§ 11.14 a.m.
§ Mr. David James (Brighton, Kemptown)
I am very grateful to you, Mr. Speaker, for giving me the opportunity to raise on the Adjournment the question of the protection of the general public against crimes of violence.
There is no doubt at all that the fivefold increase in crimes of violence which have taken place since the war gives grave cause for apprehension to many defenceless people. If I can possibly declare my interests in this matter, I have five children who have to walk up a narrow lane to get home from school and, owing to the zeal of the Whips' Office, my wife spends many evenings on her own, so I am fully a party to the apprehension which all of us feel.
An American judge recently said in New York:The philosophy of responsibility has been replaced by the philosophy of excuse. Under this new concept all criminals, young and old, are sick people and far from seeing in their criminal actions anything for which the offenders are responsible, we are told to learn to recognise in criminality the existence of something for which society alone is responsible.He concludedAt this juncture, when teenage crime is of such general concern, it would be fruitful for our civilisation to reaffirm a philosophy of responsibility and cut down the philosophy of excuse to proper size.I want particularly to associate myself with that concept, that the overwhelming majority of us are completely free, because I am about to explore one of the harder frontiers of responsibility as opposed to irresponsibility.
My first slight complaint is that notwithstanding the Mental Health Act, 1959, not enough people are being segregated under Section 72. Surely the principle must be that the wicked go to prison and the sick go to hospital. One effect of the failure to segregate is that the genuinely wicked tend to "swing the lead." I am told that it is a commonplace in prison for people to say, "You cannot say that to me; I have been under the doctor."
The majority of people are completely normal, so if we can get the people who are genuinely ill out of prison, it can only be to the benefit of such reformative 1803 use as the prisons may have. Quite frankly, an immense amount depends on the way we play this hand. When the Army invented the term "battle sickness" the number of people who found that the war was rather tedious grew considerably. The Royal Air Force, I believe, with a much greater sense of actuality, referred to it as "lack of moral fibre," and one result was that extraordinarily few people found that they did not want to fly.
My real concern is not with the schizophrenic and others who have definite mental disease but with the psychopath. I am aware that this is an extremely unsatisfactory term and, in many ways, an unscientific term. The schizophrenic stands astride any normal frontier between the responsible and the irresponsible. It is further complicated by the fact that there are apparently two different types, those who learn by experience that crime simply does not pay, which suggests, at least, that they are wicked, and those who are not affected by any treatment whatever until whatever fire within them burns out, which possibly suggests that they are not responsible. I do not want to go into a philosophical argument as to whether these people are mad or bad; the only point that I want to make is that they are extremely dangerous.
The 1959 Act defines psychopathic disease as meaninga persistent disorder or disability of mind (whether or not including subnormality of intelligence) which results in abnormally aggressive or seriously irresponsible conduct on the part of the patient, and requires or is susceptible to medical treatment.I have no fault to find with that definition except in so far as I am led to believe that no medical treatment is available.
I think that the Danes are something like a quarter of a century ahead of us in this respect. Dr. Stürup, medical superintendent of Herstedvester detention centre, which is a psychopathic detention centre, says,There is a group of individuals who are not mentally ill, nor mentally defective, and yet they differ so widely in their conduct from the general run of people that they frequently become a serious problem to others and to themselves.I think that an even better definition is ascribed to one of the chief professors of psychiatry in this country, who said 1804 that he could no more define a psychopath than an elephant, but he recognised an elephant when he saw one in the zoo. That is the key to what I am saying. Even if we know nothing about this condition and cannot say whether these people are mad or bad, they are definitely recognisable as such. It might help if I were to give a very brief description of what a psychopath is. A psychopath apparently—he may be a person of high or low intelligence—is someone who seems to suffer from a lack of maturity.
All of us, I imagine, have gone through the phase when we knocked our small sister down or smashed our brother's train. Our parents did not worry much about that, because they knew that we would grow out of it, but the psychopath does not grow out of it. When these destructive tendencies are allied, not only to full strength, but also—and this is vital—to full sexual power, the community at large is at serious risk. I shall quote one or two examples.
Another fact about the psychopath is that he is incapable even of taking a sensible view of his long-term interests and is not capable of weighing the consequences. There was the case of Terry who was hanged for the Worthing bank murder. There is no doubt that he was a psychopath, yet so little was he capable of appreciating the consequences of his act, that he actually committed the murder on the day when his closest friend was being hanged for another murder. I do not want to get into the turgid waters of controversy over the death penalty, but in so far as British justice gives people the benefit of the doubt, I take serious leave to wonder whether We are right to hang people who suffer from this perculiar complaint.
Looking to more recent cases which have shocked the general public a great deal, I think that it can be quite confidently asserted that we under the existing law—and the Danes as long ago as 1939—should have and could have put both Heath and Albert Edward Jones inside on an indeterminate sentence. Had that happened four peculiarly unpleasant human tragedies would have been averted. By the same token, Donald Hume, who served eight years for being an accessory after the fact of murder, was a blatant psychopath. While I know that there were no powers then to detain him, it was none the less 1805 an assumption of our judicial system which allowed that man to be set free and to murder two innocent people in Switzerland.
We have reached the absurd position that while in the last year we have hanged two people whose mental soundness was in doubt, we have also in the case of Jones, in his first trial, given a determinate sentence to a man of whom it could be said that there was every probability and a certainty that he would do it again. My object in raising this matter is to urge that psychopaths, as in Denmark, should receive an indeterminate sentence.
