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Parental Responsibility

A recent safeguarding Serious Case Review (SCR Family V, published on the Lincolnshire LSCB website) highlighted the importance of knowing who has parental responsibility for a child. In this case, a man had repeatedly taken a child to multiple medical appointments, and the child had received treatment, despite the fact that the man did not have parental responsibility for the child. The consultations, examinations, and treatments given, had, therefore, been administered without consent. This by definition constitutes assault. The SCR urged greater professional curiosity and that parental responsibility should not have been assumed.

In another similar case, a grandparent attended for a child to be given an immunisation. The child received the immunisation, but later the mother, who had parental responsibility, complained that the child had been assaulted, as she had not consented for the immunisation, and did not want the child to be immunised. The practice left itself open to claims in the civil court (for damages), criminal court (for assault) as well as a charge of professional misconduct.

These two cases illustrate the importance of identifying who has parental responsibility, and making sure that there is consent in place when examining and treating children.

What is parental responsibility?

Parental responsibility means the legal rights, duties, powers, responsibilities and authority a parent has for a child and the child’s property. A person who has parental responsibility for a child has the right to make decisions about their care and upbringing. Important decisions in a child’s life must be agreed with anyone else who has parental responsibility.

Who has parental responsibility?

The following people automatically have parental responsibility:

All birth mothers

Fathers married to the mother at the time the child was born

Fathers who are not married to the mother, but are registered on the child’s birth certificate. The registration or re-registration must have taken place after December 2003

Civil partners and partners of mothers registered as the child’s legal parent on the birth certificate.

The following people can get parental responsibility:

Biological fathers

If a father isn’t married to the mother, and isn’t registered on a child’s birth certificate, he won’t automatically have parental responsibility. If he is registered on the birth certificate, but it happened before December 2003, he will also not automatically have parental responsibility. Biological fathers can get parental responsibility by-

Re-registering the birth of the child

Making a parental responsibility agreement with the mother

Applying to the court for a parental responsibility order

A child arrangements order is in place, with the father named as the person the child lives with

Marrying the mother

Married and civil partnered step-parents

A step-parent will not automatically get parental responsibility for a child if they marry or enter into a civil partner-ship with a child’s parent. A step-parent means a person is married to or in a civil partnership with a child’s parent; it does not include couples who are cohabiting. A step-parent can get parental responsibility by-

Making a parental responsibility agreement

Applying to the court for a parental responsibility order

Other carers who are not parents

It is possible for other people who aren’t a child’s parent or step-parent to obtain parental responsibility in certain situations. Other people such as grandparents, family members or other carers may get parental responsibility by:

Securing a child arrangements order which names them as the person the child lives

Being appointed as a guardian

Being a special

Adoption

More information about parental responsibility can be found at http://www.gingerbread.org.uk/factsheet/19/Parental-responsibility-

Parental responsibility and general practice

When treating all patients it is essential that GPs and other clinicians ensure that they have consent to treat. To ensure that this happens when treating children we must gain consent from the person with parental responsibil-ity, and ideally the child as well. Thus, the LMC recommends that clinicians always check that the person accompa-nying a child has parental responsibility, and to record this in the medical record. For instance a note to say "seen with (enter name) who has parental responsibility" would be suitable. It would also be appropriate to record pa-rental relationships in the patient’s record in the relationships section.

If a person who does not have parental responsibility attends with a child, the LMC would recommend that the cli-nician seeks consent from the parent before treating the child. If this scenario happens regularly, the parent could write a letter to the practice giving permission for the child to be treated when attending with the named person.

It may also be prudent to ask who has parental responsibility for a child at the time of joining a GP practice – this could be easily incorporated into the new patient registration form. This is also an ideal opportunity to gain con-sent from parents to allow grandparents or other named carers to attend with the children.

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