Firearms Licence Holders: Mandatory Medical Markers

GPs also must already abide by several safeguarding protocols and laws. The Care Act 2014 sets out six key principles of safeguarding, including prevention, noting that it is sometimes possible to act before harm has come to an individual. With those existing guidelines, mandatory markers are not an attempt to reinvent the wheel; they are simply a way of flagging vital information that is key to the patients and public safety. The Royal College of General Practitioners considers it valuable to have those digital markers in place, and notes that software systems should develop, implement and secure the functionality of the markers in patient records. The college recommends that the Government work with the providers of GP systems to resolve this issue.

The BMA also supports medical markers. They told me that doctors have a professional responsibility to share information that might impact on the safety of someone holding firearms in the community, and we need effective systems to do so. The Domestic Abuse Commissioner’s office welcomes the digital medical marker and recognises the work of bereaved families who have lobbied tirelessly to ensure that action is taken to prevent future harm and further loss of life. The British Association for Shooting Conservation and the Countryside Alliance, who have a combined membership of over 200,000 people, both support the introduction of mandatory medical markers.

June 2010, March 2020, August 2021, February 2023—these dates are etched in the memories of families torn apart by gun violence: each one a failure of the system; each one a life that could have been saved. The Government have a choice: they can listen to the families of victims, to medical professionals, gun owners and the organisations working to end violence, or they can continue to leave the door open to tragedy. The Liberal Democrats believe that mandatory medical markers are a proportionate evidence-based safeguard. They allow concerns to be flagged early if someone’s health changes, rather than waiting years until a licence renewal, and can save lives. So I ask the Minister today: will he finally release the data on how many GPs are using the markers and will he commit today to making them mandatory?

As the hon. Lady said, having had it flagged up in the GP’s mind, he or she would have a conversation with that person: “I see you are a shotgun certificate holder. You tell me you are feeling terrible and that you sometimes have feelings of wanting to commit suicide. We’re going to do our best to provide treatment for you, and it may be that in future you could return to a normal position where you could hold a shotgun, but at this particular time, do you think you are a fit person to be holding that shotgun certificate?”

One of two things then happens. If the patient is a belligerent sort of person, he or she would say, “Of course I’m a fit person.” The GP would then be in the position of having to say, “Well, I’m very sorry, but I don’t consider that you are, and I’m going to have to report your medical condition to the police.”

On the other side of the coin, there could be a more sensible conversation with a more rational person, who would say, “Doctor, I hear what you say, and I think it is a concern. I will now take steps either to transfer the guns that I hold in my gun cabinet to a person who has a certificate, to a firearms dealer or to the police, until such time as you and the local constabulary think it is fit for me to repossess those weapons.” That is how it ought to work; that would have prevented a lot of these tragedies.

I think the Government have a role here. As the hon. Lady made clear, the lacuna in the system is that not all GPs currently operate a medical marker. She was quite right to ask what percentage of GPs operate a medical marker, and it would be really interesting to hear the answer from the Minister. If he and the Department of Health and Social Care do not know, they should send out an inquiry to all GPs to find out, and then he could begin to have a negotiation with the General Medical Council and the BMA about whether doctors should operate this service when the Government next sign a contract with them.

There are two principal reasons why doctors do not operate a medical marker—something that is actually very easy to do and involves very little work. As I said in my intervention on the hon. Lady, the first is that there is a widely held concern among the people who will not do so that they will be regarded as the decision maker. They do not want to be the decision maker because, at the margin, it will be quite difficult to decide whether a person should possess a shotgun or other firearm. But that is not the case, as I made clear in my intervention; the chief constable of the constabulary that granted the certificate is the final decision maker. Of course, the normal appeal rights apply to the chief constable. If he has decided that somebody’s firearms licence should not be granted or should be revoked, the affected person has the right to appeal against that decision. It is quite clear that the GP is not the decision maker, and I therefore cannot see any reason why they would not want to operate the medical marker.

The second reason that GPs do not want to operate the medical marker is that they are very busy people—they are overworked—and it is another thing that they have to do. But if they are going to do it for driving licences, heavy goods vehicle licences and a number of other categories, I cannot see why they would not do it in the public interest for firearms.

My sister was a GP and the senior partner of a GP practice. One of her partners was a conscientious objector to people having guns, and she ended up having to do all his casework to do with firearms. Even if a GP is a conscientious objector, they still ought to be interested in public safety as an overall priority of their work, so it would be reasonable to require them to just look at a person’s medical notes and take account of whether their medical condition made them a suitable person to hold a firearm.