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.
This is a reflective piece from the Tribunal result and the stage 2 result and ‘punishment’.
Day 264 of 55 is brought to you by stopping off before Journeys End
After what seems like ages, well mainly because it HAS been ages (about 194 days), it seems we have a DECISION!
Yes, at last. In a trial set down for 56 days, which took 56 days, but without the vital conclusion, has FINALLY ended………Well this stage. Ill come to that later.
In my last blog on this matter (Part26 Why are we waiting?), all the way back in November, we were waiting for the tribunal to deliver its verdict.
In that blog, I alluded as to why it was taking so long. Since then, so much has happened in the world of Trans people, especially in the UK, and frankly, most of it is bad. When I started writing this it was bad, right now (summer 22) it’s very bad and getting worse.
Today, a change.
The panel has released its judgement on the trial and the judgement on each of the charges accepted and tried.
For those who may well have fallen asleep, and I don’t blame you, the charges fall into the basic categories.
1) Those that were put in the hearing and were ACCEPTED (at or before the hearing) by the Blue team (Dr HW). Essentially those are a success for the GMC (The Red team). On those, penalties will be levied, unless, in the very unlikely event the tribunal strike them out.
2) Those charges for which Dr HW was AQUITTED at ‘half time.’ They were the claims from the GMC that were dropped or struck out by the panel at that time and wouldn’t be pursued. Those were essentially a WIN for Dr HW and the blue team.
3) The remaining charges that formed the thrust of the second part of the hearing and those about which the panel have been deliberating for so long. The tribunal have to decide if those GMC charges are ‘Proven’ or ‘Not Proven’.
Before, I consider the judgement in whole and in detail, its important we set out some background here.
Dr HW has been SUSPENDED from working since the time the GMC investigation started. That means throughout the investigation, the preparations, the hearing AND the seemingly ridiculously long deliberation period, she has NOT been allowed to practice as a Doctor. That is approaching FIVE years.
Late last year/early this, an application was made to Court for her to continue to practice, based on the hearing evidence and the extended time the panel needed to decide this case. Most of that being the inability of the QCs and others to find a mutually convenient slot in their collective schedules.
At one point, even this April looked shaky, and AUGUST was mooted.
So, 194 or so days after the official end date of the hearing we are at Judgement day.
The judgement was quietly released and there was no hearing day or announcement. The parties were handed the judgement, and that was, well, sort of that.I think, it is worth spending a little time on reflecting on where we are as a nation on trans rights today (April 2022), compared to even October 2021 and why those rights and this particular judgement are inextricably interlinked.
In the time since the hearing ended, the UK Government has imploded in respect of the trans agenda, and that agenda is in a dire state.
Our very own Prime Minister has openly spoken negatively about trans rights and the “respect for biology” He has made an election decision to side with the GCs. This when poll after poll shows the country is wholly supportive of trans people and rights.
Not only that, the long awaited and intended ban on Conversion Therapy (CT) turned into a complete farce on, of all days, the Trans Day of VisibilityTrans Day of Visibility International Transgender Day of Visibility (often referred to as TDOV or Trans Day of Visibility) is an annual event occurring on March 31[1][2] dedicated to celebrating transgender people and raising awareness of discrimination faced by transgender people worldwide, as well as a celebration of their contributions to society. Further Reading https://en.wikipedia.org/wiki/International_Transgender_Day_of_Visibility (TDoVTrans Day of Visibility International Transgender Day of Visibility (often referred to as TDOV or Trans Day of Visibility) is an annual event occurring on March 31[1][2] dedicated to celebrating transgender people and raising awareness of discrimination faced by transgender people worldwide, as well as a celebration of their contributions to society. Further Reading https://en.wikipedia.org/wiki/International_Transgender_Day_of_Visibility ). Within a period of only 30 MINUTES, was firstly totally binned, then pulled from the bin, and dusted down but the trans ban somehow fell off and got left behind.
This created TWO major backlashes within an hour, which must be some sort of (sad) record even for this waste of a government.
The end result of all this was a MASSIVE show of SUPPORT from the entire LGBT+ community, with some notable hateful exceptions, I might add. A show of support, that for trans people was overwhelming and instant.
