HC Deb 19 July 1973 vol 860 cc920-32

2.25 a.m.

Mr. Eric Cockeram (Bebington)

I am pleased to have the opportunity to raise a most important matter which, although it does not have general application, concerns one citizen of this country and involves fundamental freedoms which we hold so dear.

I am referring to the case of Michael Biggs, a youth aged 19, who lived at 40 Gateacre Court, Ellesmere Port Wirral, in Cheshire. Last November he was arrested by the police and detained in Ellesmere Port police station. He became ill the next day and the police showed proper concern. They called on his mother to inquire whether he had previously been under treatment by the doctor. He had previously been suffering from stomach complaints, and the police took the appropriate medicine to the police station.

Subsequently he was seen by the police doctor, Dr. Corbett, who also prescribed. The police immediately obtained the proper medicine, later calling on Mrs. Biggs for reimbursement of the prescription costs. Neither I nor Mrs. Biggs has any complaint against the police in Ellesmere Port or Dr. Corbett. The police attitude to Michael was entirely proper and appropriate to a youth detained on charges. If anything, they leaned towards the side of humanity and showed the appropriate concern for a youth who was held in their custody and was clearly ill.

Michael appeared in court and was remanded to Risley Remand Centre. His medicine went with him. That is confirmed in a subsequent letter I have received from my hon. and learned Friend the Minister of State. Michael reappeared at Ellesmere Port court on 30th November, when he pleaded guilty to a number of charges. The details do not directly concern us but they related to having drugs and vandalism, charges of a nature which unfortunately are prevalent amongst a small proportion of the youth of this country today.

He was remanded for sentence to the Crown court and again held in Risley Remand Centre. During this period his pains became more severe. They were of an abdominal nature and he was vomiting. He sought to register his illness and to receive medical attention on a number of occasions, but without success. He learnt from a fellow prisoner at Risley that the way to get attention in those circumstances was to threaten suicide by slashing one's wrists, and that he did on 6th December. It proved sound advice. He was immediately moved to the prison hospital, where he was placed under the attention of a Dr. Banajee, who specialised in psychiatry and mental disorders.

The vomiting and pain continued, and there are medical records at Risley of a number of complaints—for example, on 13th December, Dr. Banajee continued with what he considered to be appropriate treatment.

On the Saturday and Sunday, 16th and 17th December, Dr. Banajee went on weekend leave, leaving Dr. O'Reagain in charge. On the Saturday Dr. O'Reagain read the medical records of all the prisoners under his care. On Michael's record he read that he was being treated for a peptic ulcer. There was no record of vomiting in the medical records.

Next day Dr. O'Reagain felt that he would like to follow up Michael's records. He found that the patient's condition and the treatment were continuing unaltered. He considered that there should have been an improvement, so he decided on his own initiative to examine the patient. He immediately diagnosed something quite different from what was on the medical records and noticed evidence of vomit on the floor of the cell, whereas there was no record of it on Michael's medical cards. He diagnosed that Michael was suffering from acute intestinal adhesions. He immediately decided that an emergency operation was necessary. Michael was in consequence rushed to Walton Prison hospital and an emergency operation was performed that evening, the Sunday.

At this point the question is raised whether it would not have been more appropriate for Michael to have gone to the local hospital, Warrington General Hospital, which serves a large area and has a casualty ward, rather than to a prison hospital some further distance away. Upon subsequent inquiries being made on this point, the answer ascertained was that it was more convenient to send prisoners to the prison hospital because it was not necessary for them to have special security guards at the prison hospital, whereas if they were sent to a general hospital someone had to go to act as a security guard and it was difficult to get people to do this.

However, be that as it may, an emergency operation was performed on the Sunday evening at Walton Prison hospital. Michael's state of health did not improve. Further emergency operations were performed on 12th and 16th January. Indeed, after the first operation on the following day Michael complained of pain in his leg and a needle was found to be still in his leg, having been left there from the drip used in the operation.

