§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Chapman.]
2.30 pm§ Sir William Shelton (Streatham)I wish to raise certain events which have taken place in Brixton prison, in my constituency.
Brixton is a remand prison for people who have not yet been sentenced. In 1985, two prisoners took their lives by their own hands at the prison. In 1986 there were three, in 1987 two, in 1988 one; and in the first 10 months of this year, eight prisoners have taken their lives. Also, three prison officers serving at Brixton have committed suicide during the first 10 months of this year.
The chairman of the Brixton Prison Officers Association is quoted in The Independent as saying that he knows of three more prison officers who previously served at Brixton, who have committed suicide this year. There is no evidence to link the stress of working in that prison with those suicides by prison officers.
I applaud the circular that the Home Office issued in May 1989 for prisons, entitled, "Prisoner Suicide prevention … New Guidance". Quite rightly, the Home Office is bearing the problem in mind.
However, the tragic facts that I have just mentioned imply that something is very wrong. Why has it happened? It is certainly not due to sloppy indifference or casualness by the prison officers or the governor. On the contrary, they are dedicated men. They are caring and concerned, and I admire them enormously. No one would work in a prison—especially in the hospital or F wing at Brixton—unless they were dedicated and had the interests of the prisoners at heart.
What has gone wrong? All the prisoners who committed suicide were disturbed, confused or mentally unbalanced, and all except one were in F wing, which adjoins and is part of the hospital wing at Brixton prison.
I suggest to my hon. and learned Friend the Minister that the root cause for those tragedies goes back to the move to close psychiatric units, which started some years ago with the White Paper on care in the community. Perhaps there has been inadequate community care to provide for people leaving those units.
I welcome the Government's recently announced measures to improve care for people who are dismissed or discharged from psychiatric hospitals. Between 1982 and 1986, the number of psychiatric beds in the South East and South West Thames regional health authority areas dropped from 13,000 to 11,000, and I understand that a further 3,000 are to go.
The chairman of the Brixton Prison Officers Association said:
Prison is not the place for these people … should be looked after by staff trained to do the job".He was talking about mental nurses and mental hospitals Nevertheless, these people find themselves in F wing. Mr Stephen Shaw, director of the Prison Reform Trust, has said that the term "prison hospital" can give a false impression:They are not hospitals as people on the outside would recognise them. In large parts they are corridors of converted cells. The doctors are not subject to the same scrutiny as in the NHS and less than one in 10 of the hospital officers have proper nursing qualifications.413 I believe that Brixton prison was built 140 years ago. In general, prisoners at risk have what is called continuous supervision. They are put in a ward of perhaps 15 beds and a prison officer seated in a glass cubicle watches them 24 hours a day. If they are not at risk, they might receive intermittent supervision. They might be alone in a cell or share it with one other prisoner. An officer will look through the window once every 15 minutes. Brixton prison has only three open wards, in which there are some 45 prisoners and about 200 cells, in which there are 230 or 240 prisoners. In some they have had to double up. There should be more open wards and fewer cells, but that is impossible because of the structure of the building, which was built so many years ago.There are 12 or 15 strip cells which have no furniture except a bed. The prisoner has only his prison clothing, with which it is impossible to commit suicide. It is not possible to keep people in such cells indefinitely. People can be prevented from committing suicide if they are chained up against the wall, but neither that nor putting them in strip cells indefinitely is possible or desirable. Prisoners therefore have to be put under intermittent supervision.
I have described the physical characteristics of this elderly prison. The second problem is that the staffing levels are inadequate. I understand that the problem arises not so much from lack of funds as from problems with recruitment and training. 1 am told that the hospital wing and F wing can be as much as one third understaffed. The manpower assessment was made at the beginning of "fresh start" some two years ago. I am told that it was done by a discipline grade which made no allowance for the hospital input. Some 50 additional places at the prison have been made by doubling up in cells, but there has been no new appraisal to take account of them. One of the consequences is that prisoners may remain locked up for 22 or 23 hours.
