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Lord Harris of Greenwich: My Lords, like the noble Lord, Lord McIntosh of Haringey, I am in the happy position of being able to welcome the Statement. Indeed, it is the first Home Office Statement for some substantial time where one has been in that position. It

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is a grudging but almost total climbdown. For that all of us who have expressed concern about the matter are profoundly grateful. This has been a lamentable episode which has, undeservedly, done serious damage to the reputation of the Prison Service. I say "undeservedly" because the decision was taken not by officials but by Ministers of the Crown. That is what is so unjust so far as concerns many dedicated and honourable people in the Prison Service.

I wonder whether the Minister is able to comment on one particular point in the Home Secretary's Statement that I noticed with interest. I refer to the point where the Statement says that,

    "where, following a rigorous risk assessment, the Governor comes to the conclusion that restraints are unnecessary they will no longer be used".

I am certainly in favour of risk assessment by governors because inevitably, so far as concerns male prisoners, some inmates may indeed represent a serious potential security threat. However, the use of the word "rigorous" is interesting. I understand the concept of risk assessment; on the other hand, I wonder what "rigorous risk assessment" means. I suspect that it probably means that when something goes wrong the governor will of course be attacked and Ministers will, as usual, hide behind that. I do not believe that Ministers have any realisation of the degree of scepticism--I put it as politely as possible--with which they are viewed by the Prison Service at present.

There will be a welcome by many civilised, decent and humane people in the Prison Service for the Statement. However, I must point out that extravagant rhetoric which gets Ministers standing ovations at party conferences is, unfortunately, a rather poor guide to implementing an intelligent policy in the prisons. Those who receive warm applause from the tabloids in October should not be surprised when the same tabloids denounce them in January.

Baroness Blatch: My Lords, I must say, first, how grateful I am for the way in which noble Lords have responded, albeit with a number of criticisms. However, notwithstanding that fact, I believe that both noble Lords have accepted and welcomed the Statement. Perhaps I may put one or two things right as regards several points made by the noble Lord, Lord McIntosh. I shall start with some chronology. Until 1994, the presumption was that female prisoners being escorted outside of the establishment were not handcuffed--I believe that the noble Lord is aware of that fact--unless the governor or the head of custody had reason to believe that the inmate would pose security or control problems during the escort.

The noble Lord seemed to think that there was no reason whatever for a review of that policy. However, it was in fact reviewed in April 1994. It has to be said that, in five years, 20 female prisoners escaped from hospital and seven of those women were in fact pregnant or had just given birth. That is no light matter for the Prison Service because not only myself, but certainly my predecessor in this office, have had to come to the Dispatch Box and account to the very noble Lords who are being critical today as to why it was that the Prison

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Service had relaxed security to the extent that people were escaping from hospitals. Therefore it is proper that the Prison Service should always seek to balance the importance of protection of the public, security as regards the prisoner and the proper medical needs and dignity of the prisoner who may be experiencing some difficulties. The policy was reviewed in April 1994. Handcuffs were made mandatory for Category A female prisoners being escorted outside an establishment. However, for other female prisoners the policy was not changed.

There was indeed a further review in April 1995 and as a result of that all female prisoners are now handcuffed when they go outside an establishment, irrespective of the risk. Handcuffs are removed from female prisoners only at the request of a doctor and only for the shortest possible time. There has been a great deal of confusion, and a good deal of criticism has been bandied around, as regards how that policy has worked in practice. There has been only one serious breach of that policy--this incident was quite unacceptable in the view of both my right honourable friend and subsequently the Prison Service--when a lady was handcuffed throughout the birth of the baby. Apologies were made both to the lady concerned and in a letter to Mr. Alan Howarth back in the summer.

The noble Lord, Lord McIntosh of Haringey, was also quite wrong to say that we have not addressed the whole issue of the post-natal period. I said in the Statement that no woman who goes into hospital to give birth will be restrained from the time she arrives in hospital until she leaves hospital. That includes all of the post-natal attention to the baby, which of course includes feeding the baby and attending to the baby and the mother. Until the female prisoner leaves the hospital she will not be restrained.

