving NHS more money during the EU referendum, a hoax is debatable but I believe people have been betrayed)
    Sign of the times, sign of times. Hope you guys would understand.......

    Zhuge Liang(諸葛亮) (181 – 234)(courtesy name Kongming) (those familiar with Three Kingdoms in Chinese History) wrote in his most famous official/military memorials,Chu Shi Biao(出師表):'' this autumn is the most desparate time of life or death'' (此誠危急存亡之秋也)

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  • Vinci Ho

    Correction
    ......the likely forthcoming parliamentary debates IF Supreme Court consolidated the verdict that Brexit must pass through the parliamentary debates for new legislations......

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  • Fat lot of good this will do
    We live in an age of 'GPs will do what the hell we tell them to do ' and carry the can for any crap that arises

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  • I can always give an opinion. It will be that because of absence of funding for this activity I am sadly unable to give an opinion. Yes, we have added shotgun icon to patients notes. But do I have any concerns? I'm afraid, I don't know.

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