Examination of Witness (Question Numbers
50-59)
PROFESSOR KARIM
BROHI
25 NOVEMBER 2008
Q50 Chairman: Professor Brohi, good morning.
Thank you very much for coming to give evidence and sharing your
thoughts with us. We know you must be extremely busy. How many
people with stab wounds are admitted every month to the hospitals
in which you are involved, Barts and others in London?
Professor Brohi: The data I can
give you relate only to serious stabbing injuries, that is, ones
that are either life or limb-threatening rather than all injuries.
We collect data of our own accord rather than as part of any national
policy based on certain injury severity criteria. I can give you
those data but not for the more minor stabbing injuries. Just
to put it in context, the Royal London Hospital is the trauma
receiving hospital for most of the capital. We take trauma cases
from most of the capital during the day from our helicopter service
and at night we have a car service. We estimate that our figures
probably represent one in four, perhaps one in five, of all injuries
in London.
Q51 Chairman: One in four injuries
are knife-related?
Professor Brohi: No. I am talking
about the London population we see. As to knife crime, currently
we see 23 severe injuries a month. So far this year we have had
255 injuries and project 278 up to the end of the year. That compares
with 68 injuries in 2003 when our database started.
Q52 Chairman: There has been an increase?
Professor Brohi: Yes.
Q53 Chairman: Perhaps I may put to
you the comments of Professor Coats of the University of Leicester
at Leicester Royal Infirmary who you may or may not know. He talks
about the high level of serious stab wounds in Leicester. In comparing
the nature of knife crime in London and Leicester he said this:
"In central London knife crime seems to relate to gangs and
drugs but not in Leicester; it appears to come from normal street
fighting alongside the way we drink." Basically, he was pointing
to the very large number of people who were involved in knife
crime which in some way was alcohol-related. Is that also your
finding in London? Has there been an increase in this crime because
of the amount of alcohol people drink?
Professor Brohi: It is very dangerous
to lump knife crime into one single category of person. Undoubtedly
there are brawls in the street among people who happen to carry
knives, muggings and such things. That has really been constant
since our records began and long before that. Although we see
a greater number as a percentage of the number of injured people
we see that figure has not changed. The change that we see is
really in the teenage group and the rise of a new demographic
of teenager being stabbed. That is a very different category of
person with a very different background and reason for carrying
the weapon. They tend not to be alcohol-related and have more
to do with school gangs or local gangs. When we talk about gangs
it is important to separate out the organised gangs which tend
to be people in their mid-20s and late 20s, often of ethnic or
organised crime origin, with teenage school gangs which are more
dependent on the area. They may be Asian, black or white gangs
depending on where you are. These are different groups and the
root cause for each is different.
Q54 Mr Streeter: You have answered
a question about trends. You said that five years ago the number
of admissions for stab injuries was about 60; this year it is
about 270. Is that how long you have been keeping records?
Professor Brohi: That is how long
we have been keeping our own personal records. We have been submitting
data to the trauma audit and search network, of which Professor
Coats is the chairman, since 1994. They have a longer but slightly
different data set. I believe that they are to present that to
you in January. These records are the most reliable that I can
give you.
Q55 Mr Streeter: Of the 270 knife
victims that you or your hospitals will see this year how many
are not connected with gang culture in any way and are innocent
people walking down the street who are jumped on and stabbed?
Professor Brohi: A very small
proportion.
Q56 Mr Streeter: It is mainly gang
culture?
Professor Brohi: Yes.
Q57 Mr Streeter: While you are treating
someone are you thinking that the individual is not just a victim
but also a perpetrator, or does that not cross your mind?
Professor Brohi: No.
Q58 Mr Brake: You said that it was
mainly gang culture, but is that correct? What percentage is domestic
violence, for example?
Professor Brohi: I cannot give
you an accurate figure, but a very small number of incidents of
domestic violence lead to knife injuries compared with the wider
street violence that we see.
Q59 Mr Streeter: Are you using the
wide definition outlined earlier which includes anything from
a bottle to a sharp implement to a knife?
Professor Brohi: Often we do not
see the implement unless it is imbedded in the patient, but most
of these injuries will be from knives rather than glass or anything
else.
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