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UK pediatrician who led review of child ‘transitions’ says US medical groups ‘misleading the public’

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Dr. Hilary Cass, author of the Cass Review

From LifeSiteNews

By Calvin Freiburger

The typically left-wing New York Times published an interview on Monday with consultant pediatrician Dr. Hilary Cass on her comprehensive review of so-called “gender medicine” in the United Kingdom, indicating that awareness of the damage due to surgical and chemical “transitioning” continues to spread despite the best efforts of LGBT activists.

Released in April, 366-page Cass Review was commissioned by National Health Service (NHS) England following ongoing scandals about the practices of British “gender clinics” such as the Gender Identity Development Service (GIDS), operated by the Tavistock and Portman NHS Foundation Trust. The four-year project consisted of comprehensive reviews of current research and international standards, as well as extensive interviews with gender-confused children and adults, family members, detransitioners, doctors, and activists.

It found that “gender medicine” is “built on shaky foundations” and that while such interventions require a great deal of caution, “quite the reverse happened in the field of [so-called] gender care for children,” and that “[w]hile a considerable amount of research has been published in this field, systematic evidence reviews demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices.” Her findings led NHS to stop prescribing puberty blockers to children with gender confusion earlier this year.

Speaking to the Times, Cass explained that she was planning her retirement when she was first asked to tackle the project and was initially apprehensive about wading into the controversy.

“The most important concern for me is just how poor the evidence base is in this area,” she said. “Some people have questioned, ‘Did we set a higher bar for this group of young people?’ We absolutely didn’t. The real problem is that the evidence is very weak compared to many other areas of pediatric practice.”

The Times acknowledged that her “findings are in line with several European countries that have limited the treatments [sic] after scientific reviews. But in America, where nearly two dozen states have banned the care outright, medical groups have endorsed the treatments as evidence-based and necessary,” including groups the paper contacted for its latest story. Cass described American medical consensus as “out of date” on the issue.

“When I was president of the Royal College of Pediatrics and Child Health, we did some great work with the A.A.P. [American Academy of Pediatrics],” she elaborated. “They are an organization that I have enormous respect for. But I respectfully disagree with them on holding on to a position that is now demonstrated to be out of date by multiple systematic reviews.”

“It wouldn’t be too much of a problem if people were saying ‘This is clinical consensus and we’re not sure,” she added. “But what some organizations are doing is doubling down on saying the evidence is good. And I think that’s where you’re misleading the public. You need to be honest about the strength of the evidence and say what you’re going to do to improve it.”

significant body of evidence shows that “affirming” gender confusion carries serious harms, especially when done with impressionable children who lack the mental development, emotional maturity, and life experience to consider the long-term ramifications of the decisions being pushed on them.

Yet while mounting evidence against youth “gender transitions” is prompting European nations such as the United Kingdom and France, which are normally to the left of America, to move away from the practice, in America, the medical establishment and the Biden administration continues to dig in their heels, despite Biden’s own Substance Abuse & Mental Health Services Administration (SAMHSA) releasing a since-deleted report last year acknowledging that “lesbian, gay, and bisexual adults are more likely than straight adults to use substances, experience mental health conditions including major depressive episodes, and experience serious thoughts of suicide.”

The White House’s comprehensive pursuit of the transgender agenda has included reopening the military to recruits afflicted with gender dysphoria, promoting gender ideology within the military (including “diversity” and drag events on military bases), holding White House events to “affirm transgender kids,” condemning state laws against underage “transitions” as “close to sinful,” promoting underage “transitions” (potentially at taxpayer expense) as a “best practice,” and trying to force federally funded schools to let males into female athletic competitions and restrooms.

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Fraser Institute

Enough talk, we need to actually do something about Canadian health care

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From the Macdonald Laurier Institute

By J. Edward Les for Inside Policy

Canada spends more on health care as a percentage of GDP than almost all other OECD countries, yet we rank behind most of them when it comes to outcomes that matter.

I drove a stretch of road near Calgary’s South Health Campus the other day, a section with a series of three intersections in a span of less than a few hundred metres. That is, I tried to drive it – but spent far more time idling than moving.

At each intersection, after an interminable wait, the light turned green just as the next one flipped to red, grinding traffic to a halt just after it got rolling. It was excruciating; I’m quite sure I spied a snail on crutches racing by – no doubt making a beeline (snail-line?) for the ER a stone’s throw away.