On 23rd December lice were found in his hair. This youth had at that time been held in custody for over a month. He was a youth who, between the ages of 15 to 19, had been a junior guardsman in the Army, used to keeping himself fit and clean. It was concluded by those concerned that the lice must have been picked up while he was in Risley, because he had been examined by doctors on arrival at Risley and it is inconceivable that he could have had lice-infected hair for a month without its being discovered.

At this time his state of health had deteriorated enormously. He was previously a fit youth. Anyone who is a junior guardsman has to be just that. His normal weight was 10 stone 11 lb. By this time he was down to 7 stone. His condition continued to deteriorate, and he was transferred from the prison hospital to Walton General Hospital, which confirms the point made by Mrs. Biggs and others that he should have been sent to a general hospital in the first place.

On Saturday 13th January, when 1 was holding one of my normal constituency "surgeries", Mrs. Biggs came to see me. it was then that I learned the story I have just recounted. As soon as Mrs. Biggs mentioned the name Risley I pricked up my ears, because Risley, unfortunately, has a local reputation which is not high—putting it in the most complimentary way. In the past five years there have been 86 attempted suicides at Risley. There have been six deaths; five by suicide and one by injection. The number of visits to Risley by Home Office officials of relatively senior rank for specific purposes is quite high, and boards of visitors have visited, on average over the past five years, 50 times per annum.

Conditions at Risley are not what they should be. Michael's death is the second death in Risley of which I am aware this year. I was, therefore, more than surprised to receive from the Minister of State, Home Office a letter this week, in answer to one of my letter expressing my concern about the reputation of Risley, in which he said: I was surprised to hear that conditions at Risley have been causing you concern for some years. I should be surprised if anyone who had studied the record of Risley was not concerned, and I think it inappropriate that a Minister of State at the Home Office should express surprise that a Member of this Parliament should be upset at its reputation.

However, having heard the story from Mrs. Biggs on Saturday 13th January, first thing on Monday morning 15th January-I wrote to the Home Office outlining the facts as presented to me and explaining that this clearly was urgent. The boy's health was deteriorating markedly. Although I had a formal acknowledgment, I had no reply as such.

Sadly, Michael Biggs died in early February. Later, on 9th February, the noble Lord the Minister of State in another place acknowledged my letter of 15th January and said that he could not answer it because the matter would have to be investigated at an inquest. An inquest was assembled but was adjourned, and continued adjournments took place. I continued to express my concern over this case and to press the Home Office, but I could get no action or reply from the Department.

I subsequently learned that behind closed doors the Home Office had conducted its own inquiry, but neither Mrs. Biggs nor any other outside witnesses were allowed to be present or to question any of those who took part in that inquiry. The result of it was not revealed. It was kept under wraps, so we do not know what happened. Suffice it to say that I, as Mrs. Biggs' Member of Parliament, had not had a reply to my complaint of 15th January. That state of affairs continued throughout February, March and April.

At the end of April I started to get very concerned indeed. I pressed the Home Office, but still to no avail, and so I applied for an Adjournment debate. On Thursday 5th May it was announced that I had been fortunate and could have the Adjournment debate on Monday 14th May-that was about 11 days later-but when I indicated to the Table Office the subject of my proposed debate I was informed, quite properly, that since the inquest had not taken place it was inappropriate for me to raise the matter as it was sub judice. I dug my heels in and said that I was not prepared to withdraw. I had already been waiting for more than three months since the boy's death, and at that time four months had elapsed since I had first complained to the Home Office. I was advised, quite properly, that nevertheless the matter was sub judice, but I did not withdraw. Finally, on Friday of that week, it was announced that the inquest would take place the following Wednesday.

That was remarkably short notice. The House will no doubt note that my Adjournment debate was due to take place on the Monday night and the inquest was to take place on the Wednesday morning, about 36 hours later. I hope the Minister will not endeavour to tell the House that that was entirely a coincidence. If he does, I shall have to inform him that no one in Ellesmere Port regards it as such.

In the face of the fact that the inquest had been fixed for Wednesday morning, I withdrew my Adjournment debate. The coroner's inquest took place. It lasted for two days and the coroner was very thorough in his inquiries. He went into every detail and cross-examined witnesses, but he was faced with a solid wall of evidence by prison officers and others from Risley, each of whom corroborated what the other said.

