en English

On day six the following accusations were discussed: 

  • Dr Webberley is alleged to have not provided ‘good clinical care’ to Patient A.
  • Dr Webberley is alleged to have not informed Patient A’s GP of the medication she had prescribed.
  • Dr Webberley is alleged to have not maintained adequate records relating to Patient A’s treatment.

The first witness to speak on day six was Dr Chang Kow Michael Young, Patient A’s GP. In answer to a question from Ian Stern QC, counsel for Dr Webberley, Dr Young stated that he had never encountered a patient with gender dysphoria prior to Patient A.

 

You can find more information about the allegations against Dr Webberley here

 

Ian Stern read from a letter from Dr Webberley to Dr Young that detailed interactions between Patient A’s mum and Tavistock. The Tavistock had told Patient A’s mum that if they didn’t stop seeing Dr Webberley then Patient A would be discharged from the Tavistock and Dr Young would be told to stop prescribing puberty blockers. Furthermore, Patient A’s mother told Dr Webberley that Professor Butler had told her that they were about to start clinical trials for testosterone for younger patients, so that Patient A could start hormones soon. However, after Patient A’s mum had agreed to withdraw from Dr Webberley’s service, stopped the testosterone, and had returned her son to Tavistock’s care, she was advised that clinical trials would not start until Patient A was at least 15. Patient A’s mother described feeling “threatened” by staff at GIDS/Tavistock. NHS guidance explicitly states that ‘your position on a NHS waiting list shouldn’t be affected if you choose to have a private consultation’. The tribunal hearing heard how Patient A’s treatment by the Gender Identity Development Service (GIDS), and the removal of testosterone caused distress to the patient, leading to a deterioration in his mental health to the point that his GP, Dr Young then had to refer him on to CAMHS. 

 

 

Dr Young also confirmed that, despite Dr Webberley’s concerns that taking Patient A off testosterone would cause adverse effects, Professor Gary Butler urged the family to discontinue treatment. Subsequently Dr Young said that it wasn’t clear from Patient A’s records whether Professor Butler had stopped Patient A’s puberty blockers or not, and so he took it upon himself to stop these. He had admitted earlier in the day that he was not aware of the risks and benefits of puberty blockers ‘apart from what I’d read’.

The next witness to speak on day six was Professor Peter Hindmarsh. Prior to Professor Hindmarsh speaking further documents were submitted to the tribunal, including a resubmission of Professor Hindmarsh’s witness testimony now ‘shorn of opinions’ and a complaint letter about Professor Butler from Patient A’s mother.

Simon Jackson, counsel for the GMC, read from a letter sent by Professor Hindmarsh to the GMC in 2016. In this letter Professor Hindmarsh claims that Patient A’s mother was upset that no follow-ups were offered for her son by MyWebDoctor (a service formerly operated by Dr Webberley). Professor Hindmarsh said that he recalled having this conversation with Patient A’s mother, but has no record of it. When Ian Stern asked Professor Hindmarsh if he could recall when this conversation took place, Professor Hindmarsh confirmed that it was July 2017. Ian Stern then asked, justifiably, how Professor Hindmarsh could have made a complaint to the GMC in 2016 based on a conversation that happened in 2017. He then went on to say that Patient A’s mother doesn’t agree with Professor Hindmarsh’s recollection of the conversation. Professor Hindmarsh backpedalled, saying that the root of the complaint was initial issues brought to him by Professor Butler, but was cut short by Simon Jackson who advised him not to disclose what Professor Butler had said to him. It is worth noting that Professors Butler and Hindmarsh both work for UCLH and have a prior professional relationship in endocrinology, having worked together on e.g. the NICE guidelines on the use of human growth hormone for the treatment of growth failure in children.

Simon Jackson then confronted Professor Hindmarsh about the inconsistency in the dates. Professor Hindmarsh responded with some uncertainty, changing his testimony and claiming that the call had in fact happened in July or August 2016. He was also asked why he thought the remarks about Dr Webberley’s service were worth including, to which he responded only that he thought it was pertinent.

After a brief break there was further confusion over the dates in Professor Hindmarsh’s records and testimony. Samuel Jackson referred to a fax from MyWebDoctor to Dr Young that had been passed on to Professor Hindmarsh, and asked when he had received it, and if it helped him remember when he had had the supposed conversation with Patient A’s mother. Professor Hindmarsh said that he didn’t know how he had obtained the fax, and reiterated his new claim that the conversation had taken place in July or August 2016. The inconsistency in his testimony led some frustrated commentators online to call for Patient A’s mother herself to speak.

 

 

The Chair then questioned Professor Hindmarsh. They asked who was involved in the assessments at UCLH, and Professor Hindmarsh responded that it was only Professor Butler. The Chair asked if this meant that a multi-disciplinary team had not been involved at this stage; Professor Hindmarsh added that someone from the Tavistock was also at UCLH (although he did not clarify whether, or in what capacity, they had anything to do with Patient A).

