BASC says don’t pay medical fee

[Patterdale Terrier]

The point made by the shooting organisation is that you do not pay for the medical report, simple as that. Having read the evidence for and against, what happens when you refuse to pay. Will the shooting organisation's lawyer step up and defend all claims against the shooter for recovery of costs by your GP? I very much doubt it.
I am a little uneasy by the BASC stance on this. I am sure there are many out there who expect a little more and surely this is an area where the shooting organisations should be seeking to meet with the FELWG/Home Office/NHS etc to settle this matter once and for all. I am also uneasy about the perceived power of the GP's in this matter. I am aware that some surgeries have a conscientous objection to shooting and hunting and have refused to supply the required medical reports, but did they communicate their feelings to the shooter/hunter? As a shooter/hunter are you aware of the politics of your surgery? Bet you never thought of that. Oh and by the way some surgeries remove your name from their lists if you have not visited the doctor for more than twelve months. Causes a problem when you furnish doctor details on the renewal application form, and you only find out you have been struck off when the FLD write to them when they renew the licence.
This is a bigger issue than that initially reported.

 

[darkstalker]

Indeed. However, as it is the work is undertaken ostensibly for the public good it seems reasonable that the police (who are requesting the report in order to be able to discharge their statutory duty) should have some public funds available to pay the general practitioners.

Dalua, as I mentioned before, the police paid for the report on two of my patients. I am not sure but I am guessing that there must be some extra funding available to the police for this purpose.

 

[timbrayford]

I am a GP. It costs us 800 £ a working hour to run the place (pay the mortgage, staff etc). I am afraid we cannot do work and take responsibility for administrative work for nothing. If the business cannot pay it's bills we could potentially loose our homes to the bank

One of the fine judgements that you have to make in the commercial world is what to charge and when.

I'll give you an example, I run a professional garden design and build company, there was a little old lady that had spent significant money with us, part of the contract was installing an irrigation system. Every summer she needed the controller reconnecting with new batteries (cost around £ 2.50), it would take around 10 minutes on site maximum to do this work. However it was a round trip of an hour and a half to do this work. So what charge would be proportionate to the work that had been done in the eyes of the customer? Do you charge the full amount according to mathematical calculation (hourly rate/callout charge & materials etc.)? A token amount ? Or not at all and instead reap the reward of substantial repeat business & recommendations?

In practice we chose the later course which has proved to be commercially sound.

I can quite understand that GP's are not in a strictly commercial environment so their attitudes to their patients are somewhat different, by way of contrast I have a private appointment with an Osteopath tomorrow, it will only cost £ 35 for a half hour consultation and no bothersome waiting lists to worry about either!

 

[rodkayak]

We are in a commercial environment. I am not sure you realise how we are paid. I cannot decide to do work gratis (for free) and my partners then charge for the same work with another patient. It would be discriminatory.
My medical legal insurance is 60£ a day. It's not just going through the notes to do the report its taking the responsibility if you say they psychologically ok and then they go on to kill somebody in a psychotic episode. I now know how FA enquiries officers feel
The 'bothersome waiting lists' are because we are very busy with conditions like terminal cancer care,diabetes and other chronic conditions. Your osteopath does well at 70 £ an hour. My drawings are 250 a day before tax

 

[timbrayford]

We are in a commercial environment. I am not sure you realise how we are paid. I cannot decide to do work gratis (for free) and my partners then charge for the same work with another patient. It would be discriminatory.

A whacking great cheque or money transfer courtesy of the taxpayer via HM Treasury perhaps? You certainly aren't reliant on the goodwill and repeat business of each individual patient are you?

 

[ferretmanabu]

A whacking great cheque or money transfer courtesy of the taxpayer via HM Treasury perhaps? You certainly aren't reliant on the goodwill and repeat business of each individual patient are you?

He has a contract with the NHS for provision of medical services to patient registered with him. Completing firearms forms is not work defined within that contract and therefore he can and should charge.

 

[rodkayak]

Thanks for your understanding. I feel a charge of between 15 to 30 pounds depending on the work is not unreasonable. The money goes to the practice not me directly. I have to go to a coroner's court next week to give evidence. They gave me 8 days notice and a locum will be £200 for the afternoon if we can get one. We may not get the money back. If there is any incident with a FAC holder including suicide, we will be called tho give evidence in a coroners court and account for our decision and possibly face legal action and GMC censure

 

[plonker]

Judging by the amount of time "men" visit the doctors surgery a doctor might have to look at a paltry amount of visits over 5 years.There might even be no history in those 5 years .

