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The Helen Webberley Tribunal

22 Sep, 8 tweets, 2 min read

Thread 6: 22 - 9 - 2021. SJ: you did not indicate that periodic review, follow up and reassessment was required. DRW: that's not how I phrase it but I was continuing to give holistic care and monitoring. SJ: Dr MW says 'counselling should continue'.

Did this occur? DRW: We talked about it. I don't recall what happened but I see that we referred to Shelley. Also A was getting support from Mermaids youth groups and resources. SJ: should you not follow up on the referral?

DRW: my approach is to make services available to patient but not to mandate the counselling at any particular time but enforcing such services is not beneficial to the therapeutic relationship.

SJ: I suggest that there's a tension. You prescribed to relieve the patients distress but then did nothing to try and mitigate the distress? DRW: there were 2 potential harms. One was the inability to access medical care. The second was the wait to start 'puberty' until 16.

DRW cont Patient A had fully socially transitioned, his gender identity was not causing him distress it was the inability to go through desired puberty was causing him distress.

SJ:Dr Klink has observed that there are other ways to alleviate distress. And from a demographic point of view, most boys present external signs of puberty from 14 with some not presenting until 16. There is no need for testosterone at age 12.

DRW: its a theoretical argument and what we looked at yesterday was an earlier presentation of puberty. Dr Klink can make a judgement but we need to treat people individually, A has identical twin going through female puberty and an older brother. Social factors impact.

SJ: discussion of paper on impacts of low dose testosterone on boys with delayed puberty. You must have been very interested in this paper. DRW: I had never seen this paper before and it is not relevant to this patient. I don't think this is the paper that should be ref'd.

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The Helen Webberley Tribunal

@tribunaltweets

23 Sep

Afternoon session about to start.
Simon Jackson (SJ), QC for the GMC, will continue to examine Dr. Helen Webberley's (DW) decision-making from 2016 re. Patient C, a 10 year old living as a boy. Jackson will pick up the issue of consent to medical treatment.
[Thread 3].

Opening remarks: Panel Chair says they would like to hear from Patient A and Patient A's mother tomorrow.

SJ: Dr Webberley can I take you back to Patient C, to deal with issue of consent. 9th Feb 2016. Looking at the records, around the timing of the patient's consent signature, what was the dialogue b/w you, Patient C and patient C's mother?

Read 74 tweets

The Helen Webberley Tribunal

@tribunaltweets

23 Sep

The session is now resuming with Simon Jackson's (QC for the GMC) examination of Dr. Helen Webberley's decision-making re. Patient B who was 16 years old when first referred to Dr. Webberley, in 2016.

[Thread No. 2]

SJ: Can I take you back to p.446 on Patient B. Against background of issue of how possible changes would be managed and desirability of managing them within MDT with specialist endocrinology input...

SJ ctd: You deal with issue of commencement with analogues and then say: 'we could also swap to injections to T as well, but the one big issue is who will do the prescribing, will your GP be happy to do this?' Is this in context of increased dose?

Read 52 tweets

The Helen Webberley Tribunal

@tribunaltweets

23 Sep

We are starting. We are continuing with Simon Jackson's examination of HW. She is being asked to speak to Professor Hindmarsh's complaint to the GMRC.

24th March 2016 is a letter from HW to Patient A's GP. But HW not sure if it's in the bundle and asking the chair. This may be returned to later.

IS (for defence) has interrupted to give important update. At 8am this morning, GMC has said it no longer wants to call Patient A or their mother - after hearing the evidence from DW yesterday. It's a surprise, says IS.

Read 78 tweets

The Helen Webberley Tribunal

@tribunaltweets

22 Sep

Thread 9. SJ: back to Patient A. Discussion of whether counselling was required or needed. DRW: it was never my practice to say 'you must have this before that, or that before you're allowed this'.

SJ: a consent form was sent on 23 March, is this the first time they had seen the consent form? DRW: I don't remember how we did the consent. SJ: did you have a dialogue and talk through the consent form with the patient? DRW: we talked through the issues,

DRW cont: I don't remember if we got out the piece of paper and went over it line by line. SJ: should there not have been a dialogue between you, the patient and parents. DRW: the piece of paper is one part of the consent process. Consent is an

Read 16 tweets

The Helen Webberley Tribunal

@tribunaltweets

22 Sep

Thread 8 of 22 - 9 - 2021.
SJ: now referring to series of correspondence between DRW and Dr Hindmarsh and Dr H's complaint. Quote 'furthermore I believe that a clinician was inflicting torture on Patient A by refusing to prescribe hormones for A'

SJ cont: I brought this up because you said that you respect the protocols of GIDS. DRW: I was attempting to acknowledge that other protocols and approaches can exist and can be followed. SJ: do you respect that he was following protocols.

DRW: the clinician in question wrote the protocol that he is following and I set out my feelings in detail for Prof Hindmarsh. SJ: you also said the Patient A was severely distressed. When and how was this distress presented?

Read 22 tweets

The Helen Webberley Tribunal

@tribunaltweets

22 Sep

Thread 7 (accidentally ended Thread 6). 22 - 9 - 2021. SJ: now discussing Patient A going for follow up with Prof B on 3 March. Prof B says A is 'initially depressed and angry calmer now'. A did not react well to blockers. Is this a pattern of not settling on blockers.

DRW: I understand the depression and anger was to do with not progressing to testosterone rather than a poor reaction to the blocker. SJ: at the time you are making a judgement to prescribe testosterone, when did you meet A? DRW: 22 March.

SJ: documentation of consultation between DRW, A, A's mother. Some confusion that A's mother says there is already a prescription on 22 March 2016. DRW says first prescription was April 2016.

Read 9 tweets

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