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GPs putting up obstacles to under-16s' contraception

The failure of many practices to offer confidential contraceptive services to under-16s has been highlighted as a cause for concern by Government advisers on teenage pregnancy.

The report by the independent advisory group on teenage pregnancy, published last week, highlighted obstacles revealed by an audit of 4,020 practices in England.

This uncovered gaps in GPs' understanding of Gillick competence and the widespread failure of practices to ensure under-16s were aware of their right to confidentiality.

It also revealed that more than a quarter of practices had at least one partner who was a conscientious objector to abortion and one in 10 practices did not offer referral for NHS abortion (see box).

The advisory group said it was encouraging that GPs expressed enthusiasm to improve their care of teenagers.

Some 60 per cent of practices wanted a seminar to explain the law on confidentiality and 75 per cent wanted training on working with young people.

Dr Alison Oxby, a GP in Morpeth, Northumberland, and a member of the advisory group, said: 'Sadly there are still GPs who won't offer the minimum of an assessment of Gillick competence as they are either ill-informed or don't care.'

Under the Lords' ruling in the Gillick case, a child is competent to take health care decisions without parental approval provided he or she has 'sufficient understanding and intelligence to understand fully what is proposed'.

The Department of Health advises GPs that a request from a child under 16 to keep treatment confidential should be respected unless there are reasonable grounds to suggest the child is likely to suffer significant harm as a result.

The group's report also

attacked the new GMS contract, claiming:

lit failed to reflect GPs' obligations to provide services

under the national sexual health and HIV strategy

lthe Carr-Hill formula for allocating funds is weighted in favour of elderly patients, leaving practices with insufficient cash for teenage care.

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