FIRST REPORT (HC 42): MANAGING DANGEROUS
PEOPLE WITH SEVERE PERSONALITY DISORDER
Published 14 March 2000. Government response
(published as HC 505) received 12 May 2000
1. The Government's response to the Committee's
report on managing dangerous people with severe personality disorder
was published on 12 May 2000. There have been a number of significant
developments since the publication of the Government's response.
2. In particular, the assessment process
and battery developed during the consultation period is now being
piloted in a refurbished assessment centre at HMP Whitemoor. Ministers
have announced that the first pilot of the assessment process
in the NHS will be at Rampton Hospital. Following the recent Spending
Review, substantial resources have now been allocated for a period
of service development and projects both to continue piloting
the assessment process, and begin piloting therapeutic interventions
across the Prison Service. The Government's formal response to
the consultation exercise will be announced when Parliament returns
in the Autumn and the detail of its proposals will be set out
in a White Paper to be published before Christmas.
3. In addition, joint programme management
procedures across the Home Office, Prison Service and Department
of Health have been put in place to manage the inter-related set
of projects needed to deliver the Government's objectives. The
objectives of the programme are:
to protect the publicby detaining
those who are dangerous and SPD until they are safe to be released;
to provide effective treatment and
management interventions for those who are dangerous and SPD which
tackle their personality disorder, thereby reduce the risk they
pose to others, and improve their own quality of life.
4. We conclude that substantial initial
expenditure will be needed for the future management of dangerous
people with severe personality disorder, irrespective of what
other changes are made in the law affecting them or the way the
facilities are organised. This is a cost which, in the interests
of public safety, we believe to be justified.
5. The Government's response to this recommendation
welcomed the Committee's recognition that the proposals for managing
dangerous people with severe personality disorder are necessary
in the interests of public safety. Paul Boateng announced on 22
September, the allocation of £70 million from the Spending
Review for a three year programme of pilot projects to assess
and treat dangerous people with severe personality disorder. This
money will fund a series of projects in the Prison High Security
Estate as part of the joint Home Office, Prison Service and Department
of Health programme. The Department of Health will shortly be
announcing resources for similar pilots in the NHS High Security
Estate. The first pilot project at HMP Whitemoor has now opened
and the first NHS pilot project will begin shortly at Rampton
6. We recommend that the Home Office
should publish the cost benefit analysis underlying its consideration
of the options proposed, including the implications of adopting
a TBS-type arrangement in the UK.
7. The Government intends to publish its
formal response to the consultation exercise to Parliament in
the Autumn. Details of the supporting material which has assisted
Ministers in their consideration of the options will be made available
to Parliament in a summary of the responses received to the consultation
8. We recommend that the Home Office,
The Department of Health and the Department for Education and
Employment should examine the costs and benefits of identifying
in early adolescence individuals who may develop a severe personality
disorder and become dangerous. It may well be that intervention
before the personality disorder becomes settled in the late teenage
years would have long-term benefits both for the individual and
for public protection.
9. The scoping review of the literature
concerning interventions aimed at adolescents at risk of developing
antisocial personality disorder in adulthood, is due to be published
shortly. The Committee's recommendation will be considered further
in light of the outcome of this literature review.
10. We conclude that among the safeguards
which ought to be introduced is a regular opportunity for Parliament
to review the operation of any legislation to implement these
11. We recommend that any legislation
should be subject to annual report to Parliament by a Commissioner
and annual renewal of the legislation by means of an order subject
to the affirmative procedure in each House.
12. The Government has said that it recognises
the benefits of an annual report to Parliament although it does
not accept that new legislation should be subject to annual review.
The Government's proposals for managing dangerous people with
severe personality disorder are being finalised and will be set
out in a White Paper to be published before Christmas. Further
consideration will then be given to the Committee's recommendation
that the legislation should be subject to annual report.
13. We welcome the attention the Home
Office is paying to bringing victims of crime closer to the heart
of the criminal justice system. We endorse the suggestion that
victims or their next of kin should be able to make statements
about the effect a crime has had on them and for such a statement
to be attached to the case papers. We also believe that the arrangements
for informing and consulting victims' families under the Victim's
Charter should apply to individuals detained under the Mental
Health Act 1983 where appropriate.
14. The Government intends to publish a
summary of the analysis of responses to the Green Paper on reform
of the Mental Health Act 1983 to Parliament in the Autumn, and
will set out the detail of its proposals, including whether arrangements
under the Victim's Charter should be extended to cover those restricted
patients who have committed serious violent or sexual offences,
in a White Paper, to be published before Christmas.
15. We recommend that the proposals should
be applied to individuals only when an assessment predicts it
is almost certain that they will commit a very serious criminal
16. The first pilot project of the assessment
process is underway at HMP Whitemoor. A key aspect of the assessment
process is to identify the link between an individual's personality
disorder and the level of risk they pose to others. The reliability
of the process will be evaluated and potential Contractors have
been invited to tender to provide research services to evaluate
the assessment battery and process at HMP Whitemoor and Rampton
Hospital. The invitation to tender has prompted expressions of
interest from a number of institutions, from a range of academic
17. We recommend that continued detention
should be subject to regular review by a judicial body at stated
intervalson the basis of multi-disciplinary assessment
and subject to independent medical opinion.
18. Detailed procedures for the regular
independent review of detention will be included in the Government's
19. On balance we recommend that a separate
service as set out in option B is most likely to protect the public,
meet the needs of the individuals concerned and satisfy the requirements
of the European Convention on Human Rights.
20. The Government announced how it intended
to proceed with these proposals on 24 October. The Government
recognises the views of the Select Committee and many respondents
to the consultation exercise who argued that a new service (option
B) was the best way to protect the public and meet the needs of
the individuals concerned. However, the Government has decided
that a period of piloting and service development is necessary
before taking final decisions about how best to organise new services.
The Government will use this period to develop capacity and specialist
provision in existing services and, as soon as Parliamentary time
permits, to introduce new powers needed under either option for
the detention of this group.
21. We recommend that new powers to detain
dangerous people with a severe personality disorder should be
accompanied by the most stringent safeguards in order to satisfy
the requirements of the European Convention on Human Rights, as
well as the liberties traditionally protected by Parliament.
22. The proposals in the Government's White
Paper will be compatible with the European Convention on Human
Rights and the Human Rights Act.