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Last week the Government published its consultation paper on new proposals for statutory guidance to the police on firearms licensing. The draft guidance and the terms of the consultation can be found here. The publication of these documents marks another step in the long process of evolution in the field of gun licensing that the BMA has engaged with over recent years. It presents a real opportunity to settle on a sustainable system for the benefits of public safety, professional protection and regulatory clarity that has hitherto been lacking.
Discussions around licensing, and the medical input into that system, have been ongoing for years. It has been widely recognised that devolving the responsibility for licensing firearms to 43 different constabularies around Great Britain without clear guidance on the system that should be in place has led to a patchwork of approaches, only one of which, logically, can be optimal. This matter overlays another central question as to whether the nature of medical advice and reporting should be integral to the process. Separate, but inextricably linked, to these issues is the vexed question of the ongoing monitoring of firearms licence holders in relation to diagnoses of concern in the context of gun ownership. And adding to an already complex interplay of agendas is the thorny question of the resources needed to run a safe and functioning system, and the widespread acceptance that NHS resources cannot possibly be used to subsidise the costs of gun ownership.
These matters are of the utmost importance in a society where there is no right to bear arms, and whose general opinions on gun ownership tend towards the cautious. As a former rural practitioner I can attest to the potentially devastating consequences and dangers of gun ownership, with licence holders themselves at the greatest risk by far, especially in times of hardship. It is therefore of paramount importance that workable solutions are found with safety at their core and within a sustainable funding model that places the costs of the system with those who benefit from it.
Against this background the British Medical Association (BMA) has been working closely with the Home Office (HO) and National Police Chiefs Council (NPCC) to achieve the aims set out above. The last framework rolled out in 2016 was roundly condemned by large sectors of the medical profession, and in particular general practice where most request for medical input are lodged, and it is in the wake of those concerns that the BMA revised its guidance and began the process of engagement that has brought us to the current juncture.
A major concern among GPs has been the nature of the medical evidence requested and which has varied between constabularies. Some forces have asked for statements of medical fact while many have sought opinions on whether an individual is medically safe to be granted a firearms licence. The latter approach has caused deep anxiety among GPs who are not trained or qualified in the proffering of such opinions, and a major step forward in our work has been a partnership with the Royal College of General Practitioners (RCGP) to produce a standardised form that is a statement of medical fact, similar to the HGV/PCV medical form which has been used by the Driver and Vehicle Licencing Authority (DVLA) for many years. This is in the final stages of design and promises to provide doctors with a standardised and medico-legally safe means of reporting medical facts pertinent to gun ownership.
A further and very significant recent step forward has been in the medico-legal protections offered to doctors in relation to the monitoring of licence holders. It has been a long-expressed view in many quarters, including more than one coroner’s report, that GPs should record gun ownership in the patient record in order to prompt action should a firearms owner become ill in a way that might impact their suitability to continue to hold a gun. This process, commonly known as “flagging”, has been the subject, more than any other, of anxiety among doctors fearful that they will be held to account for failure to spot the flag or to act. Following detailed and proactive work with HO officials and a meeting with the Minister of State for Policing the BMA has signed a Memorandum of Understanding (MOU) with the HO acknowledging that doctors can only ever act with reasonable endeavours and that the legal responsibility for monitoring firearms holders always rests with the police. This allows GPs to enter flags on patient records without the potential legal liability that we previously feared, thereby opening a consensual way forward for police and GPs to cooperate ethically and within the scope of the law to improve public safety.
The question of appropriate resourcing for medical input into the system has been repeatedly discussed and we have reached agreement on this principle with the government and police. This was endorsed at a very positive meeting we had with the Countryside Alliance (CA) with whom we hope to do further work. Some anxiety has been expressed at the range of charges quoted by different practices for this work and the BMA is working towards guidelines on reasonable charging aimed at reducing the apparent variability for the benefit of the shooting community and doctors alike. We have also re-issued our clarifying advice regarding conscientious objection.
This is an important first step in the process and follows significant work by the BMA to identify solutions that work for all those who are involved with the licensing of firearms. The next phase of our approach now sits with responding to the consultation paper. The BMA is keen to encourage and work towards a unified and optimal national system for the licensing of firearms certificate holders. In pursuit of this we are liaising with LMCs who have shown leadership in the firearms arena with a view to merging best practice. There will undoubtedly be resistance from some, and the BMA has notably come under attack from certain quarters within the shooting community. However, it is clear that there is renewed grounds for optimism and the collaborative approach between the profession, HO, police and moderate shooting organisations bodes well for a constructive outcome.
Mark Sanford-Wood is deputy chair of the England GPs committee
Its really important for people to still be able to have firearms especially in the country and remain safe so your input is appreciated .
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