I am perfectly aware that all these matters are covered by the 1959 Act, into which immense thought was put. My complaint is not so much about the Act as about its actual application. I do not believe that medical evidence is being produced in all those cases where it should be produced. I have one or two proposals to make in this connection. First, I suggest—with great deference to lawyers, because I am no lawyer—that medical evidence should be the property of the court. Normally, particularly in a capital crime, the prosecution and the defence bring forward their expert witnesses. We have the sordid situation in which the defence touts around until it can find someone, who may be far from sound, who is prepared to talk a lot of nonsense in the witness box. That does a great deal to discredit a most honourable and useful and increasingly scientific profession.
My contention is that it is the business of the judge and the jury to establish the fact, did he or did he not commit the crime? Subsequently the judge needs to know the nature of the man. He normally hears police evidence as to previous convictions. At this stage, in my contention, he should have medical evidence under Section 62 of the Act, namely, two independent witnesses to say whether the prisoner is a psychopath or not. We should be prepared to learn from the Danes and, without any sense of vindictiveness, to agree that people who are certified by two independent witnesses to be psychopaths should be given an indeterminate sentence.
My next proposal is that medical evidence should be brought in every single 1806 case involving violence of more than a certain degree. I am not suggesting that this should happen in the case of a Saturday night "pub" brawl, or anything like that. To take a case in point, I saw that a young man was sentenced to six months a couple of days ago because for the second time within a year he had made a completely unprovoked attack on a total stranger. He may be perfectly normal and merely a "bad hat," but at least medical evidence should have been given in open court in that type of case.
Since the only cure for the few psychopaths who can be cured seems to be that in the end they bark their shins so much against society that they learn from their ways, I am quite certain that we have to keep the psychopath under what might be called penal conditions. He has no other possibility of learning than in the rather hard way. This brings me to the whole question of penology, a vast question with which I cannot deal at great length. A number of people have said that if we put the psychopath inside for a long period of time that would cause difficulty because the prison service is already desperately overloaded, with 29,000 living in accommodation designed for 11,000. What do we propose to do about that?
I have some points on this about which I feel strongly. Even though I read in The Times this morning that prisoners in future are to earn up to 8s. a week, I consider that grossly and totally inadequate. We must organise prisons on a factory basis. It is always alleged, I believe quite unfairly, that this is not done owing to trade union hostility. Perhaps when we had 3 million unemployed that was fair enough, but I do not believe that this problem has been put to the trade unions since the war.
We have full employment and the unions have not objected to mental hospitals creating factory conditions in order to make life as normal as possible for people there. I cannot see how we can redeem a man unless we make him work and pay him the full rate for the job to enable him to recompense the victim. I should like to relieve the pressure by adopting the Continental system of suspended sentence in some cases. Quite a number of people, if they had a sentence hanging over their heads, 1807 would not offend again. That would save this appalling overcrowding in prisons.
I am sorry as an English Member to run a hare on my own, but I am a West Highlander by birth and my home is on the Island of Mull. I should like to see the concept of the penal colony revived. I believe that we are far more inhumane than were our predecessors. It is true that in the last century we had Botany Bay to which we could send people, but I accept with considerable reluctance that it might be necessary occasionally to send a man to prison for forty-two years. I accept with a great deal less reluctance that preventive detention up to fourteen years may be necessary in some cases. On the basis of my own prison experience in Wilhemshaven, Hamburg and Lubeck—this was one of the occupational hazards of being a prisoner-ofwar and was not due to crimes—I am appalled at the prospect of a person being put behind bars for a long time.
It is alleged that in the Western Isles of Scotland, in which I am particularly interested in this respect, we should not be able to recruit staff to look after prisoners. My answer as a Western Highlander is not that people want to leave that lovely part of the world, but that they have to do so because employment is not provided there. The islands of Eigg, Rum, Muck, Canna and Scalpa have an acreage of 49,100 acres and being surrounded by sea there would be no possibility to escape from them. The population there in 1821 was 1,620 but now it is only 130. It seems to me that, both in humanity and as part of a general exercise to make the West Islands more viable, this would be well worthy of further investigation.
I should like to conclude on what is possibly a debating point, but I hope that my hon. and learned Friend will forgive me. His right hon. Friend has stood, manfully and quite rightly, on his right leg refusing the demands of my hon. Friend the Member for Billericay (Mr. Gardner) that non-capital murderers should have a determinate sentence. I shall be interested to know whether it is possible for my hon. and learned Friend to stand on his left leg and to say that these far more dangerous people should not have an indeterminate sentence.
§ 11.31 a.m.
§ Mr. Kenneth Robinson (St. Pancras, North)
The House is grateful to the hon. Member for Brighton, Kemptown (Mr. David James) for raising this very important subject of psychopaths, which is one of the thorniest problems with which we have to deal. At the outset he made some remarks about the confusion between sanctions and medical treatment in this field. That confusion is to some extent illustrated by the fact that we have the Under-Secretary of State for the Home Department and the Parliamentary Secretary to the Ministry of Health both on the Front Bench.
