NHS Fife tries to silence nurse - Sandie Peggie vs NHS Fife Health Board and Dr Beth Upton - thread #15

[nauticant]

Sandie Peggie, a nurse at Victoria Hospital in Kirkcaldy (VH), has brought claims in the employment tribunal against her employer; Fife Health Board (the Board) and another employee, Dr B Upton. Ms Peggie’s claims are of sexual harassment, harassment related to a protected belief, indirect discrimination and victimisation. Dr Upton claims to be a transwoman, that is observed as male at birth but asserting a female gender identity.

The Employment Tribunal hearing started on Monday 3 February 2025 and was expected to continue for 2 weeks although once it was in to the second week it was looking like this would not happen. The hearing commenced with Sandie Peggie giving evidence. Dr Beth Upton gave evidence from Thursday 6 February to Wednesday 12 February.

Access to view the hearing remotely was obtainable by sending an email request to [email protected] headed Public Access Request (Peggie v Fife Health Board) 4104864/2024 and requesting access.

However, as a result of problems with the livestreaming, apparently, as a result of a very large number of observers, remote public access to the hearing was suspended on Tuesday 11 February. It was suggested that it might be reinstated at some point but don't count on it.

The hearing is being live tweeted by https://x.com/tribunaltweets and there's additional information here: https://tribunaltweets.substack.com/p/peggie-vs-fife-health-board-and-dr. This also has threadreaderapp archives of live-tweeting of the sessions of the hearing for those who can't follow on Twitter, for example: archive.is/xkSxy.

An alternative to Twitter is to use Nitter: https://nitter.poast.org/tribunaltweets

Thread 1: https://www.mumsnet.com/talk/womens_rights/5186317-nhs-fife-tries-to-silence-nurse
Thread 2: https://www.mumsnet.com/talk/womens_rights/5267591-nhs-fife-tries-to-silence-nurse-sandie-peggie-vs-nhs-fife-health-board-thread-2
Thread 3: https://www.mumsnet.com/talk/womens_rights/5268347-nhs-fife-tries-to-silence-nurse-sandie-peggie-vs-nhs-fife-health-board-and-dr-beth-upton-thread-3
Thread 4: https://www.mumsnet.com/talk/womens_rights/5268942-nhs-fife-tries-to-silence-nurse-sandie-peggie-vs-nhs-fife-health-board-and-dr-beth-upton-thread-4
Thread 5: https://www.mumsnet.com/talk/womens_rights/5269149-nhs-fife-tries-to-silence-nurse-sandie-peggie-vs-nhs-fife-health-board-and-dr-beth-upton-thread-5
Thread 6: https://www.mumsnet.com/talk/womens_rights/5269635-nhs-fife-tries-to-silence-nurse-sandie-peggie-vs-nhs-fife-health-board-and-dr-beth-upton-thread-6
Thread 7: https://www.mumsnet.com/talk/womens_rights/5270365-nhs-fife-tries-to-silence-nurse-sandie-peggie-vs-nhs-fife-health-board-and-dr-beth-upton-thread-7
Thread 8: https://www.mumsnet.com/talk/womens_rights/5271511-nhs-fife-tries-to-silence-nurse-sandie-peggie-vs-nhs-fife-health-board-and-dr-beth-upton-thread-8
Thread 9: https://www.mumsnet.com/talk/womens_rights/5271596-nhs-fife-tries-to-silence-nurse-sandie-peggie-vs-nhs-fife-health-board-and-dr-beth-upton-thread-9
Thread 10: https://www.mumsnet.com/talk/womens_rights/5271723-nhs-fife-tries-to-silence-nurse-sandie-peggie-vs-nhs-fife-health-board-and-dr-beth-upton-thread-10
Thread 11: https://www.mumsnet.com/talk/womens_rights/5272046-nhs-fife-tries-to-silence-nurse-sandie-peggie-vs-nhs-fife-health-board-and-dr-beth-upton-thread-11
Thread 12: https://www.mumsnet.com/talk/womens_rights/5272276-nhs-fife-tries-to-silence-nurse-sandie-peggie-vs-nhs-fife-health-board-and-dr-beth-upton-thread-12
Thread 13: https://www.mumsnet.com/talk/womens_rights/5272398-nhs-fife-tries-to-silence-nurse-sandie-peggie-vs-nhs-fife-health-board-and-dr-beth-upton-thread-13
Thread 14: https://www.mumsnet.com/talk/womens_rights/5272939-nhs-fife-tries-to-silence-nurse-sandie-peggie-vs-nhs-fife-health-board-and-dr-beth-upton-thread-14

