Helen Webberley

[Signalbox]

Looks like Helem Webberley's substantive case has finally been listed for 26th July 2021

www.mpts-uk.org/hearings-and-decisions/medical-practitioners-tribunals/dr-helen-webberley-jul-21

Oh in answer to my question, the HW twitter account have now said that "some charges have been dropped but not others".

It seems the following charges have been dropped (no case to answer)

Heads of Charge

8ai, 8aiv, 8bi in relation to patient E

15-17 (which includes a dishonesty charge)

21b

22b

23 (which is a dishonesty charge)

25
26
27 (which is the charge in relation to avoiding the regulatory framework of the UK including regulation by the CQC, HIW and GMC)

There are now only 2 dishonesty charges remaining which are in relation to HoC 10 to 14 (that HW lied about being a member of the RCGP) and HoC 18 to 20 (that HW did not inform Frosts Pharmacy that she had been suspended from the Medical Performers list when she knew that she should have.)

Are there any other charges besides dishonesty ones?

And thank you for updating us on this, I am finding this difficult to follow on Twitter.

What's the reason for the dropping? Not seeing that anywhere.

@CharlieParley

Are there any other charges besides dishonesty ones?

And thank you for updating us on this, I am finding this difficult to follow on Twitter.

Yes from what I can work out the following charges still stand

Heads of charge

1 and 2 (in relation to Patient A)
3 and 4 (in relation to Patient B)
5 and 6 (in relation to Patient C)
7, 8 (partially) and 9 (in relation to CQC - Dr Matt Ltd)
10 to 14 (in relation to RCGP)
18 to 20 (in relation to suspension from medical performers list)
21 and 22 (partially)
24 (in relation to operating and controlling Gender GP)
28 and 29 (in relation to HW's conviction and fine)

@NecessaryScene

What's the reason for the dropping? Not seeing that anywhere.

The reason appears to be that there is "no case to answer" which means that at the end of the GMC's case the defence made submissions that the GMC had not provided enough evidence to prove its case. The panel then consider this and they appear to have decided that the evidence (for the HoC listed above) was absent or inadequate.

I wonder if the defence will open its case today.

Seems that there is a discussion now around the GMC submitting new material that they want to question HW about. In relation to her witness statement and being a "self taught gender specialist" the panel will have to decide whether or not to allow this new material. The GMC's experts have not had the opportunity to comment on the documents so this could be a problem. I can't see that the defence will be opening their case today now.

The new material in question are documents that HW has referred to in her witness statements. The GMC want to be able to question her in relation to these documents. They relate to policies / guidelines that existed at the time. The GMC want to question whether or not they were complied with.

The defence are objecting to the documents being included because they say that they should have been included in the GMC's case. Also none of the GMC's experts have had been able to comment on the documents the defence have not had the opportunity to cross examine the experts on the documents.

I can't really work out why the GMC closed their case if they knew they wanted to submit new material. Defence are saying it's only in rare circumstances (evidence only becoming available after the close of a case) where you would expect a case to be re-opened.

The panel have decided to allow the documents and for HW to answer questions in relation to them.

Looks like HW will start her evidence tomorrow morning.

Thanks for keeping this going. I saw today's Twitter thread but it is hard to keep up with what's what. I hope if this ever ends it will be written up clearly!

Helen Webberly starting her evidence today...

I don't know why the twitter account keeps starting new threads it makes it difficult to follow.

First 3 threads here...

Thread 1
twitter.com/tribunaltweets/status/1440237464216506370

Thread 2
twitter.com/tribunaltweets/status/1440246211722633221

Thread 3
twitter.com/tribunaltweets/status/1440252245686194181

Fascinating evidence from HW today. She seems to keep comparing medical intervention for GD with adolescents asking for birth control medication.

@CatsOperatingInGangs

Fascinating evidence from HW today. She seems to keep comparing medical intervention for GD with adolescents asking for birth control medication.

NAGPALT but you might be interested in the level of understanding of some GPs about long-term conditions (corollary of long-term interventions) and how to interpret evidence or what counts as decent evidence:

Background GPs prescribe multiple long-term treatments to their patients. For shared clinical decision-making, understanding of the absolute benefits and harms of individual treatments is needed. International evidence shows that doctors’ knowledge of treatment effects is poor but, to the authors knowledge, this has not been researched among GPs in the UK.

Aim To measure the level and range of the quantitative understanding of the benefits and harms of treatments for common long-term conditions (LTCs) among GPs.

Design & setting An online cross-sectional survey was distributed to GPs in the UK.

Method Participants were asked to estimate the percentage absolute risk reduction or increase conferred by 13 interventions across 10 LTCs on 17 important outcomes. Responses were collated and presented in a novel graphic format to allow detailed visualisation of the findings. Descriptive statistical analysis was performed.

