How can the NHS cope?

[NonSuchFun]

Hi all, I haven’t seen any threads regarding how the NHS can cope with the explosion of demands for trans treatments, but do correct me if I’m wrong - I’m new, have only been lurking for a few months. Also I won’t be responding til this evening as I will be out all day, so apologies for that. I have a lot more to say!
But I will out myself as working in the NHS and I really worry about the implications in lots of ways. It’s not even on the radar in my little backwater.
Here is a link to an article in the telegraph earlier this week.
www.telegraph.co.uk/news/2018/06/04/nearly-two-million-britons-expected-question-gender-health-boss/

Unlike James Palmer I definitely don’t see it as a good thing. My own area has another £6m to save next year, is making further cuts to IVF treatment and I’m sure there are plenty of Mumsnet users who have been denied nhs fertility treatment. Dr Christian has campaigned vigorously for PrEP (pre-exposure prophylaxis to prevent HIV), and also for HOV vaccines for boys (which I support and is denied for cost reasons). HCAs working in our community area are being “asked” to take a pay cut. Another thread this week discussed cuts to sexual health and contraception services. I could go on, perhaps better not, I’m angry and in a hurry!

On the plus side, this all helps get the message out there.

It’s one of the things that concerns me TBH re the demedicalisation demands.

It isn’t however a feminist concern but rather a concern re the material conditions of transpeople where austerity, privatisation and demedicalisation combine.

I don't know how the NHS will cope. I used to know a very good NHS speech therapist who 15 years ago, was complaining that too much of her time was being spent teaching TIMs to talk like women. She made the point that it wasn't just about changing the pitch of their voices, it was teaching them on a word-for-word basis how women speak. So not 'Give me that' and pointing in a shop but. 'May I have that please?' sort of stuff. She was completely disenchanted by the trans phenomenon even before it really took off. She said she'd joined the NHS to help stroke patients and those with real speech problems, not to teach blokes how to be ladies.

HPV vaccine.

I take your point re it not being a feminist issue Offred, feel free to point me to the correct board.

However, it WILL impact women and children with cuts to services.

I recently saw an article about men complaining of being discriminated against as they were bottom of the priority list for breast augmentation after other women’s breast procedures for instance. I work with someone with an enormous bust who cannot get funding for breast reduction and can’t afford it. You can see how the weight affects her posture and causes back problems. If she is off sick with back problems it will be the NHS paying, but hey, someone else’s budget. Anyway it doesn’t matter who she works for, it really affects her health and quality of life.
Just the tip of the iceberg of how women will end up the worse off.

Merchfach - I’m amazed. I had no idea that speech therapy on the NHS was on offer! Your friend must be very disappointed with the way her work is going.

She left and the growing workload with TIMs was always the reason she gave for leaving. She didn't feel that that was what she'd trained for. When last heard of she was working at a specialist stroke rehab centre.

NC for this. Depresses me in itself.

Impact in the NHS would already baffle many if they knew. At Guy's they do SRS. A referral is given priority over scheduled cancer surgery. Despite the current focus on cancer waiting times, longer lists and general strain. Because if they get a referral, the patient will commit suicide any day without surgery.... NHS supposedly based on evidence based medicine obviously.

This may be what kills the NHS. Not the treatments, but the lawsuits that will be coming in 10-15 years.

Saying that, there's a rumor that the reason the Tories keep saying "trans is not an illness" is so that they can stop offering trans treatments... which may be quite a clever move on their part.

Outrageous that these men are so narcissistic that they take up these elective surgery places as well speech therapy time. When do we ( i incliude Women wanting cosmetic surgery here also) stop trying to alter our bodies into someone else's impossible fantasy.? We must start early educating children that their bodies are theirs, they are fine as they are, no need to change them. I think the trend for men to try to look like women, and demand that we pay for it is completely unacceptable . Getting what they want should not be through manipulation.

I meant my concern regarding this issue is not a feminist concern but a concern regarding the consequences of demedicalisation for transpeople.

I wasn’t particularly trying to say ‘take this somewhere else’!

I also would not like it if these concerns mixed with feminist concerns re institutional sexism in medicine and austerity politics in such a way that it became medicine for transpeople OR medicine for women.

That’s a race to the bottom and in direct opposition re the founding principles of the NHS.

