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Friday 30th July 1999 |
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Sex changes on NHS:
Judges say health service must pay because patients have a real illness
By STEVE DOUGHTY
Social Affairs Correspondent
TRANSSEXUALS yesterday won the right to sex-change operations on the NHS as judges ruled that they suffer from a genuine illness.
The landmark judgment means health chiefs must give the claims of the estimated 4,000 transsexuals seeking surgery a place in their planning alongside victims of cancer, heart and kidney disease.
At £10,000 an operation, it could cost the cash strapped NHS £40million. Critics last night condemned it as a misuse of funds at a time when it is claimed that 500 people a year die while on the waiting list for cardiac surgery and Britain has the worst cancer treatment record in Europe.
Transsexual lobby groups, however, hailed the ruling as a turning point in their battle to prove that their plight did warrant medical intervention. They said that a few authorities openly refused operations while in other areas transsexuals were forced to wait up to 15 years for surgery.
The three Appeal Court judges ruled unlawful a health authority’s decision to refuse ’gender reassignment surgery’ to three unnamed men, one aged 22 and two aged 52, on the grounds that it was medically unnecessary.
The North West Lancashire authority, which covers Blackpool and Preston, was acting under a policy which gives such operations the lowest clinical priority alongside cosmetic surgery and reversal of sterilisation.
It argued that patients with heart disease, kidney failure, cancer and Aids had greater priority for its scarce funds.
While claiming it would make exceptions for transsexuals in cases of ’overriding clinical need’ it has not, in fact, carried out such an operation since 1995.
And its policy states. ’Interventions on the human body are not always related to ill health, but may be related to a desire to achieve an ideal body image or a bodily function that cannot currently be achieved.’
The Appeal Court judges said that the authority was effectively operating a blanket policy of refusing sex-change operations ’because it does not believe in such treatment’.
Lord Justice Auld said. ’It does not in truth treat transsexualism as an illness but as an attitude or state of mind which does not warrant medical treatment.’
Yet leading medical experts had said that in some cases operations were necessary to relieve extreme mental distress. Lord Justice May accepted health authorities had to make ’invidious decisions’ in allocating inadequate resources.
’But those decisions must proceed from proper assessments of the conditions competing for treatment,’ he said. ’The decisions in the present case did not.’
Upholding an earlier High Court verdict in favour of the trio - named only as Miss A D and G they ruled the policy was ’flawed’, and ordered the authority to reconsider.
The three have already had treatment resulting in irreversible physical changes, and live as women.
They claimed they were in and the refusal to treat them and complete their transformation was ’irrational’.
Their lawyer Stephen Lodge said the sum the authority had spent on the case could have gone towards treating them.
North West Lancashire is understood to have spent more than £100,000 and must now pay two thirds of the transsexuals’ similar costs. The rest of their bill will be met by legal aid.
But psychologist and family campaigner Dr John Campion said: ’When people have problems with sexuality I have deep sympathy - but it is not an illness. It is most certainly not a disease equivalent to cancer.’
He added: ’These operations are not necessary. The NHS is facing exploding demand and in those circumstances you have to set some boundaries.’
Simon Calvert of the Christian Institute, a religious think tank, branded the ruling regrettable’. The NHS has no central guidelines on what clinical priority should be given to transsexuals and health authorities have full powers to decide on organisation of treatment in their areas.
Up to 100 sex-change operations are carried out annually but campaigners claim many transsexuals are forced to wait many years for surgery.
The transsexual lobby group Press for Change said the ’welcome’ decision could also apply to other patients turned down on the grounds of cost, such as those needing Viagra.
A spokesman added. ’Few authorities are like West Lancashire in openly opposing surgery. But what has been happening is that people are waiting six, ten, even 15 years for surgery even though we are told waiting lists are 18 months. In practice, they are given very low priority.’
Copyright © 1999, Daily Mail
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Friday 30th July 1999 |
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A foolish decision that hurts us all
CAN anyone in Britain be unaware of the plight of our cash-strapped health service, of long waiting lists, of the failure, in some areas, to provide treatment any better than that found in the Third World?
Incredibly, the answer seems to be Yes. For based on yesterday’s Appeal Court decision to grant transsexuals the right to free sex change operations on the NHS - at £10,000 a time it appears that at least some of our senior judges think that money for health care grows on trees.
The Court ruled that the North West Lancashire Health Authority’s refusal to carry out three such operations because of a lack of funds was not only unlawful but ’irrational’. But what is irrational about deciding that the interests of genuinely ill people should come before those who feel ’Trapped in their bodies’?
And who are judges to decree that they rather than those taking difficult decisions about limited resources, have the expertise to say that transsexuality is an ’illness that requires treatment’? There is no settled scientific consensus over this, after all.
Of course, transsexuals deserve our sympathy. But that does not mean we must remove their misery through free operations. Maintaining a modern and efficient National Health Service is already proving beyond us.
Attempting to turn it into a National Happiness Service will lead to national bankruptcy and increased suffering all round.
When will the courts start to understand that granting rights to an increasing number of minorities must necessarily reduce the rights of the majority?
The waiting list for all operations in North West Lancashire now stands at 13,000, and includes more than 200 patients with life-threatening heart complaints. How many of these people will have to wait longer for surgery as a result of this crass judgment?
Of the 24,000 patients waiting for bypass surgery throughout the country an estimated 500 will die while on the list. But no one has yet died because of a delayed sex change operation.
The disgust felt. today by the 230,580 awaiting hip replacement and other orthopedic operations, the 149,510 awaiting operations to remove cataracts or other eye defects, the 104,585 awaiting serious gynaecological operations, can only be imagined today.
They, rather than the North West Lancashire Health Authority, were the real losers in Appeal Court yesterday.
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