The factual background
The factual background
The parties
C1 is a mental health nurse and psychotherapist who previously worked in the now closed NHS Gender Identity Development Service (“GIDS”) at the Tavistock and Portman NHS Foundation Trust (“the Tavistock” and “Tavistock GIDS”). C2 is the mother of IP4, a transgender child.
The CQC was established on 1 April 2009 by the Health and Social Care Act 2008 (“HSCA”); it is the independent statutory regulator of healthcare, adult social care and primary care services in England.
IP1 is a private healthcare service and is the subject of this claim. IP1 was incorporated in May 2023 and uses the trading name Gender Plus Hormone Clinic (“GPHC”). Dr Aidan Kelly, a consultant clinical psychologist registered in the UK with the Health and Care Professions Council, is the founder owner of IP1 and has been its clinical director since its registration by the CQC on 9 January 2024. Dr Kelly is also the founder owner, and clinical director, of Kelly Psychology, which uses the trading name “Gender Plus” and which operates as a private provider of non-medical psychology, assessment, and mental health services. Following an assessment by Kelly Psychology, a patient aged 16 or over may be referred to IP1 for the hormone treatment.
IP4 is the child of C2 and is a natal female who has identified as male since December 2020. IP4 has lived with IP5, C2’s ex-husband, since October 2021, and has intermittent contact with C2. There have been family court proceedings concerning IP4’s wish to seek hormone treatment from IP1 (see O v P [2024] EWHC 1077 (Fam) and [2024] EWCA Civ 1577); neither IP4 nor IP5 have played an active part in the current proceedings. As for IP2 and IP3, both have remained neutral and have not sought to actively participate in these proceedings.
- Heading
- This judgment was handed down by the Judge remotely by circulation to the parties' representatives by email and release to The National Archives. The date and time for hand down is deemed to be 2pm on
- Mrs Justice Eady DBE
- Preliminary issue
- The decisions under challenge and the issues for determination
- The factual background
- The context
- The chronology relevant to the decisions under challenge and the current proceedings
- The registration decision
- The assessment decision
- IP1 patient data
- Advocacy
- O v P
- The statutory framework
- Regulated activity
- Registration of persons who carry on regulated activity
- Reviews and performance assessments
- Fundamental standards
- Statutory guidance for registered persons
- Relevant legal principles
- Process rationality
- Outcome rationality
- The Padfield principle
- The parties’ arguments
- The position of the CQC
- IP1’s position
- Analysis and conclusions
- Process irrationality
- Outcome irrationality
- The Padfield challenge
- Conclusions
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