That is not surprising. Four months had elapsed since I had complained to the Home Office, and more than three months had elapsed since Michael Biggs had died. The Home Office had held its own inquiry by then, and it is not surprising that the witnesses gave the evidence that they did. Indeed, it would have been surprising if the reverse had been the case and they had not discussed amongst themselves what took place and what evidence they were going to give. Presumably they had given comparable evidence at the Home Office inquiry, though no one knows just what evidence was given.

Faced with a series of witnesses each of whom corroborated what the others said, the coroner's verdict was that Michael died from natural causes, and ultimately on 5th June I received from the Home Office a reply to my letter of January. I am thoroughly dissatisfied with that reply, and I should like to ask why Michael, on complaining of a stomach condition and vomiting, was treated by a doctor who, on his own admission, specialises in psychiatry and whose training is of that professional calling. When another doctor, acting as temporary relief, examined the boy, he immediately decided that he had a corm plaint which required an urgent operation and rushed him to hospital on a Sunday night. It seems extraordinary that a proper diagnosis could not have been made at an earlier date if he had been appropriately examined.

The second point on which I should like to comment is the long delay in calling the inquest and the very short notice given for holding the inquest when I threatened to pursue my point in an Adjournment debate. The Home Office inquiry has taken place. None of us knows what happened. None of us knows what factors were brought out or, indeed, who was called to give evidence. Over and above this, there is the long delay from 15th January before the Home Office ultimately replied to my complaints.

This is a sorry story of appalling conditions and I am very concerned about it. Unfortunately all the Home Office inquiries, according to the letter which it sent me in June after the resumed inquest, are to the effect that nothing is adrift, that everything is in order and no one can be blamed. Neither I nor my constituents regard that as a fair comment on this sorry story. As President Nixon said, "There is no whitewash in the White House." Some of us may doubt that, but we think there are bucketfuls of it in Risley.

2.42 a.m.

The Minister of State, Home Office (Mr. Mark Carlisle)

This is indeed a tragic and distressing case. May I say at once that I join my hon. Friend in the concern he has expressed to Mrs. Biggs and her family over what occurred.

On the whole, as I understand it, my hon. Friend makes two general complaints, one of them about the treatment that Michael Biggs received at Risley Remand Centre and the other about the delay in investigating or in replying to the complaints he raised and which, I readily acknowledge, as my hon. Friend has told the House, he first brought to the attention of my noble Friend the Minister of State on 15th January this year.

Before I deal with those complaints, may I say something generally about Risley and about one or two of the other remarks which my hon. Friend made. He said that conditions at Risley are not what they should be, and he expressed surprise at the comment in my noble Friend's letter of 13th July when he said he was sorry that the conditions at Risley had been causing concern for some years. Risley is a remand centre for those who have been committed in custody on remand to await either trial or sentence. It has an average population of between 650 and 700 men and 100 women.

I represent a constituency in that area, about as near to Risley as that of my hon. Friend, and I know he is right to say that from time to time concern has been expressed about Risley. One has seen it in the Press. But when he refers to that and to the suicides that have taken place, I must point out that, although there was a spate of five suicides, they were in 1968 and the early part of 1969, and I have no knowledge of any complaints about Risley since that time. One must accept that a remand prison with a population of those on remand awaiting trial is unfortunately susceptible to an occasional suicide or suicide attempt.

As for the medical provision at Risley, there is a hospital with accommodation in wards and single rooms for 78 men and also hospital accommodation in the women's and girl's section. The men's hospital has three open wards, with 18 beds in each and 24 single observation rooms. The medical staff consists of a senior medical officer, four other medical officers, two part-time medical officers, one chief pharmacist and 20 hospital officers.

