Wednesday, 23 January 2008

PCT's lack of knowledge and 20th century attitudes...

Today I went to see my GP to ask her to make an application for funding for a referral to Dr Phil Thomas for sex affirmation surgery.

Now those that know my story will remember we made the last application in November 2006 and that over a year later my Primary Care Trust wrote to my MP saying the policy was to assessed by a local unit they hadn’t even set up, then fill in forms for consideration by their bureaucrats and then if they said OK wait two years for access to Charing Cross Gender Identity Clinic and then spend two more years following their diagnostic steeplechase and then Charing Cross GIC would decide which surgeon I got, if I got surgery at all.

This is of course in my best clinical interest [sic] as the poor psychiatrists at Charing Cross find it so hard to diagnose you as transsexual and they don’t want you going back and saying I wish you hadn’t recommended I have my penis turned inside out.

The PCT also think it’s not a blanket ban so they are safe legally – WRONG!

Step back & think.

The NHS works GP to Consultant to Surgeon on all medical matters. The consultant (who might also be the surgeon) makes the diagnosis and the patient decides yes or no regarding surgery. After surgery the patient is discharged back to GP care. It is that simple and anything different is discrimination or denial of human rights.

Now I have been diagnosed as having Gender Dysphoria defined in WHO ICD – 10 Code F64.0 nice eh!

This diagnosis is by Dr Richard Cutis a HM Government approved Gender Consultant and now an NHS contractor. Other PCT send patients to him rather than the local GIC where waiting times are typically 2 years.

This is patient centric care in partnership with the private sector exactly what Government Health Policy requires.

So given I am diagnosed plus I have an open referral letter from December 2006 and a recent letter saying in due course she may wish to have referral to Dr Phil Thomas an NHS surgeon specialising in gender affirmation surgery it is give us the cash yes or no?

If they say yes it’s great off I go to Brighton for my surgery.

If they say No it’s a legal issue as there are two existing court rulings they would fall foul of.

Obviously the Blanket Ban is illegal ruling. The argument being this is a blanket ban on people already diagnosed as it is was not the intent of the original legal ruling to ask them to do the whole process twice.

Secondly the European Court of Human Rights ruling did not intend the situation where the National Health Service would not accept the legal change to female and use it as a disqualification for surgery.

Separately it could be argued that this is simple discrimination on the grounds that as a diagnosed transsexual person I am being denied the correct medical care that is surgery. This being inconsistent with the existing medication that I have that has permanently changed my ability to function in my former sex.

The argument is clinical not administrative and it is the clinical justification that they would have to argue was invalid and they can’t win that one.

So my GP is writing a letter to the PCT and I will get a copy. I have no issue with her but I did point out that she gave me a legal ace by writing to the Gender Recognition Panel that surgery was currently not funded by the local PCT!

I said I thought the problem at the PCT was lack of knowledge and 20th century attitudes rather than bigotry.

Also it appears after I told her the visit to the consultant psychiatrist was less than satisfactory that they used to have a trained counsellor in the practice but they were taken away as part of PCT cutbacks!

The modern NHS appears to be all about money and management and very little to do with patient care. I do hope someone compares the cost of now funding my surgery to the cost of a legal battle. The cheaper option for the PCT is to stop acting like spoilt children and just pay up.

I’m looking forward to the PCT response either way…

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