1,000 senior doctors signed an open letter to the British Medical Association after it lobbied for the NHS to lift a ban on puberty blockers for children following the Cass Review, which found the drugs were harmful.
On August 1, the British Medical Association (BMA) – the United Kingdom’s doctors’ union – called on the government to lift the ban on puberty blockers for minors. Weirdly, the BMA also stated that in their view the implementation of NHS England’s Cass Review should be “paused” despite the fact that, as the BBC noted, the review “took four years to carry out and was widely welcomed by the medical establishment in the U.K.” The BMA called the Cass Review’s recommendations – based on “the largest and most comprehensive review” on the subject seen, looking at 237 papers from 18 countries – “unsubstantiated.”
A spokesperson for the Department of Health and Social Care responded to the BMA, firmly rejecting both the request and the claim, stating, “The Cass Review is a robust report backed by clinicians and firmly grounded in evidence. NHS England will be implementing Dr. Cass’s recommendations so that children and young people get the safe, holistic support they need. We do not support a delay to vital improvements from the NHS to gender services.” Even the leftist Guardianran an editorial criticizing the BMA’s position, stating, “The BMA’s stance on puberty blockers defies the key principle of medicine: first, do no harm.”
As it turns out, there are plenty of physicians who are very unhappy with the BMA’s move – and they are now making their voices heard. This week, 1,000 senior doctors from across the U.K. published an open letter addressed to Professor Philip Banfield, chairman of the BMA.
“We write as doctors to say, ‘not in my name,’” the letter reads. “We are extremely disappointed that the BMA council had passed a motion to conduct a ‘critique’ of the Cass Review and to lobby to oppose its recommendations. The passing of the motion was opaque and secretive. It does not reflect the views of the wider membership, whose opinion you did not seek. We understand that no information will be released on the voting figures and how council members voted. That is a failure of accountability to members and is simply not acceptable.”
The open letter further emphasizes that the Cass Review “is the most comprehensive review into healthcare for children with gender related distress ever conducted” and urged the BMA to “abandon its pointless exercise” of attacking and opposing the recommendations. “By lobbying against the best evidence we have, the BMA is going against the principles of evidence-based medicine and against ethical practice.”
Among the signatories to the letter are 23 former or current clinical leaders at royal colleges, as well as the heads and former heads of some royal colleges.
The British Medical Association is the only main medical organization to oppose the Cass Review; all others have backed it. For example, Professor Sir Stephen Powis, NHS national medical director, stated, “These plans set out in detail how we will establish a fundamentally different and safer model of care for children and young people. The work Dr. Cass has undertaken has been invaluable in helping us shape the new service offer, and we have already begun our transformation of these services by opening two new regional centres this year.” Banfield responded on behalf of the BMA council to say that the points made in the letter would be considered during their ongoing evaluation.
As Josephine Bartosch observed, “it is becoming increasingly clear that the BMA is dangerously out of step with the medical consensus. The Cass Review has sent ripples across the world, and from lawsuits in the U.S. to a change of tack across Europe – medics are increasingly acknowledging that what is a crisis in youth mental health cannot be cured by changing bodies.”
Jonathon’s writings have been translated into more than six languages and in addition to LifeSiteNews, has been published in the National Post, National Review, First Things, The Federalist, The American Conservative, The Stream, the Jewish Independent, the Hamilton Spectator, Reformed Perspective Magazine, and LifeNews, among others. He is a contributing editor to The European Conservative.
His insights have been featured on CTV, Global News, and the CBC, as well as over twenty radio stations. He regularly speaks on a variety of social issues at universities, high schools, churches, and other functions in Canada, the United States, and Europe.
He is the author of The Culture War, Seeing is Believing: Why Our Culture Must Face the Victims of Abortion, Patriots: The Untold Story of Ireland’s Pro-Life Movement, Prairie Lion: The Life and Times of Ted Byfield, and co-author of A Guide to Discussing Assisted Suicide with Blaise Alleyne.
Jonathon serves as the communications director for the Canadian Centre for Bio-Ethical Reform.
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After the Smith government recently announced its shift to a new approach for funding hospitals, known as “activity-based funding” (ABF), defenders of the status quo in Alberta were quick to argue ABF will not improve health care in the province. Their claims are simply incorrect. In reality, based on the experiences of other better-performing universal health-care systems, ABF will help reduce wait times for Alberta patients and provide better value-for-money for taxpayers.