The ramifications of that and the subsequent protests are still rippling across the Westminster bubble. What happens as a result of those ripples remains to be seen. Given what speeches, texts, tweets et al emanating from government, a significant U turn is unlikely. This despite many and well attended countrywide protests.
One major casualty was the cancelling of Safe to Be Me, the so-called Flagship ‘Inclusive’ conference. This was a total sham in my view and was right from the beginning, even when Liz Truss announced it. It was the equivalent of the Government gaslighting itself and the LGBT community. After further protests, and the calling out of how bad it was, the government bowed to the inevitable and shelved the conference in early May 2022. The overriding hashtag #UnSafeToBeMe
Why is this important to Dr HW?
The answer is VERY.
The Prime Minister said that to include trans people in the CT ban was “complex.” So complex that 20 other countries have managed it without an issue. So complex that other countries have fully banned it since with ‘Unanimous’ support in their parliaments. Probably the same “complexity” that prevents X markers on passports.
The main reason the government want to ignore trans people in the CT ban is because they fear that individuals may fall foul of the law when discussing trans issues for under 18’s.
The fear this, because the GCs and far right have told them that and that they worry about children being ‘rushed through’ the system. A system that is so slow that its pointless anyway.
They worry about the prescription of Puberty Blockers (PB’s), and they worry about children be “forced to be trans.”
This is important because this aspect in particular was the main thrust of the GMC case against Dr HW. That essentially allege she prescribed PBs to people ‘underage’ and took away decisions, changing lives thus “harming” children.
In summary, PBs are a drug that halts natural puberty and allows time for adolescents to decide if they wish to pursue transition or not. The drug prevents “the wrong puberty” for those that transition, which is costly to reverse later in life and which would then give rise to enhanced levels of Dysphoria and negative Mental Health issues (MH). All of these things at significant expense to the NHS and/or the individual.
The issue, and it is fundamental, is PBs can ONLY be given during puberty! There’s no point giving them afterwards. They should ONLY be given after puberty has commenced beyond a certain stage, (Tanner Stage 2) to gain maximum effectiveness.
Puberty starts in some as early as 11, so making the decision when to start has to be both informed, appropriate and agreed. None of that was in dispute with Dr HW. It was merely down to age, with the GMC arguing that 12 is too early and essentially against the rules.
That is mainly why we were here and why that links with the Government and CT, amongst other things. This given that the care provided by Dr HW was OUTSIDE the care of the NHS and GICs. That doesn’t make it illegal but seems that “The Establishment” frowned upon such care.
They can’t have others doing it badly, when they (GiC’s and trans healthcare generally) make such a good job of being rubbish at it themselves.
We saw in the tribunal the Dr HW’s record was largely impeccable and well above the standard of care given by the GMCs own “experts.”
JUDGEMENT DAY
When the judgement was released, it has to be said it was thorough and well considered. It is very detailed and covers each of the alleged failings individually.
It also doesn’t hold back on some aspects of its judgement and calls to account some of the very weaknesses that I and others have pointed out as this hearing progressed. The judgement is 211 pages long. I don’t propose to review it in detail. There are others that have and with more experienced legal knowledge than I.
However, I can give a summary of it, where and why it is important.
At the beginning of the judgement, the panel rightly set out the background, the claimants (Red Teams) case and list the claims at hand. That sets the scene for the judgement on each of the claims made by the GMC.
These are covered under headings of Patients, A B & C respectively, The CQC inspection of Dr Matt Ltd. (the Practice run by Drs H & M Webberley), Aneurin Bevan University Health Board, Gender GP and Convictions.
The Tribunal note the acceptance of some charges admitted by Dr HW before the trial began and then set out the list of witnesses, experts for each side and the list of documents used as part of the determination.
The Panel then set out their role, qualifications, fitness to consider and the methodology of their decision basis. This runs through the background to the case, the arguments put, and the guidance documents the panel have been asked to consider. It sets out panel’s findings and statements on specific aspects that affect the decisions on the individual heads of claim later on.
For instance, and it doesn’t hold back.
