The Minster Practice, Lichfield

Gillick competence test

This identifies children under 16 who have the legal capacity to consent to medical examination and treatment providing they can demonstrate sufficient maturity and intelligence to understand and appraise the nature and implications of the proposed treatment, including the risks and alternative courses of actions.
This test is also used to assess whether sexual health advice and intervention can be given to a child under age 16. However, the situation is becoming less clear after the Bichard inquiry (se below).

Risk checklist in sexual health in addition to Gillick competence test

• Age of the child
• Level of maturity and understanding of the child
• Whether there is a big age gap between the child and sexual partner
• Evidence of coercion, aggression or bribery of the child
• Knowledge of child sex offences within the child’s family
• Whether the child is anxious or withdrawn
• Whether drug use is affecting child’s ability to give consent
• Evidence of excessive secrecy beyond levels normal in a teenage relationship
• Child denies or minimises concerns
• Whether child’s sexual partner uses grooming methods
• If partner is know to police or other agency

After the Bichard inquiry into the Soham child murders, draft proposals were drawn up to ensure that health professionals were subject to rules requiring mandatory reporting to the police of under age sex regardless of the age of the participants. This was in conflict with existing guidelines enforcing a duty of confidentiality even to under-16s after the House of Lords Gillick judgment (see above) and the assessment of maturity it required. The latest proposals for 13-15 year olds will require us to consult a child protection expert within the PCT. The Children’s Commissioner for England will monitor the working of these proposals to ensure that young people still felt confident in accessing contraceptive and other sexual health services.

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