§ Motion made and Question proposed "That this House do now adjourn."— [Major Conant.]
§ 11.25 p.m.
§ Mr. Victor Yates (Birmingham, Lady wood)
I am raising tonight two important questions about the care of prisoners—the medical treatment of prisoners and welfare arrangements on discharge. I can make only a brief reference to the second question, as the main point I wish to bring to the attention of the House is the importance of adequate care for prisoners when they are placed in confinement. There is much disagreement about methods for the prevention of crime, but I do not think there is any disagreement about the fact that when prisoners are compelled to be confined in prisons they should not be placed in conditions which are a positive danger to their health. Such conditions would surely be an additional punishment which would be a crime on our part.
For that reason I want to raise the issue whether adequate care is being taken of those who are behind prison bars, a question which is raised particularly when one reads in the Press a story such as there was on 6th May under headlines which stated "Lack of treatment hastened man's death." That kind of headline and the information contained in the story give rise to serious concern among the public. The case I am referring to relates to an inquest on a prisoner named Ernest Walker Robinson, a prisoner at Wandsworth, who died in St. James Hospital, Balham, on 1st May.
The foreman of the jury at the inquest stated, and here I quote from the "Evening Standard":We are quite agreed that the deceased died from natural causes, but we think that it was accelerated by the lack of treatment he received while he was serving his prison sentence. We think he should have been sent to another hospital much earlier than he was.That I submit is a serious indictment by the jury, and I think it is almost without precedent. I do not want to press this particular case, except to say that it does require investigation. My hon. Friend the Member for Ealing, North (Mr. James Hudson) is also interested in that 2452 case, and, if he catches your eye, Mr. Speaker, he may be able to add something to what I have mentioned.
I am concerned about the conditions in all prisons, but particularly in Wandsworth, and I am extremely perturbed by this and other cases brought to my attention. I think that there is lack of adequate care, and the Chief Medical Officer must accept some responsibility for what is taking place. I now refer to the case of Leslie Morris Kane, who was discharged from Wandsworth on 4th December last. From September until December—and I have examined letters and documents relating to that period— the utmost pressure was placed on the authorities, not only by the man but by his relatives, for further medical examination.
On 5th October, the Governor of Wandsworth, replying to this man's sister, enclosed a letter which he had received from the medical officer Dr. Murdock. This letter said that there was no need to feel any anxiety about his condition and that any steps which might be necessary would be taken for the further consideration of his case. The man requested an examination at the London Hospital. It was stated that the London Hospital could not examine him without a letter from the Medical Officer at Wandsworth. This was refused, and, therefore, the man did not have the examination, nor the treatment to which he was entitled.
It was perhaps merciful that his period of imprisonment came to an end, and he was discharged on 4th December. Within one and a half hours of being discharged he went to his doctor—Dr. B. I. Copeland, of 70, Regents Park Road, London—who said that on 4th December,…he came to me and told me that he had just been discharged from Wandsworth prison that morning. He did not look well, and I examined him. I found (1) A recurrence of an inguinal hernia; (2) Signs suggesting a duodenal ulcer; (3) He still had pain in the back. I referred him back to the London Hospital, where my suspicions were confirmed after a thorough investigation. They diagnosed a duodenal ulcer. Also he is due to be operated on again for a recurrence of his hernia. He is also having to attend their Department of Physical "Medicine for treatment of his back.I think it is extremely serious that that man should not have been able to get 2453 proper medical advice until he was discharged. At the moment he is still waiting for his operation.
I know full well from my examination of prison conditions, when the Select Committee on Estimates was examining this matter, that the medical facilities at prisons generally are most inadequate, and I appreciate that there is a shortage of medical officers. I think that it is little short of a miracle that worse does not happen as thousands are sleeping three to a cell. From my own personal experience while visiting Parkhurst, I believe that the arrangements, particularly for prisoners suffering from tuberculosis, are totally inadequate. I saw a prisoner named Smith who was actually dying in his cell. I tried to get him brought home. I thought it was absolutely horrible that that man had to be confined to his cell.
No tubercular patient is allowed to be in an open ward, and if a patient is bedridden he is confined to his cell. One realises that these prisoners have done wrong, but when a prisoner's health is in such great danger it is a serious matter, and the whole question ought to be investigated. I do not believe that prisoners who are suffering from tuberculosis can be treated satisfactorily in a prison like Parkhurst in such conditions.
