Joint Committee On Human Rights Minutes of Evidence

Examination of Witnesses (Questions 160 - 167)



  Q160  Chairman: It is evident from the evidence we have had so far that there is a failure on occasion to pass on prisoners' medical information on reception in prisons. Do you have any comments about the failure in handing on of the records and any evidence about whether this problem is widespread?

  Mr Foster: We are aware of the problem. We do not see it at the prison level but we have plenty of information from people or families writing or contacting us to say that the prison does not seem to know about my son or my daughter's mental illness. There are any number of reasons that may contribute towards this. Some prisoners may choose not to pass information on about their own mental health if they do not think it is relevant. There is a civil rights issue there and how do you balance that with the need to protect people. More commonly however, if there is a relevant mental health problem, it is available through the court system and in reports. There seems to be a great lack of liaison coming through from the court system. I know this is something that the government is aware of but it certainly has not bedded down yet. Families tell us that they have information but that they are not encouraged to bring the information forward or to discuss it. Within the prison, again you have the prison ward staff on the one hand and the increased use of the National Health Service coming in by way of in-reach to prison on the other. To some extent, there is an issue of who manages the information; who is in charge at that point. We have information about tension between the primary care trust, which provides the NHS in-reach, and the prison staff who understandably think this is their information because they are their prisoners. All of these are factors that contribute. I do not think we are qualified to say whether one is more important than another.

  Q161  Chairman: What about mental health screening in prisons?

  Mr Foster: In theory, there should be a screening that takes place at the early point of reception, with an assessment and then that leads on to transfer. I believe the target figure is three months, which is still a long time for somebody with a significant mental health problem. Even that three month figure is not being hit, and it is started by the assessment so if the assessment does not happen at an early stage, or at all, then it is not picked up. Unless a prison has had previous contact with mental health services or is showing signs of distress, the distress may not be noticed. Services may not be offered and it comes back again to training and education for the staff concerned.

  Ms Corlett: There was quite a distressing case recently of a 16 year old, Joseph Scholes, who went into a young offenders' institution. He had been recommended to go to local authority secure accommodation but instead, because of his mental distress and background, he went into a young offenders' institution. His mother pointed out he had been raped in the past and that was a difficult situation for him. He was assessed when he came in. He had self-harmed all over his face very recently and had the scars still there. I gather that he was asked if he self-harmed and he said no. That was taken at face value. He was put initially in a particular type of reception cell but was then transferred into a cell on his own with no suicide watch and ligature points. Effectively, he was very poorly cared for when all the information had been available both visual, from his mother directly, verbally, and written from the court. None of that was acted on. It is difficult to understand how all of that information could have been ignored and yet it was.

  Q162  Mr Shepherd: I know from my own probation and legal service that there is extraordinary difficulty in getting medical reports within prisons. That is repeated by the doctors that have to serve these institutions themselves and there is an extraordinary degree of frustration as to knowing the medical history of the patient concerned. It is often cited that the Data Protection Act is an inhibition in this. Have you encountered that argument?

  Mr Foster: We have certainly heard of the argument. Most famously, it hit the press recently in the case of Humberside Police. The Data Protection Act, as I understand it, does not prevent anything from happening that is otherwise lawful. It is really to do with regulating how disclosure and sharing of information should take place. If therefore someone has the right to keep information confidential, the Data Protection Act does not of itself require disclosure of that. However, there are all sorts of ways at common law and in decided cases whereby information can be disclosed without the person's explicit consent. If it would be helpful to the Committee, we can certainly pass that through in writing. In other words, the Data Protection Act is used as a screen to hide behind quite often and I would suggest that is largely to do with the misunderstanding of how the Act operates.

  Q163  Mr Shepherd: I would be grateful for a note on that. It arises from particular constituency circumstances. In the case that I am particularly thinking about, there is a question of diagnosis and this is often a very muddy area between severe personality disorder and schizophrenia. It puts vulnerable people at particular risk if they are categorised as having a severe personality disorder rather than schizophrenia. How do we get this diagnosis? I know it is not an absolute but how does this need sharpening up?

  Ms Corlett: We are neither of us clinicians. I think you would have to talk to the medical profession about that.

  Mr Foster: I do not think they know either.

  Q164  Mr Shepherd: It is a frustration for families and parents.

  Mr Foster: Absolutely. It is something that Mind encounters a great deal. We hear it from individuals who are fed up with being diagnosed and rediagnosed, and families. Sometimes there is a suspicion. I certainly heard of one person who was detained as having a mental illness. She got into the ward and was apparently more trouble than the ward anticipated, so she was hastily reclassified as having an untreatable personality disorder and booted out that same night. One wonders whether this was on medical or management grounds.

  Q165  Chairman: What difference would you say the Human Rights Act has made in relation to the treatment of mentally ill people in detention?

  Mr Foster: We have had a long discussion about this. I think our view is that the Human Rights Act in itself has not made any difference because it is still down to education and processes. What is needed is a change to the mind-set, to bring it into line with the Human Rights Act. I have mentioned the case of Munjaz, which came as something of a shock to hospitals which were used to doing their own thing. We have had this a lot in terms of people getting discharged from hospital and section by a mental health tribunal. The hearings are plagued by delays and cancellations. This is immensely distressing and anti-therapeutic for the person concerned. They get themselves geared up for a hearing and suddenly they are told there is no psychiatrist to sit on the panel and the hearing goes off. There have been Human Rights Act cases which have said that this is unlawful and should not happen, and compensation can be paid in some circumstances. In other words, having cases going against the trust or prison or police service concerned concentrates the mind more than the mere words of the Human Rights Act.

  Q166  Chairman: What you are saying really is that for the Human Rights Act to have an effect on people in this situation there does need to be more training and awareness.

  Mr Foster: Training and, I am sorry to say, challenges using the Human Rights Act to make a point. If a trust knows it is going to be effectively fined for breaches, that is a great incentive to moving on the procedures and bringing them into line. It is a shame to put it in those terms.

  Q167  Chairman: Thank you both very much for coming here today to help us with this inquiry into an increasingly serious issue.

  Ms Corlett: There have been a number of things which we have been unable to cover. Would it be helpful to send those in?

  Chairman: It would be extremely helpful and we would be very grateful.

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