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Gillick competence

Gillick competence is the test for whether a child under 16 can consent to their own medical treatment.

Updated 12 October 2026 (2 minute read)

Summary

  • It comes from a 1985 House of Lords case, Gillick v West Norfolk and Wisbech Area Health Authority.
  • A child is Gillick competent if they have enough understanding and intelligence to fully understand what is proposed.
  • It is judged decision by decision. A child might be able to consent to a vaccination and not to major surgery.
  • The Fraser guidelines are narrower. They come from the same case and deal with giving contraceptive advice to under 16s.
  • From the age of 16 a young person can consent to their own treatment, and no parent's consent is needed.

In practice

  • The case began with a government circular. In December 1980 the Department of Health and Social Security advised that, in exceptional cases, a doctor could prescribe contraception to a girl under 16 without her parents' consent.
  • Mrs Gillick challenged the circular in court, and the House of Lords gave its ruling on 17 October 1985.
  • The rule for those aged 16 and 17 is in statute. Section 8 of the Family Law Reform Act 1969 covers surgical, medical and dental treatment.

In Hong Kong

  • The Medical Council of Hong Kong's code applies a similar test up to the age of 18. Consent from a child under 18 is valid only if the child can understand the nature and implications of the treatment (section 2.12.1).
  • How much maturity is needed depends on how important and complex the decision is (section 2.12.2).
  • One parent's consent is usually enough. For major or controversial procedures the other parent may need to be consulted, and if the parents cannot agree the doctor should seek legal advice (section 2.12.4).

Interview questions

  • A 14 year old asks for contraception and does not want her parents told. What do you do?
  • What is the difference between Gillick competence and the Fraser guidelines?
  • Can a competent child refuse treatment that would save their life?

Sources

  1. Global Health and Human Rights Databaseglobalhealthrights.org/…/HL-1985-Gillick-v.-West-Norfolk-and-Wisbech-Area-Health-Auth
  2. legislation.gov.uklegislation.gov.uk/…/8
  3. Medical Council of Hong Kongmchk.org.hk/…/Code_of_Professional_Conduct_%28English_Version%29_%28Revise

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Cases that turn on it

Weight loss drugs for children Autonomy Weight loss injections such as Wegovy are licensed in the UK from the age of 12, and drug companies are testing them in children as young as six. On 7 October 2026 the World Health Organization said it does not recommend any obesity medicine for a child under 10. It said too little is known about what the drugs do to a growing body.

More NHS hot topics, medical ethics case studies and medical school interview questions are in AlphaMED Resources, which we add to and update through the application cycle.