Med­i­cal mad­ness

David Frost out­lines the sham­ble of the li­cens­ing process and what you should do.

Sporting Gun - - CONTENTS - WORDS DAVID FROST PIC­TURES RICHARD FAULKS, ALAMY

As part of the end­less tin­ker­ing that goes on with firearms leg­is­la­tion and li­cens­ing pro­ce­dures, 1

April 2016 saw yet another change. This time the in­ten­tion was to get GPs more closely in­volved in the li­cens­ing process. Some of us warned at the time that there would be a sham­bles but it’s fair to say our worst fears have been ex­ceeded. Why did we get in this mess and what should you do if it af­fects you?

Early days

In the early days of firearms li­cens­ing there were few med­i­cal con­sid­er­a­tions. In re­cent years we’ve be­come ac­cus­tomed to an­swer­ing vaguely worded med­i­cal ques­tions. At­ti­tudes be­gan to change af­ter Christo­pher Fos­ter mur­dered his fam­ily in 2008. It turned out he had been hav­ing sui­ci­dal feel­ings but the GP seemed un­aware of his own­er­ship of guns. The po­lice, how­ever, were aware he had made threats of vi­o­lence and could have re­voked his cer­tifi­cate in 2006.

Why ac­cept full re­spon­si­bil­ity when you can off­load part of it onto some­one else such as the medics? The po­lice sought, in con­junc­tion with the BMA, to have an en­dur­ing marker placed on the med­i­cal record of all cer­tifi­cate hold­ers so the po­lice could be in­formed if rel­e­vant med­i­cal con­di­tions were later iden­ti­fied. The In­for­ma­tion Com­mis­sioner (IC) had con­cerns be­cause the num­ber of in­ci­dents was very small in re­la­tion to the num­ber of cer­tifi­cate hold­ers. BASC also ex­pressed con­cern but even­tu­ally a deal was reached that from 2011 GPs would be told when a pa­tient’s cer­tifi­cate had been granted or renewed. Wor­ries that cer­tifi­cate hold­ers might be stig­ma­tised or even dis­crim­i­nated against were brushed aside.

Known as Post Grant No­ti­fi­ca­tion (PGN) it had the merit of be­ing cheap and sim­ple to op­er­ate and there is ev­i­dence to show it re­vealed a num­ber of peo­ple who had failed to de­clare a rel­e­vant med­i­cal con­di­tion. Such fail­ure is not nec­es­sar­ily crim­i­nal. The med­i­cal ques­tions were very vague; GPs don’t al­ways pro­vide a clear di­ag­no­sis and peo­ple gen­uinely for­get. PGN is good but not fool proof.

The po­lice were not happy and, be­fore PGN had been given a fair run, pressed for fur­ther med­i­cal in­volve­ment. It’s worth re­mem­ber­ing that at this time more than 13,000 cer­tifi­cate hold­ers were be­ing left in un­law­ful pos­ses­sion of their guns due to po­lice in­com­pe­tence over the re­newal process. You’d have thought the po­lice would have been more in­ter­ested in putting that right than in heap­ing fur­ther stigma on cer­tifi­cate hold­ers. They weren’t and sel­dom have been – the ser­vice in some force areas is still ap­palling.

Record marker

Wind on a bit and by early 2016 the Home Of­fice’s Med­i­cal Ev­i­dence Work­ing Group (MEWG) was close to reach­ing agree­ment on a new sys­tem which would see GPs told be­fore a cer­tifi­cate was granted and be­ing asked to place an en­dur­ing marker on a cer­tifi­cate holder’s med­i­cal record. MEWG is com­posed of civil ser­vants, po­lice, the BMA and shoot­ing rep­re­sen­ta­tives.

The IC who had orig­i­nally raised con­cerns about pro­por­tion­al­ity and data se­cu­rity was strangely ab­sent. By the time I was in­vited to join the MEWG, is­sues about pro­por­tion­al­ity etc had been side lined and it be­came a mat­ter of cob­bling to­gether a sys­tem that might work.

The stick­ing point was whether or not a charge would be levied by the GP for an ini­tial trawl through the pa­tient’s records when the im­pend­ing grant of a cer­tifi­cate was no­ti­fied. The BMA and the Royal Col­lege of GPs hap­pily signed up to there be­ing “no ex­pec­ta­tion of a fee”. The med­i­cal rep­re­sen­ta­tives do not seem to have con­sulted their mem­bers, many of whom be­came in­censed at hav­ing to do the work at no cost. Other doc­tors, who don’t ap­prove of pri­vate own­er­ship of guns, were un­happy on con­sci­en­tious grounds.

Fees

De­spite the agree­ment struck with the medics, some doc­tors charge a fee which varies hugely from prac­tice to prac­tice. Some pa­tients have been black­mailed into pay­ing on threat of their cer­tifi­cate not be­ing renewed or granted. This is an empty threat be­cause the po­lice are re­quired to process an ap­pli­ca­tion if they’ve not heard from the GP within 21 days.

The an­tics of the BMA have been quite ex­tra­or­di­nary. Its web­site never sug­gested it had agreed to a no fee ex­pec­ta­tion.

It got so much flak from their mem­bers that it then told GPs to re­turn the po­lice let­ter and take no action on it. Later it de­cided that was un­eth­i­cal and is now ad­vis­ing mem­bers to par­tic­i­pate in the scheme. Those who have a con­sci­en­tious ob­jec­tion are be­ing told to direct pa­tients In­com­pe­tence

Cer­tifi­cate hold­ers are be­ing left in un­law­ful pos­ses­sion of their guns due to po­lice in­com­pe­tence to another GP.

A con­sci­en­tious ob­jec­tion? This is just an ad­min­is­tra­tive ex­er­cise in which the GP is asked to pro­vide factual in­for­ma­tion, not give an opin­ion on suit­abil­ity to hold a gun. If GPs can opt out of this what else can they opt out of do­ing for a cer­tifi­cate holder?

Will cer­tifi­cate hold­ers be dis­crim­i­nated against when scarce NHS re­sources have to be shared?

Se­cu­rity

Nor are doc­tors the safe repos­i­tory of in­for­ma­tion about firearms that you might ex­pect. Dr Bi­lal Ab­dul­lah is serv­ing 32 years for his part in the Glas­gow air­port at­tack in 2007. Dr Sabeel Ahmed, brother of the driver of the car which rammed the air­port, was con­victed of fail­ing to pro­vide in­for­ma­tion about the at­tack. Bri­tish doc­tors have been re­ported work­ing for ter­ror­ist groups in the Mid­dle East. Over 41,000 medics plus their staff will have ac­cess to the ad­dresses at which firearms are kept. In March the Daily Tele­graph re­ported that the records of 26 mil­lion pa­tients were em­broiled in a se­cu­rity breach. Are we happy with all that?

BASC ad­vice

BASC rightly ad­vises cer­tifi­cate hold­ers not to pay the GP for an ini­tial trawl. If you’re asked to do so you should po­litely de­cline, re­mind­ing the GP that a re­port is not es­sen­tial. The po­lice will grant or re­new your cer­tifi­cate any­way if they’ve heard noth­ing within 21 days.

“BASC rightly ad­vices cer­tifi­cate hold­ers not to pay GPs”

Ac­cess

More than 41,000 medics and their staff will have ac­cess to ad­dresses where firearms are kept

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