In my last two articles I first revealed that the Model of Care (MoC) followed by the National Gender Service (NGS) did not originate from an 2017 MoC developed by the Quality Improvement Division (QID) of the HSE in cooperation with professional bodies and patient organisations, and subsequently revealed that not only did the MoC approval process ignore its own calls for involvement involving trans representatives but that the doctors who wrote the MoC were among the key people who approved it.
The Terms of Reference (TOR) for the steering group define a 60% quorum for the group:
These were signed off by the steering group itself on the 28 June 2018 meeting, the 3rd of the 5 meetings of the steering group:
As you may recall from my previous article by the 28 June 2018 meeting there were 16 members of the steering group. With a 60% quorum that means that 10 members need to be present for a meeting to happen. For example in the 6 September 2018 meeting where the MoC was approved, there were exactly the 10 attendees required for quorum.
The Final Meeting
The last meeting of the steering group was on 20 September 2018, and it was below quorum. In fact only 5 people attended, far below the 10 needed:
No mention of this lack of quorum appears in the minutes, and business continues as though things are perfectly normal starting with the approval of the previous minutes.
The first decision made to rename from the National Transgender Service to the National Gender Service, which in my personal opinion feels like a better name though does not justify ignoring quorum:
They then makes change to the TORs that define how the governance group for the NGS will work:
Next they decided who would be in the governance group, which is 8 people working in St. Columcille’s Hospital/St. John of Gods, a digital media manager, and 2 trans representatives for 11 people in all.
TENI were indeed emailed on 9 October 2018 to nominate someone:
A FoI to the Department of Health happens to mention that TENI attended the week of 19 November 2018:
Prof O’Shea was to select the patient to be part of the governance group:
There is no mention of how he was to select this person, such as whether it was a random pick, voting among patients, or his personal choice. I don’t currently have any minutes of the governance group, however in the letter of 28 January 2021 to the CEO of the HSE at the core of a previous article on behalf of a governance group meeting of 28 January 2021 neither TENI nor patient representatives were present. So while it appears there was some involvement after the NGS was created, sometime within the following two years patient voices were once again not present.
Continuing on there’s various other matters discussed, including about Speech and Language Therapy recruitment:
As someone who has personal experience of vocal transition, I don’t quite see how a psychiatrist and endocrinologist are important for knowing the skills required for speech therapy. Particularly given that a Speech and Language Clinical Lead is also on the interview board.
From this sample of minutes you can see that without having a quorum that’d allow the meeting to be valid, multiple significant decisions were made.
The Terms of Reference for the NGS were changed, who would govern the NGS was chosen, and the doctors who wrote the NGS’s MoC ensured they’d be a part of interviewing new staff.
Of course Jes has green hair and pronouns
Featured image via the Center for Applied Transgender Studies