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Minimum age to register independently with GP

Can you tell me what the regulations are relating to how old a patient has to be before they can register without the consent of a parent or guardian?

There appears to be no definitive answer to this question. The Terms of Service 6(1) set out that 'a doctor may agree to accept a person on his list if the person is eligible to be accepted by him'.

The BMA expressed the view that over the age of 16 a young person may register independently, but that under 16 it is a matter of judgment on the part of the doctor.

BMA guidance on confidentiality and people under 16 provides ethical advice on confidentiality in treating young people under 16. The following points have been extracted from that guidance and would seem to be relevant to your question.

lAny competent young person, regardless of age, can independently seek medical advice and give valid consent to medical treatment.

lParental consent to that treatment is not necessary.

lIt is obviously preferable for young people to have their parents' support for important and potentially life-changing decisions. Often, however, young patients do not wish parents to be informed of a medical consultation or its outcome and the doctor should not override the patient's views.

lEstablishing a trusting relationship between the patient and doctor at this stage will do more to promote health than if doctors refuse to see young patients without involving parents.

People under 16 are legally able to consent on their own behalf to any surgical, medical or dental procedure or treatment if, in the doctor's opinion, they are capable of understanding the nature and possible consequences of the procedure. Clearly, the more serious the medical procedure proposed, a correspondingly better grasp of the implications is required.

Few patients are aware that they have the option of registering with another GP for contraceptive services only.

It seems probable, therefore, that you may accept a young patient below the age of 16 on your list, provided you believe the person to be competent to make that decision. You must, however, be mindful of all the ethical guidance in relation to treating young people under 16.

You should also be aware that a young person registering without parental consent or knowledge may well be at risk. However, he or she would probably be at much greater risk if you refused to offer medical services when the relationship with the parent or guardian had completely broken down.

Dr Christine Dewbury, Wessex LMCs

Neither Pulse nor Wessex LMCs can accept any legal liability in respect of the answers given. Readers should seek independent advice before acting on the information concerned.

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