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Providing Contraception Through School-Based Sexual Health Services

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Most young people under the age of 16 are not having sex and the majority of people - parents, professionals and young people - agree that young people, including those under 16, have a right to confidential advice and treatment as required.

This right to confidentiality is enshrined in case law following the case of Gillick vs West Norfolk and Wisbech AHA & DHSS 1986 in which Ms Gillick took the Health Authority to court for failing to consult with her about providing her daughter with contraception. Lord Justice Fraser who ruled in the case ruled that it is legal for health professionals to provide contraceptive advice and treatment if the young person has sufficient maturity and judgement to enable them fully to understand what is proposed. The case identified the following five expectations of best practice which have come to be known as the Fraser Guidelines:

  • the young person will understand the professional's advice;
  • the young person cannot be persuaded to inform their parents;
  • the young person is likely to begin, or to continue having, sexual intercourse with or without contraceptive treatment;
  • unless the young person receives contraceptive treatment, their physical or mental health, or both, are likely to suffer;
  • the young person's best interests require them to receive contraceptive advice or treatment with or without parental consent.

Evidence shows that high quality sex and relationships education, provided by parents and at school, combined with access to free, confidential sexual health services delays the age young people first have sex and increases the likelihood they will use contraception when they do have sex. Evidence also shows that access to contraception reduces teenage pregnancy - in England our rates are now the lowest they have been for over 40 years.

Contraceptive advice and treatment in schools or Further Education colleges is provided by highly trained health professionals, often with the support of equally skilled youth workers. It is not new for schools or Further Education colleges to provide these services which are developed in consultation with parents, young people and the community. Indeed you can find articles that I have written about this issue earlier this year:

Over many years parents have told me they hope their children won't have sex too early. They also hope that their children will be able to talk to them with any questions about relationships, sex or sexuality. Many of them also say they accept that may not feel possible and that in those circumstances they absolutely want their children to be able to get the help and advice they need from health professionals, especially if the alternative is they are denied the support and information that will help protect them from harm.

We must challenge the myth that health professionals undermine parents wherever we hear it. It has the potential to unfairly and unnecessarily damage the confidence parents have in health professionals.

Over the past almost 50 years since Brook was established we have learnt that the younger someone is that comes to us for advice and treatment the more likely they will be in need of emotional and practical support and advice that goes well beyond the provision of contraception. All of us must be committed to ensuring they get that support. We have also learnt that the individual and personal circumstances of the young person will also determine who they can and feel able to trust.

I, like most sensible adults who work with young people, want them to be safe and happy, and to only have sex when they are able to enjoy and take responsibility for it. Sexual health services and the professionals who work in them tirelessly day in day out are fundamental to achieving that goal. Central to the work they do is ensuring young people understand their rights, the law, the importance of consent, health risks and how to protect against them. If they believe there is a risk of harm or abuse they will ensure that young person is supported appropriately.

Brook's strategy states "children and young people deserve the best support and services so they can take responsibility for and enjoy their relationships, sex and sexual health. We must have high expectations for them so they can set high expectations for themselves."

This isn't the first time that there has been a moral panic about young people under 16 and sex and contraception and I know it won't be the last. All the evidence shows there is a broad consensus in support of sex and relationships education and young people's rights to access confidential advice and treatment in the UK. And it is good to see this reiterated by Dr Dan Poulter, the Health Minister who states unequivocally in The Daily Telegraph that 'young people under the age of 16 are legally able to access contraceptive and sexual health services and any advice given will be kept confidential'.