 

[kes]

I just typed a very long critique of the parties involved in this process and lost it by accident - maybe a good thing. To keep this short, you dont walk away from a meeting without knowing what exactly was agreed - so who is 'bending the agenda' ? I wouldnt put it past some police or GP's reps to do so, I dont think shooting orgs would be so stupid but I have said that before and the examples are numerous.

Someone needs to look at the minutes and implement the agreement - without increasing fees yet again,. I would expect the Home Office - but didnt they propose clause 81? Doesn't look good for the sport or those people who simply want to enjoy it safely. Strong representation is the key - I look at Mr Glenser and think he is no pushover but he has a lot of 'making up' to do.

 

[ferretmanabu]

Judging by the amount of time "men" visit the doctors surgery a doctor might have to look at a paltry amount of visits over 5 years.There might even be no history in those 5 years .

Or there could be 200 consultations and 50 letters from different specialists to look through.

 

[David63]

700,000 certificate holders (give or take)
68,000 GP's in the UK (give or take)
Certificates renew over a 5 year period
You work out how many forms on average a GP will have to review per year...

I agree I am not up to speed with what some GP's systems are like and what they have to do. I can only speak to my experience with my GP surgery. My records are on computer and a quick flick through brings up a list of my treatment regime / illness. I expect my GPO would take a moment or two to see if I was being treated or had been treated for anything on the list

 

[ferretmanabu]

700,000 certificate holders (give or take)
68,000 GP's in the UK (give or take)
Certificates renew over a 5 year period
You work out how many forms on average a GP will have to review per year...

I agree I am not up to speed with what some GP's systems are like and what they have to do. I can only speak to my experience with my GP surgery. My records are on computer and a quick flick through brings up a list of my treatment regime / illness. I expect my GPO would take a moment or two to see if I was being treated or had been treated for anything on the list

The work is not part of GPs NHS contract and therefore incurs a private fee.

 

[Eddie P]

From the BMA website.......

In the same letter the GP will also be asked to notify the police if they have any concerns. At this stage the GP will only need to respond to the letter by ticking yes or no to the following questions.

1. Do you have concerns about your patient being issued with a firearm or shotgun certificate?
2. Has your patient suffered from any relevant medical conditions listed below during the previous five years?
   • Acute Stress Reaction or an acute reaction to the stress caused by a trauma
   • Suicidal thoughts or self harm
   • Depression or anxiety
   • Dementia
   • Mania, bipolar disorder or a psychotic illness
   • A personality disorder
   • A neurological condition: for example, Multiple Sclerosis, Parkinson’s or Huntington’s diseases, or epilepsy
   • Alcohol or drug related abuse
3. Have you placed a firearm or shotgun reminder code on the patient record?

The 5 years question is fairly straightforward (defined time frame and conditions). But what if the patient had psyche problems over 5 years ago or any issues.

To be able to tick "no" in box 1 then they will need to review all paperwork available. I'm guessing lots of this isn't computerised as it is for the most part deemed not relevant enough for most day to day care.

As GPs and others have said above, to not do a full check and then sign it is risking registration and a visit to the coroner to explain their reasoning. I don't know any coroners, but I'm guessing "I couldn't be arsed to check properly" isn't an appropriate answer.

And to BASC, I think the GPs issue with you is that you said it is simply a 2 minute box ticking exercise which belittles the importance that is placed on this part of the process. As I've said above, it is far more than that.

 

[Kalahari]

I think we are straying from the point here. It isn't that the GP's work is worth nothing, but rather that this is a condition imposed by the government supposedly for "the public good" therefore the costs should be borne by the state.

Just my 2p.

David.

 

[timbrayford]

I think we are straying from the point here. It isn't that the GP's work is worth nothing, but rather that this is a condition imposed by the government supposedly for "the public good" therefore the costs should be borne by the state.

Just my 2p.

David.

I agree, the respective costs of grants and renewals are set out by statute, the compulsory opinion from GPs must therefore be included within this cost. Clearly the NHS and Home Office need to sort out between themselves which of them is to fund this.