Lord McIntosh of Haringey: My Lords, I am grateful to the Minister for giving way. I acknowledge that a manuscript amendment to the Statement uses the words "until she leaves". But of course post-natal care does not occur only on the occasion of giving birth. It can be given on later occasions. I would welcome an assurance that the request of the Royal College of Midwives that there should be no restraint or prison officers present during post-natal treatment, will be agreed to, whether or not that occurs on the occasion of the visit to hospital to give birth.

Baroness Blatch: My Lords, I have dealt with the period in hospital for the lady giving birth. I shall now refer to the post-natal period--which is just as important--when the female prisoner has returned to prison. We welcome what is contained within the statement of the Royal College of Midwives in that regard because we believe that is a basis not for me to make announcements at the Dispatch Box but for the proper operational liaison and collaborative workings between the hospital establishments and the prison institutions. We expect that situation to be improved. We know that the Royal College has said that it will do what it can to improve its services to female prisoners within prison, both before the baby is born and following the return of the female prisoner to prison.

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I believe that we can look forward to better working relationships between the establishments because I believe that much of the criticism that has arisen has resulted from the way in which that relationship has worked out in practice in the past.

The noble Lord, Lord Harris of Greenwich, made reference to the word "rigorous". Female prisoners can come from many different parts of the Prison Service. They may come from open prisons where a prisoner may already de facto be trusted in open prison conditions. Therefore that prisoner may be unescorted when attending a hospital appointment outside the prison. Or there may be good reason for escorting that prisoner. However, for other prisoners whose situation may be more serious a more rigorous assessment is essential. There is a distinction between the kind of assessment one would make for a prisoner where there was such a degree of trust that the assessment need not be so rigorous and those prisoners in custody where assessments have to be made about the degree of security that is necessary when they move from prison to hospital. In that case I believe the word "rigorous" is appropriate.

4.55 p.m.

Lord Glenarthur: My Lords, I thank my noble friend for the Statement which she has made which I certainly found encouraging. My noble friend will be as aware as anyone of the considerable disquiet, anxiety and deep disgust held generally as regards some of the cases which have come to light of late. That is felt particularly among hospital staff treating prisoner patients and it is felt by other patients who are naturally aware of what is going on on these difficult occasions. I must declare an interest as chairman of St. Mary's NHS Trust. Indeed the noble Lord, Lord McIntosh of Haringey, referred in a sense to my knowledge of a particular case at St. Mary's which has recently been reported in the press. I believe that my noble friend would expect me not to give details of a particular case and I hope that the noble Lord will understand that. However, I can tell the noble Lord that it was certainly true to say that the circumstances of that case gave rise to a considerable amount of professional concern among the staff of St. Mary's. It was proper that that concern should have been raised. I am grateful to those who took note of those concerns when I made them known.

I should inform my noble friend that I am particularly aware, as a former Home Office Minister who 10 years ago had responsibility for prisons for 18 months or so, that this is a difficult matter to deal with. Ensuring that prisoners do not escape at times when they are more vulnerable in that respect is an important matter. However, this particular issue and the circumstances surrounding the cases that have arisen have given a clear impression that somehow procedures have gone rather over the top and have become excessive. I hope my noble friend would agree that the degree of security that is necessary must depend on the individual circumstances prevailing at the time and the clinical condition of the patient. The expert views of hospital staff must be taken seriously by the Prison Service staff

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who otherwise would have the responsibility for the patient. Does my noble friend also agree that patients, prisoners or others, are entitled to dignity in their treatment? The same quality of care and consideration must apply universally to patients.

Finally, will my noble friend reinforce her assurance that wherever it is humanly possible women prisoners are escorted only by female prison staff when they are in hospital and that male officers would be used only under exceptional circumstances, and those male officers would not be asked to be present--or think of being present--when certain treatments and procedures are being carried out during which their presence would be wholly inappropriate? That might well apply to female staff too. My noble friend has made an important Statement. Certain events have caused great concern among the hospital community and I am grateful to her for going a large way towards putting matters right.

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