Ms Peggie is suing her employer and Dr Beth Upton after she complained at having to share a changing room with the transgender medic at Victoria Hospital in Kirkcaldy on Christmas Eve 2023.
She was placed on special leave after Dr Upton made an allegation of bullying, harassment and patient safety concerns.
A judgment in this case is still a long while away, with oral submissions pencilled in for September 1 and 2. Employment Judge Sandy Kemp will deliberate from there.
Dozens of witnesses gave evidence and thousands of pages of documents were considered.
But these are the most jaw dropping points from an intense 10 days.
Sandie Peggie cleared
There were rumours NHS Fife were considering withdrawing from the case hours before it even resumed.
The claimant, Ms Peggie, was cleared of all four gross misconduct allegations, with NHS Fife stating there was “insufficient evidence”.
NHS Fife did not concede in the case but there can be no doubt that this set the tribunal off on a fiery start.
Alongside allegations of misgendering Dr Upton, it was alleged that Ms Peggie walked out of a resuscitation unit because the trans doctor entered, leaving a patient unseen.
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Another allegation claimed a child patient was triaged by Ms Peggie but left the hospital unseen, with the nurse refusing to speak to Dr Upton about the incident.
She was cleared of them all. But these allegations were still a key part of the 10 days of evidence and the fall out from this leaves more questions for NHS Fife.
Isla Bumba: I don’t know my own sex
One of the standout – and jaw-dropping – interactions in this case came from NHS Fife’s equality and human rights lead Isla Bumba.
She was tasked with advising staff on transgender workplace policies, and admitted to Googling other heath boards because NHS Fife did not have its own policy.
That was a shocking revelation but it is not the jaw-dropping exchange.
Ms Bumba told the tribunal that people do not necessarily know whether they are male or female, unless they’ve had their chromosomes tested.
She said: “I don’t know anything about Beth’s body. I don’t know what my own body is made of biologically. No one knows what their chromosomes are or their hormonal composition.”
She added she would “hazard a guess” that she was female, stating: “I don’t know my chromosomes. No one knows what they are until they are tested.”
This evidence took place on day one of the tribunal restarting but it haunted it until the very end.
Confidentiality breaches
Consultant Dr Kate Searle, the supervisor of Dr Upton, was one of the most important witnesses in this case.
She had a lengthy discussion with Dr Upton after the incident on Christmas Eve.
And on December 29, 2023 she emailed around 19 consultants working at the emergency department setting out the medic’s story. In that email, she also expressed support for Dr Upton on behalf of the department and condemned the actions of Sandie Peggie. The allegations had not been investigated.
Naomi Cunningham, the barrister acting for Ms Peggie said this exchange meant the integrity and confidentiality was “hopelessly lost”.
Dr Searle defended her actions, stating she had a “duty of care” to Dr Upton and wanted to let colleagues know in case the medic became upset on shift or could not work.
The consultant admitted that with “hindsight” her email had been a “flagrant breach” of confidentiality.
NHS Fife mid-tribunal statement
NHS Fife published a lengthy – and now infamous – 1,700 word statement on July 18.
Ms Peggie’s lawyers described the statement as “irresponsible” after it alleged the tribunal had triggered a threat of physical harm and sexual violence against NHS staff.
The original statement also referenced Maya Forstater, chief executive of Sex Matters and barrister Ms Cunningham.
The next paragraph said “what began as debate has evolved into much more worrying behaviour, including a threat of physical harm and sexual violence, which has required the involvement of Police Scotland”.
Ms Peggie’s legal team said it linked Sex Matters with the behaviour.
That statement had been edited multiple times, and days later, all reference to the organisation had been removed.
‘Culpable’ Dr Searle
Back to the patient safety claims.
We heard that HR administration Lottie Myles originally dismissed concerns about Ms Peggie as ‘hearsay’.
Ms Myles instructed senior medics that Ms Peggie’s suspension would be lifted.
However, she said three staff members, including Dr Searle, raised concerns at this, telling the HR worker it was the “wrong decision”.
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The tribunal then heard that Dr Searle informed Ms Myles of “patient safety” allegations.
Dr Searle had not reported or escalated these concerns and the medic was told she could be “culpable” in the incident as a result.
‘Troublemaker’ Upton
A significant part of Ms Peggie’s case centred around the previous conduct of Dr Upton.
The tribunal heard that the medic kept logs of incidents with other colleagues with Ms Cunningham putting it to witnesses that Dr Upton was a “known troublemaker and a bully”.