If I have drawn the right conclusion from the signs which I have detected, the Under-Secretary of State for the Home Department will reply to the debate. With great respect to the hon. and learned Gentleman, I think it is the wrong Minister, because I take the view that this is primarily a medical problem and not a penological problem. The Royal Commission on the law relating to mental illness and mental deficiency grasped this nettle and made very firm recommendations that psychopathic disorder should be treated as a form of mental disorder. It would have been all too easy for the Commission to sidestep the problem, because we all agree that it is extremely difficult. To some extent it did sidestep it by suggesting that it should not be defined, but the Government, in my view, in their wisdom, decided that it would be impossible to make provision for psychopathic disorder in a Statute without defining it, and in the circumstances they produced a pretty good definition, which was read by the hon. Member for Kemptown.
This indicates that the problem of the psychopath should be regarded as a medical and psychiatric problem. I think that the hon. Member himself to some extent fell into the confusion to which he drew attention because he kept talking about indeterminate sentences. One does not sentence a sick man to medical treatment. Nor do I think that medical treatment, or training, whatever it is called, should be regarded as appropriate to this type of offender within a prison setting.
It is unfortunate that, although it is nearly two years since the Mental Health Act was put on the Statute Book, 1809 that is about as far as we have gone. There are no new provisions of which I am aware for treating psychopaths under the National Health Service. There are, of course, existing provisions; there are the special hospitals at Rainpton, Broad-moor and Moss-Side, to which I suppose the great majority of psychopaths who are subject to compulsory detention and treatment are being sent at present.
In this connection, I agree very strongly with the conclusions of the Minister's working party on the special hospitals, which indicated that these should be regarded as very much a last resort, appropriate only for those types of offender who cannot be accommodated in other hospitals—in special units with perhaps slightly less security precautions than these hospitals have.
The Working Party recommended that regional provision should be made for setting up psychopathic units. I advocated this many times during the discussions on the Mental Health Act. It is vital that there should be at least one purpose-built unit for treating psychopaths in every hospital region in the country. They need not be large. In fact, there is much to be said for them being of perhaps no greater capacity than 30 or 40 patients, at any rate in the early stages, but unless we set up such units we shall never learn anything more about this problem.
The problem has been set out for the first time by the definition in the Mental Health Act. For the first time we have an opportunity of categorising these people and studying them. As far as I can see, this opportunity is not yet being grasped. Will the Minister tell us how many regional boards in the country are planning any such provision of this kind, in accordance with the recommendations of the working party and, I think, in accordance with the wishes of the Minister of Health? In respect of the special hospitals. I hope that he will give a time when, like the old mental hospitals, they will have withered away because newer, better and more appropriate provisions for treating this type of patient will have been made. In the meantime, they include most of the psychopaths under detention.
I was very disturbed by the reply which I received yesterday from the Home Secretary to a Question about 1810 those patients in the special hospitals who had applied for discharge to the mental health review tribunals. Some of us had a great struggle during the passage of the Mental Health Act to persuade the Government to allow access to those tribunals to those patients, many of whom will be psychopathic, but eventually the Government gave way, with one proviso. The proviso was that in those cases in which there is an order restricting discharge—in other words, those in which the responsibility for discharge rests on the shoulders of the Home Secretary and not on the medical staff—access to the tribunal would be granted but the tribunal's recommendations would be only advisory.
I asked the Home Secretary how many patients in Broadmoor—because I gather that there has been no application from Rampton and Moss-side—had applied to the tribunal. The answer was that so far 88 had applied, and in 84 of those eases the tribunal had not recommended discharge. In four cases, however, it had recommended discharge. This independent tribunal, set up under the Act, consists of lay elements, legal elements and psychiatric elements, but in two of the four cases the Home Secretary has rejected the advice of this independent tribunal and in the other two he has not yet made up his mind.
This is not good enough. When we set up machinery which in effect is appeal machinery, and appeals are allowed, using the jargon of the courts, in four out of the 88 cases, it is very disturbing to have the Home Secretary's veto on the successful appeal in the only two cases in which he has yet reached a conclusion.
I wish to raise one other point about the problem of treating psychopaths. Under construction at present is Grendon Underwood Prison, which was planned 25 years ago as a psychiatric prison. It was originally called the Hubert-East type of institution because of Norwood-East and Dr. Hubert's report on the appropriate methods of treating this kind of offender. Because of the war, the plans to build the hospital had to be shelved, and it was only about 18 months ago that the Home Secretary laid the foundation stone. But the prison is going ahead. As far as I understand, the original plans have not been modified to 1811 a great extent. We are now going to have a psychiatric prison designed to the requirements of twenty-five years ago I do not think it is exaggerating matters to say that the Home Office does not know what it is going to do with it when it has got it. This prison was planned at a time when nobody thought that hospital treatment was appropriate for the psychopathic offender. Criminological ideas have changed since then. Indeed, psychiatric ideas have changed very much in twenty-five years.
It seems to me wholly inappropriate to have a hospital provision which we hope to see extended in a network all over the country for psychopaths, many of whom will come from the courts, who will be the subject of a hospital order, perhaps with an order restricting discharge, and alongside that a prison which is presumably going to be staffed—I would hope, at any rate, that it will be well staffed—with psychiatrists giving presumably the same kind of treatment within a prison setting for psychopathic offenders whose offences are exactly the same as or certainly parallel with both types of case.