(page 34) “111. The Tribunal finds that the reluctance of the Endocrine Society and others to
embrace enlightened views of transgenderism is symptomatic of the tendency in all
professions to be slow to move with the times.”
(page 35) 113. The Tribunal also finds that the ICD is a reference manual and not a practice manual.
There was no evidence placed before the Tribunal to suggest that the ICD10 mandated that
clinicians treat transgenderism as a mental illness prior to January 2022 and that ICD11
mandates that transgenderism is treated as a sexual health condition from 2022.
(Page 35) 114. The Tribunal finds that the ‘de-psychopathologisation’ of gender dysphoria and the
contemporaneous rethinking in 2016/17 that transgenderism was no longer to be regarded
as mental illness, is highly relevant to this case. The reclassification of transgenderism as a
somatic state related to sexual health, as opposed to a mental illness, had clear implications
for the competencies necessary to deliver safe and effective care to those presenting with
gender dysphoria.
Those are important statements in how the panel will decide the GMC claims based on evidence given and read from the documents.
Dr HW herself.
(Page 35) “117. The GMC case was that ‘Dr Webberley is entirely self-validated’ as a GP with a special interest in gender dysphoria.”
This is important as it makes or breaks aspects of the case. In particular the type and availability of FORMAL training available at the time. Don’t forget this is the GMC claiming she was unsuitably qualified for treatment of transgender patients. At no time did the GMC say she was unfit to be a Doctor.
(page 36) “120. Professor Butler [GMC witness] confirmed that there were no specific training courses for paediatric endocrinologists practising in transgender health at the material time or at any time since.
I.e., the GMC themselves expected Dr HW to take formal training that didn’t actually exist! As a result of this and Dr HWs efforts to find and take training off her own back and to learn the tribunal said this:
(page 36) “121. The Tribunal therefore finds that any doctor practising in transgender healthcare in the UK at the material time could be described as ‘self-validated’ in that there were no independently validated qualifications in what Professor Butler referred to as ‘a new field of medicine.’
(Page 36) “122. The Tribunal received evidence that the only UK training in transgender healthcare offered by the RCGP at the material time was a basic introductory e-learning module, which Dr Webberley completed in 2015. This module has now been deleted from the RCGP website.” Not only did Dr HW avail herself of training, but she also tried to help other doctors AND make a case with the GMC to do the same and they STILL accused her of insufficient knowledge.
Astonishing!
The panel clarified this point.
(page 36) “125. Dr Webberley herself had been striving to educate fellow GPs in the care of transgender patients. She published an article in ‘Pulse,’ a monthly news magazine and website aimed at GPs. The article was titled ‘Why do GPs have to prescribe for gender dysphoria?’ Dr Webberley had also tried to engage with the GMC [the claimant in this case] in advancing the educational opportunities for GPs in regard to transgender healthcare: ‘I offered my services, as a doctor and educator, and started to develop and formulate protocols and provision that was in line with the International guidance that seemed the most evidence-based and affirmative for patients. I reached out to the GMC to offer to help develop training materials for doctors and had several good discussions about the challenges faced by patients and doctors.”
(page 39) “131. The Tribunal finds that Dr Webberley was hampered by the lack of formal training opportunities in transgender health at the material time and that her lack of validated qualifications in transgender healthcare cannot, therefore, be held against her.”
(Page 39) “132. For the avoidance of doubt, the Tribunal does not suggest that Dr Webberley was free to dabble in a field of medicine in which she lacked competence merely because there were no certificates or diplomas available. In fact, Dr Webberley did take appropriate steps through continuous professional development and networking to pursue an ‘apprenticeship.’ She also applied her prior experiential learning as an experienced GP with validated qualifications in sexual health to a nascent, but related, field of medicine. She had successfully undergone appraisal at ABHUB during the material time in order to maintain her GMC licence to practise. Dr Webberley’s transgender practice was considered as part of that appraisal and no concerns about it were raised by Dr Paul Buss, her appraiser and Responsible Officer. The Tribunal note that appraisal was a process introduced by the GMC for the very purpose of identifying under-performing or incompetent doctors.”
The panel are saying that Dr HW did all she could to get the training she thought she needed to be able to properly give the medical advice that was required in this field of medicine. This despite the GMC (her accusers) basically doing nothing to assist and essentially actually standing in her way.
