Examination of Witnesses (Questions 43-59)
RT HON
BARONESS SCOTLAND
OF ASTHAL
QC, MS CHRISTINE
KNOTT, MR
PHIL WHEATLEY
AND MR
JOHN BOYINGTON
8 NOVEMBER 2005
Mr Wheatley: I am Phil Wheatley,
Director General of the Prison Service, that is, the public sector
prisons.
Ms Knott: I am Christine Knott,
I am the National Offender Manager and currently the Acting Chief
Exec of NOMS.
Mr Boyington: I am John Boyington,
Director of Health and Offender Partnerships which is a joint
post between the Home Office and the Department of Health.
Q43 Chairman: Thank you. Minister?
Baroness Scotland of Asthal: First,
may I say what a pleasure it is actually to appear before this
Committee, not least because you are dealing with an issue that
is absolutely critical to all of us. I would very much welcome
this few minutes to update the Committee on what the figures currently
are. Now, as many of you will know, recent trends of self-inflicted
deaths in prison are going on a downward trend rather than an
upward trend and that is quite a positive thing, but we think
it is probably because of the combination of reasons: the effect
of giving a high priority over the last four years to addressing
sentencing issues[3];
the introduction of improved risk identification and care arrangements,
and I know that we will later on talk about the ACCT change which
has come about; and really a stress on mental health inreach and
detoxification. That is one of the reasons, I think, why John
Boyington is here with us because they have made a really important
advance. This year's numbers are thankfully down by about 25%
at present in the calendar year, that is 66 compared to 88, and
20% in the financial year, that is 47 compared to 59. However,
I must make it absolutely plain that we are by no means complacent
because we have to keep on driving these figures downwards, but
I think the short-term trends can be quite misleading, so what
we have tried to do is to look over the wider pattern. The rate
has reduced two years running, that is from 148.3 in 2002-03 to
126.2 in 2003-04 and 113.7 in 2004-05. I think the prisoners we
are looking at are a recognised high-risk group within the Government's
wider strategy. The overcrowding issue is obviously a matter of
concern, but it does not appear at the moment necessarily, as
such, to lead to more deaths. As many of you know, cell-sharing
can in fact be a protective factor and it is one of the factors
we have to take into account. I think also, just to highlight
the nature of the prison population that we currently have, we
are dealing with a very vulnerable, highly vulnerable group, many
of whom have life experiences which make them innately vulnerable
and have had quite a high incidence of attempted suicide before
they get into the prison estate. More than 40 prisons now will
implement the new ACCT during 2005 and they are doing that in
close collaboration with the regional mental health fora, so the
inreach teams working together with prison staff and the greater
training has started to make a difference. Those are just the
sort of preliminary issues I wanted to touch on because I think
they do go to many of the things which you may be interested in.
Chairman: That is very helpful, thank
you.
Q44 Mr Winnick: Minister, you have been
mentioning, as indeed did your memorandum to the Committee, the
numbers involved in suicides and your own memorandum, as far as
the numbers are concerned, says that in 2001 it was 95, the following
year 94 and last year 95. Where is the improvement?
Baroness Scotland of Asthal: Really
if you look at the numbers coming into our prison estate, they
have gone up, so if you look then at the percentages of people
who are attempting or committing suicide, those figures, relatively
speaking, demonstrate a downward trend.
Q45 Mr Winnick: So it is an average of
the prison population with the actual total number of course,
as your memorandum stated, the figures which I have just quoted,
being the loss of lives involved?
Baroness Scotland of Asthal: That
is right.
Q46 Mr Winnick: But you are saying it
is an improvement of a kind, and I am sure you, no less than anyone
else, deplore suicide.
Baroness Scotland of Asthal: Absolutely.
Q47 Mr Winnick: Exactly, and that is
not in question, Minister. Your position is that if you take the
prison population, it is an improvement?
Baroness Scotland of Asthal: Yes.
