Doctors ordered to respect confidence of girls seeking Pill: GPs place jobs on line if they breach trust of under-16s

ALL FAMILY doctors are being told that they must respect absolutely the confidentiality of girls under 16 - the legal age of consent - who come to their surgeries seeking the Pill or other advice about contraceptives.

The new statement emphasises that doctors do not need parents' consent. They will put their jobs on the line and may have to answer to the General Medical Council if they break this ethical code and tell a girl's parents.

The move comes eight years after the House of Lords ruled that under-16s who can fully understand what a doctor proposes, and its implications, are competent to consent to treatment. Yesterday, a coalition led by the British Medical Association issued guidelines to doctors stating unequivocally their legal position.

The Lords' decision in October 1985 followed protracted legal argument in which Victoria Gillick had maintained that parental consent must first be obtained. Mrs Gillick lost the case but the confusion remained.

'The evidence shows that concerns over confidentiality are one of the main things that prevent a young person seeking advice. We are making it very clear that confidentiality must be recognised as a fundamental aspect of the doctor-patient relationship, if we are to develop trust,' Dr Fleur Fisher, head of the ethics, science and information division of the BMA, said yesterday.

It was estimated in 1991 that 52,000 15-year-old girls were sexually active; of these, only 18,000 went to family planning clinics and only some of the rest saw a GP. In 1990 in England and Wales, approximately 1 in 100 girls aged 13 to 15 got pregnant.

Dr Fay Hutchinson, medical spokeswoman of Brook Advisory Centres, which specialise in contraceptive services for young people, said that the UK had the worst record in western Europe for teenage conception, and a rate seven times higher than in the Netherlands, where advice was easily available.

'Confidentiality is the prime issue. They want to be assured that no one is going to tell anyone. It is not unusual for them to say at the end of a consulation, when trust has been built up: 'that was not my real name or my real address'. Without this trust, they are not prepared to talk about their life as it really is,' she said. Seventy per cent of girls under 16 were not prepared to go to GPs. The guidelines have been produced by the BMA, the Royal College of General Practitioners, the Family Planning Association (FPA), the Brook Advisory Centres and the Health Education Authority.

Doreen Massey, director of the FPA, said: 'The majority of pregnancies among the young are unplanned, contraceptive use is low and there is little knowledge of emergency contraception. Our surveys have shown that almost half of GPs think it is illegal to prescribe contraceptives to under-16s, and 40 per cent believe that parents should be told.'

The Government's White Paper, Health of the Nation, has a target of reducing by half the number of pregnancies in under-16s by 2000. Last night, Tom Sackville, the junior health minister, welcomed the guidance, which, he said, should 'do much to remove the confusion'.

Nuala Scarisbrick, a trustee of Life, the anti-abortion group, said: 'It seems an odd situation that parents are deliberately excluded from these decisions. The Pill has long-term effects on women's health and there must be a question mark about putting young girls on the Pill.'

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