Dr Webberley’s Competence as a Mental Health Professional
The panel moves on to this aspect. This is clarification of her skills to consider and treat issues of mental health as part of transgender patient care.
The panel considered statements from witness and looked at the relevant guidance and said this of Dr H W (a GP), given the GMC were trying to show she was unsuitably qualified (as a GP)
(Page 40) “145. The Tribunal therefore finds that those assessing the health needs of transgender persons must be competent to recognise reactive anxiety and depression arising from minority stress and to treat it or make necessary referrals to specialists. The Tribunal finds that GPs are very well placed to do so.” *my emphasis
The panel, however, weren’t stopping at the good stuff for Dr HW but were prepared to call out poor performance as well. You may recall that this was noted at the time. It seems the panel were indeed taking notes. This is important as it underlies credibility of witnesses.
(page 41) “150. The Tribunal notes that Dr Dean’s expertise in transgender healthcare has been acquired in the adult setting. He has never treated transgender adolescents. The Tribunal further notes that Dr Agnew has never practised in transgender healthcare. *my emphasis
After quoting Dr Dean’s testimony relevant to this the panel said this.
(page 41) “152. The Tribunal finds Dr Dean’s opinion here to be inconsistent with his oral evidence that ‘being transgender diverse isn’t a disorder, that it isn’t a mental health condition, that gender diverse people may experience mental health, common mental health problems more frequently than the general population, but that is not inherent in them being gender diverse’…”
The panel then considered the other experts including Dr Bouman (Dr HW witness) and said this of their opinion of Dr HWs suitability.
(page 43) “164. The Tribunal therefore finds that GPs are competent to recognise and treat, or refer onwards for specialist treatment, persons with mental ill health arising as a reaction to minority stress. Dr Webberley, as an experienced GP and as a doctor with a special interest in transgender healthcare, was most certainly competent in those respects.”
GMC case undermined, mainly due to the sheer difference in the quality of the ‘experts’ put forward. I have said before that the GMC may have struggled to find suitable witnesses as most Drs agreed with Dr HW and NOT the GMC. We will never know.
competence to recognise neurodevelopmental conditions
The next section looks at the competence of Dr HW to understand and treat neurological conditions. This is a technical area and one that was raised due to aspects of the case surrounding Patient B and the patient’s ability to be able to consent to treatment taking account of other neurological conditions as well as gender dysphoria. A lot of time was spent in the hearing on this aspect as it was central to a large part of the GMCs case.
Again, the panel considered the quality and content of the witness testimonies.
(Page 44) 171 “….The Tribunal finds Dr Dean’s opinion here to be unhelpful. Dr Webberley did refer Patient C to an appropriate specialist and the Tribunal finds that this evidences Dr Webberley’s competence to detect or recognise potential neurodevelopment conditions, to make appropriate referrals and to take into account reports from specialists when assessing a patient’s capacity to consent.”
If you recall the job of a witness, especially and ‘expert’ witness is to act for the court and help the panel. The panel do not take too kindly to inconsistency. In summary:
(Page 45) “173.The Tribunal accepts Dr Webberley’s evidence that GPs have the competence necessary to recognise potential neurodevelopmental issues when assessing their patients.”
So Acceptable as A GP, acceptable as a transgender care Specialist GP and able to recognise neurodevelopmental conditions.
Dr Webberley’s Competence as a Hormone Prescriber
This relates specifically to the assessment, prescription and monitoring of hormones for transgender patients.
The issue here for the panel is one of age and when puberty starts. It was more of a concern for treatment of patients under sixteen. This is one of the biggest issues surrounding treatment of patients in the USA right now and the roll back of trans medicine in many anti trans state legislators.
However, here we are dealing with 3 patients in the UK.
Even TWO of the GMC witness agreed IN THE TRIBUNAL the issue was largely acceptable.
