Brook's position on under sixteens

Brook believes that young people need access to impartial and confidential information and advice in order to help them make informed choices about their sexual health.

We do not have a lower age limit. The younger the age of the client at the time they present at Brook the more likely they are to need advice, information and support.

Brook operates within the Department of Health's best practice guidance for health professionals on contraceptive and sexual health advice for young people under 16.

Brook has pioneered work to ensure that under 16s are seen in confidence not just by providing services ourselves but by forming coalitions with other professional organisations to produce guidance and training manuals for professionals and leaflets to raise awareness amongst young people. It is vital we continue to advocate for the confidentiality of young people's services and to ensure that young people understand that they are entitled to a confidential consultation.

We need to improve young people's knowledge and confidence in contraception and make access to advice as easy as possible if we are to improve young people's sexual health.

The legal situation

Young people under the age of 16 can consent to medical treatment if they have sufficient maturity and judgement to enable them fully to understand what is proposed. This was clarified in England and Wales by the House of Lords in the case of Gillick vs West Norfolk and Wisbech AHA & DHSS in 1985. Similar provision is made in Scotland by The Age of Legal Capacity (Scotland) Act 1991. In Northern Ireland, although separate legislation applies, the then Department of Health and Social Services Northern Ireland stated that there was no reason to suppose that the decision in the Gillick case would not be followed by the Northern Ireland Courts.

Although it is an offence for a man to have sex with a girl under 16 (17 in Northern Ireland) it is lawful for doctors to provide contraceptive advice and treatment without parental consent providing certain criteria are met. These criteria were laid down by Lord Fraser in the Gillick vs West Norfolk and Wisbech AHA & DHSS case and require the professional to be satisfied that:

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

The duty of confidentiality towards under 16s is as great as for any other patient. If someone under 16 is not judged mature enough to consent to treatment the consultation can still remain confidential.

Background information

Nationally, 26% of women and 30% of men aged 16-19 report having had sexual intercourse before the age of 16.[1]

The Department of Health estimates that around 9% of 13-15 year olds in England attend family planning or Brook Centres.[2]

Over 17,000 young people under 16 used Brook Centres in 2004/05 and this age group now constitutes 17% of all clients.

18% of boys and 22% of girls who had first intercourse at 13 or 14 and 10% of young people who had first sex aged 15 did not use contraception. [3]

25% of women under 16 at the time of first intercourse did not attend services because of worries about confidentiality compared with 12% of over 16s. [4] In a Brook survey in 2005 74% of respondents under the age of 16 said they would be deterred from seeking advice if health workers had to pass on details of sexually active young people to social workers.

In England 8,076 under 16s became pregnant in 2003; a rate of 8 per 1000 13-15 year olds. Around 4,600 (57%) had terminations. [5]

In Scotland 694 under 16s became pregnant in 2002; a rate of 7.4 per 1000 13-15 year olds. 399 (57%) had terminations.[6]

In Jersey the conception rate per thousand girls aged 15 was 9.9 in 2003.

During 2004, 2% of chlamydia cases and 3% of gonorrhoea cases diagnosed at GUM clinics were in girls under 16.[7]

Brook provides free and confidential sexual health services and advice for young people under 25. Brook is a registered charity number 239966.