THE Council of the British Medical Association has voted to oppose the Cass Review and to support the prescribing of puberty blockers to teenagers with gender-related distress. As a member for over 30 years I have resigned from the BMA.

The BMA says that it has concerns about "weaknesses in the methodologies used in the review" and vows to lobby ministers and NHS leaders to "oppose the implementation of the recommendations of the Cass review". I find such a stance barely believable. It seems to have no concern for "methodologies" when encouraging the unlicensed use of puberty blockers and cross-sex hormones in troubled teenagers. There are no studies showing convincing benefit at all. The prescribing is often described as "experimental". That is partly true but since no follow-up of patients is conducted it is not really an experiment. It is just reckless.

It says that the ban is "discriminatory". What is discriminatory is that more than 80% of the teenagers given puberty blockers and cross-sex hormones are same-sex-attracted and many are autistic. They are being given unlicensed medication which, in time, will cause sterilisation and loss of sexual function as well as other irreversible changes.

The BMA should remember the principle of First Do No Harm and reverse its decision. It should cooperate with all efforts to provide evidence-based holistic care for teenagers and others with gender-related distress.

Meanwhile I urge all members of the BMA to resign and to write explaining their reasons.

Dr Richard Watson, GP Principal, Cambuslang.

Universities must be able to charge

THE calls for review and reform of university funding highlight issues which go beyond the cashflow concerns of universities ("Tory MSP says politicians have ‘heads in the sand’ over free university tuition", The Herald, August 5). The economic future of Scotland is at stake, setting the context as the purposes of universities within a vibrant economy. It is about the nature of economic growth and the contribution higher education institutions make to the sustainability of a knowledge economy. Universities should be intellectual powerhouses, but they must also sit on economic frontiers.

In Scotland, future economic growth will require a coherent combination of:

• Leading-edge and world-class universities, defined by their ability to attract the most talented students and staff, and engage with internationally recognised research;

• A higher education sector, composed of universities and colleges, and which provides opportunity and supports aspiration and ambition as widely as possible;

• A base of skills and aptitudes across the wider population and which is internationally competitive.

Currently, we live on the edge by:

• Underfunding universities, with enforced dependence on public funding leading to constraints on domestic numbers and over-promoting the gamble of international recruitment;

• Somehow confusing the dilemma of achieving social inclusion by imposing barriers to the recruitment to our universities of the best-qualified applicants because of a crude system of quotas and a postcode device. We "exile" talent to England and elsewhere, the bulk of which will not return;

• Shackling state schools to the Curriculum for Excellence (CfE) and denying students the knowledge base to succeed.

Left unchallenged, these inhibitors will continue to forestall economic growth. Scotland depends on inward investment to achieve economic development, but with the characteristics outlined above, that investment will turn elsewhere. Recent experience should remind Scotland’s politicians and leaders that you cannot construct an economy based on call centres; and that dependence on manufacturing assembly will, inevitably, see that activity depart for cheaper overseas locations.


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In the face of this depressing critique, how do we achieve the appropriate balance between talent production and retention, so as to attract meaningful investment? It requires allowing universities to set appropriate fees, ending the no-HE fee, fixed-rate diktat from the Scottish Government. It would put universities on their mettle: charging students fees in a competitive market, but a significant improvement on taking bulk numbers on discounted tariffs. And it would allow universities to calculate better the bias between research and teaching activity.

Universities could be mandated to sign up to access and inclusion targets, without compromising entry criteria. Release of that public funding currently absorbed by universities could go substantially to colleges, which see themselves as underfunded critically, in need of capital investment, and capable of being redefined fundamentally as the skills engine underpinning a progressive Scottish economy.

Alongside the commitment to excellence in universities and the identification of an effective vocational education strategy, re-examining the principles and outcomes of CfE would re-establish the primacy of knowledge and give employers and investors confidence in the employee platform.

Professor William Wardle, Glasgow.

Police ignore speed offences

I FEAR that Green MSP Mark Ruskell may be whistling in the wind if he thinks that an effective, "life-saving" default speed limit can be introduced in Scotland ("Greens call for 20mph road limit", The Herald, August 3). It may well be that road casualty figures in Wales showed a reduction after the lower default speed limit was introduced but I doubt if this could be replicated in Scotland.

Some five years ago a 20mph speed limit was introduced in my village after lengthy discussions with the council, but the speed of vehicles has now returned to pre-"Twenty's Plenty" days because the legislation has not been enforced by Police Scotland. The force has ignored or at best paid lip service to community concerns about the speed of vehicles. Admittedly, Police Scotland is under-staffed but it could be the case that better resource management would improve matters.

Should the Kippen situation be experienced throughout Scotland then Mr Ruskell's proposals would seem to be a waste of time.

Bob MacDougall, Kippen.

Would a default speed limit of 20mph be enforced in Scotland?Would a default speed limit of 20mph be enforced in Scotland? (Image: PA)

Cycle folly

I SEE that Glasgow City Council is to install another 500 bike storage shelters ("500 more storage shelters for bikes planned", The Herald, August 6). Stirling has also gone down the "cycle route", installing protected cycle lanes all over the place over the past three years or so. All these cycle lanes yet the other day there was a tailback of traffic including the park & ride bus behind three Lycra-clad cyclists who studiously ignored the cycle lane.

The obvious alternative, of course, is for the traffic to move on to the clear cycle lane and leave the roads for the cyclists.

Steve Barnet, Gargunnock.