Medical Declarations

Adult Staff
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Ok - seeing as my other can of worms has kept many of us on here busy this morning… let’s try a different one…

Medical Declarations…

I came across a situation once where I was asked by a cadet whether they had to declare their contraceptive implant.

I was somewhat taken aback - nothing in AVIP on this one!

I thanked the cadet for trusting me / confiding etc - and said I’d find out - without disclosing their identity… but was confident that it was nobody’s business but theirs!

Asking around I got a range of answers - the loudest person making a point of stating “ALL MEDICAL CONDITIONS MUST BE DISCLOSED - INCLUDING ALL PRESCRIBED MEDITATIONS”.

An immediate response of “contraception” is not classified as a medical condition… was met by “it may not be, but the risk of stroke is!”

This then triggered a search for a better answer, as I was asked to find something more iron clad…

Again, going up the CoC the answers varied… but essentially came back to “we need to be able to provide as much medical information as possible, if we send a cadet in an ambulance etc”

Going outside of the organisation, I asked a close friend who at the time was a senior A&E clinician - they were horrified by the response on the basis that it is extremely invasive.

It then led to comments along the lines of “patients with protected treatments - such as HIV, Hep, Gender Reassignment, as well as young people who have been prescribed contraception for either therapeutic or non-therapeutic reasons - whether or not their parents know…!”

In other words - when parents do not have the right to be told that their children are being prescribed contraception, then as an organisation RAFAC certainly doesn’t have the authority to demand to know…

Ok - so can of worms, all over the floor…,

If only it stopped there…

I was then made aware that the LOUD person I mentioned earlier had made a point of addressing an assembled group of male and female cadets - reminding them that TG forms had to be filled in accurately and fully - including details of any contraceptives…!!!

I just about exploded and challenged them on what was an egregious over reach and breach of privacy.

The individual stated “it’s fine, either they disclose or they don’t, but, if we discover they ar staking medication that we don’t know about, it will be confiscated and they risk not being able to attend future activities…

Eventually I took what I found to HQAC - to be told yes RAFAC were looking into it - but given the complexity of the situation, they didn’t have an answer at that time.

That was 2019.

Has anyone heard anything since…,?

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I don’t have an answer, but I’d love to see him try and confiscate a contraceptive implant.

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The way I see it, it’s up to them / their parents what they disclose. They’ve been given the forms and the opportunity. Should the worst happen and they need to go to hospital, we hand those forms over and the hospital takes it from there.

That’s the beginning, middle and end of our involvement.

Any throbber who thinks they can demand more is welcome to try, but they’ll get treated in the manner they deserve.

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Following on from that…

What do you do now that SMS indicates they have a medical condition (and thus you would expect a TG23) but the cadet indicates 0 health issues on their TG21?

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Coincidentally, I’ve just come across this situation and am debating what to do…

I’m leaning towards leaving it - they’ve decided not to declare the condition.

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The legality, or moral righteousness of confiscating someone’s prescription medication. I think the big issue here is with the idiot with the big mouth!!

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I wish you were there at the time!!!

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Going to be interesting to find out how they would confiscate an implant?

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Just made the same comment, very interesting.

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In the UK, all the A/E need is access to patients name and address and medical records can generally be accessed if their local hospital/GP is paperless, otherwise the parents can give details. Hospitals will treat what they are presented with systematically.

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According to the rules

TG21 must be signed by a parent or guardian for under 18s, including a statement of ho many TG23s have been competed…

But - a TG23 can be submitted by a cadet aged over 16.

Cadet under 16 requires a parent or guardian to sign it.

Personally, I can’t think of many under 16s that would be “happy” about disclosing contraception to their parents - let alone staff!

Similarly, laws specifically cover disclosing HIV/Hep status - and the fact that no one can demand to know!

As for the LOUD person - I am confident that they were genuinely coming from a position of “wanting to provide the best possible care, on the event of a serious problem - and handing over as full a patient history as they can”.

I must stress that I have no reason to question their motives - but… now this was the scary point… this subject came up again when drinking with friends (no idea how!).
We were joined by a friend who is a copper.

The matter of disclosing contraception prompted a disturbing comment - among new red flag warning signs, identified as a result of Operation Yew Tree - suspects were found to have targeted girls that were on the pill… because it meant there was no chance that their victim became pregnant / indelible proof!

Again - I restate my confidence in the individual, but I did pass on this comment to my CO at the time, the individual concerned and to the Officer at HQAC I had originally addressed my concerns to.

For what it’s worth - HQAC did agree that contraception was definitely NOT required to be disclosed.

My concern is more targeted at the lack of information given to staff as to what should / shouldn’t be disclosed - and the confusion caused.

I believe at some point medical info was meant to be a feature on CP…

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Confiscate that medication and something happens, remembering all medications have a half life which beyond a certain point the level in the bloodstream is ineffective in treating the condition for which it is prescribed then your outlook could potentially be through a set of bars.

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Maybe each member of staff and cadets should be encouraged to buy these, which give all their data including medication and contact details etc. No passwords, plugs straight into a computer. At home, you just load it from your own pc and the advantage it’s not on a password protect phone which can also run out of power, break etc. If out on exercise hike etc, it’s just dropped into the bottom of a rucksack in a plastic bag.

I’ve had one for years as until recently I did a lot of international travel, one in the bag one on the key ring.

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It’s a much better way of doing things. I’ve had a fair few A&E visits with cadets in my time, and not once have the hospital taken the TG forms when proffered…

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The advantage is that the parents can load the device with all sorts of information.

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Good to see this being used 100% correctly.

Paracetamol endorses this message.

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But - it wouldn’t necessarily cover medications that the young person was taking - that parents weren’t aware of.

As mentioned above - paramedics, clinicians etc will deal with any unfolding emergency in front of them, based on their years of training and experience.

Providing a clutch of TG forms was regarded as a double edged sword - on the one hand, a potentially useful stating point of clues - but according or friends, just as possible to create red herrings.

Between accidental and intentional omission of conditions / illnesses, to cadets forgetting of / when they took their meds…

The Dudley’s would have you believe that you’re required to document everything from worms to cancer!

Because there was such confusion over whether or not something potentially as “common” as female contraception, perfectly illustrates the need for proper guidance.

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Indeed and if a child is deemed ‘Gillick competent’ they don’t have to be told which leaves the organisation in a very difficult situation. There is no easy answer to the problem. Maybe in such a situation a sealed envelope is given to the staff which has been signed across the flap and a second one from a GP or even consultant just stating that in their opinion a cadet is able to participate in a list of activities only without stating the reason or medical condition.

As regarding remembering or not taking medication I’ve come across this with someone who is now a friend but actually worked for me who was a type 1 diabetic, a qualified nurse but relatively newly qualified who should know better who wasn’t managing her Diabetes properly when she spoke to me. Laid it on the line and was also very sympathetic to her what the risks were, straightened herself out and is now a mum of two. Teens go through those rebellious phases in particular when they have chronic diseases such as diabetes and don’t take medication or do what they should be doing.

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Thank you for remembering the case name! I couldn’t get Garlic out of my head - and I knew this wasn’t correct… funny, but not correct.

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I ask if they have forgotten to bring a form, if they say no then that’s fine.