The curious case of Dr Webberley Part 9
I have been asked to provide a comment on the current ongoing case of the GMC v Dr H Webberley. The Tribunal hearing is being held at the Medical Practitioners Tribunal Service (MPTS).
Firstly, this blog is an opinion on matters as they proceed, and I have no part in the case. I am merely viewing aspects from the outside, like many others. I am preparing this in a non-professional capacity, but I do have some experience at giving expert evidence at tribunal over many years.
I am getting updates from ‘live Tweets’ from the hearing provided from the Tribunal service and will see if I can get a press update as well. I am also thankful to @truesolicitor and others for their updates on this case. We are aware of other live feeds but are also aware that these are not as accurate and the reporting is, let’s say, skewed.
I am trying to remain faithful to the feeds and comments made, but to report the facts and give a background to the proceedings and how the trial system works.
In this case, and current tribunal hearing, Dr Webberley (Dr W) is accused of practising medicine outside the rules and regulations of the General Medical Council (GMC) during the period March -November 2016, A failure to hold a proper safeguarding policy, and (2018) a failure to be registered as a practice in Wales. But there is more to it than that.
This update is from day 18
Day 18 is brought to you by Don’t panic but looking for the exit.
(Tuesday) [week 5] of the public hearing.
Intended start at 09:30am.
Today saw QC battles trying to establish what is and isn’t admissible and why/why not.
In the end it got a bit heated in a QC sort of a way.
We were supposed to have a witness today (Dr Klink) but in the end, that didn’t happen.
So, what is all the fuss about?
OK, so the ‘fuss’ is about the evidence and statements to be presented by Dr W as part of her defence.
The red team are objecting to aspects of this for which IS calls “spurious reasons”.
Firstly, SJ is objecting because the documents are ‘late’ and won’t be fully ready yet.
Secondly SJ is objecting because Dr Bouman states he has only treated trans children from age 15, yet has reported on Patient A in this case, who was 12 at the time (2016).
Thirdly SJ is objecting because Dr Shaumer wants to apply the Bolam test. “It’s not about negligence, it’s about conduct” SJ states.
Fourthly SJ is objecting to Dr Schumer was not engaged on the day he says he was. (There is an apparent conflict of dates when he was engaged by the defence team to write his report. Whilst this is about 3 weeks it, in their opinion, somehow materially affects his conclusion on matters from four years earlier.)
Fifthly SJ is objecting because he feels this new evidence impacts on the witness that is due to stand (Dr Klink) and he needs time, and this ‘delay’ will impact on the case management of the hearing.
There was a much discussion between the two QCs and the chair of the panel about how to proceed.
Polite but firm legal discussion.
From that dialogue, the pendulum swung both ways as to whether this would be allowed or not.
The Chair asked to be given the documents to decide what was and wasn’t admissible and then consider whether none, all or some were acceptable and (as may be the case) parts of some, with parts redacted. Of course, once seen, then can they be unseen? The chair then said he would be mindful of the objections from SJ but hoped he wouldn’t object to them being admissible.
PubMed (or rather can’t see med)
It also transpired that the GMC STILL can’t get or see the PubMed material that is being presented as reference for the refence by Dr W.
It seems there was an oversight in who sent what, but more importantly, WHY can’t the GMC, the governing body for the regulation of medical practitioners NOT have access to this by ordinary paid for means. HOW can they remain up to date as a regulatory authority when publications that are readily available are beyond there subscription service?
As I understand it. the reference documents are published in the public domain, albeit behind a subscription paywall. They are not secret or hidden away to be revealed as and when needed. These are freely available to ANYONE with the correct subscription.
Back to the admissibility
It’s all in a statement
SJ read to the hearing a paragraph from Dr Bouman’s report. Remember Dr Bouman is the rolling chairperson of WPATH, the body that gives guidance on healthcare protocols. He is/was also a director of the GIC in Nottingham and has wide experience in treating trans patients, including children.
SJ read out this:
“Dr Webberley has acted in the best interests of the Pt, preventing years of suffering, on balance of probability her prescription of T was adequate.”
That one statement doesn’t help the GMC one little bit. It needs to be seen in the context of the whole report to understand how and why he came to that conclusion.
SJ suggests that Dr B isn’t qualified to be the expert on matters of pt. A as he hasn’t treated a patient under 15.
Let’s not forget, that his ‘expert’ witness Dr A, hadn’t treated a trans patient for GD or prescribed medication for a trans patient AT ALL, EVER.
Why is SJ worried?
He is potentially worried with good reason.
He (SJ) has to cross examine the witnesses put forward by Dr W’s team. As such he is trying to find holes in their argument, to help prove his own case.
He knows, but is not saying, that is going to be an up-hill task with the quality of experts and witness being put up by Dr W.
He also knows, that IS has already seriously undermined the GMCs witnesses, and it is evident that they have far inferior qualification and experience in treating trans patients.
SJ also has to cross examine Dr P, and he already knows she alone pulled apart the report presented by Dr A.
What is the test here?
Firstly, this not about negligence. No one has intimated or suggested Dr W is negligent as SJ has already identified.
The test, the line to cross is “adequate”. Was her care and treatment “adequate”? That is a much lower standard, but still needs to be judged against the rules of adequacy.
Dr B uses that very word in his conclusion. Perhaps, it is easy to say he would, as he is acting in the defence of Dr W. The question is the quality of his experience and the likelihood he would reach that conclusion.
It could also be argued that neither of the two ‘experts’ put up by the GMC suggested Dr W’s care was inadequate, but that they didn’t say it was either.
So, for SJ, to get these documents rendered inadmissible in whole or in part, is a massive gain for him. He is objecting to a single sentence within one document and the conclusion (stated above) in the other.
However, if the panel rule in his favour (and they could) it would be a travesty and the outcome would be a let down to the patients in the system. It would have to be argued that failure to have a proper hearing with ALL the evidence would be a failure of the tribunal system itself.
The reason this argument is being had, is the failure, laid open for all to see, of the GMC to manage this case, obtain and prepare everything in preparation for the hearing and in good time for the defence to prepare and respond.
Both sides being able to openly and in public give and receive the facts and evidence for the panel to decide. That, so far, has NOT happened. The loser here is the system and how it is seemingly being played.
That is not to say, that if roles were reversed, IS wouldn’t be trying to achieve the same. It is up to the panel to be strong, see through the games and tactics, and not be led by one or other side on this.
That said, they are aware of what has been said in that one paragraph and by someone well qualified to say it. They have to decide if that statement is robust enough.
They have already seen the delays and difficulties already experienced from the GMC side, and we haven’t even got to the Defence case yet.
With the chair having viewed the documents ad what they contain, we wait on their decision. Of course, they now know what is in them, even if they refuse them. That could be crucial.
Back tomorrow (day 19) for more argument perhaps but a booked witness with an early start at 09:00. Bring in Dr Klink for a second try.
To be continued…../