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The Minister of State, Home Office (Baroness Blatch): My Lords, with the leave of the House, I shall now repeat a Statement on prisoners in hospital which is being made in another place by my right honourable friend the Home Secretary. The Statement is as follows:
"The acting Director General of the Prison Service, Richard Tilt, met Caroline Flint, the President of the Royal College of Midwives, on Monday to discuss the use of physical restraints on women prisoners admitted to hospital to give birth. The discussions were constructive and I am very grateful to the Royal College for its help. I should like to make it clear that it has never been the intention of the Prison Service to apply handcuffs or chains to women who are confirmed as being in labour and never to apply restraints contrary to medical advice. That will continue to be the case. But the Royal College has asked for certain modifications to be made to the use of restraints on pregnant women and the Prison Service has accepted its recommendations.
"In future, women taken from prison to hospital to give birth will normally be escorted by two female members of prison staff. In exceptional circumstances, where this is operationally not practicable, at least one will be female. No restraints will be applied to the prisoner from the time at which she arrives at the hospital. No prison staff will be present in the delivery room unless the prisoner requests it. Governors will continue to be encouraged to liaise with hospital managers and midwives on these and all other security measures for women admitted to hospital to give birth.
"The Royal College of Midwives has also expressed concern about the application of physical restraints to pregnant women waiting in public areas in hospitals for antenatal checks. In future, all physical restraints will be removed from a prisoner on her arrival in a hospital waiting room unless she is judged to present a particularly high risk of escape and of course there is no medical objection to restraints being applied.
"The Prison Service has a responsibility to balance the need to hold prisoners securely with the duty to treat them with humanity and to maintain their dignity and privacy. The modifications I have announced will, I believe, allow the Prison Service to strike a reasonable balance on behalf of the public. We are confident that this revised policy provides the correct balance without reducing security to unacceptable levels.
"The Prison Service has also taken this opportunity to review its policy of applying physical restraints to other prisoners. Following a thorough risk assessment, some prisoners already attend hospital appointments without an escort under the temporary licence scheme. This will continue to apply. When a prisoner is escorted to hospital, physical restraints will continue to be used in most cases unless there is a medical objection. But where, following a rigorous risk assessment, the governor comes to the conclusion that restraints are unnecessary, they will no longer be used. In such cases, the prisoner will, however, still be accompanied and supervised by Prison Service staff. This builds on the experience of the Prison Service in using risk assessments under the temporary licence arrangements introduced with great success last year.
"Let me summarise the new arrangements. First, no woman who goes into hospital to give birth will be restrained from the time she arrives at the hospital until she leaves. Secondly, a pregnant woman who goes to hospital for antenatal checks will have her restraints removed on arrival in the waiting room unless there is a particularly high risk of escape. Thirdly, in most other cases physical restraints will continue to be applied. But governors retain the discretion to release prisoners on temporary licence or to send them to hospital under the supervision of staff but without restraints being applied. I am confident that these revised arrangements will strike a better balance between the various considerations which the Prison Service has to take into account.
Lord McIntosh of Haringey: My Lords, we are grateful to the Minister for repeating the Statement. It is tempting to say simply that this is a climb-down, indeed a humiliating climb-down, to thank the Minister for the concessions that have been made and to sit down. But I am afraid that my responsibilities go wider than that and I cannot take that easy course.
Of course, this Statement is welcome in so far as it meets the requirements of the Royal College of Midwives and follows the meeting between the acting Director of the Prison Service and Caroline Flint of the Royal College. We are grateful for the recognition that the Royal College was right in its protests and has been so for a number of months.
But we cannot allow this climb-down to pass without saying also that the policies which have now been abandoned were introduced deliberately by the Prison Service under the aegis of this Government no longer ago than April 1995. They were introduced presumably because of a panic reaction to the escapes from Parkhurst and Whitemoor which led to the setting up of the Learmont inquiry.
We cannot avoid noting that when the Learmont Report finally appeared it had references in paragraphs 5.38 to 5.40 to the position of women prisoners. But there is no suggestion that any of those physical restraints on women prisoners outside prison are a necessary addition to security or, indeed, that they are justified. Therefore, the action of the Government and the Prison Service in response to those escapes--all, of course, by men--was entirely unjustified and is shown to be unjustified by the inquiry which the Government themselves established.
Having introduced those new rules, which are very precise and rigid, the Prison Service then proceeded to ignore a number of warnings over a period of months that they were intolerable and inhumane. The Royal College of Midwives protested against the rules in July 1995. The particular example which has given rise to this change was the treatment of women prisoners from Holloway in Whittington. The Whittington Hospital wrote to the Prison Service in August 1995 making it clear that there were serious concerns among hospital staff and particularly among the midwifery staff, asking for talks about it and offering a community midwifery service within the walls of Holloway Prison.
So far as I know, no adequate response was given to those requests and the matter was allowed to continue with this inhumane treatment being applied right up until the present time, despite the fact that my noble friend Lady Hayman wrote to the Minister of State in December 1995 asking for a meeting and expressing her concern about the views of her staff regarding the conditions under which such pregnant women and women in labour were being treated.
At the very least, there ought to be an apology to the women and, indeed, to the hospital staff concerned for the way in which the women have been treated and also the way in which the hospitals have been treated in being forced to participate in and observe such inhumane treatment. I see no sign of any apology by the Government as a whole to those concerned, although there was of course an apology by the Minister of State to the House of Commons earlier this week.
As I say, in most respects the Statement reflects an agreement between the Prison Service and the Royal College of Midwives. However, can the Minister say why there is no reference to the demands from the Royal College for reform of the way in which women are treated in the case of post-natal care? The Royal College asked that there should be no restraints and no prison staff present at medical or midwifery examinations; or, indeed, when women were breast feeding. I see no reference to that in the Statement and I should be
There are two different problems in that respect. First, there is the assumption that, apart from exceptional circumstances, physical restraints will still continue to be used. Surely the presupposition must be that, unless there are really exceptional circumstances, women will not be taken to hospital in chains--and I do not mean pregnant women; indeed, I mean any women in need of medical help--or be in chains while in hospital. The recent release of the woman in St. Mary's Hospital who was in chains, despite suffering actively from AIDS, gives us hope that that must really be the intention, even though the Statement does not say so.
and that leads me to ask what is meant by the word "confirmed". There has been a suggestion that it means that a form must be filled in stating that the woman concerned is in labour and, therefore, should not be handcuffed--
However, I am advised that there are many examples of restraints being applied contrary to medical advice. I believe--and the noble Lord, Lord Glenarthur, may wish to comment on this point later--that the staff at St. Mary's Hospital were not happy with the restraints being used on the woman in that hospital and that, certainly medical protests, as we know from the Whittington case, had been overruled by the rigid rules of the Prison Service.
We shall need to study the new rules laid down by the Prison Service to see how they differ from the existing rules, before we can be satisfied that there is a real change here. My understanding is that restraints have been used contrary to medical advice. I believe that it would have been more gracious of the Government to recognise that fact rather than to claim nothing was wrong in that respect.
Of course we welcome the Statement in so far as it goes, but it fails to show an adequate degree of contrition for the inhumane and degrading treatment which has been in place for a number of months now. Moreover, it fails to satisfy the remaining concerns about the civilised treatment of women prisoners leaving prison in order to go to hospital.
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