(Page 46) “179. Dr Klink confirmed that testosterone is a safe agent when administered to adolescents to induce a cisgender puberty, but he stated that there is insufficient evidence concerning the safety of testosterone when used to induce a transgender puberty in adolescents.
and
(Page 46) “180. Professor Butler was more emphatic. He stated that the NHSE Clinical Commissioning Policy, into which he had ‘considerable input,’ found that there was no evidence of using testosterone to induce transgender puberty in persons below the age of sixteen.”
So, what’s the fuss then? Well, it’s more complicated below sixteen, so they say, and when is puberty, puberty and when not exactly?
(Page 46) “182. Dr Klink [GMC witness] revealed under cross-examination that he had treated a transgender adolescent aged thirteen with gender-affirming hormones and that he was aware of centres elsewhere that treat transgender adolescents from the age of fourteen.”
Part of the discussion was “stage not age” and that was Dr HWs view. In addition, the question was raised about whether the treatment was the same for Cis adolescents compared to trans adolescents, The panel seemed, again, to be listening.
(page 50) “190. The Tribunal therefore concludes that the safety of administering sex steroids to adolescents in the cisgender context was well established at the material time. Published evidence relating to the safety of administering sex steroids to adolescents in the transgender context was limited, but there is no basis to suggest that it would be unsafe and there was evidence, albeit limited, that it is safe.”
So far, a lot of the ‘crucial’ elements of the GMC case are being torn to shreds, not helped by the poor quality of their witnesses and the fact they agree with Dr HW in some respects.
(page 51) “191 The Tribunal now turns to the question of who is qualified to be a hormone prescriber.”
A section of choppy waters in some respects but one helpfully smoothed a little by the GMC themselves.
(page 51) “196. The competence of GPs to prescribe gender-affirming hormone therapy was endorsed in 2016 by the GMC,…..” stating “… we don’t believe that providing care for patients with gender dysphoria is a highly specialist treatment area requiring specific expertise. “
The panel, having considered the arguments said this. Bear in mind this is a comment about the defendant, a person usually struggling to show they have not done what they are accused of having done. This set against the (poor) quality of some of the GMC witnesses.
(page 52) “203. The Tribunal found Dr Webberley to be an impressive witness. She answered technical questions about hormone therapies unhesitatingly and authoritatively. Whilst this Tribunal is not itself qualified to assess Dr Webberley’s competence in hormone therapies, the Tribunal was impressed by the depth and breadth of her knowledge of endocrinologyendocrinology https://en.wikipedia.org/wiki/Endocrinology Endocrinology (from endocrine + -ology) is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones. It is also concerned with the integration of developmental events proliferation, growth, and differentiation, and the psychological or behavioral activities of metabolism, growth and development, tissue function, sleep, digestion, respiration, excretion, mood, stress, lactation, movement, reproduction, and sensory perception caused by hormones. Specializations include behavioral endocrinology[1][2][3] and comparative endocrinology. and gender dysphoria. The Tribunal was in no doubt that Dr Webberley had immersed herself in the field of transgender healthcare to the extent that she could properly be described as a GP with special interest in gender dysphoria, both in respect of the psychosocial and the endocrine facets of this field of medical practice.” *my emphasis
That sets the scene very nicely so far. A witch hunt by the GMC?
Alternative Models of Transgender Healthcare
The panel have succinctly done my job for me in the following paragraphs.
(page 50 -All) “205. A central plank in the GMC’s case against Dr Webberley was that in providing care to Patients A, B and C Dr Webberley did not operate within a multidisciplinary team setting, as advocated in WPATHSOC7 and Endocrine Society Guidelines 2009 and as exemplified by GIDS.
206. In rebutting this criticism, Dr Webberley relied on the case of Bolam v Friern Hospital Management Committee [1957] 1 W.L.R. 582. Dr Webberley’s case was that her practice was ‘in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art’ notwithstanding her departure from the model of care deployed at GIDS. *panel emphasis.
207. The Tribunal finds that Dr Webberley’s practice was indeed in accordance with that considered proper by a responsible body of medical practitioners. It also finds that her mode of practice did involve a multidisciplinary team, albeit not one that precisely emulated the configuration at GIDS.
208. The Tribunal’s analysis of Dr Webberley’s decision to stray in some respects from the approach enshrined in WPATHSOC7 and Endocrine Society Guidelines 2009 necessarily begins by confronting the metaphorical elephant in the room, namely waiting times.
