§ Mr. Campbellasked the Secretary of State for Scotland whether he is yet in a position to make a statement on the result of his inquiries into the circumstances of the murders at Gartnavel hospital creche on 5 February 1980 for which Mr. James Harkins has since been convicted.
§ Mr. YoungerI have now received full information about the events leading to the murders, by way of documents and reports from those principally concerned in the procurator fiscal's office, the Scottish Courts Administration, the Health Service and also the police. A note, based on these reports and documents, listing the events and the procedural steps which were taken, has been prepared and is available in the Library of the House.
The first crucial decision in the chain of events preceding the murders was made when Mr. Harkins who, following charges of assault, breach of the peace and attempted murder, had been committed on remand to Woodilee hospital under section 25 of the Criminal Procedure (Scotland) Act 1975, appeared again before the Glasgow sheriff court on 15 January. A bail application was made and was refused; and he was recommitted by a sheriff to the hospital. His further committal on remand to Woodilee hospital instead of to prison does not appear to have been warranted since the hospital psychiatrist's report on his mental condition, to the effect that he was sane and fit to plead, did not satisfy the terms of section 25 of the 1975 Act for the continued detention of an accused person in a mental hospital. In compliance with the judicial order Mr. Harkins was readmitted by the hospital.
The hospital staff were not, however, clear about what was expected of them by this recommittal. The psychiatrist taking responsibility for Mr. Harkins' case states that he telephoned the procurator fiscal's office for information about the reason for Mr. Harkins' return and was promised further information when the appropriate official was contacted. The procurator fiscal's staff have no record of the receipt of such a call. At the time of Mr. Harkins' readmission no fresh grounds had appeared to suggest that, if his medical condition warranted his committal to a mental hospital, Woodilee hospital, which is not a place of strict security and in which he had already been detained for seven days, was not a suitable place for his detention. These circumstances of his readmittal are relevant to subsequent events.
167WI must express concern that Mr. Harkins was able to abscond without difficulty from Woodilee hospital and that immediate action was not taken to secure his return. The precise arrangements made at a mental hospital for the detention of a particular patient rest on the assessment and clinical judgment of the consultant psychiatrist. When Mr. Harkins was taken into custody, the police had considered him to be a special risk prisoner with a history of violence and attempted suicide, and the report form which went with him to hospital was marked accordingly. The form also shows that the police had not thought he was likely to escape. In view of his satisfactory behaviour at the hospital and apparent mental stability, it was considered safe to move Mr. Harkins to a more open ward and to grant him ground parole. Whilst on ground parole, he left hospital. A member of the nursing staff failed to follow instructions regarding the reporting of absences. At about 5 pm that day Mr. Harkins committed the murders. The police were not informed that Mr. Harkins had absconded from the hospital until after the murders had taken place. They were therefore in no position to take any protective action or to seek to apprehend Mr. Harkins beforehand.
The House will be shocked, as I am myself, at the sequence of misunderstandings and, as the tragic outcome shows, misjudgments and shortcomings in this case. I share the public concern which will undoubtedly arise at the apparent misunderstanding in court which resulted in Mr. Harkins being recommitted to Woodilee hospital instead of to prison. That misunderstanding was not, of course, tragic in itself, but it was the first step in the chain of unfortunate events which culminated in the tragedy. It left the staff of the hospital in doubt as to what was required of them by his recommittal. It is fair to acknowledge the great pressures under which Glasgow sheriff court has to operate, and I pay full tribute to the Bench and staff who work there. But this does not condone a misunderstanding which appears to have resulted in a failure to take due account of the statutory provisions which governed Mr. Harkins' recommittal to hospital. I can assure the House that much anxious consideration has been given by myself, the Lord Advocate and officials in our respective Departments and in the sheriff courts to eliminating the possibility of a recurrence of this type of situation. I shall explain in a moment what has been done to this end.
