Just posted by Christine Burns on Yahoo TS UK ......
FYI
----- Original Message -----
From: "Christine Burns" <
To: "'Press for Change News Distribution'" <
fc-news@...>
Sent: Saturday, June 11, 2005 7:27 PM
Subject: UK: A Petition About Healthcare in the NHS
>
> From Christine Burns...
>
> Having taken the opportunity to wax lyrical about the work of two
> well-established and experienced campaigners today, it seemed like a
> particularly appropriate opportunity to post news about a very valuable
> initiative taken by someone whose name has not come to my attention
> before.
>
> Thank you to Christopher Pearse for:
>
>
http://www.petitiononline[...]on.html
>
>
> Some Background
> ---------------
>
> The general state of medical provision for trans people will not need to
> be described to most readers. Next to the overall struggle for broader
> acceptance in society, I'd guess that the controlling and demeaning way
> in which trans people have traditionally been treated by some medical
> practitioners is the SECOND most discussed topic when trans people come
> together anywhere on the planet.
>
> Western medicine offers us a system which is at present still founded in
> a long tradition of pathologising and proscribing difference. This is
> especially the case within psychiatry. Trans people are not the only
> minority to have suffered this way in the West. Long after psychiatrists
> officially gave up stigmatising gay and lesbian people with a mental
> illness label, there are still many self-agrandising "experts" who would
> like to put the clock back. And, in our case, there are many who would
> quite like to keep the clock just where it is.
>
> See "Echoes of a Bygone Age",
>
http://www.pfc.org.uk/pfc[...]073.htm
>
> Many developments are taking place at the current time. On the heels of
> the Gender Recognition Act there is actually quite a lot of activity to
> try and reform UK health provision for trans people in various ways ..
> from challenging the monopolistic power of the largest GIC to drafting
> new UK-specific standards of care which everyone can embrace.
>
> New Guidelines on Commissioning
> -------------------------------
>
> Earlier this year the Parliamentary Forum on Transsexualism agreed and
> published its own long awaited guidance for health organisations
> commissioning treatment services for trans people.
>
> See
http://www.lynnejones.org[...]sex.htm for more details.
>
> These commissioning guidelines are not intended to be a recipe or manual
> for modern standards of care as such - that will follow later this
> autumn we hope (see below). However, with the input and support of many
> of the leading figures in UK trans health care, you CAN look upon the
> Parliamentary Forum's guidance to the people who make and pay for
> referrals as an indication of the way in which the wind is blowing.
> Notice in particular the strong emphasis on concepts such as rights,
> partnership, autonomy and choice.
>
> Work is now underway to promote awareness and adoption of these
> guidelines. One product of that will be more questionning of the way in
> which care is structured and provided, and which services can be sourced
> locally to provide choice and convenience, whilst still achieving
> joined-up care. YOU can help by ensuring that your own local health
> hierarchy is aware of this document and uses it to ask overdue questions
> about spending hundreds of miles away in a service which so many detest.
>
> Local Pressure for Change
> -------------------------
>
> On various other fronts there are initiatives to actively encourage
> local health care trusts to break away from an unthinking reliance on
> Charing Cross and to design their own approaches to meet local needs.
> One particularly notable example is in Sussex, where one Primary Care
> Trust set the ball rolling by commissioning a study .. and (in spite of
> some high level embarassment about the powerful conclusions) the process
> is now broadening into a region-wide debate about alternatives.
>
> See "Report Criticises Charing Cross" at:
>
>
http://www.pfc.org.uk/pfc[...]069.htm,
>
> followed by the report itself at
>
>
http://www.pfc.org.uk/med[...]rum.pdf.
>
> Other local care trusts are going through similar processes. The
> challenge for these is to ensure that they evolve into a healthy system
> of diverse services, and not simply local-funded clones of the same
> repressive and archaic thinking. Another challenge is to ensure that
> guidance on the actual approach to care in the UK (so-called "standards
> of care" or SoC) develops in a way which doesn't inhibit the evolution
> of different approaches and the acheivement of realistic CHOICE for
> service users.
>
> Standards of Care
> -----------------
>
> Work on standards of care designed specifically for the UK's modern
> vision of health provision began around two years ago with the formation
> of a joint committee of the Royal College of Psychiatrists (RCPsych) and
> the Royal Society of Medicine (RSM). The committee is chaired by Dr
> Kevan Wylie of the Porterbrook Clinic in Sheffield.
> (
http://www.porterbrookcli[...]org.uk/) and still has a long way to go
> before getting to something which everyone can endorse. Nevertheless, at
> present, this is the cutting edge when it comes to the question of
> whether practitioners simply document what they do at the moment, or can
> be challenged to think out of the box about how it CAN be done better.
> This is an area of deep conservatism in some quarters. Others on the
> committee hold more modern and liberal views about their role and the
> way they work. But we need to help THOSE friends to help us.
