§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Berry.]2.30 pm
§ Mr. Thomas Cox (Tooting)
Richard Campbell, aged 19, arrested in Brixton on 1 March 1980, died at Ashford remand centre on 31 March 1980. That is the background to this Adjournment debate, which I share with my hon. Friend the Member for Battersea, South (Mr. Dubs).
This is a sad and tragic case. My hon. Friend and I have sent our deepest sympathy to the parents of Richard Campbell. The case has caused great concern in communities in South London, and in the view of many people a great deal more could have been done for Richard Campbell while he was in custody.
This youngster, when charged with attempted burglary on 3 March, gave the name of Anthony Brown. At Camberwell court, he was remanded to Lewes prison, where his fingerprints were taken. Why, from that moment, did not the police quickly establish that Anthony Brown was Richard Campbell? At that time his parents, his friends and his probation officer had no idea where he was. One is told that he signed a form saying that no one was to be told that he was in prison. Is that true? If so, who has seen that form? On 10 March he again appeared at Camberwell court, and from there he was sent to Ashford remand centre for medical and psychiatric reports.
At Ashford I understand that Richard Campbell was quickly moved to the medical wing, but why was that and 1069 who ordered it to take place? At about that time he also began to refuse food. I ask the Minister what, at that stage, the medical authorities did about this youngster. Were reports being made daily on his condition? If so, to whom were they made and what happened about them? Was any action taken on those reports? What consideration was given to his loss of weight? On his reception into Ashford remand centre on 10 March, Richard Campbell weighed 9 stone 8 lb. By 26 March his weight had gone down to 7 stone 4 lb.
When did drugs start to be given to Richard Campbell and why were they given? Who examined him, both during and after those drugs were being administered? On about 20 March he was examined by a psychiatrist. Why was it necessary at that time to start what I describe as the shunting around of this young man from hospital to hospital? Was there any discussion with local hospitals on the question whether they could accommodate him were he sent to such hospitals?
I understand that at about 2.30 on the morning of 24 March he was returned to Ashford from St. Bernard's hospital, Southall, where the doctor who examined him stated that he could find nothing at all wrong with him. At about this time I understand that Richard Campbell's probation officer became aware of his whereabouts and saw him. Why did it take so long for the probation officer to be informed that he was at Ashford?
I come now, sadly, to the last week in the life of Richard Campbell, when the decision was taken to force-feed him. Was the governor consulted about this, and how often had the governor seen Richard Campbell while he was in Ashford—and by now, surely, he had become seriously ill? Was his probation officer called in to see him and asked to talk to him in an effort to get him to take food again?
Why, despite Richard Campbell's having signed a form—if, indeed, he did sign such a form—was no action taken, in view of his condition, to overrule any declaration so that the probation officer or relatives or friends could be made aware of this boy's condition? How often was he being force fed? How often were checks made on this youngster by staff at Ashford, both day and night, in 1070 view of his condition? What decisions took place with the prison authorities and the Home Office about Richard Campbell's condition during the last days of his life? Those are some questions on which we should like answers.
This has been a sad case to be involved in. One must ask whether Richard Campbell was in the first instance sent to the establishment most suitable for him. Was the fact that he was a Rastafarian something that the authorities did not understand? It would be interesting to know the Home Office's attitude towards Rastafarians.
What is to be done to ensure that relatives and friends know when someone is being held, especially when he becomes very ill, irrespective of any statement that he has signed that no one is to be informed where he is? Above all, what is the Home Office doing to see that no similar cases occur? That is something that many people are now asking.
This case has caused great concern in South London. My hon. Friend the Member for Battersea, South and I have sought a public discussion of it today, but in view of the events surrounding the case, which most people find as distressing as we do, we seek the Minister's agreement to a public inquiry into the events between 1 and 31 March in the life of Richard Campbell.
§ Mr. Alfred Dubs (Battersea, South)
I am grateful to my hon. Friend the Member for Tooting (Mr. Cox) for the opportunity to take part in this debate. He has already gone over the sad events that led to the death of Richard Campbell, and I should like to add a few remarks.
I confirm that there is a great deal of local concern, in my constituency as well as in that of my hon. Friend, about the way in which a healthy young man could have been arrested and sent to gaol and could die in his cell a few weeks later in the most distressing circumstances.
I understand that Richard Campbell had no legal representation when he appeared at Camberwell magistrates' court. There may have been good reasons for that, but if he had been legally represented some of these events might have been avoided. Someone would then have had contact with him in prison and could 1071 have made representations to the authorities that all was not well.
Secondly, it is accepted by the Home Office that the relationship between the Prison Department and National Health Service hospitals leaves a lot to be desired. That has been a problem for some time. How can the difficulties that prisons face when attempting to get prisoners into hospitals be overcome?
Is the Minister satisfied with nursing care in prisons? In women's prisons nursing care is normally carried out by people with proper nursing qualifications, but that is not so in prisons and penal establishments for men, where staff have the minimum of nursing training and are not as well qualified. Given the sad case of Richard Campbell, we should look again at the quality and experience of nursing care in prisons.