As regards the hospital's part, it is customary that the Secretary of State does not comment on the exercise of a doctor's clinical judgment in the treatment of an individual patient under the NHS. However, the part played by the award of ground parole in this tragedy emphasises clearly the necessity for psychiatrists to pay special regard to the need for close supervision in making their professional assessment of the regime to be provided for a patient received from the courts for detention at hospital. It is difficult for the public to understand why a prisoner who had been charged with attempted murder and whom the police had advised was extremely violent, should be given ground parole at the hospital. In fairness, one has to acknowledge the uncertainty as to why the court had remanded the prisoner to Woodilee hospital, and the fact that the doctor would know that his own recommendation to the court did not provide a basis under the statute for such a committal. But until these matters had been cleared up there was surely a case for exercising special caution in relaxing the supervision of this patient in the period until he would be returned to the court for trial. Similarly, I am 168W disturbed at the lack of a sense of urgency by the hospital nursing staff in responding to Mr. Harkins' unauthorised absence from the hospital grounds.
The provisions of sections 25 and 330 of the Criminal Procedure (Scotland) Act 1975 under which persons accused of crimes and offences who appear to be or are found to be mentally disordered can be cared for in hospital pending trial instead of being remanded to prison are humane provisions. They have, without untoward result, been used in many cases since first enacted in 1960, and there is no case for changing the law on the subject. Nevertheless, what has been revealed in this case shows the risk that may arise if great care is not taken in their operation. For this reason the Lord Advocate and I have considered what we as Ministers might do to minimise the possibility of recurrence. I have instructed the Scottish Courts Administration, and the Lord Advocate has instructed the Crown Office to draw firmly to the attention of those concerned in the courts the need to ensure that medical reports and recommendations are fully understood and recorded. Both our Departments, in conjunction with senior court staff, have closely examined present procedures to see what changes or further steps are necessary to avoid a repetition of this occurrence. A revised form of committal order has been introduced in the sheriff courts throughout Scotland. Adjustments have also been made to the standard form of extract warrant. These revised procedures which will apply to all cases involving detention under sections 25 or 330 of the 1975 Act will ensure, as far as humanly possible, the elimination of the type of procedural misunderstanding that occured in this unfortunate case.
In future, reports from psychiatrists are to include a passage in which the psychiatrist will state his formal advice to the court in terms related directly to the wording of the statute. This should minimise the possibility of misunderstanding of the purport of the psychiatrist's full report, as evidently occurred at court in this case.
I am also seeking to arrange with psychiatrists that in future no prisoner remanded to a mental hospital by the courts will, unless with the agreement of the procurator fiscal be given parole within the hospital grounds except in circumstances which can be closely supervised. Such an understanding should minimise the possibility of recurrence of the second contributory factor in the tragic course of events. The health board has itself dealt with the failure to follow instructions for reporting absences.
My Department has already written to all health boards with mental hospitals stressing the need to ensure satisfactory arrangements for the detention of mentally disordered persons remanded by the courts pending trial. The letter emphasised that privilege should not be granted which would have the same effect as if the court had released the person on bail, and it stressed that if it appeared there might be difficulty in detaining a person, consideration should be given to his transfer to the State hospital.
The Harkins case has also been studied from the point of view of whether it reveals any relevant shortcomings or weaknesses in the mental health and criminal procedure law itself. This does not appear to be the case.
I have considered whether a more formal public inquiry would be warranted. It does not appear that a formal inquiry would be able to throw significant further light on the events leading to the tragedy. Careful consideration has already been given, as explained, to means of 169W tightening up court and hospital procedures in order to minimise the possibility of recurrence. I have myself in this statement drawn attention to the main areas of concern and expressed what I think will be the House and the public's views in relation to them. In the circumstances I do not think that the setting up of a further, public, inquiry would be warranted. I propose that those concerned with the court and hospital services should concentrate instead on the effective implementation of the safeguards to which I have referred aimed at preventing any recurrence; and I am confident that I can assure the House and the public that all concerned are anxious that their procedures and practice should take full account of the lesson to be learned from this tragic case.