I know of the case of a man named Robert Edward Davies, who has been in Parkhurst for about six years. He has twice been released from Parkhurst for operations for tuberculosis, and at the moment he is in a chest hospital in Godalming. He has written almost pleading that he shall not be taken back to a cell and perhaps end his days there. I suppose he has about a year to serve. Under better circumstances he might be able to overcome the difficulties of his ill-health. I should have thought that tubercular patients could have better treatment.
Nor do I think that the punishment cells at Parkhurst are adequately heated. I am told that prisoners often have to put on their coats. Prisoners whose health is in danger should not be put under such conditions. Those are just some examples. If necessary, I could provide further information about cases which have been the subject of correspondence between the hon. Members concerned and the Home Secretary.
2454 I turn to the second aspect. The test of a good prison system is what happens to the prisoner when he comes out. I shall not go into individual cases, but I feel that there is need for closer examination by the Home Office, the National Assistance Board and the after-care associations to see whether more adequate arrangements cannot be made to help these people, and more especially the homeless prisoners.
I was told by one prisoner who had served ten years that he was given 5s. on his release. That is totally inadequate help to give a man, even for one night. At Birmingham there is a prison-gate shelter where it is possible to offer a bed, but in many cases the only help is a 5s. grant. In Birmingham, one cannot get any accommodation better than Rowton House for that sum, and the Salvation Army hostels are generally full to overcrowding. I have received a letter from a woman who was convicted of shoplifting. When she was discharged she was homeless. She cannot find a job, she is homeless, and says: "I am shoplifting again and keeping my fingers crossed." That is a most extraordinary thing for a woman to write and to put her name to. She says that she and others like her know they have done wrong, but they are without work, they are homeless and she asks if I cannot do something to help them.
I feel that the two aspects of this subject which I have raised are worthy of further study by the Home Office. If the Minister can go into these matters carefully I am sure that the country will be grateful.
§ 11.40 p.m.
§ Mr. James Hudson (Ealing, North)
I will take only a minute or two of the time which remains for the Parliamentary Secretary to reply. I am interested in the first case which my hon. Friend the Member for Ladywood (Mr. Yates) raised, namely, that of Mrs. Robinson, the widow of E. W. Robinson, sentenced to two and a half years imprisonment in Wandsworth since 16th March. He was awaiting an opportunity to appeal against conviction. He fell ill. During his illness it appears that his wife wrote urgently to the Home Secretary. I spoke to her, and today she brought along a copy, or as good a copy as she could prepare, of that letter. She is not accustomed to keeping copies of letters.
2455 She wrote on 23rd April describing her husband's condition in the hospital at Balham, to which he had been moved. She said that while he was there a prison officer was constantly in attendance at his bedside, and as her husband was very ill the officer was a great cause of disturbance to him. She asked, among other things, for removal of the officer. That poor woman's letter was ignored. She has had no reply.
A further letter was sent by Messrs. F. A. Tickner and Co., Solicitors, of Paddington, asking, on the woman's behalf, about her husband's health when he was in the prison hospital. Although that was clearly put to the Governor, with a complaint that his illness did not appear to be attended to, no reply was sent by the Governor. I would ask that further inquiry be made into this case. The man is dead and gone. One deplores the possibility of a prisoner getting inadequate medical care, and of no one being willing officially to take the responsibility for saying what is going on.
§ 11.44 p.m.
§ The Joint Under-Secretory of State for the Home Department (Sir Hugh Lucas-Tooth)
The treatment of prisoners is a subject on which public opinion is extremely sensitive and rightly so. There are moral implications of the highest importance. While punishment is one of the essential purposes of imprisonment, cruelty, either physical or mental, will not be tolerated by any hon. Member of this House. Every hon. Member will agree that once a man has purged his crime and leaves prison, he should be helped to re-establish himself, both in his own opinion and in the opinion of the community.
I have not much time in which to deal with this wide and important subject. Regarding the medical treatment of prisoners generally, every prison has a medical officer. Some have more than one, and some of the smaller ones have only a part-time officer. At the end of 1953 there were nine principal medical officers in the service, and 33 full-time medical officers. In addition, there were a number of part-time medical officers. Taking the part-time officers into account, there was rather more than one medical officer for every 500 prisoners in jail at any time. At the end of 1953 there were 2456 11 vacancies. There has been a slight increase in the number since, and the Prison Commissioners are now trying to bring the number up to establishment. There is a shortage, and we want to meet it as soon as possible.
Every prison has a separate hospital or, in the case of smaller prisons, separate sick rooms. There is a surgical unit at Wormwood Scrubs and, of course, there is the closest co-operation by outside hospitals with the prison medical services. About 600 cases were dealt with by outside hospitals as in-patients in 1952, which is the last year for which I have complete figures.