If a patient is in need of treatment which cannot be provided in the hospital at the remand centre, he is transferred either to an outside hospital, as my hon. Friend said, or to the surgical unit at Liverpool Prison, at which one of the full-time medical officers is a Fellow of the Royal College of Surgeons. The staff there consists of a senior medical officer, three medical officers, two part-time medical officers, six consultant surgeons, seven consultant anaesthetists, a pharmacist and a staff of 11 sisters and nurses and 25 hospital officers. I assure my hon. Friend that the standard of medical treatment available at that special unit at Liverpool Prison is of a high standard, comparable to that which is provided elsewhere.

I turn now to the case of Michael Biggs. He arrived at Risley on 13th November, having been remanded from Ellesmere Port magistrates' court on a charge of unlawful possession of cannabis. Later he was charged with a series of other offences, the details of which have no relevance to this debate, to which he pleaded guilty and of which he was convicted on 30th November, and thereafter he was committed in custody to the Crown court for sentence.

I understand that, as my hon. Friend said, Michael Biggs had complained of stomach pains while in police custody on 10th November. and he had been given some medicine at that time by the police surgeon. On 13th November when he arrived at Risley, in accordance with normal practice he was seen by a medical officer. He was given an examination. I understand that he made no complaint at all to the doctor who saw him, and there was no suggestion in any records at the time that he was either unwell or requiring treatment or, as I say, had complained of his physical condition. He was, therefore, allocated in the normal way to the young prisoners wing.

My hon. Friend says that from time to time while in Risley Michael Biggs complained of stomach pains. The first evidence we have of his reporting sick is on 25th November, 12 days later, when he reported sick with stomach trouble. On that occasion he was given some medicine. The next time he complained was 11 days later, on 6th December, when he again complained of a stomach pain and was again provided with medicine. From all I have been able to ascertain, those were the only two occasions on which he reported sick or made any complaint during that period from 13th November when he was received into Risley.

On the evening of 6th December, as my hon. Friend said, Biggs inflicted upon himself an injury of a fairly superficial nature by scratching his wrist. In accordance with the normal practice after such an incident, not only was the scratch dressed, of course, but he was at once admitted to the hospital where he could be put under full-time medical observation. Again in accordance with normal practice after an incident of that kind, he was at first put in a room where he could not inflict further injury on himself.

He remained in that single room until 8th December, when he was transferred to a hospital ward. I am told that his behaviour in that ward was perfectly normal, and he mixed in an ordinary way with other patients. He was then interviewed at some length by one of the medical officers on the staff on 12th December.

During that period, from 6th December when he was brought into hospital, the reason for his being there and the observation of him while in hospital was related not to any complaint of abdominal pains but to the incident when he had cut his wrist on 6th December. As I understand it, the interview on 12th December related to a possible report on his condition to the court.

The following day, 13th December, Michael Biggs again complained of abdominal pains and said that he had vomited during the night but had then gone back to sleep. As a result of that, he was at once transferred from the ward into a single room in the hospital where he could receive medical observation as to his physical condition.

From 13th to 17th December Biggs remained in bed in a single room in the hospital. During that period lie was examined regularly by a full-time doctor on the medical staff. He was receiving treatment throughout that time. It is right that it was not until 17th December when he complained of cramp-like pains and further vomiting that he was first diagnosed as suffering from an intestinal obstruction.

The moment that diagnosis was made, immediate arrangements were made to transfer Biggs to the surgical unit at Liverpool Prison. He was operated on the same day and further operations were performed on 12th and 16th January. He was transferred to the intensive care unit at Walton Hospital on 22nd January where he regrettably died on 3rd February. There is no dispute between my hon. Friend and myself that everything possible was done for him at that stage.

Mr. Cockeram

I support that and on behalf of the family of Michael Biggs state that they have no complaint against any of the medical staff in respect of the period when Michael was in hospital under treatment. The staff were the essence of courtesy.

Mr. Carlisle

I am grateful to my hon. Friend. Mrs. Biggs has made it clear that her complaint is limited to the treatment leading up to Biggs's removal from Risley.