The third problem is that there are inadequate association areas where prisoners can mix, play cards or watch television. The governor is taking steps to remedy that. There are bars in some cells, from which people can hang themselves. The governor is taking steps to replace them with steel mesh, which, unhappily, reduces ventilation.
Fourthly, the prison officers are not adequately trained to deal with prisoners with psychiatric problems. When future teachers are studying for a bachelor of education degree, they are taught how to identify and deal with subnormal children, for example. As far as I know, prison officers have no such training.
What must be done? At Brixton, staffing needs must be reassessed urgently. The staffing of F wing and the hospital should be brought up to full complement. Secondly, the number of association areas must be increased and bars must be removed. I understand that that programme is already under way. Thirdly, we must reduce the time that prisoners spend on remand for medical reasons. I understand that the average is six weeks, and that is too long. There must be closer and more careful medical screening of prisoners on admission.
Finally, for Brixton, I would ask my hon. and learned Friend the Minister to give serious consideration to granting an independent inquiry. I urge that course upon 414 him. He know the situation in Leeds prison, and I shall not deal with that now. I call for an independent inquiry, in support of the prison officers' call for such an inquiry, for two reasons. First, the inquiry could confirm the need to put into practice the recommendations that I am making. Secondly, it would protect prison officers from any allegations that may be made against them. They are good and honourable men, but some prisoners are disturbed, and allegations may be made against the officers. We owe it to them to ensure that they are protected by an inquiry. I hope that my hon. and learned Friend will respond to that.
If someone wants to commit suicide, he will always manage to do so unless he is kept in a strip cell. We must try to create a situation in which prisoners do not want to commit suicide, but I suggest that, however much money is spent and whatever the good will may be, it will be well nigh impossible to do that in Brixton for the type of people I am talking about. The prison was built 140 years ago, and the layout is inadequate. There is a rumour that Woolwich prison is being built as a remand prison and that Brixton will become a hospital prison. I suggest that this will not prove to be satisfactory.
It is true that magistrates can make section 35 and section 36 orders to remand people to secure units in the National Health Service. I am told, however, that they do not make those remands. I do not know why they do not do so. The NHS may be unwilling to take people on remand who are on bail, or it may be that beds are not available. There does not seem to be a satisfactory alternative. I urge my hon. and learned Friend to consider the provision of new units for the mentally ill, the mentally confused and those who are on remand for medical reports.
Various hospitals have been closed, including Banstead and Kane Hill. Tooting Bec will be closed eventually. Would it not be possible to consider taking over these institutions and turning them into secure units for those on remand in custody, who are still innocent in the sight of the law, and for those who have mental problems? The second option lies with the probation service, although I recognise that bail hostels are not secure. I understand that the Home Office has considered the options, and I have seen a letter in which it is stated that the Home Office rejects the creation of secure bail hostels. However, I ask my hon. and learned Friend to reconsider the option.
The third option is contract secure bail hostels—in other words, secure hostels that are built and staffed by the private sector. I know that such a suggestion is before the Home Office. I urge that there should be provision that comes somewhere between F wing and the NHS—a sort of halfway house—that is secure but is not a prison. Both of those suggestions are cheaper than putting people in F wing at Brixton.
I urge a review of sentencing procedures. I understand that Sir Montague Levine, the Southwark coroner, presided over six inquiries on people who took their lives. He has repeatedly called for a closer examination of court powers and a system for evaluating the mental condition of prisoners. That must be right, and I add my voice to his.
If the Home Office is prepared to adopt my suggestion of special units or to ensure that beds are readily available in secure NHS units, in the prison service, the probation service or the private sector, it will give the magistrate a wider choice and a wider discretion when those confused people come before him.
415 I know that my hon. and learned Friend the Minister needs no urging, but I urge the Home Office to show greater humanity for those casualties of our society.
§ The Minister of State, Home Office (Mr. David Mellor)It is, of course, ritualistic always to say how grateful one is to the hon. Member who introduces an Adjournment debate, even if it is sometimes not quite the truth. However, my hon. Friend the Member for Streatham (Sir W. Shelton) has performed a valuable service not only in bringing this matter to the attention of Parliament, but in the constructive way in which he has suggested a number of solutions—or, at least, worthwhile avenues for exploration—to deal with the problem.