The street’s sluggishness is perhaps reflective of the hospital next to it, given that our once-cherished universal health care system has crumbled into a universal waiting system – a system seemingly crafted (like that road) to obstruct flow rather than enable it. In fact, the pace of medical care delivery in this country has become so glacial that even a parking lot by comparison feels like the Indianapolis Speedway.

The health care crisis grows more dire by the day. Reforms are long overdue. Canada spends more on health care as a percentage of GDP than almost all other OECD countries, yet we rank behind most of them when it comes to outcomes that matter.

And we’re paying with our lives: according to the Canadian Institute for Health Information, thousands of Canadians die each and every year because of the inefficiencies of our system.

Yet for all that we are paralyzed by the enormity and complexity of the mushrooming disaster. We talk about solutions – and then we talk and talk some more. But for all the talking, precious little action is taken.

I’m reminded of an Anne Lamotte vignette, related in her bestselling book Bird By Bird:

Thirty years ago my older brother, who was ten years old at the time, was trying to get a report written on birds that he’d had three months to write, which was due the next day. We were out at our family cabin in Bolinas, and he was at the kitchen table close to tears, surrounded by binder paper and pencils and unopened books about birds, immobilized by the hugeness of the task ahead. Then my father sat down beside him, put his arm around my brother’s shoulder, and said, “Bird by bird, buddy. Just take it bird by bird.”

So it is with Canadian health care: we’ve wasted years wringing our hands about the woeful state of affairs, while doing precious little about it.

Enough procrastinating. It’s time to tackle the crisis, bird by bird.

One thing we can do is to let doctors be doctors.  A few weeks ago, in a piece titled “Should Doctors Mind Their Own Business?”, I questioned the customary habit of doctors hanging out their shingles in small independent community practices. Physicians spend long years of training to master their craft, years during which they receive no training in business methods whatsoever, and then we expect them to master those skills off to the side of their exam rooms. Some do it well, but many do not – and it detracts from their attention to patients.

We don’t install newly minted teachers in classrooms and at the same time task them with the keeping the lights on, managing the supply chain, overseeing staffing and payroll, and all the other mechanics of running schools. Why do we expect that of doctors?

Keeping doctors embedded within large, expensive, inefficient, bureaucracy-choked hospitals isn’t the solution, either.

There’s a better way, I argued in my essay: regional medical centres – centres built and administered in partnership with the private sector.

Such centres would allow practitioners currently practicing in the community to ply their trade unencumbered by the nuts and bolts of running a business; and they would allow us to decant a host of services from hospitals, which should be reserved for what only hospitals can do: emergency services, inpatient care, surgeries, and the like.

In short, we should let doctors be doctors, and hospitals be hospitals.

To garner feedback, I dumped my musings into a couple of online physician forums to which I belong, tagged with the query: “Food for thought, or fodder for the compost bin?”

The verdict? Hands down, the compost bin.

I was a bit taken aback, initially. Offended, even – because who among us isn’t in love with their own ideas?

But it quickly became evident from my peers’ comments that I’d been misunderstood. Not because my doctor friends are dim, but because I hadn’t been clear.

When I proposed in my essay that we “leave the administration and day-to-day tasks of running those centres to business folks who know what they’re doing,” my colleagues took that to mean that doctors would be serving at the beck and call of a tranche of ill-informed government-enabled administrators – and they reacted to the notion with anaphylactic derision. And understandably so: too many of us have long and painful experience with thick layers of health care bureaucracy seemingly organized according to the Peter Principle, with people promoted to – and permanently stuck at – the level of their incompetence.

But I didn’t mean to suggest – not for a minute – that doctors shouldn’t be engaged in running these centres. I also wrote: “None of which is to suggest that doctors shouldn’t be involved, by aptitude and inclination, in influencing the set-up and management of regional centres – of course, they should.”

Of course they should. There are plenty of physicians equipped with both the skills and interest needed to administer these centres; and they should absolutely be front and centre in leading them.

But more than that: everyone should have skin in the game. All workers have the right to share in the success of an enterprise; and when they do, everybody wins.  When everyone is pulling in the same direction because everyone shares in the wins, waste and inefficiencies are rooted out like magic.

Contrast that to how hospitals are run, with scarcely anyone aware of the actual cost of the blood tests or CT scans they order or the packets of suture and gauze they rip open, and with the motivations of administrative staff, nurses, doctors, and other personnel running off in more directions than a flock of headless chickens. The capacity for waste and inefficiencies is almost limitless.

