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.’