Quite independently of the call for this debate, I have become seized of the matter. I had become aware of the increase this year in the number of suicides in prison. That is paradoxical because never has more been done to try to avoid suicides. It is ironic and tragic that there should be a sudden upward movement in numbers, but it clearly requires fresh thinking. I like to think that I would have willingly engaged in that fresh thinking even if my hon. Friend had not raised the issue. I shall do so with all the more vigour and determination in the light of what he has said.
I want to consider some of the merits of the matter and the difficulties that we face, as well as some of the action that we have already taken nationally and, in particular, in the context of the problems of Brixton. I share my hon. Friend's profound concern about the increase in the number of prison suicides. I am only too well aware of the very good efforts that the prison service has made, and is continuing to make, in trying to prevent suicides. I willingly join my hon. Friend in paying tribute to the strenuous efforts of prison staff and the difficult work they have to do, especially when dealing with mentally disturbed prisoners.
It appears that, so far this year, 46 inmates have committed suicide in English and Welsh prisons. Not all of those deaths were subsequently confirmed as suicides, but I am not anxious to take refuge behind a technicality. It is clear that, in each case, the inmate died by his own hand. We recognise that that is the strength of the case that we must meet. In 1986 there were 25 such deaths. The number jumped to 46 in 1987, it went down to 37 last year, and obviously it will be significantly higher this year.
We must consider carefully the reasons for what has happened. Although there is a much higher incidence among the prison population of high risk factors that might lead someone to attempt or commit suicide, it is not something about which we can be complacent.
I shall begin by setting out our general strategy to try to prevent people from seeking to kill themselves by their own hand. I can identify four strands of our policy that developed from our intensive study and led to the issue of the prison circular earlier this year which my hon. Friend warmly commended. It is designed to draw those strands together. First, it is essential to identify inmates who may be suicidal. That is not just a question of picking out inmates who have attempted suicide in the past but of looking more carefully at the psychiatric and offending history of all inmates to detect signs of risk.
Secondly, having identified a need for help, we must ensure that the prisoner at risk is assisted to get over the 416 crisis period. My hon. Friend is right to say that there are occasions when strip conditions are required, but he has the sensitivity to appreciate what others do not—that there is a limit to how long a prisoner can be kept in strip conditions and held in a bare cell without normal items of clothing, normal ventilation, and access to normal light. Although those are the conditions that must be imposed if one is to keep a prisoner away from the remotest risk, prolonged exposure to such conditions could, as my hon. Friend acknowledges, aggravate the inmate's problems. But that is not to say that there is no case to be made for imposing such conditions in certain circumstances. Judgments must be made as to when an individual must be kept in strip conditions and when he can be returned to a more normal location and level of supervision.
There are a number of ways in which we can help prison staff cope with the difficulties involved. A prison governor can allow extra visits from relatives if that could be helpful in dealing with a severely depressed prisoner. The Samaritans are increasingly involved in prison work. They currently have access to 50 prisons and we are looking to expand their involvement. Card phones are being installed for use by all category C prisoners in addition to those already in operation at open prisons. Improving contacts in that way can also help to alleviate severe depression.
Thirdly, we are trying to increase and maintain staff awareness of the problem of suicide. All newly recruited prison officers now receive training in suicide prevention, and refresher training for established staff is fitted in whenever possible. All establishments have been asked to establish a suicide prevention management group to co-ordinate efforts within the prison, consider improvements, and generally to ensure that the approach remains fresh and does not become stale.
Fourthly, as my hon. Friend made clear, we must study ways of reducing the opportunities for suicide. The true suicide-proof cell would demand an inhumane and unacceptable level of sensory deprivation. However, there are still improvements to be made, and my hon. Friend rightly pointed to efforts made at Brixton in respect of cell windows. Having regard to the frequency with which cell window bars have been used to provide the basis of a suicide attempt, we must obviously examine that aspect.