I hope the Joint Under-Secretary of State will be able to say something about the Government's intentions, or at least his right hon. Friend's intentions, about Grendon Underwood. I believe that it has not been thought out sufficiently closely or sufficiently recently. The best solution, if it is not too late to alter the design, would be to hand over Grendon Underwood to the Minister of Health and make it not a psychopathic prison but a psychopathic unit for the training and treatment of persons suffering from psychopathic disorders and who have been awarded a hospital order through the courts.
I sum up by saying that this confusion about the proper way to treat the psychopathic offender ought to be cleared up here and now. Are these offenders sick people who require treatment, who are susceptible to treatment and to that extent not wholly responsible for their action—that is what I believe—or are they to be treated, as they have been treated in the past, as tiresome offenders who are going to disrupt almost any institution in which they are detained and, therefore, should be sent 1812 to prisons to undergo the ordinary prison regime plus such psychiatric assistance as may be available? I do not use the word "treatment", because there is very little psychiatric treatment in the prison service at the moment.
I believe that to send them to prison does no good at all. There is not much agreement about psychopaths and psychopaths, but the one thing on which almost everyone agrees is that prisons make them worse. It is on this note that I am afraid I must disagree with the hon. Member for Kemptown, who suggested indefinite sentences in prison. The appropriate course is that they should be treated and trained under medical supervision for as long as is necessary, and that is not the same thing as an indeterminate sentence. I hope that we shall have from the Joint Under-Secretary some clarity of the Government's thinking about what I believe we all agree is one of the most difficult social problems of our time.
§ Mr. David James
May I ask a question of the hon. Gentleman? I think that we have got into a difficulty of terminology. Is the hon. Gentleman aware that the Danes, who have a great deal of experience in this matter—I do not care whether one refers to a hospital or a prison—find it necessary to keep those people for an indeterminate period under maximum security in semi-penal conditions?
§ Mr. Robinson
Yes, I am aware of that. I am aware of the excellent work which has been done by the Danes and by the Dutch. They do inflict indeterminate sentences in the courts. But I think that concept is wholly alien to our own judicial system and I should not like to see it adopted here. To some extent, both countries are guilty of the same confusion that we have been discussing this morning.
§ 11.45 a.m.
§ Mr. William Roots (Kensington, South)
No hon. Member can be left in any doubt from his postbag about the very serious disquiet which exists in the country not only on the question of the prevalence of violence generally but also on this aspect of the treatment of psychopaths. To some extent, I think that may be a matter of lack of knowledge and lack of publicity.
1813 I would say to my hon. Friend the Member for Brighton, Kemptown (Mr. David James) that, in my view, the general legal system in this country is inappropriate to impose on a psychopath a long sentence, simply because he is a psychopath. In other words, if of two people who strike a man, one is sentenced to 18 months in prison and the other who had been a psychopath is sentenced to 20 years, that to my way of thinking is inappropriate.
Surely, at the moment there are in Section 60 of the Mental Health Act powers for a court to take into account medical evidence, I believe from two medical practitioners, and in effect to order the prisoner to receive appropriate hospital confinement and treatment. However, I think there was much in what my hon. Friend said, that Section 60 leaves the matter indeterminate as to who is to be responsible for calling the evidence and who is to be responsible for recognising the psychopath.
No doubt, my hon. Friend's Department and the prison authorities will be aware of the well-known case of Heath, to whom I would refer as a notorious criminal. But the vast majority of these cases are dealt with at quarter sessions or assizes, and I do not have to remind my hon. and learned Friend of the circumstances in Which those cases come forward. While the chairman of quarter sessions may have legal knowledge, he almost cetrainly does not have medical knowledge, and one can scarcely expect him to recognise a psychopath simply by looking at him in the dock or from the limited amount of evidence that the man gives.
For Section 60 to be not only effective but to be seen by the public to be effective, there need to be alterations or directions from my right hon. Friend the Home Secretary. The better and more fruitful course is to be found in the powers contained, I believe, in Section 72 of the Mental Health Act under which the Home Secretary is able—if I may use a colloqualism—to "board" a prisoner who is found to be suffering from a specified mental illness and in respect of whom a hospital detention order is made, if my memory serves me correctly. It seems that this method of "boarding" is probably the right course because on that basis, if the case is properly reviewed from a psychiatric point 1814 of view and if the person is recognised as a psychopath, he can be ordered to undergo hospital treatment whether it be of a penal nature or of a purely curative nature.
A large number of courts and certainly the general public are unaware that this power exists, and it would be of enormous assistance if my hon. and learned Friend could tell us the number of cases, first, that have been dealt with under Section 60 and, secondly, and to my mind more important, that have been dealt with under Section 72—that is, cases of "boarding."
It is vitally important, in the second instance, to distinguish between cases where "boarding" has been of a prisoner who has merely suffered a mental disturbance while in prison and is, therefore, sick, and the man who has been convicted of a psychopathic crime, has been sentenced and, while in prison, is recognised as being a psychopath and in need of special psychopathic treatment.
The House is thankful to my hon. Friend the Member for Brighton, Kemptown for raising this matter, because it is right that the public should know that we are concerned about this problem. The public is concerned, and while it is one thing to say that it is a difficult problem—and there are differing points of view about the varying methods of solution—the public should get the impression that this House is deeply aware of these matters, some of which have resulted in much public disquiet.
