When G.I.C lacks N.R.G
Just before Christmas (2021) I put out an @Twitter Poll asking the Question:
How long have you/did you wait for a 1st NHS CIC appointment?
Over the course of a week, this received 165 votes. OK, not a large number, but double the amount needed to justify a biased and hateful untruthful article on the BBC.
I monitored the poll over its consultation period and the results settled into a pattern fairly early on. This would suggest the poll wasn’t ‘hijacked’ or rigged by dissenters.
The result, perhaps largely predictable, given the current state of trans healthcare in the UK in late 2021.
This poll received some individual responses which reinforced what the poll data was showing.
Primarily, those who had applied to and had had contact with the GIC system 5 or more years ago had received a far quicker and more positive response and experience than those since.
7% of people waited less than 18 weeks for a first appointment. That was the smallest group.
The time frames for a first appointment are worsening daily. Not slowly, but a massive and exponential rise in times and delays.
The largest group, waiting OVER 3 years for a 1st appointment or waiting to hear anything was 53%. That’s over half the sample.
The rest, 24% waiting up to two years and 17% up to 3 years.
That means, from the survey 93% of respondents have waited more than the 18 weeks (NHS target maximum) and 70% over two years.
Much of this was identified in the GMC-v-Dr Webberley hearing earlier in 2021. That is the subject of other blogs. Event that hearing is suffering from its own delays and deferrals whilst, like many thousands in the GIC queue, wait for an answer.
Is it getting worse?
Pink News reported this in on April 20th, 2021.
In 2019, there were 1,700 people on The Laurels’ waiting list for an appointment following a referral, with the longest wait at just over three years.
In September 2016, there were 580 people on the waiting list. The wait then was 12 months for a first appointment, followed by an additional wait of between six to nine months to be given a medical diagnosis by one of the clinic’s four doctors.
In the same article they also reported
In 2020, more than 13,500 trans and non-binary people in the UK were on a waiting list for an NHS gender clinic. Waiting times vary by location but nowhere is it possible for a trans patient to see a gender specialist within the NHS legal guideline of 18 weeks.
The waiting times are partially due to a large rise in case numbers. That said, there are no resources being put to resolve this issue now or pre covid.
As I have said many times over, the entire trans healthcare system is not so much as broken but smashed. It has been dismantled from the inside.
The entire system isn’t fit for purpose. It’s being ignored and side-lined by many in government and the media. That save the constant bleating and outcries of the same groups, encouraged and flame fanned by GCs when it comes to trans teens and puberty issues.
The estimated waiting time for a ‘first appointment’ at any given GIC has moved from about 12-18 months (already far to long) three years ago to a prediction today of about THIRTY years.
That is totally and utterly shameful.
The CASS review, initially hailed as being something much needed to review and consider the entire trans healthcare system, has itself been hijacked and will now give an entirely rigged result.
Because Dr Cass, a GC, has essentially forbidden ANY trans LGBT representation on her committee. That is a “do they take sugar” approach.
How on earth can a review into the poor and dilapidated state of trans healthcare give any form of rounded and reasonable representation of the system by ignoring the views and opinion of those in and directly experiencing the system?
This stance is typical of many GC groups, organisations, or reviews. They, see the views of Trans and NB people as being an obstacle to their own.
The BBC, for example, will only allow trans representation on ‘talk’ programmes if there is GC representation as well. However, they are happy to allow GC representation on its own, WITHOUT a counter position, when discussing trans issues. Who is being silenced now?
The anti-trans media, rarely publish pro-trans articles or will always use and twist a pro-trans issue into an anti-trans twist.
Liz Truss disbanded the LGBTQ+ representation on her “equalities” brief and is due to appoint a new panel that is “in line with current [i.e., her] thinking” (see a separate article on that aspect.)
There is, therefore, a common and consistent practice of side-lining the views of the very people about whom representation and/or policy is desperately needed.
This isn’t an accident. It's too frequent and consistent for it to be. All the government departments, sub-committees and ‘reviews’ are interlinked. We know this as I and other Co-Editors have blogged on this very issue.
GICs are the solution right?
The GIC clinics are a lifeline to providing connection for trans people and access to the healthcare they desperately need. Many feel they just can’t wait that long and decide to pay the ultimate price with their lives. That is just an appalling review of a broken system.
Many studies show and prove beyond any doubt that access to good health care for trans people and access to the HRT and other medication significantly improves mental health and wellbeing. Yet the government consistently continues to deny entry by making it harder and rarer to access. This is a serious discriminatory and human rights issue.