DH was alert to the dangers of gender ideology about 3 years before I was. We are both fairly left (ish), erstwhile “be kind” types.

I thought he was being unspeakably cruel by refusing to say TWAW and he asked me whether I really believed TWAW. I said no, but there was no harm in being compassionate. He smiled, and said, “You’ll get there” and was right.

The reason he was correct is because if you don’t really believe that men can become women then there’s a point where reality interjects and this ultimately trumps ideological #bekind.

This case is important because loads of women are appreciating that they can be kind, respectful, use pronouns etc but unless they accept men in women’s changing rooms, they will also be vilified as a bigot. A lot of women will be realising that no, they also don’t want to be dealing with menstrual flooding with a man in their space. I know I wouldn’t.

"Aligned with gender identity" is a bit of a stretch. More like "aligned with the powerful drugs the patient is taking".

That part was interesting because it would have been easy to avoid them overlapping. The suspension policy says to try to keep people working as much as possible but SP was moved to day shifts in another dept. SP was disappointed as “I loved my job in A&E). Some meeting notes confirmed that the managers looked into it. Do we know for sure that DU scotched it?

Because this and DU’s comment at the end that they were scared of SP organising the nurses to keep DU out of the CR, doesnt that get a long way towards proving the whistleblowing or victimisation claims?

Directly related to SP’s sex and her asserting rights to a female only space in the CR, DU worked to keep her out of the A&E dept - to avoid an emperor’s new clothes moment which would interfere with DU’s immersive role play?

That caused her detriments including being suspended, reputational damage, moving to day shifts, moving out of A&E a jog she loved…

Or is that all circumstantial?

I'm diligent about keeping up to date with many matters and I'm a regular reviewer so I would expect to pick up proposed changes to reference ranges among other matters.

There are some proposed changes to reference test ranges but one that springs to mind is one to challenge poor assumptions that are not grounded in plausible evidenced-based data:
Anaemia is associated with increased morbidity and mortality in patients undergoing anaesthesia; however, women are defined as being anaemic at a lower haemoglobin level than men. In this narrative review, we present the history of iron deficiency anaemia and how women’s health has often been overlooked.…We present data of population screening demonstrating how common iron deficiency is, affecting 12–18% of apparently ‘fit and healthy’ women, with the most common cause being heavy menstrual bleeding; both conditions being often unrecognised. We describe a range of symptoms reported by women, that vary from fatigue to brain fog, hair loss and eating ice…Overall, we demonstrate the need to single out women and investigate iron deficiency rather than accept the dogma of normality and differential treatment; this is to say, the need to change the current standard of care for women undergoing anaesthesia.
…
iron deficiency is so common in women that it can be regarded as ‘hiding in plain sight’, so much so that the original World Health Organization definition of anaemia, being a haemoglobin concentration < 120 g.l-1 in women compared with < 130 g.l-1 in men, was ‘arbitrary’ at best
…
Treatment of iron deficiency can improve skeletal muscle function and physical function, particularly in women, so if the target haemoglobin for optimal health is 140 g.l-1, then there is a need to single out women and investigate iron deficiency rather than accept the dogma of normality and differential treatment. Consideration of routine measurement of ferritin and haemoglobin in reproductive-aged women should be on the agenda of all healthcare provider systems.