The GMCs case to try and prove incompetency has so far shown only incompetence on the side of making a decent case! I am using the actual words of the panel to be as transparent as I can without just printing the whole judgment.
The panel also took a wider look at transgender healthcare in general. It considered the Acts of parliament and protocols plus the Women’s and Equalities Committee reports and others. It was NOT HAPPY!
(page 51) “215. By the time CQC inspected GIDS in October/November 2020, they concluded: ‘The service was difficult to access. There were over 4600 young people on the waiting list. Young people waited over two years for their first appointment.’ Such a backlog could not occur overnight: it was evidently the culmination of a long period in which capacity could not meet demand.
(page 51) “216. The Tribunal therefore finds that at the material time there was immense pressure on GIDS and that some aspirant service users were, as a result, left in a state of desperation.”
(page 51) “217. The Tribunal also received evidence that some service users found that the rigid and protocol-driven approach at GIDS did not meet their needs in terms of timeliness of interventions and that the protracted and repetitive nature of the psychological assessment phase was intrusive and overbearing. The Tribunal has set out at some length the revision in thinking that was taking place in the mid-2010s that has led to the ‘depsychopathologisation’ of gender dysphoria in ICD11.”
Conclusions
(Page 56) “237. Dr Webberley was at the material time a GP with a special interest in gender dysphoria and she was competent in the roles of mental health professional and hormone prescriber. Dr Webberley adopted a hub-and-spoke approach to her care for Patients A, B and C, referring them to specialists if and when required. She was competent to determine when such referrals were necessary. Dr Webberley was not bound to follow precisely the WPATHSOC7 or Endocrine Society Guidelines 2009 guidelines, although she did avail herself of the guidance therein. She was at liberty as an autonomous medical practitioner to look to alternative guidance and did so. Her reliance on the UCSF Guidelines was in accordance with a responsible body of expert medical opinion.”
The Tribunal’s Finding.”
The panel then considered the qualifications and training of Dr HW as a foundation for decisions.
The panel then reviewed each of the heads of claim and associated sub heads of claim in turn.A detailed description is set out for each item and a finding stated as either :
”proved”
“Not Proved” or
“Admitted and Proved”
“Withdrawn following a successful Rule 17(2)(g) application.”
Of the four categories of charges that were listed above, these can summarised as follows.
1) Admitted and Proved (guilty) on FOUR All as expected as guilty pleas were rendered at the hearing.
2) Withdrawn or struck out and NOT guilty on FIFTEEN. Again, as expected as struck out during the hearing.
3) Of the 106 charges that remained, Dr HW found NOT PROVEN on 87 and Proven on 29
That counts as a HUGE WIN for Dr HW and the Blue team.
This was largely as expected, for those following this with any degree of an independent view.
In total it means of the 135 charges bought; Dr HW was AQUITTED of 116
Given the list was SO long and covered various areas of practice as well as individual specific aspects such as HEIGHT and TEMPERATURE as individual charges, to win on all of them was an uphill task.
That said, clearly to be found guilty on even ONE serious charge is a bad thing. However, the ‘proven’ aspects are minor inflections as a departure from ‘good’ practice. None are such that the overall care and wellbeing of the patient were affected.
The remainder are procedural matters. Whilst to be proved guilty of these isn’t a good thing, they are administrative departures and for many, by way of the administration an, alteration of the rules and practices mid-stream. Those were largely admitted at an early stage and in some cases, relevant fines already paid, before the trial began.
The main principle ones surrounding the treatment of trans children were WON with minor infringement where proven as unsatisfactory.
In conclusion (well nearly)
Was it worth it? Yes for Dr HW in some ways, but many ways No.
Was it necessary? No, not really. Perhaps some aspects surrounding the license element could have been dealt with, but that wasn’t straightforward, and the overall case was very flimsy.
It seems the GMC went looking for problems that weren’t there, especially given the time and inevitable cost to both sides.
Should we be here: Well, no, not really. If the GMC set out to ‘show trial’ Dr HW, they failed miserably.