Access to healthcare should be universal. Healthcare should be free at the point of use and based on need. The practice of medicine should be evidence based and steps should be taken to eliminate as much unconscious bias as possible in order to reduce discrimination. The evidence should be high quality and relevant.

Although isn't it the case the around 80% of transgender people decide against surgery? I can see that talking therapies and drug treatments will cost the NHS - but surgeries may not be performed as much as all that.

Although the numbers of transwomen getting unnecessary women's health checks might create a burden. Not to mention those who end up with male cancers because they have failed to attend their male health checks.

Access to healthcare should be universal. Healthcare should be free at the point of use and based on need.

I agree. Trans healthcare should be as comprehensive as all other health care and waiting lists should be as much a priority to reduce as all other healthcare. That said, a belt and braces requirement for dysphoria diagnosis should be required for any procedures - including things like speech therapy. There is a high bar for women to receive things like breast reductions and electrolysis and that high bar should be equally applied for transgender healthcare. All cosmetic procedures should require a high bar from the NHS.

I don't know how the NHS will cope. I used to know a very good NHS speech therapist who 15 years ago, was complaining that too much of her time was being spent teaching TIMs to talk like women. She made the point that it wasn't just about changing the pitch of their voices, it was teaching them on a word-for-word basis how women speak. So not 'Give me that' and pointing in a shop but. 'May I have that please?' sort of stuff. She was completely disenchanted by the trans phenomenon even before it really took off. She said she'd joined the NHS to help stroke patients and those with real speech problems, not to teach blokes how to be ladies.

I had no idea Speech Therapists had to do this. Naive of me I guess, I'm certain it wasn't why she entered that profession. God, so many people are affected by this 'small number of people' aren't they. So many people whose personal feelings and beliefs must take a back seat to this 'oppressed minority' .

At Guy's they do SRS. A referral is given priority over scheduled cancer surgery. Despite the current focus on cancer waiting times, longer lists and general strain.

And there goes my blood pressure. I am properly wound up now

forgive me, but what's SRS?

Sex Reassignment Surgery. Sorry.

And yes, the budget for lawsuits is going to be horrendous. Private practice insurance premiums for urology surgeons quadruple for those who carry out SRS. I may have some opinions as to why. They take the patient at the point of referral but ultimately they've wielded the knife.

Outline of services to be made available on the NHS here.
www.engage.england.nhs.uk/survey/gender-identity-services-for-adults/user_uploads/gender-identity-non-surgical-specification.pdf

I don't have a problem with any of it for any given individual if clinically indicated (in as much as it would be hard to say where to draw the line) , but it does seem pretty optimistic given the severe pressures the NHS is under.

And yes when there are lots of people struggling with lots of aspects of their physical appearance and mental health why the provision under this service is special.

I am far more interested in provision of

…. mental health services generally

The NHS has been doing gender reassignment surgery since 1999 so what makes you think there will be a 'sudden explosion' of these?

Whatever the problem is, it must be the fault of trans people. Straight from the Nigel Farage School of Logic:

www.theguardian.com/politics/2014/dec/07/nigel-farage-blames-immigration-m4-traffic-ukip-reception

The NHS has been doing gender reassignment surgery since 1999 so what makes you think there will be a 'sudden explosion' of these?

daimbars, Wakame - there are only so many times you can throw the same old canards at women on FWR. Why not go on a conversion attack at, say PistonHeads or Datalounge, and find some new people to talk nonsense at? I mean, the menz have got all the social power and are the ones doing all the violence - surely they should be a conversion priority for you?

there are only so many times you can throw the same old canards at women on FWR. Why not go on a conversion attack at, say PistonHeads or Datalounge, and find some new people to talk nonsense at? I mean, the menz have got all the social power and are the ones doing all the violence - surely they should be a conversion priority for you?

May I copy this please, as a stock response to certain posters?

Or you could explain why this is nothing like Farage's argument about being late because of immigrants. You know - break down the analogy. Otherwise people might think you people have right-wing tendencies. I mean you'll be posting articles from Catholic websites and the Daily Mail next... Oh, wait a minute...

"the menz have got all the social power and are the ones doing all the violence - surely they should be a conversion priority for you?"

On that basis, surely they are the conversion priority for you too?

jgrobinson - that is just referrals for under 18's. Has anyone got numbers for referrals to adult clinics?