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26 July 2024

Why are BMA Council’s confidential discussions on the Cass Review a matter of public interest?

Because the members and the public have a right to know.

By Hannah Barnes

On 17 July, the governing body of the doctors’ union, the BMA Council, discussed the Cass Review. The night before, I’d written for the New Statesman that the body, comprised of 69 voting members, were set to vote on whether or not to “disavow” the Cass Review into gender identity services for children and young people.  

According to several sources, that was indeed the plan. But it’s not what happened on the day. I can’t tell you exactly what did; it appears to be shrouded in secrecy. Council meetings are meant to be confidential and those present are fearful of speaking publicly. But here’s what I can say: there was a vote related to the Cass Review; that vote wasn’t on the motion that was initially planned, and, at the time of writing, those who were present and cast votes have not been told the result. It’s understood that the original motion was amended at the meeting, calling instead for the BMA to thoroughly review the Cass findings before coming to any conclusions on how to actually respond to it. That seems sensible. 

As is standard practice in journalism, before publishing my original article I went to the BMA seeking comment and asking for clarification on certain points. I quoted from the motion on the agenda for the Council meeting, and asked the BMA a series of direct questions. The union’s response was included in the published copy. 

Dr Hilary Cass’s response to the idea that the BMA Council was even contemplating voting to ‘disavow’ the results of a thorough four-year investigation was to express disappointment that the BMA should be basing their official response to her work on “the votes of Council, rather than a transparent and scientific appraisal of the report”. Dr Cass has confirmed that, more than a week on, the BMA has still not contacted her. “Neither I nor any member of the review team have met with the BMA since the publication of our final report,” she told the New Statesman. “Nor have they expressed any concern about its contents to me since then. Our report reflected concerns the BMA had in the early stages of the review, including GPs prescribing medications (including puberty blockers and masculinising/feminising hormones) beyond their expertise, as well as the need for additional training in this area of healthcare.” Dr Cass repeated that she would welcome the opportunity to discuss her findings with the BMA, were they to extend an invitation to do so.  

When I sent a detailed email to the BMA with my understanding of what had taken place, and asking again for the result of the vote, they did not wish to say. A spokesperson told the New Statesman: “The matters discussed by our Council, and the processes we follow, are confidential. Any decisions regarding the sharing of information about Council-related matters, with Council members, will be taken by the BMA and we will not comment further on that.”

BMA Council discussions are intended to be confidential. That’s not unreasonable. But when these discussions involve serious matters surrounding the health and wellbeing of distressed and – often – vulnerable children, their contents are a matter of public interest. It’s also of great importance to their wider membership when a small group are speaking on behalf of 190,000 doctors who may or may not agree with them, and may not have known about the planned vote. That a significant number of the trade union’s governing body were contemplating a rejection of the Cass Report is something that the BMA should be open about. 

What was the wording of the final motion the BMA Council voted on? And how did its members vote? I think BMA members and the public, whom so many of them dutifully serve, have a right to know.  

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