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liaison, diversion and healthcare

Minutes of the All-Party Penal Affairs Parliamentary Group held on
13 May 2014 at 5.00 pm in Committee Room 5, House of Commons

Liaison, Diversion and Healthcare

Kate Davies OBE, Head of Public Health, Armed Forces and their Families, and Health and Justice Commissioning NHS England
Darron Heads
, Working for Justice Group and KeyRing member
Janice Langley
, Chair, National Federation of Women’s Institutes (NFWI)
Jenny Talbot OBE
, Director, Care not Custody programme, Prison Reform Trust

Lord Ramsbotham, in the chair
Lord Bradley
Baroness Howe of Idlicote
Baroness Linklater of Butterstone
Baroness Masham of Ilton
Lord Ponsonby of Shulbrede

Lord Ramsbotham opened the meeting, explaining that there had just been a vote in the House of Commons which may have detained some people. He drew members’ attention to the next meeting, which would be the AGM, followed by an address from the Chief Inspector of Prisons Nick Hardwick.  This would take place on Tuesday 8 July, at 5pm in Committee Room 5.  The PRT would by that time have published their interim statistical report, which would show a disturbing rise in prison violence and suicide. This, together with a fairly damning series of reports from the Prisons Inspectorate, should make for an interesting session.

This evening’s subject was Liaison, Diversion and Healthcare.  He was delighted Lord Bradley could be present, because his commission on this subject had done such important work to reduce the imprisonment of those people who should not be there.  He then introduced the four speakers, who he hoped would follow on after one another to allow time for questions. He was delighted to see Kate Davies, Head of Commissioning for Health and Justice for NHS England.  He was very pleased that the Health and Social Care Bill had introduced commissioning in this way. Consistency had long been missing in criminal justice, and this would help ensure there was a common approach across the country. She had an impossible brief as she was also responsible for military health and public health too. Now that prison healthcare had at last been recognised as a public health issue, this too should bring welcome change.

He went on to welcome Darron Heads of the Working for Justice Group and KeyRing, and the meeting looked forward to learning more about the work of both; Janice Langley, Chair of the National Federation of Women’s Institutes, which he knew had been hugely influential in this field; and Jenny Talbot, of the Prison Reform Trust’s Care not Custody Programme.  We were in for a very interesting meeting.

Janice Langley began: ‘The NFWI has been working to achieve an end to the inappropriate detention of the mentally ill in the criminal justice system since 2008. We are a unique organisation in that all our campaigns emerge from the resolutions proposed by the members themselves. Care not Custody has been special to us because it arose from the very tragic experience of one of our Norfolk members. Her son John committed suicide in custody.  Now John was a brilliant young man, a high-achieving student who had secured a first class degree in physics, and had been accepted to start post-graduate studies in astrophysics.  Following a break down at 21, over a series of years he developed depression and began suffering a loss of reality.  He developed an addiction for alcohol, and eventually was diagnosed with schizophrenia.  John was arrested in 2002, after an incident in a private home where he had threatened to commit suicide with a replica air gun. The incident led to his arrest and eventually to death by suicide in the segregation unit of a Manchester prison.  

John was not a criminal. He was in prison because there was no alternative place for him to be. Our member, another Janice, his mother, brought her experience to her local WI, and then in turn to the whole of the national organisation through our resolution process. Her experience highlighted a systematic and widespread failing of some of our most vulnerable citizens, a failing that NFWI members determined they were going to address.  I know that everyone here is aware of the scale of the problem. Evidence that has built up over the course of years shows that too many people who have been diverted from police stations and courts into mental health and social settings are ending up in prison. Rather than a place of last resort it had become a default option. This is not only damaging for the individuals concerned but it also places a duty of care on stretched prison estates and staff, and for the families of the people that this has happened to.  By raising awareness of this complex and taboo subject, NFWI members have been able to highlight what for too long has been a hidden issue, despite the tremendous impact that this has on the people affected.