That was evident a short journey into the hearing. The GMC case was flimsy, poorly compiled and rather haphazard in its execution and performance. The witnesses were of no material benefit in most cases, and merely highlighted the utter shambles of NHS provision rather than the ‘Gold Standard’ that it should be. The reason it isn’t Gold Standard is because of many of the individuals that were GMC experts and NOT on trial at this hearing.
What’s the cost?
The costs are huge in many ways.
The cost in purely financial terms is massive. The costs to the GMC are about to become much higher still perhaps.
The cost to Dr HW in both MH and loss of earnings, fitness and ability to practice are irreputable.
The biggest cost of all, is the trans people harmed in this Not BY Dr HW, BUT BY THE SYSTEM. A totally broken and uncoordinated, gate keeping negative and adversarial system.
In reality, it has to go. It needs to be dismantled and properly funded GP lead care system put in place. But…. This is already happening. The pilot programmes of trans care ARE in place and are working well.
A system, not unlike that provided BY Dr HW and one the GMC roundly attempted to crash and burn.
So, the GMC need investigating over this as does the NHS GIC system. Not a biased, bigoted CASS review, but a proper ‘root and branch INDEPENDENT review.
Javid can stick his unrequired ‘urgent review’ some where dark as it isn’t needed (Assuming the current PM leadership race doesn’t squash it anyway.
The answers ARE already in place and working. It’s just this introverted, biased, bigoted hateful waste of a government can’t see that.
The end?
As this ‘stage 1’ was completed, the case moves to Stage 2.
This is a behind closed doors hearing to review the results of the tribunal’s decision on for a ‘punishment’ to be considered and meted out.
This happened in Late June 2022 and took about a week or so of deliberation.
The result:
Dr HW Webberley was suspended from practice as a Doctor for TWO MONTHS.
That is the sentence after ALL OF THIS TOTAL CHARADE. The time and effort the GMC put into this case. That alone shows how flimsy and without standing the case had.
Of course, it doesn’t include ALL the time that has passed since the investigation began, nearly FIVE YEARS, where Dr HW has been prevented from practising.
Most of that has been simply waiting for the process, including a VERY lengthy period for the tribunal to decide that she was right on most of the aspects of her care.
As I said before, the small area that she was found to have erred, is minor and was not from any form of complaint by the patients or their families or care team. ONLY from the GIC/GMC and that’s the best they got.
It’s WORSE than that.
Why?
Because the new set up and ‘trial’ GICs such as Indigo and many GP lead health boards are adopting the very practice that Dr HW was taken to tribunal for.
Using the very model and interconnected methods rather than the rigid inflexible outdated and prehistoric model of the GICs, especially the TAVI has shown to be both workable and more efficient, for post 16 trans healthcare.
It is only government interference and intransigence and the refusal of the GIDS/NHS to reinstate use of PBs (without a court order) as overturned in (December 2021) [Bell Appeal Bell v [2020] EWHC 3274 (Admin)] that stops the U16 system from working as it should.
This is a case of prosecuting a pioneer, a well read, learned and well researched pioneer then adopting the very system the pioneer was prosecuted for in the first place.
The whole system can work, work well and efficiently. It’s the simple fact there are power crazy GCs nobbling it at any expense that is the problem.
A trans lead service for trans people is what is needed. There are many eminent people who know how it should and can work, but are prevented from doing that by Autocracy, Bureaucracy and bloody mindedness.
Things MUST change to SAVE LIVES.
Where next?
Dr HW can accept the proven charges and the punishment, serve her sentence and then continue to practice, should she so wish. That would be about the beginning of September 2022.
Alternatively, she can appeal the decision of the punishment and try to reduce or repeal that. The indication is that process could take over 12 months. All that time, she would not be able to practice until the appeal is decided.
That is a decision for her and her legal team. That decision will have to be based on the evidence from the stage 2 hearing and the details of the final sentence judgement handed down by that tribunal. Considerations will be the likelihood of success, based on previous similar appeals, the motivation, to want to continue.
For now, at least this process ends here.
Nicola.
Thank you to everyone for following this case and taking the time to read and understand what has happened and how the Healthcare systems for UK trans patients, particularly U16 is so antiquated and broken.