For reasons of time, I have kept to the psychopathic aspect of the matter, but I must comment on the general side of crime, particularly crimes of violence. I suggest to the Home Secretary that the time is now more than ripe when either he or, perhaps, a senior member of the Judiciary, should make it clear that at this period in our history crimes of violence must be considered in a category of their own and that it must be known to the criminal classes that they will be so considered and so treated. We know, as do the criminal classes, that where an assault takes place on the police in the case of premises being entered—the criminal being armed with a loaded revolver—that is automatically considered in a category of its own. I am sure that beneficial results 1815 have been produced as a result of this knowledge.
For example, if a youth or a gang of youths enter a café armed with a bicycle chain and an affray occurs and someone is hurt it should be known that that, in itself—the possession and use of a bicycle chain—will draw on the persons concerned probably a serious sentence, and certainly a very serious view on the part of the court and that if, in addition, there is robbery and a personal injury to someone is done, an additional sentence, on top of what would be given for the mere possession of a bicycle chain, will be meted out. If it were known that if one was found in an affray with a bicycle chain the courts would start with a three-year sentence and work from there, then that would have a salutary effect.
I do not believe that brutality, in terms of punishment, is the answer. One is always accused of that when one suggests a more serious penalty. But we must take a public stand that violence will be condemned by the courts.
§ 11.54 a.m.
§ Mr. T. L. Iremonger (Ilford, North)
I should like to associate myself with the expressions of gratitude to my hon. Friend the Member for Brighton, Kemptown (Mr. David James) and say how glad I am that this matter has been raised. It is the point I emphasised in a speech I made on the Second Reading of the Criminal Justice Bill on 17th November. It is, further, a subject on which the House has so far not had an adequate reply from the Home Secretary, and I hope that the Minister who will today reply will enlighten hon. Members on this subject.
I am not in agreement with the hon. Gentleman the Member for St. Pancras, North (Mr. K. Robinson) who suggested that the wrong Minister will be replying to this debate today. We are, of course, talking about psychopathic patients—if one likes to call them that—and it puts them into a category of their own. After all, they have broken the 11th Commandment. They have been found out. They are before the courts and are, therefore, in the penal system. Having got into it I think that they should be taken out. However, having got in, it 1816 is the responsibility of the Home Office to deal with them and I hope, therefore, that the Minister will be able to give an indication of what is being done in this respect.
We have had the report of the working party which was set up by the Minister of Health to inquire into the special hospitals and it has made extremely thoughtful and far-reaching recommendations. Coming into being is the new psychopathic prison at Grendon Underwood. While I am satisfied that proper consideration has been given to the possible dovetailing of these possible two systems, I should like the Minister to say what consultations he has had with the Minister of Health concerning the treatment of aggressive, intelligent psychopaths who come within the penal system. They are sentenced by the courts, but their treatment is fundamentally a medical problem. This is a small but important little knot in the whole problem of protecting the public.
§ 11.59 a.m.
§ Mr. Eric Fletcher (Islington, East)
The House will be grateful to the hon. Gentleman the Member for Brighton, Kemptown (Mr. David James) for introducing this important subject as the first of this series of Adjournment debates today. I imagine that the reason why the Under-Secretary of State is answering this debate, and not the Parliamentary Secretary to the Ministry of Health, is that the duty of protecting the public is the paramount duty of the Home Secretary.
Hon. Members already stated, and rightly, that the public is becoming increasingly concerned about the considerable increase in the number of crimes of violence in Britain. That fact was underlined in the report of the Commissioner of the Metropolitan Police which was published the other day. But, on the general subject of crimes of violence, I believe that the best way to deal with them is to increase the certainty of detection. A large part of the recent increase in crimes of violence, and crime generally—including adolescent crime among delinquents—is due to the fact that so much of it goes undetected.
The fact that many criminals and adolescent irresponsibles are not caught is, I imagine, largely due to the inadequacy of the size of the police force. 1817 I hope that everything will be done by the Home Secretary to encourage recruitment to the police force, because only by that means will it be possible to ensure a much higher percentage of crimes being detected In the vast majority of cases the only sensible way to deal with the criminal classes is some form of reformative treatment.
Hon. Members, particularly my hon. Friend the Member for St. Pancras, North (Mr. K. Robinson), have dealt largely with the special cases of psychopaths. Having listened to the debate, I believe that we must now try to make some change in our present arrangements to deal with this limited class of persons who do not fall entirely within the category of requiring penological treatment but who are far more in need of medical treatment. It is important that we should realise that in this respect there ought not to be, and cannot be, any hard-and-fast line of division between the functions of the Home Office and those of the Ministry of Health.
Psychopaths call for special treatment, and it is obvious that prison treatment is inappropriate for recognised psychopaths. It may well be that in certain cases the intervention of the police and of the criminal law is necessary to ensure that these people are apprehended and that they obtain the requisite treatment, but the difficulty that society is in at the moment is that there appears to be this hard-and-fast division between the function of the Home Office to deal with criminals through the prison system and the functions of the Ministry of Health to provide medical treatment in those cases where, as a result of mental abnormality, persons are more likely to commit crimes than are others.
We all recognise that in recent years there has been a most satisfactory improvement in the degree of medical knowledge and skill in dealing with cases of mental disorder and abnormality and the country can justly pride itself on the very considerable progress made in recent years. I hope that we can now go a stage further and that, as a result of this debate, and of the presence of the hon. Lady the Parliamentary Secretary to the Ministry of Health, we shall be told that there will be much more administrative co-operation between her 1818 Department and the Home Office in dealing with this class of person.
