I have been asked to provide a comment on the nearly completed case of the GMC v Dr H Webberley. The Tribunal hearing is being held at the Medical Practitioners Tribunal Service (MPTS).
Firstly, this blog is an opinion on matters as they proceed, and I have no part in the case. I am merely viewing aspects from the outside, like many others. I am preparing this in a non-professional capacity, but I do have some experience at giving expert evidence at tribunal over many years.
I am getting updates from ‘live Tweets’ from the hearing provided from the Tribunal service and will see if I can get a press update as well. I am also thankful to @truesolicitor and others for their updates on this case. We are aware of other live feeds but are also aware that these are not as accurate and the reporting is, let’s say, skewed. ‘live tweets’ are taken from them being in the room and hearing and seeing proceedings. Apart from being there, it’s the best we can get.
I am trying to remain faithful to the feeds and comments made, but to report the facts and give a background to the proceedings and how the trial system works.
In this case, and current tribunal hearing, Dr Webberley (Dr W) is accused of practising medicine outside the rules and regulations of the General Medical Council (GMC) during the period March -November 2016, A failure to hold a proper safeguarding policy, and (2018) a failure to be registered as a practice in Wales. But there is more to it than that.
Days 39-41 are brought to you by run for the line and HypocrItic Oath.
(Monday – Wednesday) [week 10] of the public hearing.
Rather than go through what turned out to be THREE LONG days of summing up and legal argument, I proposed to summarise where we are, who listened, who didn’t and what is likely to happen.
Monday (4th October)
After a delayed start, today, turned out to be SJ’s day, ALL day. He spent the ENTIRE day going through the case item by item (as he is permitted to do) summing up where HE thought the RED teams’ case sat.
He summed up, over the entire day, why He felt that Dr HW had been a BAD person and that she shouldn’t be let near a prescription pad again, let alone communicate with actual patients about medicine.
In the late afternoon IS was given the chance to start his summing up. He, rightly, decided that reflection and a darkened room were needed. As such, the day ended there.
Tuesday (5th October)
Today was IS’s turn to sum up on exactly why he felt that the BLUE team should triumph, and why all the facts and evidence showed that Dr HW was a GOOD egg, and deserved far better than what had been dished out to her by the GMC.
He took most of the day, as he is also entitled to do, going through the case, and explaining exactly why the blue team are wrong.
His summing up and questions to both QC’s from the panel ended mid-afternoon. However, the day didn’t end there.
Both QCs has presented written statements to the panel and there were points of law to be considered. This needed finer review and the intention was the QCs reach agreement, as far as possible, on this for the morning.
Wednesday (6th October)
A delayed start to the day. Originally, intended to be 09:30, became 10:30 then 11:30. Why, the rain, trams, busses, sound issues, who knows.
It was partially QCs trying to reach agreement. I quipped at the time it was because SJ was still trying to re-open the GMC case and introduce new evidence EVEN at this late stage….
Guess what, It turned out to be not so far from the truth. He was trying to get matters amended and aspects reintroduced where he had felt “the GMC had not covered these matters fully”.
IS, as you could imagine, was having none of it at all. It was agreed and decided, that evidence and summing up was indeed FINAL and that was that.
That was only part of the day. The rest was taken up with legal argument, surrounding Bell v Tavi and Gillick. I am still not sure why the GMC are relying on this so heavily. The point is, that in 2016 (when this case and the “investigation” started), B -v-T hadn’t happened. Its initial decision wasn’t handed down until December 2019 and the Appeal decision to overturn it happened in September 2021.
There is perhaps an eye on an Appeal to the Supreme Court, but even so, this post dates the facts and policy AT THE TIME.
So, after a days wrangling, the Chair felt he was able to give the guidance to the (three member) panel and they could move to the Decision phase of this hearing.
The hearing had been set down for 55 days. The chair felt that 7 days to make the decisions needed, would not be enough and longer will be likely.
As such from Thursday (7th October) at least a week will be needed before a judgement is made. That would suggest the 15th October at the earliest but more likely the 18th-20th October.
Patience is now required.
What needs to be decided?
In short, did Dr HW breach the guidelines and satisfy the claims in the Heads of Claim (HoC) that remain on the list? You will remember that many secondary charges were dismissed before the defence case began.
The bar to be reached, is not one of negligence, but one of honesty and integrity.
This isn’t as easy as it may seem. It comes down to nuances of issues and who would do what and how.
The three cases relate to people at or below 16 at the time, and it is likely that that is deliberate given the source of the complaints and charges rendered.