>
> Experienced trans campaigners can lobby and in some cases win individual
> points; however they need a strong mandate to lend power and
> authenticity to what they say. That is why it is particularly valuable
> if a significant number of trans people ARE now finding the courage to
> stand up and denounce the traditional way of controlling rather than
> caring.
>
> Christopher's Petition
> ----------------------
>
> Christopher's petition was actually a surprise from the blue.
> Communications somehow failed on this occasion .. which is a shame,
> because we could have done more then to help shape the statement of the
> petition to maximise its impact and to help us encourage people to
> support it sooner. Press for Change has the largest mailing list and
> news forwarding capability of any trans organisation in the UK, and
> PFC's entire organisational philosophy is about nurturing the
> campaigning initiatives of people who want to stand up and do their bit,
> large or small.
>
> Some may debate the value of petitions. On their own, petitions are
> seldom large or powerful enough to create change. Nevertheless they CAN
> be a good indicator of the strength of feeling about an issue - and
> that's certainly where this one holds the greatest potential value.
>
> Defending the Behemoth
> ----------------------
>
> Charing Cross claims to have recently carried out its own audit of
> service user satisfaction (partly in response to concerns voiced about
> James Barrett's unfortunately expressed views). In spite of MP's
> questions being raised with the Chairman of the West London Mental
> Health Trust about Dr Barrett's views, the Trust has recently appointed
> Dr Barrett as the new clinical lead, replacing Professor Richard Green
> (who is moving now to a part time involvement). In a recent letter to Dr
> Lynne Jones MP, chair of the Parliamentary Forum, Trust Chair Professor
> Smidt apologises (in effect) for the fact that Dr Barrett's email came
> into our hands, rather than for the content and says that,
>
> "...Dr Barrett supports patient centred care and
> patient satisfaction questionnaires have been
> undertaken by the service"
>
> The latter was in fact no surprise. At a recent meeting of Kevan Wylie's
> SoC committee, Dr Barrett was keen to volunteer news about the Charing
> Cross patient satisfaction "audit". According to Dr Barrett, all users
> of the Claybrook Clinic (aka "Charing Cross GIC") had completed a
> questionnaire and 75% of the responses had given "satisfied" (or higher)
> ratings to the service. Dr Barrett advised the committee that,
>
> "Most discontent was around time taken for funding
> and then a second discontent over time taken for
> obtaining funding for surgery. Speech and Language
> Therapy were rated very highly and one of the
> suggestions to improve the service was to have
> refreshments and snacks in the waiting area which
> the Clinic has followed up."
>
> Some might find it strange, therefore, that at the present time (and
> long before this first ever promotion by the country's largest lobbying
> group) a petition critical of NHS services (but Charing Cross in
> particular) should have drawn 100+ signatures.
>
> Some of the disparity could be accounted for by the methods used in the
> Charing Cross audit. Sources say that the questionnaire was distributed
> by the staff of the clinic itself, who also then received back the
> completed forms and analysed them. Respondents to the questionnaire
> could in many cases be identified by their answers, so it was hardly an
> independent process designed to elicit opinion from critics.
>
> In politics, of course, people just remember the headlines. "75%
> satisfied with our service" sounds good to outside observers and peers.
> Do 100 signatures saying something different in a petition alter that?
>
> The Importance of Speaking Out
> ------------------------------
>
> History teaches that bad things happen when people are afraid to speak
> up. This certainly seems to have been the case with the treatment of
> transsexual people, where methods and medical attitudes have changed
> very little in 40-50 years. Once those methods could have been defended
> as necessary in a world that was generally very hostile towards us. The
> world has changed, but some practitioners behave as though it hasn't;
> instead they cling on to ways of thinking about and controlling
> transsexual people as though it were still 1955 rather than 2005. And
> that's the way it will continue unless people begin to change it by
> voicing their feelings.
>
> One hundred signatures sounds impressive. Unfortunately, even in a
> community of just 5-6,000 people it isn't enough. Charing Cross boasts a
> case load of 600 service users at any one time. 1 in 6 complaining is
> therefore no more significant than the results of James Barrett's own
> internal poll .. less so, in fact.
>
> Charing Cross is developing a take it or leave it attitude these days
> too. Richard Green certainly stunned me this week when he said that he
> wasn't bothered if people went elsewhere because the clinic is happy
> enough with the 600 clients it has got.
>
> So, the opportunity is in your hands. If you agree with the broader
> statement of Christopher Pearse's petition then, by signing it, you
> signify the extent to which trans people in the UK are dissatisfied in
> general with the quality and choice of services made availble to them
> through the NHS.
>
> One hundred points to a problem. Five hundred (10% of the community)
> suggests some sort of crisis. How many signatures make this a scandal?
> You decide.
>
> The petition will be found at
>
http://www.petitiononline[...]on.html
>
>
> Christine Burns
> Trans Rights Campaigner and Educator
>
http://www.pfc.org.uk/cam[...]rns.htm
>
>
>
