Dr Michael Webberley

This really is horrifying to read.

Obviously it's clear why MW isn't attending - this is literally indefensible surely? Does anyone know if his lack of attendance/refusal to engage will have any bearing on the case/outcome?

I am another one wondering about possible criminal implications from this. I am thinking of Ian Paterson - IIRC, he received a long sentence for carrying out unjustifiable medical procedures and I can't remember the exact details but there seems to be a lot of similarities here, especially the "profit before patients" aspect.

I also wonder what the implication may be for the parents of these children, reading about the 9yr old and the assessments and the parental involvement there, is absolutely shocking.

Job description.

Essential criteria:

• Medical experience preferable but not required

• Demonstrate a disregard for record keeping and/or note taking: precision is not required. We need someone to help us move away bureaucracy.

• Should be able to demonstrate excellent insight into how important hormones are for everyone and not show any bias based on someone's gender when prescribing

• Must be enthusiastic about ignoring present consent models

• Demonstrate a sound understanding that values and ethics differ for our clientele group and be prepared to be bold and brave by working against the grain.

• A track record of risk taking and ability to strongly rebuff any criticism.

• Court/tribunal experience is desirable.

This is so depressing. Will mainstream media report at some point? More people need to know what has been/is going on.

Their strapline is 'ready to disrupt the healthcare status quo?' like experiments are a bit of 'high jinx'.

The salary is £80-100k. They have some serious money in that business.

Job comes with pension, health insurance and a fast-track passport to Wormwood Scrubs.

Somebody mentiioned upthread that Gender GP are not tweeting much. I'm sure that will soon change when they recruit their new head of content. 'Highlights' of the current job ad here:

'Are you passionate about disrupting the status quo in healthcare, transgender and non-binary healthcare, Telehealth, and HealthTech?'

'We are on a mission to build an on-demand healthcare ecosystem without discrimination, prejudice or gatekeeping for the global transgender and non-binary community, and we’re looking for an extraordinary Head of Content to align our content strategies and narrative decisions with the business vision and message. We’re about to invest in creating seamless digital experiences for our audience & customers and need a strong leader for our content team of 5 to deliver extraordinary, high-impact content.'

I was trying to find Something Sensible about how they use Gillick Competence with paeds oncology patients but Google is bullying me & being literally violent with search results

However, this 2015 article from the European Journal of Paediatrics was an interesting read: [[www.doc.rero.ch/record/332145/files/431_2014_Article_2462.pdf Decision-making capacity of children
and adolescents—suggestions for advancing the concept’s implementation in pediatric healthcare]]. I’d never really thought about the fact that there’s a total (as in global) lack of tools/frameworks for clinicians to use when assessing Gillick Competence*. Relying solely on the best judgement of clinicians puts a huge amount of [additional] stress on dedicated & diligent medics - & at the opposite end of the spectrum, allows absolute nightmare practice like that of Gender GP.

Towards the end of the article the authors point out that The way childhood and children’s position in society are conceptualized influences how they are perceived and shapes the broader framework in which assessments of DMC take place. (DMC here = Decision Making Capacity). Assessments for children (Jesus, children, should be a red flag not a green light) & teens wanting blockers [& cross-sex hormones] have been taking place in a socio-cultural context where childhood is under siege.

Children are being exposed to porn at ever-younger ages; girls of 14 are attending A&E with injuries sustained the first time they try having sex because [they &] their boyfriend think violent porn’s a “How To… guide; rates of sexual assault by peers in primary school are rising; girls are ashamed of having their period (61% of them according to Always, unless they did indeed go all equal opportunities & talk to the boys & truly mean “61% of people” ); there are girls who’ve never posted an unedited photo of themselves to social media; people with eating disorders (admittedly this happens with adult services too) get told their BMI is too high for them to be treated; schools have been teaching children regressive gender stereotypes as absolute truth & pretending biology isn’t really a thing; girls are being encouraged to consider Only Fans & general cam-work as Good Choices to help fund their place at university; there is absolutely social pressure on children & teens to be “other” in some way, & there is social capital in belonging to an oppressed/minority group; and “trans children” are being ruthlessly exploited by campaign/pressure groups who continue to trot out That Suicide Stat & make shameless-baseless claims about how vulnerable trans people are.

Obviously nothing in medicine happens in a vacuum - but we’re seeing here just how dangerous the lack of framework for determining Gillick Competence can be when culture & society are pushing a certain way.

• and/or international equivalents

Actual Gillick isn’t a problem at all - clearly children below the age of 16 are able to consent to some medical treatments themselves, and not to others, and that needs to be carefully assessed on a case by case basis when there is no parental consent. That is all Gillick says. If the parents consent, as in this case, Gillick is irrelevant from a legal standpoint, though not necessarily from a “good medical practice” perspective.