I turn to the role and particular problems of Brixton prison. It is a Victorian prison built on a small and constricted site. As my hon. Friend made clear, it offers little or no scope for making available additional space. In recent years it has had to cope with and bear the brunt of increases in the number of remand prisoners. With about 33,000 receptions a year, it ranks second among all such establishments in England and Wales. Brixton prison's remand population includes all those in the London area with special psychiatric needs. That population is obviously high risk from the point of view of suicides which is why I pay warm tribute to the work of Brixton's prison officers. The task that we give them is not an easy one to fulfil.
My hon. Friend already pointed out that in some years the suicide rate at Brixton has been very low. Sadly, however, after a pattern of decline against the trend in recent years, it has risen to its former level. The prison governor, the regional director and the director of prison medical services are all well aware of the problem. They have thoroughly re-examined the prevention strategy, and conditions in F wing in particular, to see what improvements can be made.
417 My hon. Friend has made a number of suggestions. Some have already been considered carefully, and others will certainly be considered in the future. He suggested more association, for instance. I can tell him that there are plans to extend two of the landings on the wing to increase floor space for association and other activities. Manning levels have been increased in the area of F wing where prisoners are subjected to intermittent watch because of the risk of suicide: they are looked at every 15 minutes. Inmates are also allowed some association when watching television.
We are of course aware of the problems posed by single cells. It is clearly right to put inmates in shared cells if possible so that their cell mates can talk to them and keep and eye on them, although the behaviour of some is so disturbing or anti-social that they must remain in single cells. My hon. Friend was also right to point out the need for more ward accommodation in the hospital complex, and that, too, will be considered seriously. I know that my hon. Friend will continue to work closely with those at the prison to ensure that we are helped to overcome the difficulties.
My hon. Friend's most significant points, in my view, were those that offered some hope outside the system. Of the eight prisoners who committed suicide in Brixton this year, four were seriously mentally ill and awaiting transfer to NHS hospitals. The prison system must cope with those whom the courts decide to put into it; it has no choice. It is questionable, however, whether so many mentally disturbed people need end up in prison. Unlike my hon. Friend, I do not consider that transferring people from the old mental institutions into community care has added to the problem: we are talking not about those who are mentally ill and in need of care in isolation, but about those who have allegedly committed serious offences—a very special category.
Let me reiterate my firm conviction that there is no shortage of alternative ways of dealing with such 418 offenders. The police can apply a caution, and arrange for their admission to hospital or support in the community, although that would not apply in the case of serious offences. When a mentally disturbed offender is brought before the courts, a variety of alternative disposals are available under the Mental Health Act 1983. He can be remanded on bail, with a condition of residence at a psychiatric hospital or bail hostel, or remanded directly to hospital for reports on his mental condition. In cases of severe mental illness, the Crown court can remand him to hospital for treatment. Much more attention should be given to those alternatives.
I appreciate that it is sometimes difficult to find available places in the mental health system of the NHS. We have made great strides in recent years; we now have a system of regional secure units, which did not exist a decade ago. Nevertheless, beds may not always be available, and there may be reluctance in parts of the system to take offenders who are on remand.
I am very alive to the need for us to take steps to try to ensure that the suicide figures are brought down. As I said at the beginning of my speech, it is a cruel paradox that, at a time when so much attention has been given to the issue, we should face an unacceptable upsurge in prison suicides. I intend to look seriously at my hon. Friend's suggestion that more public ventilation of the problem might lead to a better understanding of it.
There are, I think, three key questions. First, could the courts do more to keep mentally disturbed offenders out of the prison system? Secondly, could we do more within the prison system to help people over the periods of crisis in which they wish to take their own lives? Thirdly, could the NHS be more responsive to the needs of mentally disordered offenders?
I assure my hon. Friend that I shall consider all those points very carefully. He will understand why I cannot announce any further proposals, but I expect to be able to make more progress in the weeks ahead. That will certainly be a priority.
Question put and agreed to.
Adjourned accordingly at Three o'clock.