I do not know what the statistics are of those criminals who are wholly bad, as the hon. Member for Brighton, Kemptown said, as distinct from 'those who are mad, or partly mad, or suffering from some abnormality. It is probably a matter of degree. I suppose that we can isolate the criminal classes, and say that they are deliberately vicious and wicked, and that we can isolate another class and say that those in it commit crimes entirely because of mental abnormality that calls for medical and not penal treatment. I imagine, too, that there are cases in between, in which the actions result partly from one cause and partly from the other.
If, however, society is to be adequately protected, which is the function of the Home Office, and if these individuals who are suffering from mental disorders are to have the assistance from society to which they are entitled then, as the hon. Member and as my hon. Friend the Member for St. Pancras, North have pointed out, some change in our present administrative arrangements is required. That seems to me to call for a different approach on the part of the courts, and a different approach on the part of the Home Office in the arrangements it makes in regard to the prisons, and particularly the special prisons, for persons suffering from mental disorders.
Personally, I like the suggestion that, wherever there is any reason to suppose that a crime has been committed because the prisoner is suffering from a mental disorder, there should be medical evidence, and that it should be the duty of the court to consider that medical evidence and to consider the appropriate treatment for that individual. In those cases, it is obviously not good enough to send the person to an ordinary prison, because that will have no reformative effect on his character and will do nothing to give him the medical psychiatric treatment he requires if he is to improve his conduct.
I realise that this will require a certain amount of expense, but I do not think that that matters. Expenditure in the medical hospital field and in the prison service has been stultified in recent years; it has not matched the increased State expenditure in other spheres of social 1819 work. It is, therefore, high time that this problem should be dealt with, and I want to support the suggestion of my hon. Friend that this prison, designed some time ago as a psychiatric prison for psychopaths, should be transferred to the jurisdiction of the Minister of Health.
It may well be that a number of experiments are required here, but what is quite evident to my mind—and it has arisen clearly in the speeches we have heard—is that a change is required in the attitude of the courts and of Departments in providing special facilities where psychopaths who have committed crimes and who, therefore, come before the courts—and, indeed, those who have not committed crimes and have not come before the courts—can get the medical treatment they require.
I hope that the Under-Secretary of State will take to heart what has been said on both sides this morning, and will be able to give, if not today, at any rate subsequently, an assurance that reforms of the kind proposed on both sides of the Chamber will be carried out.
§ 12.7 p.m.
§ The Joint Under-Secretary of State for the Home Department (Mr. Charles Fletcher-Cooke)
We are all grateful to my hon. Friend the Member for Brighton, Kemptown (Mr. David James) for raising the subject of the protection of the public, particularly against the psychopath. This is a very real problem, although it is only in recent years that the country and society have really done anything about it, or even become aware of it; so recent that I do not think it altogether fair to test or criticise the new arrangements on the very limited experience we have so far had.
I must at once say, although this is a real problem and one which worries the public enormously, it would be wrong to give the impression that it is of more than limited dimensions within the whole ambit of the criminal law. I do not think that there is evidence that a high proportion of the crimes of violence is committed by unstable persons who cannot be deterred from offending again by any of the penalties available to the courts.
Such evidence as there is suggests that most of these offences arise either out of brawls or family disputes, or are 1820 committed by men who knowingly and deliberately resort to violence as a means of gaining their particular ends. Psychopaths are, no doubt, to be found among those who commit every kind of offence, but there is good reason to believe that the great majority of crimes, whether crimes of violence, or sexual crimes or crimes against property are not committed by psychopaths, even if that term is used in its widest and loosest sense.
Our general approach to the problem, and the reason why I am replying to this debate rather than my hon. Friend the Parliamentary Secretary to the Ministry of Health is, as was said by the hon. Member for Islington, East (Mr. Fletcher), that our paramount consideration in dealing with these people, unfortunate though they are and needing treatment as they may do, is that the public must be protected. That must come first, even though in this difficult balance there is always a risk that someone may he injured. The protection of the public comes first, and my right hon. Friend adopts that policy throughout.
One of our difficulties is know how to distinguish that class of criminals who have been referred to as psychopaths. The definition in the Mental Health Act is as good as we can get, although it has been gravely criticised in some quarters as being too restrictive. It has been suggested that Joan of Arc, Napoleon and Lawrence of Arabia were psychopathic personalities. Lord Goddard, although in not so many words, recently said something to the effect that we are all psychopaths now.
§ Mr. Fletcher-Cooke
She may have shown signs of dementia praecox, but I do not wish to go into the diagnosis of Joan of Arc. The definition in its limited sense in the Act has, I think, commanded respect, but even within that limited definition there is the grave difficulty of identifying the individual psychopath.
My hon. Friend the Member for Brighton, Kemptown made a most interesting and provocative speech, but I think that the problem of identifying the psychopath is rather more difficult than he suggested. If 1821 it is difficult to identify the psychopath, as I submit it is, a great deal of my hon. Friend's thesis falls to the ground, because it would be quite insufficient if, except on an absolute certainty of definition, one was to detain people indefinitely in the way that he suggested.
Although I do not wish to mention any of the names given by my hon. Friend, there is in many, if not all, of the cases he mentioned difference of opinion among medical people as to whether they were psychopaths. The psychopath is often a man of considerable intelligence and able to conceal his true condition for a long time. He is often an ingenious liar and may confuse the issue with plausible stories. On the other hand, there are people who commit apparently purposeless crimes of violence who do not exhibit the normal features of psychopathy. All these factors tend to make it difficult to distinguish the criminal from a prisoner who is simply wicked.
