Keira Bell and Mrs A vs. Tavistock - Court of Appeal hearing 23 & 24 June 2021

I don’t think that’s as uncommon as you might think. As in MF’s case, the appeal found the tribunal had erred in law, and ordered a fresh tribunal

That's not true.

They'd never even got onto the Employment Tribunal bit. Before they could start, the needed to establish whether the belief in two sexes was protected under the Equality Act.

Normally when someone alleges discrimination, it's in a category already understood by the court, e.g. discrimination on the basis of sex, race or religious belief.

No one's ever claimed discrimination based on gender critical beliefs (in biological facts) before, so the court had to be satisfied that it was allowed under the category of belief. The more junior judge found it wasn't and therefore the tribunal couldn't proceed.

The senior judges in the appeal court found that, actually, the first judge was wrong, Maya's belief's (in biological facts) are protected, and therefore the brakes are off and the original employment tribunal can continue.

No one ordered a new tribunal at any point.

I don’t think that’s as uncommon as you might think. As in MF’s case, the appeal found the tribunal had erred in law, and ordered a fresh tribunal

I don't think the tribunal hasn't happened yet. Only the preliminary matter has been heard.

These words are professional guidance not the law, though. I’d need to go back to the Medicines Act and/or human medicines regulations to see whether this might have been an alternative avenue. IANA lawyer or prescriber though so someone else may have better insight.

The Saatchi Bill failed in 2015 though - this sought to remove the risk of prosecution for doctors who harmed patients by prescribing experimental treatment, so this is a remedy in some circumstances. pharmaceutical-journal.com/article/news/saatchi-bill-defeated-at-emotionally-charged-healthwatch-uk-debate

Sorry, just thinking aloud here.

Most of us aren't lawyers (I'm not anyway) and the judges are new to this case and are dispassionately looking at facts and arguments and the technicalities of exactly what they're meant to be deciding.

If the QC today had been ready with a robust answer to their question then we wouldn't be on this thread discussing it. Unfortunately he seemed a bit wrong footed by the question.

This is why the law isn't a science but an art. It's about being persuasive and confident and making a good case. It's not really about truth. It's about whoever makes their particular truth most persuasive on the day.

Isn't it to be expected that Tavi will take these procedural/jurisdictional points? because the alternative is to defend on the basis that Tavi policy was in fact rational, and that would mean the upper court combing through all the evidence again which it shouldn't usually have to do.

You know, reading this today and trying to get my head round all this I am starting to think I might give up, and I am just an interested observer, I guess.

I think Keira bell must be one of the bravest people on the planet. She could have sued, right? But decided a JR would protect others from going through what she went through?

And if it has all been for nought because, somehow, a JR isn't the appropriate course of action, well..... At the very least I would be wondering why noone had told me earlier.....

This bit:

*be satisfied that there is a sufficient evidence base and/or experience of using the medicine to show its safety and efficacy
*take responsibility for prescribing the medicine and for overseeing the patient’s care, including monitoring and follow-up

So, what am I missing?

I'm not sure this is the same though gingerandbiscuits MF's case was asking the appeal court about protected characteristics so that she could then have her case re-heard. This is about a full JR and an appeal to that review. If the original JR should not have heard the case at all, then is that likely? That was a senior judge and although I can understand the AC saying that the ruling was to make Gillick essential to all cases where medication is needed and would that be the right thing to do. I am sure the previous Judge would have know that. I am confused (I'm not alone I'm sure), surely in the JR they were not talking about the process being correct but whether the ages of competece could be met in this case.... and on and on

I still find it bizarre that we even have to argue that it's wrong to medicate healthy children for not conforming to gender norms.
The world has lost the plot.

www.gov.uk/drug-safety-update/off-label-or-unlicensed-use-of-medicines-prescribers-responsibilities

An interesting extract is below (sorry for terrible formatting - using my phone)

Advice for prescribers says you should:

• be satisfied that an alternative, licensed medicine would not meet the patient’s needs before prescribing an unlicensed medicine
• be satisfied that such use would better serve the patient’s needs than an appropriately licensed alternative before prescribing a medicine off-label,

• before prescribing an unlicensed medicine or using a medicine off-label you should:

It's un-fucking-believable.

Yup. Adults being treated like kids, and kids with no life experience being treated like adults.

As to whether or not it's legal to give puberty blockers to children, as far as I know, none of the medication given is officially approved for use in children for the purpose of blocking puberty. Isn't it all used off-label?
What's the process for legal usage of off-label drugs? Surely, that would be relevant?

Maybe bitheby they're giving Mr Hyam a going-over to get the best case out of him so if they did decide to uphold the decision it will look very solid.

It's all so baffling.

Jesus, we just want to protect little kids.

I am thinking, it should not be this hard, it should never have been this hard.

Don't worry. Jeremy Hyam QC will be poring over the law this evening to make a coherent case in the morning. Hopefully he'll spell it all out and the judges'll be satisfied that they have jurisdiction.

The thing with sexual function is that you can never be in a position to know what you've lost because you'll never get it back. You can regret an abortion once you are in a position to have another children and realise what could have been. I guess that argument holds for fertility. You might not want to be a parent at 10/11/12/13 but you realise that you do at 23 and how much harder that process might now be.

So..... Keira bell and representatives raised hundreds of thousands of pounds to take this case to judicial review, it was in the papers, on telly, has had loads of publicity, they eon the judicial review, which the Tavistock appealed....

...... and only now is someone pouting out that a judicial review might not have been the appropriate action?

Is that right?

^ And while we wait for that to happen?

My overall impression is that the Court of Appeal is questioning whether a JR was appropriate because the courts should be very reluctant to find unlawful medical decision making in general when it is in highly contested areas because this should be tackled by medical institutions behaving professionally based on robust evidence.

But then "Yes, true, but the point in the original case seemed to be that the judge was pointing out that GIDS was failing to apply Gillick competence, and the ruling was an attempt to correct that."

I don't know what the role of the court is in that.

Sorry Cardinal - I didn't mean you were making an argument, I was just pondering.