Gillick Competence?

[MissyB1]

So this is a weird one, and I wasn't expecting to be writing this just yet! I've been trying to get a repeat prescription for my ds eczema, he's 12 years old. The system at our surgery is order online, if it's for your child you add them onto your own online account. However the surgery have informed me that as he is now 12 I can't order his prescriptions for him, they want to seee him to assess him for Gillick competence.

At 12?? is that normal?

Yes

I don't agree this is normal. My surgery havent done this with my children, they simply said that if I wanted to order prescriptions etc then the children would need to agree to me being added to their record.

Frankly I am not sure how you deem a child Gillick competent, it just seems to me that it is assumed their right to see the doctor, get prescriptions without you. I understand the reasons for it however I don't agree with it.

For him to be Gillick competent that would mean I am no longer involved in his healthcare, is that right? To be honest he's a young 12, and would be very nervous about seeing a Dr on his own.

Oh and I tried to get them to set him up his own account for his prescriptions (as they don't want him added to mine), but they said "oh no he needs assessing for Gillick Competence first". Round and round in circles.

I was trying to save wasting an appointment (as they are like gold dust anyway). Sigh.....

It's a bit young. I understood previously, that the Care Quality Commission's general recommendation was that whilst there was no legal lower age limit, under 13s should still largely be supported by parents to make medical decisions.

That being said, Gillick Competence isn't a hard line. Theoretically, children over the age of 13 should slowly start to take greater responsibility over a period of time. Some things they can decide for themselves. For other things, decisions would still be made in conjunction with parents etc. And it should be individually tailored to the child.

You might find that your child still wants you to go with him for a while yet anyway.

From around that age, I accompanied my dcs to the doctors, but the doctor spoke directly to the dc. I was just in the background.

When DS1 had an operation (broken bone) at 14 years, he made the decision whether to have the operation and we both signed the consent form.

That doesn’t sound right to me. They’d have to assess ‘gillick’ competence (now an outdated term by the way) if he wanted to access health care without a parent at this age but not the other way round. Our online prescriptions are set up so I order for everyone (teen and husband as well as me) or nobody sound have any meds ever!!

@northernlightsea that’s what I thought! It seems arse about face to me! He wants me to do it for him, he’s a young 12.

DS13 has a heart condition and meds on two monthly repeat. Last year the GP surgery called to ask me for his mobile number. When I ask why the said so we can arrange his appointments and blood tests with him and send him reminders. For a start, I have to take him too and from appointments at a time I’m not working and I don’t have his three siblings in toe with us.
Secondly, he is good and getting his bloods taken but like me to tell him the day of the appointment as he would get a bit worked up if he knew in advance. Given it’s me that orders and collects his dads heart meds too I think I can continue to do it for my 13 year old.

If he is assessed as competent at this age, he'll take you along anyway!

What absolute bullshit! They are daft.

It sounds as if GP's surgery are going about things in a slightly weird way, don't know if it is a weird policy or a sensible one badly explained...

Parents can still give consent to medical treatment in a young person who is "Gillick competent" ie mature enough to weigh and understand treatment. It's a framework to give an extra "key" to the "lock" of consent if that makes sense? So his having competence in this context wouldn't exclude parents from decision making per se.

I wouldn't consider "Gillick competence" outdated terminology, it appears in current teaching from a variety of expert bodies, within health at least (eg RCPCH).

No, they are wrong

You don't just do an assessment to see if someone is Gillick competent.

If a child tries to access healthcare without a parent/guardian who can consent you would assess at each appointment if they are gillick competent dependent on the situation. They maybe competent to consent to say antihistamines for hay-fever but not for a heart transplant. A child is not gillick competent or not, it is a decision based on each individual situation.

An adult with parental responsibility for that child can override their decision legally. Essentially a child under 16 can consent for treatment but legally would struggle to refuse treatment.

At 12 you are still responsible for his healthcare, you still have ultimate responsibility and will do until he is 16. He is very young to be making decisions about his health

The ideal scenario is that both parent and child are there and both want the same thing. But ultimately you still have responsibility. He is only 12! Gillick competence really only comes into play when theres no adult available to provide consent

In my experience 12 year olds would struggle to make even the most basic decisions about their healthcare without seeking the advise of a trusted adult (usually their parents). The GP surgery are being bizarre

“ It was determined that children under 16 can consent if they have sufficient understanding and intelligence to fully understand what is involved in a proposed treatment, including its purpose, nature, likely effects and risks, chances of success and the availability of other options.”

“ Gillick competence is the principle we use to judge capacity in children to consent to medical treatment.”

Gillick Competency

Gillick Competancy and what it means.

Each person has to be assessed, not assumed to have Gupillick competancy.

Thanks everyone , it does sound as though the surgery are trying to tick boxes rather than think this through.
Ridiculous but because we couldn’t actually manage to book a GP appointment for this until July (!!) we’ve ended up seeing a private dermatologist, just to get a prescription for eczema creams!

Our surgery refuse to do online accounts for children on the grounds that once they reach 13 they are entitled to privacy🙄 but they also won't do them after 13 - you have to wait until 16. Because of this I can't do repeat meds online for my kids, I have to call the pharmacy to order them. Stupid system!