Case Summary - Gillick V West Norfolk And Wisbech AHA [1985] UKHL 7

Facts

Mrs Victoria Gillick was a mother of five daughters. She was concerned about the availability of contraceptive advice and treatment to girls under the age of 16 without parental consent.

She wrote to the West Norfolk and Wisbech Area Health Authority, asking them to stop providing contraceptive advice and treatment to girls under the age of 16 without parental consent.

The health authority refused to do so, and Mrs Gillick took legal action.

Legal principles

A child under 16 can consent to medical treatment if they have sufficient understanding and intelligence to understand fully what is proposed.

When assessing whether a child has the capacity to consent, the doctor must consider the child’s age, maturity, and understanding.

Parents still have a right to be involved in their child's medical care, but their consent is not always necessary.

Doctors should encourage children to discuss their treatment with their parents, but not refuse to treat a child who does not want to involve their parents.

The Fraser Guidelines – named after the presiding judge – set out factors for doctors to consider when deciding whether to give advice about sexual health to a child under 16 without parental consent. These include whether: 

·        the child is mature and intelligent enough to understand the nature and implications of the treatment proposed;

·        it is possible to persuade the child to tell their parents or let the doctor tell them;

·        they are likely to begin or continue having sexual intercourse with or without contraception;

·        their physical or mental health is likely to suffer unless they get the advice or treatment;

·        the advice or treatment is in their best interest.

Decision

The House of Lords held that a child under 16 can consent to medical treatment if they have sufficient understanding and intelligence to understand fully what is proposed.

More recent cases 

Gillick v West Norfolk & Wisbech Area Health Authority has been cited and followed in many subsequent cases, even where the facts differ. Some examples include:

·        Axon, R (on the application of) v Secretary of State for Health & Anor [2006] EWHC 37 (Admin): The court rejected a claim that not granting parents a right to know whether their child had sought an abortion, birth control, or contraception breached Article 8 of the European Convention on Human Rights expressed in UK law as part of the Human Rights Act 1998.

·        Bell and another -v- The Tavistock and Portman NHS Foundation Trust and others [2021] EWCA Civ 1363: This case appealed a previous decision that it was highly unlikely that under-16s would ever be competent to give consent to treatment with puberty blockers and a court decision would be required on every occasion. The appeal was allowed. The Court of Appeal confirmed that it was for clinicians to exercise their judgment on whether the patient’s consent could be properly obtained.

Significance

Gillick v West Norfolk & Wisbech Area Health Authority is a landmark case that has had a significant impact on the law on medical treatment for children. The case has been cited and followed in many subsequent cases, and it remains an important authority on the subject. The case has helped to ensure that children have the right to make their own decisions about their medical care, even if they are under the age of 16.