Results A total of 443 responders were included in the analysis. Most demonstrated poor (and in some cases very poor) knowledge of the absolute benefits and harms of treatments. Overall, an average of 10.9% of responses were correct allowing for ±1% margin in absolute risk estimates and 23.3% allowing a ±3% margin. Eighty-seven point seven per cent of responses overestimated and 8.9% of responses underestimated treatment effects. There was no tendency to differentially overestimate benefits and underestimate harms. Sixty-four point eight per cent of GPs self-reported ‘low’ to ‘very low’ confidence in their knowledge."

GPs’ understanding of the benefits and harms of treatments for long-term conditions: an online survey
Julian Stephen Treadwell, Geoff Wong, Coral Milburn-Curtis, Benjamin Feakins, Trisha Greenhalgh BJGP Open 2020; 4 (1): bjgpopen20X101016. DOI:10.3399/bjgpopen20X101016

bjgpopen.org/content/early/2020/03/03/bjgpopen20X101016

@CatsOperatingInGangs

Fascinating evidence from HW today. She seems to keep comparing medical intervention for GD with adolescents asking for birth control medication.

Bonkers...

"DRW: with regard to the GMC, my role is to assess the patient de novo and determine diagnosis. SJ: do you accept that the psychological assessment is a formal mandatory step that needs to be undertaken?

DRW: in America there is a requirement for a letter of referral. Usually comes from psychologist or psychiatrist. In the UK, we've learned that GD or GI (gender incongruence) is NOT a mental disorder.

DRW: the best person to 'diagnose' someone's gender identity is the adolescent or they and their family. The role of the medical doctor is to help the individual achieve their goals. (disagreeing with the need for a mental health diagnosis).

DRW: my job is to determine how to intervene. SJ: is your approach that there does not need to be a psychological diagnosis of identity disorder or comorbid disorders?

DRW: my view is that the function of the diagnosis is to ensure that the patient fulfils the criteria for medical intervention. Now to give an example. If someone is asking for birth control, no need for a diagnosis.

DRW: Gender incongruence is similar to a request for birth control. Do they fulfil the criteria for medical intervention. It's not my job to diagnose their gender identity."

Tweets by @tribunaltweets**

EmbarrassingAdmissions
That's just incompetence isn't it? Are we saying that GPs are effectively guessing when treating long term conditions? Are they any better at acute conditions? I wonder if consultants are better or if a condition enters another specialist's territory they resort to guessing too? Or are they better at processing data at least?

Just goes to show a lot of GPs don't bother keeping their knowledge up to date. They often make way more money than specialists too.

Gender incongruence is similar to a request for birth control. Do they fulfil the criteria for medical intervention. It's not my job to diagnose their gender identity.
That's genuinely shocking

That's just incompetence isn't it? Are we saying that GPs are effectively guessing when treating long term conditions?

In the context of this thread, I'm offering this survey as a feasible insight into Webberley's lack of understanding of statistics, outcomes, and what constitutes reasonable standards of evidence.

No - GPs aren't guessing as they are following well-researched guidelines (NICE's, those from relevant professional organisations or the best practice guidance put out by them etc.). The deficit turns up in the way that they share that information as part of the clinical shared decision making process in which they and the patient discuss which treatment option should suit them and any relevant outcomes, side-effects etc.

The adult average level of numeracy in the UK is that of a 9 year-old. An adequate, or decent knowledge of statistics is rare even among professionals when it's not part of their academic course.

OK I read it as poor knowledge as well as an inability to understand statistics. I know GPs rarely get involved in research and rarely attend conferences, and have heard anecdotally that they (tend to) take less of an interest in keeping up to date with developments. But I don't want to go further off - topic. Thanks for the link.

I read it as poor knowledge

Part of the current examination relates to whether or not Webberley followed the best practice guidance etc. and her (documented?) rationale for her actions where these are not in accordance with the guidance that existed at the time.

The adult average level of numeracy in the UK is that of a 9 year-old.

Sorry about this derail, but this is the second time I've seen this posted recently. It makes no sense to me. Can you explain what it means?

I read it as "The adult average level of numeracy in the UK is that of the average 9 year-old." Because presumably the 'level of numeracy of a 9 year old' refers to the average level of children of that age.

So in that case, to compensate for the fact that the numeracy of many adults is greatly superior to that of a 9 year old, there must also be a great number of adults whose numeracy actually regresses after the age of 9.

Or is the 'level of numeracy of a 9 year old' referring to something other than the average level? If so what does this actually mean?

Thread 4
twitter.com/tribunaltweets/status/1440267041718472717

Thread 5
twitter.com/tribunaltweets/status/1440276149788033044

Break for lunch.

@OldCrone I would read that as the level of numeracy expected for a 9 year old according to the national curriculum. There's also an issue in the UK that many people who pass GCSE Maths at grade C (or above) actually don't have sufficient functional maths skills for daily living. So the content of the GCSE maths syllabus isn't relevant or helpful to daily numeracy requirements. And that children are often pushed very hard to scrape a grade C and then never do any kind of maths/numeracy ever again after the age of 16.