Parents could be told to let children see doctor alone

For the first time doctors have been ordered to "respect the rights" of children to make decisions for themselves and refuse treatment if they wish.

Official guidance from the General Medical Council says doctors should treat children confidentially and inform them of their right to a private consultation.

It applies to all 240,000 doctors - not just GPs - and is aimed at improving medical care for children and teenagers.

Researchers for the council found that most children said they were not taken seriously by their doctor. Some GP surgeries also displayed posters saying under-16s could not make appointments without an adult.

Council president Professor Sir Graeme Catto said: "This is the first time the GMC has set standards for doctors specifically about children and young people. It recognises that children are individuals with rights that should be respected."

Luziane Tchiegue-Nouta, 16, Lewisham's acting Young Mayor - elected by 11- to 18-year-olds to represent them in the borough - said: "Young people need to know they can see their doctor in confidence. It is important that they are treated as patients in their own right."

The GMC guidelines cover advice on sex, abortion and contraception for under-16s, as well as child protection.

They say doctors can legally offer advice to under-age girls about sex as long as five key tests are met - one of which is that they cannot be persuaded to tell their parents. Doctors who object should refer the patient to a colleague. The document tells doctors "usually" to share information about under-13s having sex, as they are under the age of consent, and to inform authorities about fears of abuse.

The key instructions are:

Involve children and young people in discussions about treatment and take views seriously.

Give them respect and treat confidences in the same way as with adults.

Share information only in the "best interests" of a child.

It means children of any age would be allowed to refuse treatment if the doctor judged them capable of making their own decisions.

The document states: "Parents cannot override the competent consent of a young person to treatment that you the doctor consider is in their best interests. But you can rely on parental consent when a child lacks the capacity to consent."

Michael Keegan, ethics policy adviser for the council, said: "This is about involving children and engaging with them directly. There is clear harm in overriding anybody's autonomy. What doctors need to do is communicate properly with young people.

"Sometimes that might mean asking the parent to step out of the room for a moment if the conversation is being inhibited, but more often it is going to mean making sure doctors are making eye contact with children and engaging them about their own treatment."

Mr Keegan acknowledged that parents could be concerned but said doctors needed to make sure children's views were being heard.

The guidance, which applies to 14 million under-18s, was drawn up after a three-month consultation with more than 800 people, including children.