BASC AGM

[jer]

The agreed arrangement was that if the police had not heard back from an applicant’s GP within three weeks of sending their letter to the GP, enquiring if the applicant had any of the relevant medical conditions in the guidance, the police would assume all was well, and grant the certificate. As the BMA reneged on their part, which was to do the check without a fee, an increasing number of police forces began to insist that the GP respond and confirm the position, or no certificate. Chief Constables have the jurisdiction to vary Home Office ‘guidance’ - it’s similar to the NICE guidance with which doctors are issued, but we do not have to do what it says if we can justify departure. GPs meanwhile are not as I have previously emphasised legally obliged to do this work, neither is it part of their NHS contract, and so they can charge what they like. Advising members not to pay became unsustainable, as the situation developed to the point where the advice was resulting in members’ certificates not being granted.
There is no flat fee of £120 or other figure. That is why there is nothing in BASC’s archives. The fee is privately arranged between the applicant member and the doctor member. The work involved is very variable indeed in the time taken. I would not consider it appropriate to charge anything for a simple check on the records of a member who had no relevant conditions, as the work would not take more than half to one hour, as previously it’s my contribution to the shooting community. I would in that case send a very brief letter myself, saying there were no conditions, and not incur my typist’s charges. The last letter I did was for a member with a history of depression, which took some time as the letter included an account of the medical history plus arguments to justify my opinion, which was that the relevant condition did not afford any significant risk to the applicant member or anybody else. The member paid me £50, half of which went to my typist, and the certificate was granted. If BASC doctor members want to help out fellow members in difficulty with their expertise once every five years, one may argue that members are having to pay for something which was not previously necessary, but that’s thanks to the BMA and the police, not BASC. That I am on Council is irrelevant, I would have agreed to be on the BASC doctor members’ panel anyway. Council affords no opportunities for income generation. I hope I’ve clarified the points, thank you for raising them.

I find your post very interesting particularly the account of where you successfully argued for a certificate grant despite the applicant having suffered with depression. It is widely believed amongst certificate holders that the mere mention of depression will automatically be grounds for refusal which almost certainly prevents some who may have issues seeking help. Uness it already exists perhaps a publication of the facts surrounding the issue would be worthwhile.

 

[Ladygun]

I find your post very interesting particularly the account of where you successfully argued for a certificate grant despite the applicant having suffered with depression. It is widely believed amongst certificate holders that the mere mention of depression will automatically be grounds for refusal which almost certainly prevents some who may have issues seeking help. Uness it already exists perhaps a publication of the facts surrounding the issue would be worthwhile.

Thank you Jer. It’s not possible to quote official statistics upon grant refusal or revocation for depression, or any mental illness, because they are not reported upon by the police or the Home Office. My experience suggests that although psychotic illness such as schizophrenia or bipolar affective disorder (used to be called manic depression) may mandate refusal, depression particularly without suicidal thoughts does not. Most depression is actually adustment disorder with depressed mood - in other words understandable misery, albeit with knobs on, when things go pear shaped. Getting help demonstrates a responsible attitude, which should benefit the applicant. You are correct - my personal and professional experience is that certificate holders are very negative about disclosing emotional distress. It’s worth pointing out that FEOs are far more worried about suicide risk than homicide, since homicide with legally held firearms is vanishingly rare, but suicide rates were ~ 100 per year the last time the figure was published in 2017. Out of ~ 750,000 certificates this is still rare, but no FEO wants to make a grant to an applicant who ends up deceased by firearm. My advice would be that applicants, FEOs and GPs work together to manage risks, recognising that the FEO still has the final say. A counsel of perfection but crucial for professional SC/FAC holders. You ask about publications - I wrote one for an issue of ‘Shooting and Conservation’ a while back, and also one in ‘Advances in Psychiatric Treatment’. I‘ve written another one for BASC which is (I hope) in the pipeline, but that one just says what I’ve said in previous posts. I am not aware of anything else, apart from an American publication ‘Gun Violence and Mental Illness’ of course it’s completely different in the USA. Best wishes, L

 

[jer]

Thank you Jer. It’s not possible to quote official statistics upon grant refusal or revocation for depression, or any mental illness, because they are not reported upon by the police or the Home Office. My experience suggests that although psychotic illness such as schizophrenia or bipolar affective disorder (used to be called manic depression) may mandate refusal, depression particularly without suicidal thoughts does not. Most depression is actually adustment disorder with depressed mood - in other words understandable misery, albeit with knobs on, when things go pear shaped. Getting help demonstrates a responsible attitude, which should benefit the applicant. You are correct - my personal and professional experience is that certificate holders are very negative about disclosing emotional distress. It’s worth pointing out that FEOs are far more worried about suicide risk than homicide, since homicide with legally held firearms is vanishingly rare, but suicide rates were ~ 100 per year the last time the figure was published in 2017. Out of ~ 750,000 certificates this is still rare, but no FEO wants to make a grant to an applicant who ends up deceased by firearm. My advice would be that applicants, FEOs and GPs work together to manage risks, recognising that the FEO still has the final say. A counsel of perfection but crucial for professional SC/FAC holders. You ask about publications - I wrote one for an issue of ‘Shooting and Conservation’ a while back, and also one in ‘Advances in Psychiatric Treatment’. I‘ve written another one for BASC which is (I hope) in the pipeline, but that one just says what I’ve said in previous posts. I am not aware of anything else, apart from an American publication ‘Gun Violence and Mental Illness’ of course it’s completely different in the USA. Best wishes, L

Thank you for a very clear, full and easily understood explanation, I know from conversations I have had with most certificate holders they would never admit to having any mental health problem for fear of loosing their certificates, perhaps if more are made aware of your explanation it would provide some reassurance. I think your patients, particularly those who are certificate holders are fortunate to have you, not least because you are prepared to put the extra effort in to assist in dealing with this sort of issue, many however are not so fortunate as some GPs are positively anti gun ownership. I would also like to say that its refreshing the way you have responded to posts and given more of an explanation than is usual from a BASC representative. I could perhaps be considered a BASC basher because I have little faith in how it sometimes operates and deals with cerain issues and I often say as much, but I would say that if everyone representing BASC went the extra mile in responding and explaining the issues raised here there may be a few less negative comments.

 

[Ladygun]

Thank you for a very clear, full and easily understood explanation, I know from conversations I have had with most certificate holders they would never admit to having any mental health problem for fear of loosing their certificates, perhaps if more are made aware of your explanation it would provide some reassurance. I think your patients, particularly those who are certificate holders are fortunate to have you, not least because you are prepared to put the extra effort in to assist in dealing with this sort of issue, many however are not so fortunate as some GPs are positively anti gun ownership. I would also like to say that its refreshing the way you have responded to posts and given more of an explanation than is usual from a BASC representative. I could perhaps be considered a BASC basher because I have little faith in how it sometimes operates and deals with cerain issues and I often say as much, but I would say that if everyone representing BASC went the extra mile in responding and explaining the issues raised here there may be a few less negative comments.

Thanks Jer, I appreciate it. It’s part of what I’m on Council for, and the reason I stood in 2015 was because of the dissatisfaction with BASC current at the time. Constructive criticism is always welcome! Take care, L.