This failure and dismantling of the trans healthcare and support system is written like a name through a stick of rock, it is systemic and organised. It shouldn’t be and is a failure of the management of the system and targeted against a minority group of people. That is pure discrimination.
GICs are not exempt from CQC inspection, but none have been on their own except on three occasions, all for Tavistock and each timed to link with aspects of a legal case.
To put that into context, of all the other types of organisation the CQC inspect, many have been inspected multiple times, GICs are not on that list. Why? Especially why, when is well known and published how bad they are. Why are they not being inspected? Probably because inspection and failure of those inspections would fall indirectly on the government. However, inspections of PRIVATE clinics and trans healthcare organisations ARE inspected, especially when there is a GMC axe to grind.
These are the latest figures from the @GIC NHS website today (01.01.22)
So, first appointments are THREE years behind (156 weeks NOT 18) 866% above target
It takes on those figures, 6.2 months to see 1 months’ worth of referred patients.
That’s 74.4 months (6yrs 3weeks) for 1 years’ worth of patients. PLUS, the min FOUR-year current wait, so that’s 10 years plus at least from a referral today.
Pink News reported in Match 2021 that The Laurels GIC (in Exeter) saw TWO new patients in TWELVE months!
It is accepted that figures will have worsened due to the ongoing Covid-19 Pandemic. All areas of healthcare have suffered as a result where staffing and services have been focussed on that. However, that doesn’t explain the already worsening situation before the pandemic measures in early 2020.
For me, my referral was in March 2019, when the wait was already 12-18 months and concerns were being raised as to the rapid increase in waiting times.
We are now January 2022, (33 months from referral) and I am likely to still wait another 36 months. If they are seeing patients referred in Nov 2017, I have 16 months’ worth of patients ahead of me. As they are not seeing all patients referred in each month, the wait will be long, perhaps too long.
The NI GIC operates practices that can only be considered as barbaric. Much of this was openly and happily shown and given in GMC evidence as part of the GMC – v -Dr Webberley case. This evidence, by the GMC witness, was presented as “as good practice”! At the same time, the GMC is trying to prosecute a Dr who treats trans patients privately, but well, as harming patients and bringing disrepute to doctors and the GMC.
It comes to something when the governing organisation of Doctors can’t actually see how bad the system is but then uses that poor quality as a benchmark of how ‘good’ it is thought to be.
The point being, even when someone is lucky enough to get a first appointment, the level of care received varies widely. That can’t be acceptable. The type and level of care shouldn’t be up to the location you are referred to. Again, we know from GMC – v – Dr Webberley, that not only does the quality care vary but so does the attitude of the staff. That is a whole blog subject on its own but has wider implications on patients and their direct welfare and MH.
Trans healthcare in this country is in a dismal state.
The recent Women’s and Equalities Committee report “Reform of the Gender Recognition Act” chaired by C Noakes MP stated
“We were also keen to explore some of the wider issues affecting transgender people. We recommend that the Government Equalities Office and Department for Health and Social Care should develop a healthcare strategy for transgender and non-binary people within the next year. We are extremely concerned that the Government Equalities Office appears to have abandoned the LGBT Action Plan and we urge the Government to commit to continuing to implement the Plan across all departments.”
They can see this, yet The minister and Secretary of state can’t/won’t. Cass can’t/won’t.
No wonder trans people are disillusioned.
However, unless it can be sensationalised by the media, little is heard. This is because they don’t want it to thrive either. The GC invasion is everywhere. The government is so entrenched in the GC camp they can’t and won’t hear any pro-trans views.
OK, they may pay lip-service to some aspects, to maintain a tissue of credibility, but beneath the surface it's vehemently against trans people. It's all smoke and mirrors to them. Placid on the surface but pedalling hard to make life difficult under the surface. Sadly, the under-surface activity is becoming more obvious as time goes by.
The government trumpeted an announcement about three new GICs. Those are ‘pilot schemes’ and also have long waiting lists, are restricted to local applicants only and are woefully understaffed. Essentially, it's not an improvement, it's just more of the same, which is, little or nothing.
We are potentially on the cusp of a Tory leadership change. Sadly, the prospects for a new leader making things better are grim. If the rumours turn out to be true, it could get a whole lot worse before the next General election.
That means no improvement anywhere in the system for trans people.
A 10-12 year wait for a first appointment may as well become 50 or 60. It makes no difference at that point.
The poll I put out was a reflection on the current state of affairs in the trans healthcare system. This turned out to be just grim and isn’t about to get better soon.
A seismic change is needed. That requires a new and positive mindset. That is most likely going to need a change of ruling party or a coalition.
The point is NONE of this is difficult to resolve. It takes money, people, and a positive attitude of the state towards a targeted but vocal minority group.