The Tavistock-Bell case centred on Gillick because the Tavistock were insistent that they didn't and couldn't rely on parental consent for something this serious - the child needed to understand it, hence be Gillick competent.

So they did not use parental consent for what they were doing.

Although they then changed their minds on this for the appeal, and did argue that they didn't need the Gillick competency if doctors and parents agreed.

(I think that's accurate, it's been a while).

The Bell findings said that medics could be pursued in civil courts, didn't they?

What's the threshold for criminal?

This is shocking - the more I read the worse it gets

@tabbycatstripy
'Gillick doesn’t seem like the problem. The treatment is shit, and the medical care being provided is worse.'

Yep, pretty much.

Yes agree @Changechangychange

If MW wrote 'Gillick competent' in the notes of a 9 year old whose parents had asked for treatment, not the child, and on whom he had not performed a full capacity assessment (which I argue in this case would involve a discussion with a 9 year old involving future sexual function that would leave an adult on thin ice in terms of safeguarding), then you might wonder does MW actually understand Gillick competence or is he just recording the phrase 'Gillick competent' in the notes thinking that is sufficient to medicolegally cover a decision to proceed with treatment?

Actual Gillick isn’t a problem at all - clearly children below the age of 16 are able to consent to some medical treatments themselves, and not to others, and that needs to be carefully assessed on a case by case basis when there is no parental consent. That is all Gillick says. If the parents consent, as in this case, Gillick is irrelevant from a legal standpoint, though not necessarily from a “good medical practice” perspective.

The issue is, as you say, children being ascribed capacity to consent to things they clearly cannot consent to, and parents being able to obtain treatments that are not in their child’s best interests, on the flimsiest of evidence (a tickbox filled in by the mother?!).

‘ In practice an assessment of Gillick competence would be done for a 13-15 year old to assess their capacity to consent to a particular treatment or intervention independent of or without parental involvement. I know there is in theory no lower limit for the age of Gillick competence but in practice the kind of thing a very young child could be deemed to have capacity to consent to would be for example that the school first aider could put a simple dressing on a cut.’

I don’t know a lot about it but I suppose this means it hasn’t been tested much in law? Because we have - on the one hand - what seems to me to be the appalling scenario of a parent consenting to their child’s fertility being removed for what is clearly an unnecessary treatment, and we have on the other people claiming competency for children who obviously can’t understand the issues.

Gillick doesn’t seem like the problem. The treatment is shit, and the medical care being provided is worse.

@YesSheCan I agree you would be treating a nine year old under best interests. I assume that to ensure you were acting in the child’s best interests you would need to be very sure that cross sex hormones and infertility were in their best interests, and so you would need to check what they understood by “changing sex”, and what that meant for their future health… it seems like a very circular argument!

I personally cannot see any way that you can induce infertility in a prepubescent child in their best interests, when a nine year old’s understanding of fertility and relationships is so limited.

I remember when I was about 8-9, all of my friendship group swearing blind we would NEVER do anything as disgusting as sex - funnily enough we hit puberty and all rapidly changed our minds.

I think what came to light was that in some situations - when it suited - practitioners were suggesting children were Gillick/Fraser competent, when they might be in one circumstance, but were not assessing competency for each decision.

I am just absolutely floored by the testimony. It's absolutely horrifying.

Someone will have a better memory than me, but I think it came out during the Kiera Bell case that Gillick competency was wrongly being claimed for 12 year olds who absolutely did not have capacity to consent to losing their fertility or never experiencing an orgasm.

GP here (although have had long period of time out so not currently in practice). Staggered by the negligence, reckless practising and prescribing outside area of expertise and sheer failure of duty of care outlined in these accounts so far.

Something I'm having difficulty understanding. Obviously as a doctor I know about Gillick competence. But why is Gillick competence relevant in the case of a 9 year old whose parent(s) is/are requesting the treatment? In practice an assessment of Gillick competence would be done for a 13-15 year old to assess their capacity to consent to a particular treatment or intervention independent of or without parental involvement. I know there is in theory no lower limit for the age of Gillick competence but in practice the kind of thing a very young child could be deemed to have capacity to consent to would be for example that the school first aider could put a simple dressing on a cut.

A 9 year old could safely be assumed not to have the capacity to independently consent to puberty blockers and cross-sex hormones. Assessing the child's Gillick competence would involve asking the child if they were prepared to consider the potential loss of fertility and sexual function - totally inappropriate to ask a 9 year old.

So why is the panel asking about the Gillick competence of this child? And happy if I've got this wrong for someone with more knowledge to point out.

Sorry, off on a tangent. My point being that MW saw it fit just to tick a fucking box and be done with it. There was no regard for the process or Gillick at all. A 9 yr old, fgs, 9!