I have not time to review the specialist arrangements but I can tell the hon. Member for Ladywood (Mr. Yates), who takes an interest in this matter, that there has been a substantial increase in the mass-radiography examinations. The round figure for 1952 was 2,900 such examinations, and by 1953 these had risen to 5,700, which is a substantial increase. The hon. Member referred to particular cases of tuberculosis in Park-hurst. Cases in that prison are treated in consultation with the Island's T.B. medical officer and I understand that he has expressed himself as satisfied with the arrangements there. I cannot give a more complete answer on that point now.
Every prisoner is medically examined on his reception in prison, on being transferred from one prison to another, and on his discharge. The House may wish me to say something about the methods of reporting sick because they are important in this context. In the ordinary way the prisoner reports to his landing officer when he is unlocked in the morning. The particulars are reported to the medical officer and examination takes place on the medical officer's rounds. In the case of sudden illness or accident in the day time, the prisoner is escorted or, if necessary, carried to hospital immediately, and in the case of sudden illness by night, the prisoner has a bell which he can ring, and the night duty officer has complete discretion as to what action he should take on being summoned in that way.
All doctors rely a good deal on what their patients say, and prisoners are peculiarly prone to conceal, exaggerate or to simulate their ailments. There are both psychological and practical reasons 2457 for that on which I need not enlarge. The prison doctor, therefore, is at a peculiar disadvantage by comparison with doctors generally, and, on the other hand, the need for correct diagnosis and treatment is peculiarly great in the case of a prisoner 'because of the rigorous discipline of prison life. For that reason we have a rather elaborate system of appeal—I hope I may use such an expression—from the decision of the prison doctor.
A prisoner who is dissatisfied may ask to see the director of medical services or his assistant. He may also petition the Secretary of State and, if he has petitioned the Secretary of State, he may thereafter write to a Member of Parliament. I think hon. Members on all sides of the House will appreciate that that is a right which is pretty freely exercised. At any rate, if any hon. Member doubts it, I can assure him that it is so.
I do not want to be complacent in this connection. I know that there is a deficiency of medical officers, and the present overcrowding in prisons is a very grave menace. But I should like to tell the House that among the prison population last year deaths from natural causes were at the rate of only two per thousand, which is not a high rate when one considers that the percentage of sick treated daily in prisons in 1953 was no less than 12 per cent, of the prison population.
Those figures, side by side, tell something of a tale on which I need not elaborate. There were no serious outbreaks of infectious disease, and I think it is true to say that prisoners generally leave in better health than when they come into prison, though it must be admitted that there are other reasons for that—a steady, good diet, and so on.
I would not for a moment say that there are no cases of faulty diagnosis or treatment in this service. There are in every service. But I do not think the case to which the hon. Members have referred1—the case of Robinson—is a good example. He was undergoing sentence for one offence and was due to appear on 13th April last at the Old Bailey on another serious charge. He 2458 was, therefore, no doubt, in a state of considerable mental disquiet.
He was a difficult prisoner because he was what is generally called "an escaper." I think, perhaps, that gives some answer to the hon. Member for Ealing, North (Mr. J. Hudson) as to the reason for having to keep an eye on him. He had made numerous attempts to escape. He complained, at various times between 9th and 21st April, of constipation, of having sore muscles, lack of sleep and headache. Those are matters of which all of us, I think, from time to time complain without being seriously ill. There was a slight rise in his temperature on 14th April, and some other slight symptoms, not of an alarming character, and he was put to bed. He felt better after that and was allowed up to take some exercise. He stated that he had enjoyed his exercise.
On 21st April, at 7.30 a.m., he was visited by the hospital principal officer, and said he was feeling all right. At 8 o'clock that morning he vomited blood. He was seen immediately by a doctor, Dr. Lee, who happened to be available, and by 8.55, within the hour, he was admitted to St. James Hospital, Balham. He was there examined by several well-known consultants. I should tell hon. Members that the diagnosis remained obscure for the ten days in which he was in that hospital before he died.
In fact, he died of periarteritis nodosa, which, I am advised, is a rare complaint. It has extremely variable symptoms and in the majority of cases in which it occurs it is not revealed until post mortem, as was the case here. I think hon. Members will see, therefore, that this was not a case in which there was any laxity at all, and in respect of which anyone can be blamed for what occurred.
The hon. Member for Ladywood, raised the case of Leslie Maurice Kane—
§ The Question having been proposed after Ten o'Clock and the debate having continued for half an hour Mr. SPEAKER adjourned the House without Question put, pursuant to the Standing Order.
§ Adjourned at Five Minutes to Twelve o'Clock.