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Feminism: Sex and gender discussions

GIDS granted permission to appeal

92 replies

TheFleegleHasLanded · 18/01/2021 15:25

twitter.com/BenInLDN/status/1351184741828067330?s=20

GIDS granted permission to appeal
OP posts:
RedToothBrush · 20/01/2021 09:34

There is a thread on twitter by @hannahsbee and linked by @deb_cohen about the CQC inadequate rating which i dont have time to copy here before a zoom meeting.

OvaHere · 20/01/2021 09:43

@RedToothBrush

There is a thread on twitter by *@hannahsbee and linked by @deb*_cohen about the CQC inadequate rating which i dont have time to copy here before a zoom meeting.
For those without Twitter this might be an easier format

threadreaderapp.com/thread/1351793414812086274.html

RedToothBrush · 20/01/2021 09:55

www.bbc.com/news/amp/health-55723250?__twitter_impression=true
NHS child gender clinic rated 'inadequate' by inspectors

Record-keeping at Gids was also criticised, with the CQC noting that "staff had not consistently recorded the competency, capacity and consent of patients referred for medical treatment before January 2020".

This had changed since, but the CQC noted that in an audit of 10 records of young people referred for hormone blockers in March 2020, "only three contained a completed consent form and checklist for referral".

And

After reviewing 35 care records, the CQC found there was "no clearly defined assessment process" and "many records did not demonstrate good practice".

The records also appeared to be "insufficient" in considering the needs of young people with autism spectrum disorders.

In a sample of 22 records, the CQC found more than half mentioned autistic spectrum disorder or attention deficit hyperactivity disorder (ADHD), but "records did not demonstrate consideration of the relationship between autistic spectrum disorder and gender dysphoria".

And

CQC deputy chief inspector of hospitals Kevin Cleary said his team continued to monitor the trust "extremely closely" and inspected the service again because "we were extremely clear that there were improvements needed in providing person-centred care, capacity and consent, safe care and treatment, and governance".

"In addition, vulnerable young people were not having their needs met as they were waiting too long for treatment."

The leadership at the trust knew "exactly what improvements are needed", he added.

Article by Ben Hunte btw.

Imnobody4 · 20/01/2021 10:07

Update on Protect gender dysphoric children from experimental treatment by Keira.
It seems that it's the Gillick judgement is the issue they're focusing on.

Hi everyone,

Earlier today it was confirmed that the Tavistock have been granted permission to appeal at the Court of Appeal. There are two grounds on which they can be granted permission; realistic prospect of success or some other compelling reason. The appeal has been granted on the latter. The Court of Appeal is interested in the Tavistock’s position that the judgement in Gillick has not been properly followed by the Divisional Court... We remain disappointed that the Tavistock is trying to overturn the rightful judgemen

RedToothBrush · 20/01/2021 10:14

Other highlights from the Newsnight thread

10 staff members had caseloads of less than 10 young people, but one member of staff had a caseload of over 100. The overall average was 45, which increased to 52.5 when staff with caseloads under ten were removed. 9/

Why were some staff more popular than others??

While some records demonstrated good practice, others had ‘limited information.’ Eg “one record had very little information about risks, despite the referral letter stating that the young person had frequent suicidal thoughts and had previously harmed themselves by cutting.” 11/

The report highlights how vulnerable some patients were, including: “young people who had made suicide attempts, young people who were vulnerable to sexual exploitation and young people who had a history of inappropriate or high-risk sexual behaviour.” 12/

Wtf.

The CQC reviewed 35 care records: “There was no clear rationale for clinical decision making.” The report notes wide variation in practice and in length of assessment, yet the Tavistock hadn't tried to understand why this was. 14/

Ideology and lobby group pressure was leading here

The report highlights the high % of GIDS patients with autism spectrum disorders. 28% young people assessed were referred for medical treatment. But, “records showed that the service may not have fully investigated or considered the needs" of autistic patients. 17/

Anyone surprised?

The CQC says that while “Staff were experienced and qualified and had the right skills and knowledge to meet the primary needs of the patient group,” they “did not necessarily have the skills or experience to meet the needs of young people with complex needs.” 19/

Bit of a problem this...

“However, whilst staff demonstrated their work on helping young people to understand information about treatment, there were very few details on the records of staff engaging in the more difficult task of supporting young people weigh-up the foreseeable risks and consequences”22/

GIDS carried out audits of compliance with their procedure for consent and capacity in March and September 2020. The March audit reviewed 10 records of young people referred for hormone blockers: “only three contained a completed consent form and checklist for referral.” 23/

Errrr how can you claim anything in a court case about consent when you are actively seeking it properly and documenting it?? Its a conveyer belt for drugs...

CQC: “we found no evidence that staff had completed an assessment after the documentation was found to be missing...this meant that staff had still not assessed the capacity and competency of young people receiving treatment, despite being aware that they had not done so.” 24/

Er what?!

22 young people receiving care and treatment from GIDS were interviewed as well as the parents of 13 young people using the service. “Feedback from these people was overwhelmingly positive.” 34/

This is not necessarily a good thing. Not if the serve is merely doing what people are demanding (possibly under the influence of social media or parents) rather than properly assessing their needs.

It apologised to patients and their families for the length of time they are waiting to be seen, and acknowledged the difficulty this caused. “We very much accept the need for improvements in our assessments, systems and processes,” they added. 36/

This seems to be the only apology from the Tavi... Nothing about any other lack of proper procedure and safeguarding...