Through our Care not Custody campaign the NFWI has raised awareness of the significant number of prisoners with mental health problems. We have seen our members getting involved in a range of activities, from lobbying their MPs, calling for resources for the recommendations set up in the Bradley report to be delivered, to visiting prisons and women’s centres and seeing at first-hand what life is like in the criminal justice system for people with mental health problems. A number of members have become more directly involved by training as volunteer mentors at women’s centres. We have also built a strong partnership with the Prison Reform Trust, and are delighted at the development of the Care not Custody Coalition. We have pledged to work together to support the Government in the commitment to deliver reform in this area. For too many years diversion has been an afterthought, so it has been a genuine pleasure to welcome the Government’s commitment to develop this through liaison and diversion systems. While I think we would all acknowledge there is some way to go, I am watching progress with the pilot schemes with interest, and the NFWI will remain committed to delivering on its Care not Custody promise.’

Kate Davies thanked Janice Langley and continued: ‘One of the things about following someone like Janice, as a Commissioner for NHS England, is that we have to be really careful, as we commission health and justice programmes alongside government departments, the Department of Health, the Ministry and Justice, all of which have an appropriate vested interest in the success of liaison and diversion programmes.  We must not forget that what we are really focussing on is outcomes, and what that means  for individuals and their families.

When I came into post just over 18 months ago as Commissioner for NHS England, as someone who had been commissioning the first stages of liaison and diversion schemes across five Primary Care Trusts, it was actually to do exactly as the Chair has said, and turn that into consistency of commissioning, in terms of liaison and diversion programmes for physical and mental health across the country, with 100% coverage, for a number of sons and daughters and partners, wherever and whatever their circumstances.  What was really important was to recognise at the time that we had a lot of very good ideas, and a lot of excellent work going on, but it was not consistent, and it was not fair, in terms of what that meant for numbers of men, women, children and young people - whether that was for those who ended up in crisis, in police custody suites for a report, or because of an offence, or long-term behaviour involving offending and health.

What we manage to do, as a short overview, is going to require evidencing for government departments and the Treasury.  There is a £25 million programme, as it stands now, for commissioning liaison and diversion services, with an ambition for every police custody suite, and every court, to be covered. That should ensure that we have what we call a core service specification, so that the model for liaison and diversion should be consistent, in that it is available 24 hours a day, 7 days a week. We are changing the process so that it targets service user and family feedback.  A lot of existing services are commissioned around providers’ rather than service-users’ needs. It will allow the full range of intervention and assessment, as far as physical and mental health needs are concerned. There are also rigorous referral and follow-up processes for the outcomes and sustainability of someone’s care. What that should mean in turn, for individual stories, is that the individual really does get care not custody; and that the different agencies that make this work see that clearly as part of the outcome, and the alternative to custody where appropriate, but also part of remand and sentence through-care and follow-up. That clarity is already assured as we work forward, and there is some real evidence of improvement in the quality of the schemes and also in their availability.

Lastly, NHS England is committed now to commissioning health and justice as a direct commissioning responsibility. £472 m of commissioning in England will be there to commission healthcare in our 118 prisons, our nine immigration and removal centres, our 16 children’s secure settings and our 40 polices forces, alongside mental health liaison and diversion. It is important to have integrated provision. It is not about parachuting money in to enable a good idea to happen.  We have to be sure that we commission key pathways in healthcare, particularly targeted at men and women with learning needs, around the over-representation of minority communities, about the different needs of our children and young people, and for women. I am really excited about being in this position, to be able to be part of the leadership.  We have been given a massive opportunity with the Bradley Review, and particularly with the work that organisations like the PRT have done to keep this on track, and the courage of people who have come forward in the Women’s Institute to say what this has meant for them and their families. I assure you that commissioning for health and justice will continue to grow.’