Where does she stand?
The consensus is that her defence team have done an incredible job and put together a sound and robust defence. This against a similar consensus that the GMC have put together a shambles of a prosecution case.
Don’t forget, it isn’t supposed to be like this. Ordinarily, the prosecution case is strong, and a defence case is difficult to overturn that argument. That’s not to say she shouldn’t be found innocent, but that if a proper and just case is bought, then a defence will have little or no counter to it.
The issue for the GMC, is they only have to perhaps succeed a little for them to be able to claim triumph and justify the case being bought. This, on the balance of the quality of the evidence would be a travesty.
GCs are very quiet, and this case isn’t being reported at all in the mainstream media. But it will be, win or lose, for Dr HW. More sadly, if she wins, they will find a way to twist it. It won’t be ignored.
If they can twist the jailing of a murdering policeman to show single-sex spaces are justified, then a Dr prescribing tablets to children would be no problem for the twister game at all.
Should she lose some or all aspects of this case, the attention and triumphalism will be deafening. A total GMC victory seems very unlikely however, for which there are a number of reasons.
Why exactly?
Well, several reasons.
Quality NOT quantity
Quality of witnesses. As much as SJ tried to show his witnesses were credible and true, this is FAR from the truth. IS spent a lot of his summing up showing how bad they were.
Don’t forget, the witnesses who spoke for Dr HW, didn’t have to. If they felt the case wasn’t right, they could have said no, and not given evidence. The fact they did, says a lot, especially from the leader of WPATHWPATH World Professional Association for Transgender Health https://www.wpath.org.
The quality of the GMC witnesses was frankly appalling. Why, maybe many who could have given evidence, and far more damming than was given, refused. They perhaps refused because they didn’t believe in the case being made.
Dr Agnew was paid to be an expert. He took on the case and gave his “expert” medical evidence on behalf of the GMC. Not as a joint expert, but a prosecution expert. He wasn’t a credible expert. Copy and pasting information and giving an opinion, ISN’T being an expert. He hadn’t worked with trans children..EVER. How could he be an expert?
IS essentially dismissed his evidence as rubbish and suggested it should be discounted and not be suitable or valid. For an expert that is a disaster and throws any credibility they may have as an expert in the bin.
Expert witnesses used to have a degree of immunity from being sued for giving evidence in court, especially if the side loses. However, after the Andrew Castle affair (MMR) that changed. It is possible to be sued, but mainly for lying or giving false evidence. Dr A should be worried.
Another reason is that most of the witnesses, GMC and Dr HW AGREED the dose given to Pt A was SUITABLE. Only PGB was at odds with that. He had already prescribed blockers to Pt A. Arguably, his evidence should be dismissed (as IS suggested) as he is an interested party and isn’t independent in his view. As this case is mainly driven by him, he has an axe to grind, the word vindictive, is banded around by many.
The evidence given by Dr Kierans (KOI) is borderline conversion therapy and is frankly unlawful in the way she runs that GIC.
Who’s judging who?
PGB gave evidence for the GMC in the hope of showing hoe bad Dr HW was. However, it has been shown clearly, that it is he who should be judged. He has been shown to be out of touch in method and practice and that the Tavi has a Bad CQC rating adds to this.
This on top of the fact that some of the HoC against Dr HW relate to an unfavourable CQC report. So, to judge everyone equally PGB and his team at the Tavi, should be on trial too. That or those HoC be dismissed for GMCs lack of continuity on such matters.
It is well documented, that the conditions and treatment of patients at the KOI are awful and that a similar CQC (or equivalent) assessment would follow.
The point being, how can givers of poor or worse service, be held up to be a suitable judge of another doctors performance. Additionally, as IS suggests, Dr HW has performed better than them. Given her reading and knowledge, that was accepted by many witnesses.
On the same point, and one of total hypocrisy, is the learning and competence involved to prescribe. Dr HW is accused by SJ and the HoC that she wasn’t fit or sufficiently knowledgeable to prescribe to the patients in this case.
Firstly, it has been given and accepted in evidence from both sides, that Dr HW is probably MORE knowledgeable and skilled than MANY of the witnesses on the GMC side. Not only that, but she has also searched and taken as much training as she can, and essentially exhausted the supply of training that exists on the subject.
The GMC, having set up a task force to research and deliver relevant training on this subject have FAILED to deliver any in over 4 years! Yet, the GMC are judging Dr HW on a lack of training.
