Over the last two months we have witnessed an explosion of headlines in the national press around the issues of underage sex, teenage pregnancy and the availability of confidential sexual health advice and treatment for children and young people.

May kicked off with reports of children as young as 10 being prescribed the Pill by GPs and family planning clinics, and of a mother planning to take her daughters' school to court over its decision to make the morning after pill available to underage girls without parental consent.

The month ended with coverage of the now infamous Atkins sisters, who have each had a child while still at school (see picture) and whose mother blames their schools for failing to provide adequate sex education early enough.

And in June, media interest moved on to concerns about the explicit descriptions of oral and anal sex in the latest leaflet for young people from sexual health charity fpa.

All of these examples demonstrate both the complexity of the issue of educating children and young people about sex and relationships, and the ongoing uncertainty about who is ultimately responsible for delivering this education - not to mention how and when.

Since the Social Exclusion Unit flagged up the UK's position in 1999 as the teenage pregnancy capital of Western Europe, the issues of sex education and teenage pregnancy have become top priorities for the government.

Among other things, it has set itself a target of halving the under-18 conception rate by 2010, launched a national teenage pregnancy strategy setting out how to achieve this, and set up independent advisory groups on teenage pregnancy and on sexual health and HIV.

It has also issued updated guidance on sexual health services and confidentiality for professionals working with children and young people, backed various initiatives to help parents talk to their children, and updated guidance on delivering sex and relationship education (SRE) in schools.

However, contrary to advice from the advisory groups, the House of Commons health select committee, professional bodies, and sexual health charities, the government has repeatedly refused to make the one move which many believe could make the biggest difference: making personal, health and social education (PHSE) - including SRE - compulsory under the national curriculum.

Under existing arrangements, the only elements of sex education that are compulsory are the biological aspects of human growth and reproduction covered under national curriculum science. At secondary school level, schools must also offer education about HIV and Aids, and other sexually transmitted diseases. In addition, schools are required to contribute to the personal and social development of their pupils.

Beyond that, headteachers and school governors are obliged to do no more than "have regard" to government guidance when developing their SRE policies, and make sure any sex education they do provide is embedded in PSHE "to ensure that pupils consider the moral aspects of sex education and are encouraged to develop loving and caring relationships".

But embedded or not, with PSHE remaining outside the national curriculum, SRE is rarely going to top the average school's agenda. Indeed research published in January by the schools inspection body Ofsted reveals that some schools still do not provide PHSE "in any form".

The introduction of citizenship as a national curriculum subject in 2002 has also put PSHE programmes including SRE under serious pressure in half of schools. "This has had an immediate and negative impact on the provision of PSHE in these schools, which have had to cut back on their core material," Ofsted warns.

The report, based on evidence gathered from 160 schools across the county, adds that the teaching of PSHE continues to be hindered by the failure to recruit teachers with directly relevant subject qualifications. As a result, although many schools have tried to develop specialist teams of teachers through extra training, in many others PSHE is still taught by inadequately trained form tutors.

To try to address this problem, the government has developed a certification programme for teachers of PSHE, including a specialist module for SRE. It wants to see at least one teacher in each secondary school complete the training - but has no deadlines for this or plans to make the programme compulsory.

But sex and relationship education does not start and end at the school gate. As children's minister Beverley Hughes insisted recently after Julie Atkins pointed the finger of blame at her daughters' schools, parents must do their bit too.

But many parents are not - or, at least, do not think they are - up to the job. In 2002/3, over 4,000 parents called the charity Parentline Plus with concerns about their children's sexual behaviour and relationships. Analysis of the calls reveals that parents are desperate for support and help in how to talk to their children and tackle this behaviour and its consequences. They also have little understanding of what is being taught to their children in SRE in school.

Helping parents talk to their children has been a key strand of the teenage pregnancy strategy from the outset, as has encouraging parental involvement in the development of schools' SRE policies.

The Teenage Pregnancy Unit continues to support Parentline Plus to implement the Time to Talk initiative aimed at helping parents develop confidence and skills in talking to their children about sex and relationships. And the fpa's Speakeasy community-based education project has received funding from the Parenting Fund to train children's centre and Sure Start workers so they can deliver the programme to local parents.

"Fundamentally, we know that not all parents feel able to talk to their children - they also feel they do not know enough as they didn't get good sex education themselves," explains Brook chief executive Jan Barlow.

"Comprehensive sex and relationships education helps young people delay having sex and makes them more likely to use contraception when they do become sexually active. Leaving it just to parents means you could have some children falling through the net.

"If we were to make PHSE including SRE compulsory, we would at least know there would be some consistency."

More information from:
www.dfes.gov.uk/teenagepregnancy 
www.brook.org.uk 
www.fpa.org.uk 

The facts:

* In 1998, there were over 100,000 conceptions a year to teenagers in England, of which 8,000 were to girls under 16.
* Under-18 conception rates fell by 9.8% between 1998 and 2003. The government target is a 50% reduction by 2010.
* 2004 conception data is not expected before February 2006, but the Department for Education and Skills predicts the figures will not be sufficient to meet the interim target of reducing teenage conception rates by 15% by 2004.
* 50% of under-18 conceptions occur in 20% of wards with the highest rates. These neighbourhoods have now become the subject of a new teenage pregnancy "hotspots" strategy.
* Under-16s accounted for 3967 legal abortions in England and Wales 2003.
* New episodes of chlamydia in under-16s rose from 787 in England, Wales and Northern Ireland in 1999 to 1426 in 2003.
* A recent survey of 1,300 young people aged between 16 and 18 found that just over half thought chlamydia only affected women, and almost a third thought STIs could be caught from a toilet seat.
* Around 500 teachers completed the PHSE certificate when it was rolled out nationally in 2003/4. In 2004/5, approximately 2,000 teachers embarked on the course, and funding for a similar number is available this year.
* 325 nurses participated in the certification programme for nurses working in schools in 2004/5. Funding is available for up to 800 nurses to participate in 2005/6.