Lord Ramsbotham thanked Kate Davies very much and introduced Jenny Talbot and Darron Heads. Jenny Talbot explained they would be doing a double-act and would talk a little bit about the Working for Justice Group, KeyRing, and Darron’s experiences.

Jenny Talbot: ‘I am Jenny Talbot from the Prison Reform Trust. Darron, would you just say who you are?

Darron Heads: I am Darron Heads from KeyRing and the Working for Justice Group.

Jenny Talbot: Thank you. So, a little bit about the Working for Justice (WfJ) Group and KeyRing, and then Darron will go on to talk about some of his experiences. Members of the WfJ Group are individuals who have learning disabilities and direct experience of the criminal justice system. Some have been all the way through it, and some have just experienced what it is like in police custody.  Members of the WfJ group work together and share their experiences. One of the practical things they have done is to help translate information to Easy Read; there is an example available if you are interested. We also work together as co-trainers and co-presenters running training for criminal justice staff and members of the judiciary. For example, a week ago Darron and I were running a training session for district judges at their annual training event, and a month before last we ran a training session for justices’ clerks.

Most members of the WfJ Group are also members of KeyRing Living Support Networks.  KeyRing is a voluntary organisation which provides support to help individuals to live independently in their own homes in the community.  They provide just the right level of support – not too much and not too little.  Darron is now going to tell us about some of his experiences of the criminal justice system, including how the right support has helped them to stay out of trouble. So Darron, would you like to tell us what happened the first time you got into trouble with the police?

Darron Heads: ‘It was back in Newcastle. I was one of those people who used to buy my friends. I got involved with a small group, and I was told to go to someone’s house, and because I was the new one I was told to wait outside. The next thing I knew was a tap on the shoulder and I was asked what I was doing. I said I was just waiting for some friends who had gone into that house. Unknown to me, the house in question had just been burgled. So I got taken away under suspicion of burglary. When I got to the station I was all confused and didn’t know exactly what was going on. Then in an interview they charged me not with burglary but with aiding and abetting. I still didn’t have a clue what was going on or what that meant. Fortunately my disability was picked up because I did have a social worker. She got called in as an appropriate adult. I got bailed and I got charged. It went to court and the court gave me 12 months’ probation because they said I was of sound mind and I knew right from wrong.

Then it didn’t stop there. When I went to Doncaster to be close to my Mum, who had come back from Germany where she was in the forces, my problems with the authorities followed the same pattern. It was a strange situation and I wanted to fit in, so I bought some more friends. Unbeknown to me, I befriended a drug baron. He turned my place into a crack den.  I was bullied, and that went on for a few weeks until the neighbour found out what was going on. She told the police, but she must have told them I was bullied into it. When the police raided the place, I got arrested along with the rest of them and taken to the police station. But the neighbour told them I was bullied so I wasn’t charged or anything.

Jenny Talbot: It was about that time you were put in touch with KeyRing.  Can you tell everyone about the support you get from KeyRing?

Darron Heads: I get a couple of hours a week of low level support. I have a CLV, which is a Community Living Volunteer, and what he does is comes round and helps you with reading bills or letters or doing forms, and talking about any problems you have.

Jenny Talbot: One of the difficulties you had was not knowing which of your friends were good friends and which were bad friends. Has KeyRing helped with that?

Darron Heads: Yes it has. I have trouble being with people and trying to determine if they are good or bad for me. KeyRing has helped with that. When I came into KeyRing I was with my own kind. Without sticking labels on us, I was with other people who had learning disabilities, and I felt safe in that environment.

Jenny Talbot: One last thing: when we did the training for judges the other week, you told me something that you made up to describe KeyRing. Can you remember what that was?

Darron Heads: Yes, ‘Get a life not a service’. KeyRing is a charity, and not a service, which helps people.’

Jenny Talbot: Thank you very much indeed, Darron. If the sort of liaison and diversion support that Kate was talking about had been available right at the beginning, maybe Darron would not have had certain of his experiences.’