Dugan, C., MacLean, B., Cabolis, K., Abeysiri, S., Khong, A., Sajic, M., Richards, T. and (2021), The misogyny of iron deficiency. Anaesthesia, 76: 56-62. doi.org/10.1111/anae.15432

Not related to reference ranges but I've seen that publications seem to confuse and heighten the risk of error rather than educate and contribute to patient safety. I'd originally seen the first line of this (mis)reported elsewhere but it wasn't until MedPage and reading the study that all became clear. (The risk of developing Type 2 diabetes is greater for transwomen than it is for women. However, as you might expect, the risk of transwomen developing Type 2 diabetes is is comparable to that for men.)

Diabetes Risk Higher for Transwomen vs Cisgender Females
— But risk wasn't any higher compared with cisgender men
…
Transwomen may face a higher risk for developing type 2 diabetes than cisgender women, a new study suggested.

Among those already diagnosed with type 2 diabetes at baseline, a total of 32% of transwomen were on gender-affirming hormone therapy, the group reported in the Journal of Clinical Endocrinology & Metabolism.
Transwomen also saw a 40% higher risk of developing incident type 2 diabetes during the average 3.1 years of follow-up compared with cisgender females (HR 1.4, 95% CI 1.1-1.8).
However, transwomen didn't have any excess risk for developing diabetes when compared with cisgender men (HR 1.2, 95% CI 0.9-1.5), which the researchers said "likely reflects the known gender disparity in [type 2 diabetes] risk in the general population."
And in an analysis restricted only to transgender and gender-diverse people receiving gender-affirming hormone therapy, transwomen didn't see a significantly higher prevalence of type 2 diabetes (OR 1.0, 95% 0.7-1.3) nor risk for incident diabetes (HR 1.4, 95% CI 0.8-2.4) versus cisgender females. This suggests that the excess diabetes risk for this population wasn't driven by hormonal therapy, the researchers said.

https://www.medpagetoday.com/endocrinology/diabetes/95937

Although transfeminine people may be at higher risk for T2DM compared with cisgender females, the corresponding difference relative to cisgender males is not discernable. Moreover, there is little evidence that T2DM occurrence in either transfeminine or transmasculine persons is attributable to GAHT use.

Study: Noreen Islam, Rebecca Nash, Qi Zhang, Leonidas Panagiotakopoulos, Tanicia Daley, Shalender Bhasin, Darios Getahun, J Sonya Haw, Courtney McCracken, Michael J Silverberg, Vin Tangpricha, Suma Vupputuri, Michael Goodman, Is There a Link Between Hormone Use and Diabetes Incidence in Transgender People? Data From the STRONG Cohort, The Journal of Clinical Endocrinology & Metabolism, Volume 107, Issue 4, April 2022, Pages e1549–e1557, https://doi.org/10.1210/clinem/dgab832

A long way to say, I'd be eager to rectify this vast hole in my knowledge about the (environmental? intentional?) impact of cross-sex hormones to which DU / BU refers.

@nebulousMoose you asked about the cake deletions…

When FWR is faced with sea looming and filibustering of the DU kind, frustration can be intense. People would go off at a random, stress relieving tangent and find themselves talking about cake, or indeed cereal.

The monitors then reported that as not being in the spirit failing to play by their rules or being mean and there would be a load of deletions and a warning to stick to the topic.

@FannyCann in regards to the exchange you posted, apparently yes that was the gist. Apparantly during this exchange he said 'People believe all sorts of things. Doesn't make it true'. It was him justifying that TWAW and if you disagree you are like people who don't believe in climate change or think there's a flying spaghetti monster.

I can't say I've heard of the latter before.

Quite.
It's also irrelevant to single sex provision, isn't it - that's based on bodies.

Just been skimming so apologies if already been said but - Dr Searle did an immediate datix when Dr U reported that Sandie had "stopped doing resus" when Dr U walked in. Lay people are going to assume that meant she stopped working to resus a child with breathing difficulties and that is probably how Dr Searle read it. She could have taken it to mean just leaving in the room an inexperienced junior doctor that would need a handhold, anaphylaxis being a severe emergency and upsetting for those around. I'd expect that to be explored soon by NC.