Q48 Mr Winnick: In fact this year, as
you say, 64 so far unfortunately have taken their lives and there
were 13 in June alone. Is that not a much higher average in a
month of such tragedies and is there any particular reason for
it, as far as you are concerned?
Baroness Scotland of Asthal: We
looked very carefully to see whether there was any pattern. As
you can imagine, up until June the picture did look much better
than it had been. There was a growing degree of confidence that
the sort of new approaches that we were putting in place were
having a beneficial effect. We looked very carefully to see whether
there was any particular trend which would have caused this quite
sudden acceleration, and we could not find or identify a particular
reason, although we are continuing to look with great care. What
you will notice is that after June the picture returns to one
of a more normal level. One of the really difficult things we
have found is making any judgment which is simply focused on one
particular month; you end up having to look over a longer period
to see where the trends are going, but it was a matter of huge
concern. I certainly can assure the Committee that what happens
every morning is that I have on my desk the numbers who have died
or been injured the night before and we keep a really tight view
on what is happening and I was extremely alarmed during that month.
It was a very hard month for the Service, all of whom were trying
really hard to understand what was actually causing this one.
Q49 Mr Winnick: And very hard of course
for the loved ones left behind.
Baroness Scotland of Asthal: Absolutely,
because I think it is their families, but also I think, just to
share this with the Committee, the sense of commitment and bereavement
that happens with the family and indeed with those inside who
were trying to care for them because some of the prisoners who
will have befriended those who commit suicide and take their own
lives also thereafter need quite a lot of care because they are
adversely affected too, so every death has a real impact.
Q50 Mr Winnick: June, if I can just for
a moment concentrate on June when 13 took their lives, was that
not a month when the prison population increased more than on
previous occasions?
Baroness Scotland of Asthal: I
think the prison population has continued to increase.
Q51 Mr Winnick: In June in particular?
Baroness Scotland of Asthal: In
June there was an increase, but I think if you look at the trend,
you cannot say it was so out of kilter with the increase thereafter
to make it particularly significant. You know that our highest
prison number was in November and it continued to rise, so I understand
the concern that is expressed there, but there is not a direct
correlation between the increase in number and the number of deaths
because if you look at the different establishments in which those
occurred, the picture is very different in each of them.
Q52 Mr Winnick: But you agree that in
June the prison population went up more in that particular month
than in previous months?
Baroness Scotland of Asthal: I
am not sure. I know that impressionistically that is not my view,
but I must say it is because I have been watching the way in which
the prison population has been rising and, therefore, June, when
I look back on it, does not seem to be the highest point. The
highest point actually was reached on 1 November.
Mr Wheatley: It went up 700 in
June.
Q53 Mr Winnick: That is more than usual
in a month?
Baroness Scotland of Asthal: I
have just been told it was less than a 500 jump, but we will check
the maths.[4]
Chairman: Perhaps you can come back to
us on that.
Q54 Mr Winnick: The position of the Government,
and I suppose in this respect it is almost identical to previous
governments, is that it is the same effect, but it is very difficult
to demonstrate causal links between prison numbers and deaths
in custody, but do you not accept that it is very difficult for
people outside the Home Office really to accept that there is
no link between the ever-increasing numbers in prison and those
unfortunately tragically taking their lives?
Baroness Scotland of Asthal: I
think it is absolutely reasonable for people to raise that question
because we raise that question ourselves and we are looking very
carefully to see what the empirical data tells us, not least because
we need to use that information to recast our response to it,
what we do about it. One of the things we have been able to do
is to look at the changes that are necessary in terms of the overall
culture that takes place, but also the effect that ACCT has had
because it is a different way of dealing with a number of the
issues that arise from people who do take their lives, for example,
having better training, having a better link with the healthcare
services, creating an environment which lessens the degree of
stress on the population as a whole, but taking a much more caring
and therapeutic approach towards the management of the risk. Now,
in those prisons where ACCT has been rolled out, we do see a marked
difference and a reduction, so we know, the early indications
are, that this method of working can have a material effect. The
reason I am saying that there is not a direct correlation between
the overcrowding is almost perversely that the sharing of cells
can act as a disinhibitor for those who want to take their lives
and indeed cushion them, so you have quite an interesting difference
in that and that is why we cannot say that overcrowding as such
causes an increase, but there are a lot of other things that may
be a consequence of overcrowding which can add to the risk factors
and those are things we have to look at.