I don’t mean to suggest that the goal of regional medical centres should be to turn a profit; but fiscal prudence and economic accountability are to be celebrated, because money not wasted is money that can be allocated to enhancing patient care.

Nor do I mean to intimate that sensible resource management should be the only parameter tracked; patient outcomes and patient satisfaction are paramount.

What should government’s role be in all this? Initially, to incentivize the creation of these centres via public-private partnerships; and then, crucially, to encourage competition among them and to reward innovation and performance, with optimization of the three key metrics – patient outcomes, patient satisfaction, and economic accountability – always in focus.

No one should be mandated to work in non-hospital regional medical centres. It’s a free country (or it should be): doctors should be free to hang out their own community shingles if they wish. But if we build the model correctly, my contention is that most medical professionals will prefer to work collaboratively under one roof with a diverse group of colleagues, unencumbered by the mundanities of running a business, but also free of choking hospital bureaucracy.

I connected a couple weeks ago with the always insightful economist Jack Mintz (who is also a distinguished fellow at the Macdonald-Laurier Institute). Mintz sits on the board of a Toronto-area hospital and sees first-hand “the problems with the lack of supply, population growth, long wait times between admission and getting a bed, emergency room overuse,” and so on.

“Something has to give,” he said. “Probably more resources but better managed. We really need major reform.”

On that we can all agree. We can’t carry on this way.

So, let’s stop idling; and let’s green-light some fixes.

As Samwise Gamgee said in The Lord of the Rings, “It’s the job that’s never started as takes longest to finish.”


Dr. J. Edward Les is a pediatrician in Calgary who writes on politics, social issues, and other matters.

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Addictions

Trudeau gov’t earmarks over $27 million for ‘safe supply’ drug program linked to overdoses and violence

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From LifeSiteNews

By Clare Marie Merkowsky

The taxpayer money will help fund 22 drug distribution projects in British Columbia and Ontario.

Prime Minister Justin Trudeau’s Liberal government is planning to spend over $27 million on “safe supply” drug programs this year.

This week, Health Canada revealed that the Trudeau government has budgeted over $27 million in funding for “safe supply” drug programs that have been linked to increased violence and overdose deaths across Canada, according to information obtained by Rebel News.

“With regard to planned funding by the government related to ‘safe’ or ‘safer’ supply programs: How much does the government plan on spending on such programs, broken down by department, agency, and initiative in the current fiscal year and in each of the next five fiscal years?” Conservative Member of Parliament (MP) Tako Van Popta had questioned in April.

Safe supply” is the term used to refer to government-prescribed drugs given to addicts under the assumption that a more controlled batch of narcotics reduces the risk of overdose. Critics of the policy argue that giving addicts drugs only enables their behavior, puts the public at risk, disincentivizes recovery from addiction and has not reduced — and sometimes even increased — overdose deaths when implemented.

Three months later, on June 17, the House of Commons revealed that the Trudeau government plans to spend an excess of $27 million to fund 22 drug distribution projects in British Columbia and Ontario.

The two largest recipients of federal funding are in Ontario, with Toronto’s South Riverdale Community Health Centre receiving $2.7 million and Kitchener’s K-W Working Centre for the Unemployed receiving $2.1 million.

In British Columbia, the largest recipient is the AVI Health and Community Services Society SAFER North Island in Campbell River at $2.02 million.

The Trudeau government’s funding for increased drug use comes after the program proved such a disaster in British Columbia that the province recently requested Trudeau recriminalize drugs in public spaces. Nearly two weeks later, the Trudeau government announced it would “immediately” end the province’s drug program.

Beginning in early 2023, Trudeau’s federal policy, in effect, decriminalized hard drugs on a trial-run basis in British Columbia.

Since being implemented, the province’s drug policy has been widely criticized, especially after it was found that the province broke three different drug-related overdose records in the first month the new law was in effect.

The effects of decriminalizing hard drugs in various parts of Canada have been exposed in Aaron Gunn’s recent documentary, Canada is Dying, and in U.K. Telegraph journalist Steven Edginton’s mini-documentary, Canada’s Woke Nightmare: A Warning to the West.

Gunn says he documents the “general societal chaos and explosion of drug use in every major Canadian city.”

“Overdose deaths are up 1,000 percent in the last 10 years,” he said in his film, adding that “(e)very day in Vancouver four people are randomly attacked.”

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