Until 31st October, 1960—this shows how recent our experience is—the criminal law provided only for the compulsory detention in mental hospitals of persons who were insane or mentally defective. No provision was made for psychopaths as such. The Mental Health Act, Which came into force only on 1st November, 1960, replaced the earlier legislation in this field and it provides for the compulsory detention in hospitals of persons suffering from any of four named categories of mental disorder, one of which is psychopathic disorder. I will not repeat the definition which was given by my hon. Friend.
Section 60 of the Act empowers the court to order the admission to hospital of a person suffering from such a mental disorder if the court is satisfied that he committed the criminal offence with which he is charged. Section 71 enables the Secretary of State to order the transfer to hospital of persons found insane on arraignment or guilty but insane, and Section 72 gives him similar powers in respect of prisoners under sentence and found to be suffering from mental disorder.
There has been a suggestion that these provisions are not properly applied. I beg leave to doubt that, once one concedes the difficulty, even after a long period of study, of recognising psychopathic disorder. After all, this was an 1822 innovation of far-reaching importance and the application of these provisions is bound at first to be largely experimental. A start has, however, been made and we shall gain experience and profit from it as we go on.
My hon. and learned Friend the Member for Kensington, South (Mr. Roots) asked for figures showing how the Act was working. It has been in force for only nine months and it is making a real contribution to the problem. For the period of five months from the coming into force of the Act—that is, from November last year until the end of March, 1961—which is the latest period for which statistics are available, the number of persons dealt with by the courts under Section 60 as suffering from psychopathic disorder, either alone or in conjunction with some other form of mental disorder, was 50, of whom 40 were males and 10 females. During the same period, the number of persons removed to hospital under Section 71 and classified as suffering from psychopathic disorder either alone or in conjunction with some other form of mental disorder was five, of whom three were males and two females. The number of prisoners transferred under Section 72 was seven, of whom six were males and one female. That, of course, is only for the first five months of the operation of the Act. The figures may seem small, but they will undoubtedly increase as prison medical officers get more experience.
§ Mr. K. Robinson
Does the hon. and learned Gentleman happen to have the proportion in the first category for whom an order restricting discharge was made under Section 65 of the Act?
§ Mr. Fletcher-Cooke
I do not have that information with me, but we will do our best to obtain it and let the hon. Member know.
We do not think that it would be right to widen the definition, certainly not yet. We must accept that there are offenders whose psychopathic tendencies are not covered by the existing definition. We must also accept that there is no sure way of identifying the small number of such offenders and distinguishing them from the much larger class of offenders who do not suffer from such a disability.
1823 My hon. Friend the Member for Brighton, Kemptown recognises that fact. He seeks to overcome the difficulty by providing for the detention for an indefinite period—I hope that I am not doing my hon. Friend an injustice—of all persons who commit offences at least as serious as grievous bodily harm with intent. The difficulty there—and this links up with my hon. Friend's suggestion that the ordinary forms of defence, or, for that matter, of attack, should not be available by means of cross-examination, including the production of counteracting and conflicting expert medical evidence—is that this would be such a large inroad into the liberty of the subject that it would not be tolerated by the public as such.
The particular offences would have to be specified. Assuming, however, that they included all offences against the person carrying a maximum penalty of life imprisonment, which is the maximum for causing grievous bodily harm with intent, I estimate that something like an additional 2,000 persons would be ordered life sentences each year. This number would include, as we have seen, a great many who do not suffer from any mental disorder. It would also include many convicted of relatively minor offences which, although in theory could attract such high sentences, in fact attract a light sentence only. We do not think that this will work unless one can be quite sure at the outset who a psychopath is. I do not think that at the present stage of medical knowledge it is possible so to recognise a potential psychopath.
Courts have power to impose a life sentence at their discretion for some of the more serious offences. There have been cases in which a court has imposed a life sentence in the public interest, because the offender has appeared to be suffering from some mental disorder requiring him to be detained for an indefinite period and the court has considered it advisable to leave the Home Secretary to determine whether he may safely be released. The passing of a life sentence in such circumstances is rightly limited to the more exceptional cases where, as in the case of murder, when it is mandatory, the offence itself is a grave one and the threat to public safety is poten- 1824 tially so serious that public opinion would support the deprivation of a man's liberty for a prolonged period, if necessary for life.
Before I leave the courts, I should mention two points regarding medical evidence, to which my hon. Friend the Member for Brighton, Kemptown referred. He suggested that the courts should have power to appoint medical experts to examine the accused and to give evidence at the trial—if my hon. Friend did not suggest it today, he has done so in the past—to avoid situations in which the defence touts for cranks and differences of opinion are expressed which tend to discredit the profession.
I think that this would tend to usurp the functions of the courts. The general public is always very loath to give the power of decision to experts. In the course of a very varied career at the Bar, I have noticed that experts invariably disagree, and I do not believe that medical experts are less offending in that respect than financial, ecclesiastical or any other experts. That may be one reason why the public very much dislikes the idea of the two sides not being able to bring conflicting expert evidence and of leaving the matter to a medical tribunal, rather than a lay tribunal.