Q55 Mr Winnick: In your speech in the
recent debate in the House of Lords, you make the point about
shared cells as a possible deterrent to suicide, but would you
accept that if anything possible in any way had been done to stabilise
the prison population, say, over the last 10 years, then there
would have been a real reduction in suicides or do you not accept
that at all?
Baroness Scotland of Asthal: It
is not a case of accept or not accept; there is not the data to
justify that conclusion, but what we must know is that if you
have a greater amount of time, if there is an opportunity to skill
people in a way that enables them to meet the needs of prisoners
in a more holistic way, one would hope that that would materially
affect the atmosphere, the culture in prisons and one would hope
that might have a reduction in the self-harm and in those who
take their lives. All I can say to you is that there is no empirical
data that I have which demonstrates that and in fact the evidence
that we have been able either to keep stable or reduce the numbers
committing suicide and taking their own lives during a time when
we are increasing the numbers tends not to justify that. I am
saying that I understand the way people feel about it, but I am
looking incredibly hard at the data and the data does not justify
that conclusion.
Q56 Chairman: One of the things which
has been put to us by the non-governmental organisations is that
at a time when 50% of prisons are overcrowded, actually a disproportion,
more than 50%, of suicides took place in the overcrowded prisons.
You say there is no empirical data, but that surely gives some
suggestion that the conditions of stress, which might help to
encourage suicide, are greater in the overcrowded prisons, otherwise,
there really should be no difference between the suicide rates
in the two kinds of prison.
Baroness Scotland of Asthal: The
difficulty of course is that those prisons are quite often local
prisons. The local prisons have a greater degree of churn and
the local prisons tend to have prisoners who, by their very nature,
are likely to be on the more vulnerable lists, so if you look
at the numbers who had tried to commit suicide before coming into
prison, the other risk factors which will make up the likelihood
of someone taking their life, those factors, if put in any situation,
tend to increase the number who then want to commit suicide. Therefore,
what I am saying is that it is a really complex issue. It is too
easy a correlation to make to say, "Oh well, therefore, overcrowding
equals an increase in suicide", because it does not. If you
disaggregate those issues, you see that it is those issues which
will influence whether or not the rate goes up or down.
Q57 Mr Winnick: Lady Scotland, you chair
what is known as the Ministerial Round Table on Suicide.
Baroness Scotland of Asthal: Yes.
Q58 Mr Winnick: How often does it meet
and what precisely does it do?
Baroness Scotland of Asthal: What
the Round Table does is to bring together all of those who are
responsible for suicide reduction so that we can look at the policies
that go right across the piece. One of the things we have absolutely
understood is that the changes that need to be made are not changes
which simply are within the prison estate, but it is the way we
work with health and the way we work with other organisations
that makes the difference, so the Round Table is really our opportunity
to learn best practice and seek to implement it. The importance
of the Round Table is that the people who are actually participating
in that Round Table are the ones who are going to have to implement
the changes in order to bring about the success we hope to achieve
together.
Q59 Mr Winnick: So it is the Prison Service
basically?
Baroness Scotland of Asthal: It
is not just the Prison Service. It was established by the Prison
Service five years ago, and it covers deaths in approved premises,
but it also has its discussions increasingly extended to related
issues affecting deaths and vulnerabilities of offenders in the
community. There are generally three meetings a year and frequently
in the prison setting because holding the meetings in prisons
enables prisoners to attend, it provides members with an opportunity
of seeing the prison at first hand and talking to prisoners and
the Samaritan-trained listeners in particular make a very valuable
contribution.
3 Note by witness: The intended reference was
to "safer custody issues". Back
4
See Ev 43 Back
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