Dr Andrew Stacey, Medicolegal Consultant at Medical Protection, describes your obligations to the police when there are health concerns over patients’ access to firearms
The Arms Legislation Act 2020 introduced changes to the Arms Act 1983, which came into effect on 24 December 2020. These amendments mean that health practitioners must now consider notifying police of health concerns related to their patient’s firearms access, and that health practitioners will receive a notification from the police when their patient has been issued with a firearms licence.
Police notifications to health practitioners
From 24 December 2020 all firearms licence applicants (whether they have held a licence previously or not) now need to supply police with the name and contact details of their health practitioner.
When police issue a firearms licence, police are required to notify the nominated health practitioner as soon as reasonably practicable that a firearms licence has been issued to their patient. Police will also notify the expiry date of that licence and of any subsequent changes to the licence. The purpose of sending firearms licence information to health practitioners is to make them aware their patient may have access to firearms.
This information should be stored in the patient record so it is readily visible whenever the notes are accessed. Information that an individual has a firearms licence is considered sensitive information. Therefore the information must be kept securely, just as all the rest of a person’s health records are secured.
When health practitioners need to consider notifying police
Section 92 requires the health practitioner to consider notifying police as soon as practicable if:
• The health practitioner has attended or been consulted in respect of a person who the practitioner knows or has reason to believe is a firearms licence holder and
• The health practitioner considers that the health condition of the licence holder is such that, in the interests of the safety of individuals or the public, the licence holder—
(a) should not be permitted to use or possess a firearm; or
(b) should only be permitted to use or possess a firearm subject to any limitations that may be warranted by the health condition of the licence holder.
How will a health practitioner know if a patient is a firearms licence holder? Health practitioners will only receive licence holder information for new or renewed licences issued from 24 December 2020, and only for patients who have nominated them as their health practitioner (for example, some patients consult with more than one health practitioner). Health practitioners should therefore not assume that their patient(s) are not a firearm licence holder, purely on the basis they have not received a notification from the police.
The term “reason to believe” is not defined in the Arms Act 1983. However, it can be interpreted to mean that the health practitioner must form their belief based on facts – the belief need not be proven correct at a later time.
Examples of other facts that could lead to a practitioner having reason to believe a patient is a firearms licence holder include:
• notification by the patient themselves that the patient holds a firearms licence
• the firearms licence status is recorded in the patient’s medical records
• the patient owns, or suggests they have access to firearms, and the practitioner does not have any reason to believe this ownership or access is unlawful; in which case they must be a licence holder.
Certain leisure activities (eg membership of a pistol club) or occupations (eg wild animal or animal pest controller) would be strongly suggestive of firearm access and/or ownership.
Health conditions
Health conditions that might lead a practitioner to consider notification are any that, in the opinion of the health practitioner, for the interests of the safety of individuals or the public, means that the licence holder should not be permitted to use or possess a firearm.
There is no exhaustive list of health conditions that may be relevant to safe possession and use of firearms. What is important is whether the health condition is developing or manifesting itself (or likely to) in such a way that, in the interests of individual or public safety, the person should not continue to possess firearms (or, should only do so on certain conditions, eg. suggesting that firearms should only be used under supervision or that firearms only be stored under another licence holder’s control). Examples of the sorts of health conditions, where the development of which may lead to a consideration of referral to police (depending on public and individual safety considerations) could include:
• Acute stress reactions caused by physical, emotional or mental trauma
• The development of suicidal thoughts or feelings
• Depression or anxiety
• Mania, bipolar disorder, psychotic illness such as schizophrenia
• Dementia
• Neurological conditions such as Parkinson’s Disease, Huntington’s Disease, epilepsy, multiple sclerosis, amyotrophic lateral sclerosis or multi system atrophy
• Personality disorder
• Alcohol abuse/dependency
• Drug abuse/dependency
• Traumatic brain injury
• Any physical condition that would make handling firearms unsafe.
This is not intended to be an exhaustive or prescriptive list of conditions that might give rise to a clinician’s concern about ongoing access to firearms by one of their patients. Rather this is a list designed to emphasise the wide spectrum of medical conditions and health states that may impact significantly on the ongoing propriety of an individual having a firearms licence.
The decision to notify police can sometimes be a difficult one. Practitioners are encouraged to consult with other health practitioners involved in the patient’s care and seek medicolegal advice from Medical Protection. Any decisions, and the reasons for them, should be carefully documented in the clinical record in case the practitioner(s) are subsequently called upon to justify their action.
Contacting the police
Information that should be provided
Where a health practitioner decides to notify police, the following information should be provided:
- their opinion – that in the interests of individual or public safety the person should not be permitted to use or possess firearms (or only if subject to certain limitations); and
- the grounds on which that opinion is based; and whether the practitioner believes that the licence holder poses an immediate or imminent danger of self-harm or harm to others.
The grounds on which that opinion is based may include, the nature of the person’s health condition and how that is impacting on, or is likely to impact on, the licence holder and their ability to safely use and possess firearms. If limitations are recommended, explain how those limitations are warranted with reference to the health condition. The only information that should be provided is that relevant to the practitioner’s opinion.
Protection when acting in good faith
Under section 92(5) of the Act, health practitioners are not liable to criminal, civil, or disciplinary proceedings by disclosing personal information in the course of performing any of the notifications under the new Act, as long as they act in good faith.
Other times where you might need to provide information to police
The Health Information Privacy Code guides health practitioners on their privacy obligations and should be consulted when considering making reports to police in other situations (for example, if the safety concern isn’t related to a health condition, or the safety concerns are about a patient who isn’t a licence holder). Decisions to notify are often complex and guidance should always be sought from Medical Protection in such circumstances.