You treat anaphylaxis with adrenaline. Given promptly the breathing difficulties will generally rapidly resolve and the patient then needs to be kept under observation because there is a risk of a secondary reaction. So it would not be dangerous for a nurse to leave at that stage if someone else was present to do observations and she was needed elsewhere.

Only Dr Searle can say whether she questioned Upton about exactly when the nurse left and why.

Any investigation should have looked at when the nurse left and why - you'd assume the incident took place but if Upton couldnt say when or the nurse presented a different story you'd need to look at shift patterns and records and check the paper records/ whether anyone else was present. Instead everyone seems to leap into assuming the nurse was at fault.

@Heggettypeg
Cross-posted.

At the conclusion yesterday NC suggested there were still missing communications that she fel were required. The judge, however, just wanted everything wrapped up...and rebuffed her with " Not in this jurisdiction".

Is that it, then......? Is that true for that is only permissible is only if 'the respondent' accepts it?.

My sense is that the key to DU's deception lies in what is missing.......and because the judge has not been awake to this, or because he's mainly concerned with finishing early/on time - he's denying a crucial piece of evidence?

Donated- good luck with this

I shouldn't have read this before breakfast. Now I want cake instead of weetabix for breakfast!

(The AI seemed unaware of what weetabix actually are!)

Sorry wrong board!

The only Datix produced was the bullying and harrassment Datix that Dr Upton 'didn't realise was a formal complaint'.

No reports were made for the patient care incidents. It isn't even clear if this one even existed. The meticulous note-taker can't even narrow it down to a month or week (as that might show that it didn't happen).

Sandie recalls a "Snickers bar" child at Halloween, but Dr U doesn't think it was that one.

Was the main part of my complaint, along with denying the existence of biological sex and being deluded in thinking he was a woman.

Didn't he also go back to work after the Xmas eve changing room incident and use the female changing room again? He said he put his big girl pants on specially for the occasion.

So when exactly did he get so upset that he needed 2 months off sick?

@Shortshriftandlethal " Not in this jurisdiction". was about who decided the order in which witnesses are called. That was being discussed along with more disclosure. NC wanted the disclosure before the witnesses, hence telling the judge it was not entirely the defendants decision.

In other words, men pretending to be women are biologically the same as other men.

Who knew.

I thought the 'not in this jurisdiction' was about the order of the witnesses?

@NebulousDog I should have said that Dr Searle got Upton to submit a datix rather than saying she did it. In doing so she satisfied her professional obligations to report concerns about patient safety, she would have been at fault if a serious concern ("leaving resus") was raised and she did nothing.

Where it all goes wrong is that she apparently then sent an email to others prejudging the outcome of the investigation.

Maybe we could ask for a doctor who was "assigned female at birth"? (I don't mind if she's got a beard and no tits, still a woman to me)

Though I suppose we'll be told its none of our business.

( Also, I would really like to hear an Imam's opinion on what hospitals ought to do!)

The bit that struck me on his not being able to remember the patient care issues, was that he said he had talked about the CR incident more/ to more people. Was in passing yesterday morning but shows how much he was gunning for Sandie.
Also when spreading word around did he really not mention her name? A earlier day in court he said he wanted a friend to accompany him when he returned to work but said he didn't tell her whom was the issue. Seemed like preempting a follow up Q.

Oh dear, I see auto carrot substituted that well known phrase sea looming for sealioning.

I suppose the sea does loom on the horizon…

I'm still trying to get my head around Fife's rules

You are a GC member of staff working with DU and a confused patient requests a female doctor. DU responds 'but I am a woman' and so you witness what you believe to be a deception.

Should you report this?

Do you need to report it immediately as a patient safety issue?
If you report this will you open yourself up to claims of transphobia?

If you don't report it and the patient does object then are you also guilty of the deception?

Not Dr Upton.