Now NHS Fife admits it DID break the law by giving trans doctor access to female changing rooms
NHS Fife said it had not completed an equality impact assessment before allowing male-born medic Dr Beth Upton to use the female-only facilities at Victoria Hospital, Kirkcaldy.
The Equality and Human Rights Commission has now ordered the under-fire health board to 'carry one out immediately' in yet another extraordinary intervention.
NHS Fife has been plunged into turmoil amid an employment tribunal veteran nurse Sandie Peggie brought against it, in which she has claimed being made to get changed next to the trans-woman was unlawful.
The watchdog first wrote to NHS Fife bosses in February, following the first two weeks of the landmark tribunal, to 'remind' them of their obligations under the Equality Act and how they had a duty to 'assess how their policies and practices affect people with protected characteristics'.
But this week the EHRC revealed the health board 'failed' to meet the requirement of having a equality impact assessment, which is a legal duty.
Tess White, equalities spokesman at the Scottish Conservatives, said the latest revelation showed senior health board bosses must go.
The MSP said: 'This damning directive from the EHRC confirms that, on top of being negligent, incompetent and biased, NHS Fife broke the law in relation to the Sandie Peggie case.
'It's just one failure, and one revelation, after another. It's abundantly clear that the positions of the Chief Executive and senior health board colleagues are completely untenable.
'The shameful admission from the health board confirms that Sandie Peggie was hung out to dry from the very beginning of this tawdry scandal simply for standing up for her rights as a woman.
'Fairness and accountability must prevail. Surely John Swinney and his SNP colleagues can no longer retain confidence in those in charge of this dysfunctional health board?
'The First Minister must clear out those at the top of NHS Fife and finally demand that it, and all other public bodies, upholds the clear and unequivocal Supreme Court ruling entitling women to single-sex spaces.'
Mrs Peggie had encountered Dr Upton in the female-only changing room in 2023, but had waited outside until the trans-identifying medic left.
But on Christmas Eve that year she challenged the junior doctor - the exact circumstances of which are disputed - and was suspended from work and her actions subject to an internal investigation.
Baroness Kishwer Falkner, chairman of the EHRC, said all Scottish health boards must comply with the 2010 Equality Act.
She said: 'Earlier this year we asked NHS Fife to provide us with information on the provision of single-sex changing facilities for staff and the rights of different groups in the application of these policies.
'At that point NHS Fife confirmed that no equality impact assessment was available.
'Undertaking an equality impact assessment of relevant policies or practices, and publishing the results, are requirements of the PSED [Public Sector Equality Duty] Specific Duties in Scotland.
'We believe NHS Fife failed to meet these requirements and told them to carry one out immediately.'
Maya Forstater, chief executive of human rights charity Sex Matters, said: 'This directive to NHS Fife is an unprecedented intervention from the EHRC and the kind of muscle that has been lacking from regulators across the board since gender ideology first took hold of public institutions.
'While long overdue, this is a clear instruction to NHS Fife - and in fact all employers - that it cannot get away with continuing to flout the Equality Act.'
An NHS Fife spokesman said: 'We are committed to working constructively with the EHRC to provide assurance that we fully understand, and are meeting, our obligations under the Equality Act 2010 and the Public Sector Equality Duty.
'This includes considering the implications of the recent Supreme Court ruling and the EHRC's interim guidance.
'A comprehensive review and audit of our facilities has been completed, and an Equality Impact Assessment is underway. This will be concluded and published by 30 September 2025.
'Our priority is to ensure that all NHS Fife policies and practices protect the rights of our staff and comply fully with equality legislation.'
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