Evidence, what evidence?
Patient A and his mother gave evidence in private for reasons of anonymity. This is entirely right. Later an agreed statement was read out. That showed the level of care given by PGB at the Tavi on the one hand and the level of care given by Dr HW on the other. To say the two are poles apart is an understatement.
Moreover, the GMC did not challenge any of that evidence. It’s difficult to see how they could but matters of fact could be disputed if not correct. IS suggested that the failure to challenge or the desire not to MUST suggest the evidence is correct and stands as it has been given. That is how the system works. On this basis, he suggests, some of the HoC MUST fail. That is for the panel to decide.
Weakness?
There are some weaknesses in this case for DR HW. That has to be said. The acceptance of the charges relating to the claims for practicing without a license will stand.
IS has suggested mitigating circumstances and the convoluted manner in which HIW ran the system. That failing is one of administration but one the GMC were keen to try and exploit. In the same way that they tried to show Dr HW continued to give ‘medical advice’ whilst being suspended. This by virtue of erroneous entries by a TL on the spreadsheet and the fact Dr HW ‘could’ have made remote entries in Spain. IS sought to counter those aspects, but the claims stand to a point.
Case Management
It is largely agreed by this watching this case that the manner in which this case has been put together by the GMC is bad. So bad that SJ has tried his hardest to get evidence shoehorned in as best he can.
Why?
The GMC started an investigation in to Dr HW in 2016. There was the debacle about how, why, and when she was notified, and whether she had to tell them she had been notified even though they notified her.
The late gathering of information from Dr Matt which transpired had been lost by the time the GMC requested it. Had they gathered it in 2016/17, more would have been available. It may not have made a jot of difference to the points raised, but would have shown better practice (given Dr HW is being judged on alleged poor practice)
Limiting the amount and quality of information given to GMC witnesses which affected what they could ad did say. Embarrassingly, when IS showed them better evidence, that was available, had the looked or been given it, the points made by them, in some instances, were immediately undermined. Again, good and quality information gets better result and creates reliable argument.
In this case, that was certainly NOT the case on the GMC side. Mind you poor witnesses, given partial and rubbish information, isn’t going to add up to much anyway.
The whole GMC case, despite having been FOUR years in the making, seems to have been rushed through to get to a hearing. This was probably excuse a time bar was impending. Much of the evidence is poor and needed to be properly reviewed and responded to by the defence BEFORE the hearing began than was the case. The effect was to leave SJ loundering and trying to stitch together the remnants after IS had pulled apart most of the fabric of the GMC case.
As such, in the truest sense of the words it was a “rush to Judgement”.
Why are We here?
A question asked by many reporting on this case.
We are here because one-person goaded others to complain to the GMC about Dr HW.
NONE of her patients complained, and we have seen from Pt A that the exact opposite is true, in that Dr HWs care SAVED LIVES. The care given by some at both the Tavi and the KOI, was more likely to lose lives than save them. That is an absolute inditement into the type and quality of care under the NHS in the UK for trans people.
Why would PGB and others complain? Well, most likely because they are jealous that she wanted to do the same thing under a private banner. She was likely to upset the establishment perhaps. She saw a market and a demand. Perhaps we will never know, but we ARE here, and this is what we have.
Oddly, the manner kin which this hearing has gone so far (no decisions yet) it has laid bare the weaknesses, the lack of and poor quality of care that is available and given in the NHS under the GIDs service. The endless and growing waiting times. At the time of my referral, it was 18 months, this has grown to 36 months and counting. This for a FIRST appointment. The time is growing exponentially, and the level of service is being cut all the time.
We live in a free market and dinosaurs with their head in the sand won’t stop that. They may try and stop Dr HW for spurious reasons, but they won’t stop the market.
What happens now?
We wait, that’s what.
What’s done is done, what’s said has been said. We will have to see how much the panel have been listening, what they have read and what they understand. We can only hope they are at least neutral from a trans perspective and look at the facts and the HoC in each case objectively AND on the basis of the evidence given and countered.
Suggestions could be made that the panel are perhaps leaning towards Dr HW in terms of a decision, but its not certain or guaranteed.
The question will be how much of a win is a win? And that’s the same for either side.
So, it’s a waiting game.
The panel need to come up with a robust and sound decision for each HoC whichever way the decision goes.
What next?
The case is now adjourned until the panel have reached a decision on each HoC.
We will be back then for the judgement. Advance notice of 12-24hrs will be given I expect.
To be continued…../
Nicola
