The erosion of public trust: Peggie tribunal and previous NHS Fife findings
- Administrator
- Aug 3
- 4 min read
Public trust is essential to UK communities. It forms the foundation of a functional and cohesive society. When individuals trust institutions, leaders, and each other, it encourages cooperation, civic engagement, and promotes societal stability. Public trust enables governments and public institutions to implement policies and initiatives more effectively. Citizens are more likely to engage and contribute positively to that society when they believe in the integrity and competence of those in charge. Sadly, it is clear from the tribunal’s proceedings (ended 30 July and held over until early September 2025) that public trust in NHS Fife, and indeed the Scottish Government, has been significantly damaged.
The problem is, when reality and material truth is denied, and the public sees that it is being lied to, public institutions’ structures and processes creak and stagger ever increasingly towards implosion and potential collapse. Gender identity is a false concept without an evidence base. Its promotion by activists and those who feel pressured to act complicitly, will have an inevitable endpoint of brokenness and destruction, but not without first causing irreparable harm to all those institutions and individuals who have embraced it. We have witnessed this happening before our very eyes as the tribunal has progressed.
The tribunal’s proceedings have been marked by many moments that observers have described as a refusal to engage with reality and/or indeed the law. The UK Supreme Court’s 2025 ruling regarding the Equality Act 2010 stated that ‘sex’ means biological sex. This means that with regard to the tribunal, Dr Upton had no right of access to female changing rooms. It should be simple, sex means sex and its immutability should not be in doubt.
Yet, witnesses for NHS Fife defended policies which allowed individuals who identified as the opposite sex, to use facilities aligned with their gender identity, even in the absence of clear NHS Fife guidelines at the time. Decision-making demonstrated a lack of use, or awareness of robust, evidence-based information. Witnesses claimed that they could not confirm their own biological sex. Other witnesses indicated that they had wanted to report a hate crime when there was no evidence for this. And allegations of deleted emails, manipulated records (e.g. Dr. Upton’s Google notes with questionable timestamps), fuelled perceptions of a cover-up. All of this undermines confidence in NHS Fife’s integrity. All of this is emblematic of a broader institutional tendency to obscure objective truth in favor of an unproven and mythical ideological concept.
The Women’s Rights Network Scotland report How safe are our Scottish hospitals? (C. Brown and M. Howden March, 2025), adds a critical dimension to this distrust.
The report revealed that between 2018 and 2023, Police Scotland recorded 37 sexual assaults in Fife hospitals, with the Victoria Hospital among the sites implicated. This makes NHS Fife the third worst health board in Scotland for sexual assaults. The report criticises NHS Fife for failing to adequately address these incidents, noting that hospital policies often prioritise an ideological stance on gender identity, over the safety and privacy of female staff and patients. And as with all research regarding sexual assault, the report points out that this data will be underreported. This finding contextualises Peggie’s concerns about single-sex spaces. Her objections were not merely ideological but rooted in legitimate fears about female vulnerability. The report’s findings, combined with NHS Fife’s initial refusal to disclose tribunal costs (over £258,000 as of June 2025) and its mishandling of Freedom of Information requests, as condemned by Scotland’s Information Commissioner David Hamilton, paint a picture of an institution more concerned with reputation management than accountability and concern for patients and staff safeguarding.
Public trust has been further eroded by NHS Fife’s response to the tribunal’s publicity. The statement, which implied that organisations such as Sex Matters were responsible for online threats, was criticised as “irresponsible” by Peggie’s legal team and later amended under pressure. This attempt to deflect blame, alongside the board’s failure to engage transparently with the public, has deepened skepticism about its commitment to fairness. Scottish Conservative and Labour politicians have voiced concerns stating that constituents are, “rapidly losing faith” in NHS Fife’s leadership, a sentiment echoed by commentators like J.K. Rowling, who have highlighted the case as a symptom of broader institutional failures.
When the Brown and Howden report was published in March 2025, NHS Fife Health and Social Care Partnership stated:
‘It remains incredibly rare for incidents of this type to occur in our hospitals... Where an incident is reported to us, there are robust procedures in place to ensure a thorough investigation and prompt escalation to Police Scotland.’
Given the behaviour and testimonies of many of the witnesses attending the Peggie v NHS Fife tribunal, alongside the Brown and Howden report, how can the public possibly hold anything other than a view of extreme cynicism and mistrust of Fife NHS? The denial of biological realities and the mishandling of serious safety concerns are not only a worry for all putative NHS users, but it is also an indication of a rot and a corruption that has been allowed to install itself at the very heart of a public service where it is essential to have robust evidence, truth and integrity at its core. This is the inevitable outcome of a biased promotion of a false concept which tolerates no challenge.
When witnesses and institutions prioritise ideological narratives over evidence - whether by endorsing policies without scrutiny or dismissing legitimate objections as prejudice - the public’s confidence in those tasked with their care collapses.
For NHS Fife to rebuild trust, it must, for once, confront these realities head-on.
Carolyn Brown
ScotPAG Convenor