Saturday, 21 June 2008

Moving close to legal confrontation…

I’ve just received a letter from my PCT turning down my application for surgery with Mr Phil Thomas at the Sussex Nuffield.

Now I have to be careful what I say in this blog as the Chief Executive of the PCT has in the past accused me of being a bully by criticising NHS employees. To be specific it was a criticism of an NHS gender specialist that I could back up with evidence but then my PCT yet again likes to ignore or distort evidence.

As far as I can tell the PCT (maybe backed by the Department of Health) is determined not to let me establish the legal precedent that having obtained a gender recognition certificate I am entitled to be placed directly on the surgical waiting list without having to submit to the vagaries of Charing Cross psychiatrists.

This is my initial response to my GP before I prepare a report for her that if the Chief Executive of the PCT rejects will move us to a judicial review at the very least.

Happy days LOL

Dear Dr XXX,

Individual Treatment Panel Response for funding for surgery with Mr Phil Thomas at Sussex Nuffield

This is to advise you that I will require you to make a formal appeal.

I will be producing a full report for you to submit to the PCT.

However to be frank I am utterly staggered by both the ignorance of current best practice and the misinformation given to the people considering my case.

For example in the latest letter they acknowledge that Sussex Nuffield has zero rates of MRSA etc. but don’t state the Charing Cross rates. As they know that Charing Cross rates are not zero they know that I am at higher risk.

Most importantly the PCT alleges that as the Sussex Nuffield does not provide follow up for patients beyond three months then the cost of the five years of follow up provided by Charing Cross for any gender reassignment repair surgery must be topped up making the true cost of Sussex Nuffield considerably greater than that of Charing Cross. This is misinformation.

Any physical re-examinations of a patient’s surgery over five years can be conducted by any GP it does not require a visit to Charing Cross.

They are deliberately confusing five years of gender specialist follow up with physical examination. As I pay for this with my gender specialist the cost of top up in my case is zero.

I have a gender specialist recognised by HM Government and who is a co-author of the “NHS Guidance for GPs, other clinicians and health professionals on the care of gender variant people” a document that the PCT should be aware of. I have no intention of changing my specialist and I will bear the cost myself until such time as this PCT recognises his worth.

Additionally they ignore the most important exceptional circumstance in my case in that I have a female birth certificate having met the strict medical conditions for granting a gender recognition certificate. This is proof absolute of having met the globally recognised criteria for access to surgery.

The PCT is not offering me direct access to surgery it is asking me to get in an eighteen month to two year queue to see a Charing Cross Psychiatrist who will ignore the Gender Recognition Act & the Mental Capacity Act and insist on numerous appointments with himself and/or colleagues before on average a further two to three years later allowing me access to surgery providing I meet his stereotypical views of what being female entails.

My advice is that the PCT / Charing Cross policy could be shown to be illegal as regards people with gender recognition certificates.

Additionally the British Medical Association policy that states:

“Patients who are entitled to NHS funded treatment may opt into or out of NHS care at any stage. Patients who have had private consultation for investigations and diagnosis may transfer to the NHS for any subsequent treatment. They should be placed directly on the waiting list at the same position as if their original consultation had been within the NHS.”

My position is that as I am legally female, have completed consultations, investigations and diagnosis and therefore entitled to be placed directly on the waiting list for surgery something the PCT is refusing by the selective use of a single inflexible supplier and their letter is a poor attempt to hide their unreasonable refusal.

I will not give up on this battle with the PCT whatever the cost to myself.

I have been obstructed over the past three years by members/employees of the PCT such that any reasonable person would conclude this is prejudice.

I would however like to thank you personally for supporting my case.

Yours sincerely,

Maggie Fiona Fox

Copies to Janet Dean MP and Dr Richard Curtis

NHS Guidance for GPs, other clinicians and health professionals on the care of gender variant people can be downloaded from:

Watch this space!

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