First, it’s important to understand Alberta is not breaking new ground with this approach. Other developed countries shifted to the ABF model starting in the early 1990s.
Indeed, after years of paying their hospitals a lump-sum annual budget for surgical care (like Alberta currently), other countries with universal health care recognized this form of payment encouraged hospitals to deliver fewer services by turning each patient into a cost to be minimized. The shift to ABF, which compensates hospitals for the actual services they provide, flips the script—hospitals in these countries now see patients as a source of revenue.
In fact, in many universal health-care countries, these reforms began so long ago that some are now on their second or even third generation of ABF, incorporating further innovations to encourage an even greater focus on quality.
For example, in Sweden in the early 1990s, counties that embraced ABF enjoyed a potential cost savings of 13 per cent over non-reforming counties that stuck with budgets. In Stockholm, one study measured an 11 per cent increase in hospital activity overall alongside a 1 per cent decrease in costs following the introduction of ABF. Moreover, according to the study, ABF did not reduce access for older patients or patients with more complex conditions. In England, the shift to ABF in the early to mid-2000s helped increase hospital activity and reduce the cost of care per patient, also without negatively affecting quality of care.
Multi-national studiesontheshift to ABF have repeatedly shown increases in the volume of care provided, reduced costs per admission, and (perhaps most importantly for Albertans) shorter wait times. Studieshavealsoshown ABF may lead to improved quality and access to advanced medical technology for patients.
Clearly, the naysayers who claim that ABF is some sort of new or untested reform, or that Albertans are heading down an unknown path with unmanageable and unexpected risks, are at the very least uninformed.
And what of those theoretical drawbacks?
Some critics claim that ABF may encourage faster discharges of patients to reduce costs. But they fail to note this theoretical drawback also exists under the current system where discharging higher-cost patients earlier can reduce the drain on hospital budgets. And crucially, other countries have implemented policies to prevent these types of theoretical drawbacks under ABF, which can inform Alberta’s approach from the start.
Critics also argue that competition between private clinics, or even between clinics and hospitals, is somehow a bad thing. But all of the developed world’s top performing universal health-care systems, with the best outcomes and shortest wait times, include a blend of both public and private care. No one has done it with the naysayers’ fixation on government provision.
And finally, some critics claim that, under ABF, private clinics will simply focus on less-complex procedures for less-complex patients to achieve greater profit, leaving public hospitals to perform more complex and thus costly surgeries. But in fact, private clinics alleviate pressure on the public system, allowing hospitals to dedicate their sophisticated resources to complex cases. To be sure, the government must ensure that complex procedures—no matter where they are performed—must always receive appropriate levels of funding and similarly that less-complex procedures are also appropriately funded. But again, the vast and lengthy experience with ABF in other universal health-care countries can help inform Alberta’s approach, which could then serve as an example for other provinces.
Alberta’s health-care system simply does not deliver for patients, with its painfully long wait times and poor access to physicians and services—despite its massive price tag. With its planned shift to activity-based funding, the province has embarked on a path to better health care, despite any false claims from the naysayers. Now it’s crucial for the Smith government to learn from the experiences of others and get this critical reform right.
Officials at the the National Institutes of Health and the Centers for Medicare & Medicaid Services announced a partnership Wednesday to research “root causes of autism spectrum disorder.”
As part of the project, NIH will build a real-world data platform enabling advanced research across claims data, electronic medical records and consumer wearables, according to the agencies.
“We’re using this partnership to uncover the root causes of autism and other chronic diseases,” said HHS Secretary Robert F. Kennedy Jr. “We’re pulling back the curtain – with full transparency and accountability – to deliver the honest answers families have waited far too long to hear.”
CMS and NIH will start this partnership by establishing a data use agreement under CMS’ Research Data Disclosure Program focused on Medicare and Medicaid enrollees with a diagnosis of autism spectrum disorder or ASD.
“This partnership is an important step in our commitment to unlocking the power of real-world data to inform public health decisions and improve lives,” NIH Director Dr. Jay Bhattacharya said. “Linking CMS claims data with a secure real-world NIH data platform, fully compliant with privacy and security laws, will unlock landmark research into the complex factors that drive autism and chronic disease – ultimately delivering superior health outcomes to the Americans we serve.”
Researchers will focus on autism diagnosis trends over time, health outcomes from specific medical and behavioral interventions, access to care and disparities by demographics and geography and the economic burden on families and healthcare systems, according to a news release.