Following Biggs's death on 3rd February, an inquest was held. It was opened on 1st February but was adjourned because of the difficult and complicated nature of the case. I understand that the reason for the adjournment was that Mrs. Biggs—I make no criticism of this—the young man's mother, made serious allegations reflecting on the professional competence of the doctors concerned and of the staff at Risley. The coroner felt that in view of these allegations lie could not resume the inquest until preliminary inquiries had been made and the doctors had been given the opportunity to seek advice from the Medical Defence Union, as they are entitled to do, before submitting statements to him. The adjourned inquest eventually took place on 16th May.

My hon. Friend asked why there was the delay in holding the inquest. The coroner is an independent judicial officer. He is in no way the tool of or under the control of the Home Office. The decision when to hold an inquest is for the coroner alone. I repeat that the reason why the coroner adjourned the inquest was to give an opportunity for himself to make preliminary inquiries into the allegations which had been made and to give an opportunity for the doctors whose competence had been attacked in the allegations to receive advice.

When the adjourned inquest was resumed on 16th May it took two days. As my hon. Friend has accepted, the allegations were gone into at considerable length and as a result the jury returned a verdict of death from natural causes. The pathologist who conducted the post mortem diagnosed congestive cardiac failure due to subphrenic abscess caused by a perforated gastric ulcer.

My hon. Friend said that the evidence given at the inquest all stuck together and that that was not surprising because of the delay in holding the inquest. Three members of the staff at Risley—I am not talking about the medical staff —were called at the inquest. They all gave evidence on oath and were cross-examined. I understand that the parties were represented. It would be unfair to them to assume that they did not do their best to give an honest recollection of the events leading up to this unfortunate death.

So far as the Home Office is concerned, the principal medical officer for the Prison Department's Northern Region conducted an inquiry, which surely he was right to do in view of the allegations which had been made, into the events leading up to Michael's death and the complaints made about his treatment at Risley and Liverpool Prison. He is satisfied that there was nothing to suggest that Michael did not receive proper medical care and attention. He inquired into the various allegations concerning his treatment at Risley and which were themselves questioned and cross-questioned at the inquest.

I turn to the second point which my hon. Friend made, namely, the complaint of the delay in replying to his allegations. He wrote to the Home Office as early as 15th January, but I am sure he will accept that once the unfortunate death of this boy had occurred, and once it was known that an inquest was to be held and that allegations which had been made had been brought to the notice of the coroner, it would not have been right for the Minister of State to attempt to answer fully the allegations which had been properly brought to our notice until he had had an opportunity to consider what was said at the inquest. I am sure my hon. Friend will agree that, once the inquest was over and the Home Office had had an opportunity to consider its results, there was no undue delay in replying to him. The Home Office is in no way responsible for the date at which the inquest was held and I can assure my hon. Friend that we were as anxious as he was to ensure that this distressing case was fully and adequately investigated.

As I said to my hon. Friend in reply to a Question, if there are any other aspects of the medical arrangements at Risley which are causing him concern. I shall gladly have them investigated. I understand that he has received an offer from my noble Friend the Minister of State to talk to him and to discuss the case with him, and I understand that my hon. Friend has accepted that offer. I hope he will shortly be able to take it up.

May I offer my hon. Friend an invitation to visit Risley and to see something of the facilities at first hand? I know that the governor and the senior medical officer would be glad to see him and to explain any point he may wish to raise. I know that the board of visitors, which has a statutory responsibility for the general conduct and well-being of the establishment, has made it clear that it would welcome his visiting the remand centre. I hope he will give this matter consideration.

In conclusion, I repeat my deep regret to Mrs. Biggs about the tragic death of her son. I can well understand the distress that it has caused her. But, having looked at the medical reports and at the results not only of the inquest put of the full and thorough investigation by the Principal Medical Officer, I am bound to say that they show nothing to suggest that Michael did not receive proper medical care and attention. I am deeply sorry that the efforts of the doctors, particularly those made once diagnosis had been made and he was taken urgently to Liverpool, failed to save her son's life.

I assure my hon. Friend that if there is any further information that I or the Department can provide which will in any way help to reassure him and Mrs. Biggs of the care and treatment given to her son at that time, I will gladly attempt to find it.