 

[kes]

This is the key point - can anyone see a new contract being drawn up and the parties not stating or agreeing, "including all work traditionally and explicitly undertaken prior to this renegotiation" or some such - I cant. I have great respect for doctors, I also know what practice managers are like. Its not onerous - just do it - you'll be charging for trips to the loo next because the space needs renting and cleaning.
Sorry, this is silly decision by doctors and discriminatory too.

 

[kes]

Or there could be 200 consultations and 50 letters from different specialists to look through.

This is an extreme case for the purpose of argument. How many of such cases would be FAC/SGC applicants - a vanishingly small percentage. Its also possible to set - up a database based on the flags GP's are required to put on the records and tag these to data held on individual records so - you are asked about Jimmy P, you type his name in (or get someone less expensive to do it) see if they have any recent history or doubts - (or ask someone who costs less to do it) and then, with the data to hand on your terminal, (or ask someone less expensive to do it unless there's a problem in which case you flick through) and say yay or nay.
This is not difficult - its not expensive - it just requires some management organisation.
Sorry thats how difficult I see it.

 

[Eddie P]

This is an extreme case for the purpose of argument. How many of such cases would be FAC/SGC applicants - a vanishingly small percentage. Its also possible to set - up a database based on the flags GP's are required to put on the records and tag these to data held on individual records so - you are asked about Jimmy P, you type his name in (or get someone less expensive to do it) see if they have any recent history or doubts - (or ask someone who costs less to do it) and then, with the data to hand on your terminal, (or ask someone less expensive to do it unless there's a problem in which case you flick through) and say yay or nay.
This is not difficult - its not expensive - it just requires some management organisation.
Sorry thats how difficult I see it.

The problem is they are asking your opinion you can't delegate this then sign it off.

And it isn't just those conditions from the last 5 years, it is anything ever that may be cause for concern. As shown above, not all records are electronic.

 

[kes]

The problem is they are asking your opinion you can't delegate this then sign it off.

And it isn't just those conditions from the last 5 years, it is anything ever that may be cause for concern. As shown above, not all records are electronic.

Its management - you flag the record. ok to a given date and update it when a renewal comes in or a condition change occurs (or you get someone who costs less to do it (flagging the latter to you if it coincides with an FAC tag)).
I have signed as reference to quite a number of certificate holders - I take that as a serious responsibility and always do it fully and conscientiously - I cant be sued I know but I would have to live with the consequences - do you seriously think a practice would be sued? You have professional negligence insurance anyway.
Before charging you need to look at how many legitimate shooters have gone on to kill and whether the police have been responsible for the primary failing - its called risk assessment.
Hungerford - police, Durham - police, Hamilton - police. You cannot judge your risk until you analyse the past occurrences and NONE of them were down to the former medical scrutiny regime. This is all about 'perceived new work' and with that comes 'perceived new fees' If you work it out and manage the data correctly you are simply holding a watching brief more than you did for NO extra fee - come on lets tell it like it is - not how we might justify further public resources.

 

[Eddie P]

Its management - you flag the record. ok to a given date and update it when a renewal comes in or a condition change occurs (or you get someone who costs less to do it (flagging the latter to you if it coincides with an FAC tag)).
I have signed as reference to quite a number of certificate holders - I take that as a serious responsibility and always do it fully and conscientiously - I cant be sued I know but I would have to live with the consequences - do you seriously think a practice would be sued? You have professional negligence insurance anyway.
Before charging you need to look at how many legitimate shooters have gone on to kill and whether the police have been responsible for the primary failing - its called risk assessment.
Hungerford - police, Durham - police, Hamilton - police. You cannot judge your risk until you analyse the past occurrences and NONE of them were down to the former medical scrutiny regime. This is all about 'perceived new work' and with that comes 'perceived new fees' If you work it out and manage the data correctly you are simply holding a watching brief more than you did for NO extra fee - come on lets tell it like it is - not how we might justify further public resources.

You said to use someone less expensive.

Would you sign as a referee for a friend of a friend? The law says you have to have known then for years, but if your friends says that they are a good lad then why not just accept that.

Professional indemnity doesn't cover legal responsibility.

GPs charging is OK (IMHO), but I think the rate should be agreed in advance at a level that is acceptable for all parties.