Policy responses and statements

Name of organisation:

General Medical Council

Name of policy document:

Children and Young People: Doctors' Roles and Responsibilities

Deadline for response:

23 February 2007

Background: Previously, the GMC's guidance has only referred to children and young people where the position is different to those of adults, for example in relation to consent. The Children Act 2004 creates an obligation on healthcare providers to safeguard and promote the health and well being of children and young people, that is, to do more than merely protect them from serious harm or treat illness. The guiding principles behind the changes in the law are in the UN Convention on the Rights of the Child and the report of the Laming Inquiry into the death of Victoria Climbie.

The Standards and Ethics Committee of the GMC felt that all doctors should be aware of their role and responsibilities towards children and young people, and that it was no longer adequate to just highlight where the law was different for children and young people.

The GMC also recognises the important role that doctors play in child protection. They are often in a position to notice or are told things that other professionals are not aware of. It is important that all doctors are aware of their role in and responsibilities for child protection and have helpful guidance on how to safeguard the welfare of children and young people.

The Standards and Ethics Committee decided, therefore, that in addition to the new duties included in the revised Good Medical Practice, new guidance should be prepared that deals solely with issues as they relate to children and young people. A working group comprising lay and medical GMC Council members and representatives from social care, nursing, teaching and the relevant medical specialties from across the four home countries have now developed draft guidance. It is based on the principles and issues of concern identified through discussion with the children's commissioners, other key stakeholders and children and young people themselves.

COMMENTS ON
GENERAL MEDICAL COUNCIL
CHILDREN AND YOUNG PEOPLE: DOCTORS' ROLES AND RESPONSIBILITIES

The Royal College of Physicians of Edinburgh is pleased to have the opportunity to respond to the General Medical Council on its consultation on Children and Young People: Doctors' Roles and Responsibilities. This response is a collation of views received on this issue.

In general terms, we find this an excellent document which is well written and comprehensive. We particularly commend the clarity with which the subject is approached in respect of the different legal frameworks within the United Kingdom. Guidance is not over-proscriptive and is based on common sense as well as relevant legislation.

In respect of more specific points, we offer the following comments which we feel might benefit the document:

1. In terms of presentation, it would be useful to highlight the underlying principles (as set out, for instance, in the Introductory paragraph) with a series of bullet points for clarity and emphasis.

2. The seriousness of the guidance varies, although the term “should” is used throughout being equally applied to issues which might be interpreted as a courtesy and others which represent legal requirements or defensible documentation. Perhaps textual changes might be used to emphasise the latter.

3. Whilst guidance is promised in balancing competing interests, what the document actually does is to identify these and then suggest a proportionality test.

4. In Section 10, in respect of ‘best interests’, advice seems rather open-ended particularly since they are more specifically identified in later sections (eg Sections 31, 33 or 57).

5. In Section 12 (availability to see children and young people on their own), there should be a rider in respect of appropriate chaperoning.

6. In Section 16, reference is made to provision of information that could cause serious harm but, similarly, there will be circumstances where a lack of information has the same result. An illustrative example might help.

7. The statement in paragraph 35 could perhaps usefully be amplified. This has been challenged by the new European legislation on licensing of medications to be used in children so that, whilst this sentiment is current practice, it may need reviewing in the near future.

8. In Section 42, there is some text missing in our copy of the document such that subsections a. and b. were not included.

9. With respect to confidentiality, Section 49 advises that a record should be made, and we feel that it should also be specifically recorded when a decision is made to withhold information. In the following Section 50, we find it difficult to identify this reference and an example would be helpful.

Copies of this response are available from:

Lesley Lockhart,
Royal College of Physicians of Edinburgh,
9 Queen Street,
Edinburgh,
EH2 1JQ.

Tel: 0131 225 7324 ext 608
Fax: 0131 220 3939

[19 February 2007]