Newsnight: Gender clinic ignored staff concerns

NHS England’s gender identity clinic for children has been accused of ignoring staff concerns about patient welfare.

During a recent internal investigation, staff members at the Tavistock and Portman NHS Trust’s Gender Identity Development Service (GIDS) made a number of serious allegations against senior clinicians, according to documents seen by Newsnight.

They said children were being prescribed experimental drugs after minimal consultation, standard procedures were not being followed and senior figures discouraged staff from raising concerns.

‘Medically mismanaged’

In March last year, GIDS published the findings of its internal review which stated it “did not identify any immediate issues in relation to patient safety”.

But the Newsnight team revealed it had read over 100 pages of transcripts of interviews conducted with staff raising a series of “serious” claims.

One clinician said she believed “very many vulnerable children have been very poorly treated and will be left with, potentially, a lifetime of damage”, adding that children are potentially being “medically mismanaged”.

“She was not able to say to me ‘It’s fine, we are not hurting the children.'”

Side-effects

A number of staff at the clinic raised the issue of giving puberty blockers to children, with one saying: “Maybe we are medicating children with autism, maybe we are medicating traumatised children, and if we are, we are doing bad things to these vulnerable kids.”

While GIDS claims the puberty-blocking drugs are “fully reversible”, NHS guidance was recently changed to say: “Little is known about the long-term side effects of hormone or puberty blockers in children with gender dysphoria.”

NHS England says young people should only be prescribed the drugs after three to six sessions, yet several staff at GIDS reported that one senior figure was referring children for the treatments after just one or two appointments.

One concerned clinician said this “should never happen, because this is a pathway that will lead to huge, huge changes for this young person. It could lead to, potentially, infertility”.

Concerns ‘shut down’

Clinicians also talked about how their concerns were ignored, and that there was a culture of people keeping their heads down and not rocking the boat.

One said: “The reality is that our concerns were raised all the time and were shut down.”

She added: “People who raise concerns are seen as trouble making and difficult. I think it is the case that the organisation works to evacuate people who are not compliant.

“When I raised concerns, I was told that I had to toe the line or I would never progress in my career.”

Staff fears

Senior staff were also unable to allay the fears some had about the safety of their work.

A clinician revealed: “I kept saying to her ‘are we hurting children?’ and she did not say no. I kept saying to her, ‘will we get sued?’ She did not say no.

“The only solace she gave me was she said that it would not be me that would be sued, it would be the Tavistock that would be sued.

“She was not able to say to me ‘It’s fine, we are not hurting the children.’

Lack of scrutiny

Several transcripts also reveal staff were discouraged from speaking to Safeguarding Officer Sonia Appleby by GIDS Director Polly Carmichael.

One explained: “There was a very clear message from senior management about being really cautious about how we talk to the safeguarding team at the Tavi, and specifically Sonia Appleby.

“I know that Polly feels she does not like Sonia’s scrutiny. I think that is odd. She is the Trust safeguarding lead.”