New gun laws place GPs in ‘complex position’

GPs practising in Western Australia are now responsible for conducting physical and mental health assessments for those applying for, or renewing, a firearm licence.
 
The new state legislation, effective 31 March, requires individuals to undergo a Firearm Authority Health Assessment (FAHA) to have their health status assessed by a doctor to ensure it does not compromise firearm safety.
 
The changes, first flagged to the public in July 2024, have raised concerns among many GPs who have expressed feeling uneasy about making determinations that could have significant consequences for patient relationships and community safety.
 
In a newsGP poll from July last year, almost 80% of 1347 respondents said they would not be willing to
provide a firearms health assessment for their patient, with only 10% saying they would.
 
RACGP WA Co-Deputy Chair Dr Mariam Bahemia, together with Dr Richard Taylor, represented the college council on the Health Assessment Working Group established by the Firearms Act Reform Program.
 
Dr Bahemia told newsGP that while the RACGP supports ‘community safety, strong gun control laws, and responsible firearm ownership’ it also recognises that GPs’ role in the new assessments may place many in a ‘complex position’.
 
‘We worked closely with WA Police to ensure the voice of general practice was heard, that GP concerns were raised and considered seriously throughout the process of its development,’ she said.
 
‘We are being asked to make clinical judgements about a patient’s physical and mental health, and the potential of risk to themselves or others.
 
‘For GPs already managing heavy workloads, this introduces an additional layer of responsibility – one that might be both clinically, and at times, ethically challenging. The consequences of these judgements can be significant.
 
‘Many GPs feel they are being asked to make decisions that fall outside of the typical scope of practice – particularly when it comes to risk assessment and prediction of future risk.’
 
The examination now comprises of several parts, starting with a self-assessment, to be completed by the applicant/authority holder, which they are then required to take to their GP appointment.
 
The doctor will then review the self-assessment form and conduct a medical assessment. At the conclusion of the appointment, the GP is required to provide the examination result to WA Police.
 
Dr Bahemia noted that GPs are just one part of a broader licencing process and they are not being asked to determine whether someone is granted a firearm licence.
 
‘That responsibility lies solely with the WA police force, who consider a range of information as part of their decision-making process,’ she said.
 
‘The purpose of the health assessment is to provide relevant medical information to assist in that broader context.’
 
While individuals seeking a firearm licence must undergo a FAHA, GPs are not obligated to take part in the process.
 
However, for those that choose to do so, they are free to charge a private fee that reflects the time and responsibility involved as there is no Medicare item for the assessment.
 
Dr Bahemia said while she has yet to receive feedback from the profession since the law was brought into effect last week, she noted that many GPs had already raised concerns during the consultation period.
 
‘Some have indicated they are unlikely to perform the assessments,’ she said.
 
‘Others feel uneasy about making determinations that could have significant consequences for patient relationships and community safety.
 
‘While WA Police has advised GPs are protected from civil or criminal liability should a firearm-related incident occur involving someone they assessed as medically fit, many GPs remain uncertain about their medico-legal position and how this might play out in real-world scenarios.’
 
Meanwhile, the Co-Deputy Chair acknowledged that the law introduces unique challenges for GPs practicing in rural and remote communities, which was a big focus for the college during the Working Group process.
 
‘In these settings, GPs often live and work in close-knit communities,’ Dr Bahemia said.
 
‘The assessments may introduce additional complexities as GPs are not only providing care and performing assessments but also navigating overlapping social and professional relationships
 
‘This dual role can create tensions that require careful judgement, discretion, and support.’
 
However, Dr Bahemia said that there are GPs who see some benefit in being involved in the assessment process, seeing it as an opportunity to engage with patients who otherwise rarely present.
 
‘GPs are already managing increasingly complex care needs and are often the most consistent point of care for patients,’ she said.
 
‘We understand the full context of a patient’s health and history, and we are trusted to make complex, risk-based decisions in many areas of practice.
 
‘For some, the assessment may open the door to important conversations around health, leading to earlier intervention and more preventive care.’
 
Simultaneously, however, Dr Bahemia says many GPs remain concerned that patients may ‘withhold or under report’ mental health concerns, for fear that it could jeopardise their ability to hold a firearms license.
 
‘This has the potential to reduce health-seeking behaviours and work against the broader goals of both public safety and preventive healthcare,’ she said.
 
‘The challenge lies in ensuring that this new responsibility does not undermine the therapeutic relationship we have with our patients, especially in smaller communities, where trust and continuity are essential.’
 
WA is the second state to introduce health assessments for people wishing to possess a firearm, following in the footsteps of New South Wales, which introduced legislation in 2024.
 
Dr Bahemia anticipates other jurisdictions will be closely watching to determine if they take steps in a similar direction.
 
‘If these laws are perceived as effective, they may well be adopted elsewhere,’ she said.
 
‘However, any future implementation must be approached thoughtfully and in close consultation with working GPs, in a respectful and collaborative manner.
 
‘It is particularly important that rural and regional contexts are considered. These settings face unique challenges, including workforce shortages, close knit community dynamics, and limited access to support and mental health services.
 
‘Implementation in these areas must be realistic, well resourced, and sensitive to the pressures GPs already face.
 
‘Clearly defined structures and supports are essential, along with a recognition of the potential strain on general practice.
 
‘Without careful planning, unintended consequences such as strained patient relationships or medical legal concerns could outweigh intended benefits of the policy.’

Last month, the RACGP and WA Police hosted a ‘FAHA: What GPs need to know’ webinar providing more information on the changes, including practical considerations and the role of GPs. A recording of the webinar is available online.
 
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