Its appalling.

I have to say that Newsnight reporting to the CQC is a real public service...

nevernotstruggling · 20/01/2021 10:24

The results from cqc are about so much more than the drug pushing. They are really frightening.

MichelleofzeResistance · 20/01/2021 10:30

It is a problem for most public service organisations: feedback forms that show satisfaction often reflect who got what they wanted, rather than who got quality provision. Sometimes the best practice and best team involvement to meet and identify needs didn't match up with the person's wants . Which may well mean the team did everything right, and the best they could for that service user.

It's interesting how the dots add up between the court judgement, whistleblowers and CQC: three groups telling consistent stories that match here.

Although equally I have increasing sympathy for the Tavistock staff, who seem to have been swamped with overwhelming demand, without guidance, with huge external pressures.

MichelleofzeResistance · 20/01/2021 10:32

And very complex, high need kids and families with the kind of challenges CAMHS and paediatricians and social services various family support stages would struggle with. I wonder how much buck passing of such families was done in this. No one group seems to have been in a position to have a holistic and integrated view. Demand and complexity without process developing alongside it.

Typesofcatalogue · 20/01/2021 10:42

Does anyone know can parents still consent to puberty blockers or cross sex hormones on behalf of their child?

PurpleHoodie · 20/01/2021 11:14

Where do we dig?

(Dont post any direct links. Private messages here, or a few key words in the right direction would help)

DaffodilDaffodilDaffodil

RedToothBrush · 20/01/2021 11:24

@Typesofcatalogue

Does anyone know can parents still consent to puberty blockers or cross sex hormones on behalf of their child?
Have they? Properly i mean. With the risks aquedately discussed.

Doesn't look like proper consent is being sought as the paper trail doesn't exist for either parents or children...

OldCrone · 20/01/2021 12:48

@Typesofcatalogue

Does anyone know can parents still consent to puberty blockers or cross sex hormones on behalf of their child?
Still? Have they ever been able to do this? GIDS have always required consent from the child and at least one parent.

gids.nhs.uk/informed-consent

For young people of 16 and under, consent to treatment should usually be sought from the child and from one or both parents, except under exceptional circumstances.

OldCrone · 20/01/2021 13:00

And would it really be appropriate for a parent to consent on behalf of their child when the motive for some of these parents would be homophobia or because they are paedophiles?

www.thetimes.co.uk/article/it-feels-like-conversion-therapy-for-gay-children-say-clinicians-pvsckdvq2

Article archived here:
archive.vn/zy6PA

A clinician at the Tavistock is quoted in that article.
“All the pushing was coming from the father to put the kid on puberty blockers. Thinking back on it now, I fear that the father was a paedophile and the child was being abused.”

Manderleyagain · 20/01/2021 17:42

@Typesofcatalogue

Does anyone know can parents still consent to puberty blockers or cross sex hormones on behalf of their child?
No. The judges in the Bell ruling didn't consider whether parents could consent because it didn't come up. That was because the clinic always took the view that they needed the patient's consent, so didn't treat based on parental consent. They therefor didn't argue this point in court.

Jolyan mougham's project intends to challenge this somehow according to an interview he gave. I think I've read that the Leeds clinic might be applying to the court to allow parents to consent on behalf of their child. But as it stands they can't.

nickymanchester · 20/01/2021 19:30

@RedToothBrush

Thank you for that link.

I'd seen the previous judgment which followed an urgent hearing as the girl concerned only had a matter of hours left to live. In the judgment, Sir James Munby said that a medical intervention "... is imperatively needed and within a timescale measured in hours and not days."

Re X (A Child) (2020) EWHC 3003 (Fam)

However, he did also say that the wider issues surrounding a court order relating to a Gillick competent child needed to be given a more thoughtful response.

That response came in the case that RedToothBrush referred to.

NHS Trust v X (In the matter of X (A Child) (No 2)) (2021) EWHC 65 (Fam)

For anyone with an involvement with family law or healthcare it really is worthwhile reading I would suggest. It sets out in the clearest possible language the case law around consent to/refusal of treatment by those under the age of 16 who are not Gillick competent, those who are under the age of 16 but declared to be Gillick competent and those aged 16 and 17.

The judgment is actually very detailed and nuanced. The practical upshot though is that even where a Gillick competent child or a 16 or 17 year old child either consents to or refuses treatment that this can still be overridden by the court.

Just to go back to the Bell case, it should be remembered that, unusually, there were three judges hearing the case, in the High Court it's normally just one.

This included the President of the Queen's Bench, Dame Victoria Sharp and Lord Justice Lewis, a very recently promoted member of the Court of Appeal. Two very senior judges indeed.

I would not be surprised if this were more about the Court of Appeal wanting to say something specific about Gillick competence and using this case as an excuse to do so rather than any real feeling that the judgment was wrong in any way.

MichelleofzeResistance · 20/01/2021 19:48

That's interesting Nicky

I did think with three judges and that particular choice of them it would be fascinating to see what they supposedly did wrong.

JudithButlerNot · 20/01/2021 19:58

The appeal is a good thing. The judgement in the first case was great but impractical. It needs to be looked at again and this appeal will allow for that. Hopefully they'll tweak it a bit but without any real change

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