Indeed, this was the finding in a similar case of the Royal Commission on capital punishment which did not accept this idea. The investigation of the mental condition of the inmates, including untried prisoners, is part of the prison medical officer's duty, and if, in any case, the medical officer has found that there is some abnormality in an offender's mental condition, of which the court should be made aware, he will volunteer this information, whether or not a report has been requested by the court. I appreciate that my hon. and learned Friend the Member for Kensington, South has said that in the lower courts there is not the facility in the case of grave offences, but there are more facilities than perhaps he gave us to understand.
My hon. Friend the Member for Brighton, Kemptown also referred to the treatment of psychopaths in prison—those suffering from mental disorder of a kind or degree which does not make it appropriate to transfer them to hospitals under the Mental Health Act. The investigation of the mental condition of 1825 prisoners is an important part of the duties of prison medical officers, but I entirely agree with him upon the consequences of leaving psychopaths in prison with ordinary prisoners, because it has a very bad effect, for the reasons which he gave and for others, on the ordinary prisoner.
Many prisoners suffering from some form of mental abnormality respond to treatment, guidance and supervision provided by the medical officers in their establishments. Others are transferred to those establishments where psychotherapeutic centres have been established, and, as hon. Members know, the Grendon Underwood construction is well advanced. It was criticised by the hon. Member for St. Pancras, North on the ground that it was out of date already, but I think his criticism did not embrace or take account of the fact that it is not only for psychopaths, but also for prisoners suffering from other forms of mental illness other than psychopathy. Research will form an important part in the life of the institution. It is hoped that light will be thrown on the causes of some of these difficult and intractable offenders, and we all wish the experiment well.
While on the subject of research, the hon. Member for St. Pancras, North asked about the provision of centres by the regional hospital boards. I would refer him to the speech of my hon. Friend the Parliamentary Secretary to the Ministry of Health on a Supply Day on 11th July, reported at c. 343 of the OFFICIAL REPORT. Since then, a circular has gone round urging on regional hospital boards the provision of such centres.
I think it would add a little colour, and certainly give more reality, if I were to give an example of what happens in regard to the difficulty of dealing with "irreconcilables". As hon. Members know, a wing of Brixton Prison was recently converted into a small self-contained wing for the accommodation of chronically violent prisoners and their observation by specially experienced medical officers. Hon. Members may be interested to hear of a recent case. A prisoner had an extremely bad record of violence against other prisoners and prison officers, totalling eleven offences in all, between October, 1958, and 1826 November, 1960. As a result of a violent assault on a prison officer in November, 1959, the visiting committee at the prison awarded him twelve strokes of the birch, the sentence being confirmed by the Home Secretary and carried out.
In December, 1959, following another violent attack on a prison officer, the visiting committee awarded eighteen strokes of the birch, but the Home Secretary did not confirm the award. Shortly after this, the prisoner, who had been segregated, was transferred to Dartmoor. It was found necessary to keep him segregated for the twelve months that he remained at Dartmoor in order to protect members of the prison staff and other prisoners from physical injury by the prisoner. In February of this year, the prisoner was transferred to the new unit in Brixton Prison. As a result of observation there, he was later reported by two doctors to be suffering from psychopathic disorder within the meaning of the Mental Health Act, 1959, and my right hon. Friend recently gave a direction for his transfer to Broadmoor Hospital for treatment. Two years ago, that could not or probably would not have happened, and it therefore shows the sort of progress we are making, may be, in a very extreme case, but there are other cases not so extreme where these orders have been made.
I am sorry if I have taken up too much time, though I have not dealt with all the points raised, particularly those of my hon. Friend the Member for Brighton, Kemptown. I should like to have a long discussion with him on his proposal for prisons in remote islands, and I am quite sure that a lot of people would like to spend their lives, not perhaps as prison officers, nevertheless as inhabitants, of islands like Muck, Eigg and Rhum, which he visited, but it really is not practicable in the sense that the prison officers and their wives and families, as we have had experience at Dartmoor, want to be in touch with what is the ordinary urban civilisation of our times. They cannot be expected to, and indeed will not, go to the remote places, because they will be cut off from the main stream of life and from the other amenities of modern civilisation. There will be some who may like to go there, but I doubt if we could 1827 get a sufficient number of prison officers willing to do so.
On the subject of turning prisons into factories, and that prisoners working there should be paid normal wages, in view of the increases in wages which I was able to announce in answer to a Question yesterday, and in view of other measures which we are determined to take to see that more and better work is done in prisons, I do not think I could hold out much hope of getting to the sort of standard which my hon. Friend wants. It would be quite wrong to pay prisoners full wages unless their work and output justifies it, and, unfortunately, for the present, overcrowding in prisons, the need for security, the shortage of staff and many other factors make it impracticable to bring prison industries up to the standard of efficiency which would provide an economic basis for paying full wages. It would be wrong to hold out any hope that in the near future we could do that, although with the principle which my hon. Friend has enunciated, and particularly with the belief in the therapeutic value of a long, good, hard and productive day's work, nobody would disagree.
I am very grateful to all those who have contributed to this debate, and I am very glad that my hon. Friend the Parliamentary Secretary to the Ministry of Health has been here. She has listened most carefully to all those points on the medical side, and she has made a special note of the point made by my hon. Friend the Member for Ilford, North (Mr. Iremonger), who has taken such a particular interest in this matter. I hope that the House will think, as I certainly do, that this debate has been well worth while.