In Dr Upton’s previous job, it is alleged that Dr Upton complained about an elderly patient misgendering them.
On the final day of evidence, a colleague of Ms Peggie’s was supposed to give evidence on the allegations she had heard about Dr Upton. However she did not appear.
Upton altered phone notes
Part of The Herald‘s extensive coverage involved reviewing the evidence bundle.
We revealed that Dr Upton had kept a long of her meetings with Ms Peggie from October 2023.
The key details came from the December 2023 logs.
Dr Upton’s note from December 18 described ‘hostility’ from Ms Peggie. The Christmas Eve incident followed.
But on Boxing Day, Dr Upton edited the December 18 note to add patient safety concerns accusing Ms Peggie of refusing to engage about an unseen patient.
Heresy, asymmetry and pronouns
The legal teams had their fair share of arguments throughout this case.
In one instance, Employment Judge Sandy Kemp was accused of acting with “asymmetry” towards the legal teams.
Ms Cunningham accused the judge of favouring Jane Russell KC, NHS Fife’s lawyer, more favourably.
Ms Russell had earlier interjected after he opponent repeatedly referred to Dr Upton as “he”, causing a witness to misgender the medic.
She said she had concerns Ms Cunningham using incorrect pronouns created a “hostile” environment.
Half an hour later, a second row erupted.
Ms Cunningham suggested there were attempts to punish Ms Peggie because the nurse was “guilty of heresy” by insisting Dr Upton was a man.
She said: “One aspect of my claimant’s case is she has been treated as a heretic deserving of punishment – heresy here is shorthand for someone who doesn’t believe in and won’t play lip service to the gender identity belief system.
“That is not a novel or fanciful idea.”
Peggie defends character
Shocking allegations were made against Ms Peggie’s character, with colleagues and former friends accusing the nurse of racism, homophobia and transphobia.
It was alleged that Ms Peggie called Dr Upton “it”, “weirdo” and “freak”.
She was also accused of making “derogatory” racist remarks.
Former friend Lindsay Nicoll told the tribunal she heard Ms Peggie said she had a “good mind to post bacon through the letter box” of a mosque being built in Kirkcaldy.
During her evidence recall, Ms Peggie attributed these comments to a paramedic. She said he made this remark in her presence around 10 years ago and denied repeating it.
In a Benidorm group chat, Ms Peggie also shared 10 racist jokes relating to the floods in Pakistan.
One joked about there being “too many P***’s in Britain” while another described the aftermath of the disaster as a “giant bowl of coco pops” from space.
Ms Nicoll also said Ms Peggie was “homophobic” because she was “devastated” by her daughter being gay.
The nurse was recalled to give evidence and described the jokes as “distasteful” and “dark humour”.
She also rejected that she was homophobic and said she only had concerns that her daughter would face “prejudice”.
On transphobia allegations, Ms Peggie said she did not wish harm on trans people but did not want to share a changing room with biological men.
Benidorm chat and destroyed friendships
The final parts of the tribunal featured around a Benidorm group chat which Ms Peggie was a part of with other nursing colleagues, including Ms Nicoll.
This is where the racist jokes were made about Pakistan.
However, the messages did not just damage Ms Peggie’s reputation, they also shone a light on patient confidentiality issues.
Ms Nicoll mentioned sensitive patient details, including their full name, in the group messages.
The witness admitted she had acted “unprofessionally” after she was accused of having “no respect for patient safety”.
She said: “Certainly, if I was a patient I would certainly view me as someone who didn’t respect their patients.”
It was also revealed that friendships had fallen apart as a result of the tribunal.
Ms Peggie used to go on annual holidays with Ms Nicoll and others in the group chat.
But the tribunal heard that Ms Nicoll was accused of doing a “hatchet job” on Ms Peggie’s character.
She told the tribunal: “Anybody was going to ask me for a statement I was going to be willing to do it.”
But Ms Nicoll denied she had it “in” for her former friend.
Peggie colleagues agreed on trans row
Ms Peggie named 13 colleagues who she said did not agree that a transgender doctor should be able to use the women’s changing room.
She told the tribunal she was “very sad” to have to name the colleagues because of the “very toxic” environment at NHS.
Ms Peggie said she had suffered from speaking out and did not want to put her colleagues through the same.
A key argument made by NHS Fife’s legal team is that Ms Peggie’s concerns were isolated and she was the only person with a problem.