The Chair also raised questions regarding the guidance outlined by Professor Hindmarsh in his witness statement, particularly with regard to informed consent and whether NHS guidelines apply to private medical services. Professor Hindmarsh claimed that people under 16 cannot consent to undertake something irreversible, despite the fact that in UK law Gillick competence allows children to consent to medical treatment provided they can fully understand the consequences. Professor Hindmarsh referred to the December 2020 judgement of Bell and Mrs A. v Tavistock to support his claim. However, not only did Ian Stern point out that Bell v Tavistock is not relevant to events that transpired in 2016, but even if it was, this judgement does not preclude under-16s from consenting to gender-affirming treatment.

Ian Stern also took issue with Professor Hindmarsh’s suggestion that private companies (like MyWebDoctor) are required to follow NHS guidelines. He clarified that Professor Hindmarsh is not appearing here as an expert witness, and that, like Dr Young, he has no experience of treating patients with gender dysphoria.

An important aspect from day six of the hearing was the dropping of the allegation that Dr Webberley had prescribed Testosterone to patient C. Dr Webberley’s counsel had tried to raise this factual inconsistency with the GMC Counsel last week but they maintained that she had prescribed Testosterone. On day six they admitted they had made a mistake and asked the chair to change the allegation against Dr Webberley to an allegation of prescribing GnRH analogues.

Day Six Summary:

  • Dr Webberley is alleged to have not provided ‘good clinical care’ to Patient A.

The hearing heard how testosterone was removed from Patient A by GIDS, and as a result his mental health deteriorated to the point that he had to be referred to CAMHS. The tribunal heard a letter from Dr Webberley was sent to Patient A’s GP outlining her concerns for Patient A if his gender affirming treatment wasn’t continued. These fears later came to pass. 

  • Dr Webberley is alleged to have not informed Patient A’s GP of the medication she had prescribed.

A letter was read out from Dr Webberley to Patient A’s GP offering to share information with him, including the assessments she had carried out on Patient A. Upon questioning from Ian Stern, Dr Young admitted that he did not request copies of these assessments from Dr Webberley. 

  • Dr Webberley is alleged to have not maintained adequate records relating to Patient A’s treatment.

During the hearing to date Professor Butler was unable to provide a scan on which his testimony heavily relied; Professor Hindmarsh had no record of a phone conversation with patient A’s mother and could not account for correspondence he had that was sent to Patient A’s GP, Dr Young. Dr Young did not request copies of his Patient’s assessments from Dr Webberley, nor was he given information from Prof Butler regarding dosages and so he discontinued Patient A’s treatment. Furthermore, the hearing heard that the GMC had not been forthcoming with patient records to Dr Webberley’s team, and informed Ian Stern that some of the records had been destroyed. 

 

Day Seven

Day seven of the hearing opened with confusion, as Dr Justin Walker – Patient B’s GP – claimed he never would have given approval for the shared care agreement with Dr Webberley to be signed if he’d known it was a private gender care service. Ian Stern pointed out that the shared care agreement stated that it was from GenderGP, was completely clear about the nature of GenderGP’s services, and furthermore, that the NHS has provisions in place specifically for shared care between public and private services.

When Dr Walker tried to argue that he would’ve thought the shared care agreement was an NHS document, Ian Stern pointed out that he was describing what he ‘would have thought’ rather than what he actually recalled about the time. The double standard of Dr Walker giving this testimony against Dr Webberley, who is accused of inadequate record-keeping, did not go unnoticed.

 

 

Dr Walker was followed by Dr Dhrushil Patel, the GP for Patient C. Dr Patel says that he did not see the letter from Dr Webberley requesting puberty blockers and blood tests for Patient C, and despite practice notes relating to Patient C’s blood tests and referral to GIDS he denied all involvement in treatment that was prescribed to Patient C. 

Patient C had resorted to private care, with Dr Patel’s surgery supporting with bloods, as shared care was not agreed to and the wait for GIDS was so long. The tribunal Chair then asked how it was possible that the surgery had assisted Dr Webberley with Patient C’s bloodwork without first entering into a shared care agreement? And why, given the surgery was clearly able to support with bloods, were they unable to support with medication? Dr Patel answered that Professor Butler had told him not to engage with Dr Webberley, but that the other surgery staff had attempted to help Patient C because they felt it would be detrimental not to do so. This is not the first time in this hearing that we’ve seen Professor Butler intervening in the care of a patient for whose care he is not responsible.

 

 

With that, the hearing was adjourned. Day seven was shorter, but could still be significant in light of Drs Walker and Patel’s inconsistent recollections of their shared care agreements. Can the GMC really continue to press allegations of inadequate record-keeping and care provision from Dr Webberley when their own witnesses admit to the same?

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