NHS Isle of Wight has hit the headlines with the launch of a new scheme enabling teenage girls as young as 13 to receive the contraceptive pill without their parents’ knowledge. Opponents have described the scheme as “irresponsible”, “a licence to have sex” or even, according to the local parish priest, “depraved” and an encouragement of promiscuity. In this article we look at what the scheme entails and the legal principles involved.
The backdrop to the scheme is the fact that Britain has the highest teenage pregnancy rates in Europe. In 2008, 60 out of 1,000 girls aged between 15 and 19 fell pregnant in England and Wales. The fi gure was 7.8 out of every 1,000 for 13 to 15 year olds. Labour’s target of halving the number of teenage pregnancies by 2010 is widely expected to be missed. The issue would not appear to be a priority for the Coalition Government – the Teenage Pregnancy Independent Advisory Group is one of the arms length bodies being axed following the Government’s spending review.
The pilot scheme on the Isle of Wight is targeted at girls requesting the morning after pill from a chemist. Under the scheme the pharmacist (who will have received specifi c training) will offer the girl a consultation in a private room. At this consultation advice will be given on contraception and on sexually transmitted infections and a referral will be made to the local sexual health service. The pharmacist will be able to provide the girl with a month’s supply of the contraceptive pill.
The current legislation requires women to visit their GP for a thorough consultation before they can obtain a supply of the pill. Under the pilot scheme, 10 pharmacies will provide the pill without the need for a doctor’s prescription. This pilot follows on from an existing pilot in Southwark and Lambeth, which allows women aged over 16 years to obtain the pill from select pharmacies without a prescription. NHS Isle of Wight’s pilot goes further, providing the pill to girls under the legal age of consent.
The setting up of the scheme has sharply divided public opinion.
On one side of the debate, there is dismay that parents have no involvement or even knowledge that their daughter has been given the pill. This is taken as a fundamental attack on the family. There is also concern that the girls are not seen by a doctor and there is no medical examination before they are given the contraceptive pill. Many regard the scheme as an encouragement of underage sex.
Jennifer Smith, Director of Public Health at NHS Isle of Wight, has defended the scheme:
“The main aim is to safeguard vulnerable young people who in some circumstances fi nd it diffi cult to speak to their parents about these important issues. However, all professionals who come into contact with vulnerable young people seek to encourage the involvement of a parent or other responsible adult”.
The law covering the treatment of young people and their right to confi dentiality was largely set by the leading case of Gillick, heard by the House of Lords in 1985. Mrs Gillick sought an assurance that no contraceptive advice or treatment would be given to any of her daughters whilst under the age of 16 years without her knowledge and consent. The House of Lords refused to give this and held that girls under the age of 16 years have the legal capacity to consent to medical treatment, including contraceptive treatment, if they have suffi cient maturity to understand the nature and implications of the proposed treatment.
The issue was raised again in 2006 in a case brought by Sue Axon. Ms Axon contended that a parent’s responsibility for the welfare of a child under the age of 16 gave the parent a fundamental right to be informed when the child sought advice or treatment on sexual matters. Ms Axon lost her case – a parent’s right to participate in a child’s decision making exists only while the child is so immature that the right of control remains with the parents.
The courts have been concerned to ensure that young people will feel able to seek medical treatment and advice without the fear that their parents will be told. This has been their overriding consideration and the pilot scheme launched by NHS Isle of Wight is fully in tune with that.