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BMA demands more detail over changes to GP role in gun licensing

By 20/08/2021No Comments

Following a mass shooting in Plymouth on 12 August, home secretary Priti Patel said in a written statement that the Home Office would bring forward new statutory guidance to improve how people applying for a firearms licence are assessed in future.

Ms Patel said the new guidance would ‘mean that no one is given a firearms licence unless their doctor has confirmed to the police whether or not they have any relevant medical conditions, including an assessment of their mental health’.

She confirmed the Home Office would publish new guidance ‘in the coming weeks’. But BMA lead on shotgun and firearms licensing policy Dr Mark Sanford-Wood said the plans must be shared with doctors immediately to ensure they ‘work in practice’.

GP firearm checks

Some GPs have called for the profession’s role in firearms licensing to be removed altogether – arguing the responsibility and liability should ‘not be dumped on primary care’.

Dr Sanford-Wood said the new statutory guidance needed to be ‘published without further delay’.

‘The issues within the existing guidance are complex…we really need to see the detail behind that assertion [that doctors will conduct mental health assessments]. It’s a declaration full of promise and assurance but for it to be effective, doctors need to be involved in the mechanics for making it work in practice and for there to be an agreed standard process across England.’

The BMA firearms policy lead added that the association continued to have ‘practical concerns’ about the flagging system currently used by GPs to identify on patient records when someone is the holder of a firearms license.

Mental health assessments

He said: ‘It isn’t clear under what circumstances that flag could be removed and there isn’t currently any reliable software to facilitate the surveillance and cross-referencing of flags with diagnoses of concern. The BMA has been working with NHS England and relevant IT systems suppliers to rectify this and provide further safeguards.’

Since 1 April 2016, information sharing processes between GPs and police have been in place to ensure patients are medically fit to hold a firearm or shotgun. GPs are required to provide a factual report based on the applicant’s medical history and may be asked if they have ‘concerns’ about an individual’s fitness to possess a firearm.

In February 2019, the BMA altered its firearms guidance to say that it supported the principle of flagging patient records to indicate a patient is the holder of a firearms license. But it highlighted doubts over the ‘imprecise nature of flags’ and when to remove them.

Dr Sanford-Wood added: ‘But the guidance is not a cure-all. We also need more resources to help all of those involved in deciding who does and does not get a licence and how or when it is time to revoke it.  The police and doctors somehow must find the physical and emotional time and commitment to assess whether someone is truly capable of being licensed to own something, which if not used safely, can cause damage that may never be repaired.’

Medical liability

GPs also reacted to the home secretary’s announcement on Twitter, with some suggesting that the role of GPs in gun licensing should be removed. Glasgow GP Dr Margaret McCartney said the proposals were ‘total nonsense’.

Rhondda Valley GP Dr Harry Ahmed said: ‘If this falls to GPs, I will refuse. [In my opinion], no-one should have a firearm, irrespective of a snap-shot of their current mental health or list of medical conditions. The Home Office are simply trying to absolve themselves of responsibility by dumping this onto health professionals.’

The role of GPs in assisting with firearms requests has been long debated. In 2016, campaign group GP Survival branded BMA guidance on firearms certification ‘totally unacceptable’ after it said GPs were legally obliged to engage with approving patient requests to own firearms.

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