In answer to a parliamentary question, I was told that in the past three and a half years there had, happily, been only two instances of forced feeding in penal establishments in this country. One was Richard Campbell. However, it is not clear from the information that we have been given how it comes about that someone who is being force-fed can suffer from such severe dehydration. Surely, the one thing that forced feeding can prevent is severe dehydration, when it can be established under medical supervision that an individual is getting an adequate amount of liquids. It would appear that that did not happen in this case. Something must have gone amiss in the forced feeding if Richard Campbell was so severely dehydrated when he died.
Although we are always told that drugs in prison are given under strict control, conversations with individuals who have been in prison suggest otherwise. They also suggest that they are given more frequently than Ministers and the Prison Department suggest.
There is concern in South London that all did not come out at the inquest. There is dissatisfaction with the way in which information failed to come out. It is said that it was a cover-up. In the interests of the Home Office and the Prison Department, if of no one else, all the facts should come out and be seen to do so. The Minister should urge the Attorney-General that the inquest should 1072 sit again, with a further opportunity for the full facts to emerge. Failing that, I support the request of my hon. Friend the Member for Tooting that there should be a full and public inquiry into the circumstances leading to Richard Campbell's death. If the full facts do not come out, local discontent will continue, which cannot be in the interests of the Home Office or the Prison Department. Richard Campbell's relatives should be seen to have justice.
The Minister of State, Home Office (Mr. Leon Britian)
I am grateful to the hon. Members for Tooting (Mr. Cox) and Battersea, South (Mr. Dubs) for giving me the opportunity to give as full an account as I can of the events relating to this sad case. I share their deep concern. I understand the extent of the concern in the area and wish to add my sympathy to that which has been expressed by the hon. Gentlemen.
I shall first deal with a peripheral matter that bears on issues that go beyond this case—Rastafarians, who have been coming into the prison system for several years. Most establishments, and certainly the staff at Ashford remand centre, have extensive experience of dealing with them.
A circular of guidance on the subject was issued to all Prison Department establishments as long ago as 1976. My noble Friend Lord Belstead referred to the existence of that circular when he met Members of Parliament, including the hon. Member for Tooting, last month. Indeed, a copy of that circular is in the Library of the House, and it explains the basis of the religious and political beliefs of Rastafarians as well as the nature of the special diet that should be made available to them.
It is a matter of proper public concern whenever anyone in a Prison Department establishment dies in custody. I therefore welcome the opportunity to give details, so far as I am able, of what occurred. It is fair to say that there are three main aspects of the matter about which Richard Campbell's family and friends are particularly concerned. The first is that his mother was not told where he was, or even that he had been taken into custody, until after he had died. The second is that there is an understandable reluctance to believe that Mr. Campbell was, 1073 or became, mentally ill while in custody, and reference has been made in the debate to his normal state on arrest. The third is the difficulty in understanding why he did not receive medical treatment in hospital for his physical condition.
Mr. Campbell's mother, Mrs. Paulette Campbell, last saw her son alive on the morning of 29 February. On the following day, a Saturday, at about 7.20 in the morning, he was seen by a police officer trying to break open the front door of a sports shop at 183 Ferndale Road, Brixton. He was arrested and taken to Brixton police station. As has been said, on Monday 3 March he appeared at the magistrates' court, where he was remanded in custody to Lewes prison for a week. A week later, on 10 March, he appeared in court again and pleaded guilty. Meanwhile, he had been identified by the police from his fingerprints as Richard Campbell, but in court he refused to acknowledge his name.
He was again remanded in custody, this time to Ashford remand centre, so that social inquiry and medical reports could be prepared. On arrival at the remand centre, he gave his name as Anthony Benjamin Brown and his address as that of foster-parents who were long since dead. He also signed a declaration that he did not wish his next of kin to be informed where he was, and in any case he did not specify the names of any next of kin. However, he wrote a letter, as all prisoners are entitled to do on reception at an establishment, which was addressed to a Mr. and Mrs. Campbell at 72 Durban Road, West Norwood. That was the address not of either of his parents but of his uncle and aunt.
Later on, Mr. Campbell became ill. However, for the moment I want to concentrate on the question of notification. In this context, it is relevant that in consequence of his illness he was, at a later stage, deemed incapable of making a rational decision on whether to eat and drink and was, therefore, fed artificially. However, the prison authorities still respected his wish that no one should be told where he was. I do not think that it is inconsistent to override his judgment on the acceptance of food while respecting his wishes, which he had expressed earlier, with regard to informing his relatives. Just because a person has become incapable of making a decision 1074 on one matter does not mean that an earlier decision on another matter should not be respected. Indeed, it could reasonably be regarded as a serious intrusion into his privacy to disregard his wishes in that way.
In addition, the prison authorities were under the impression that the recipients of his reception letter were, as was the case, relatives who now knew where he was, so that the full effect of the decision to comply with his request could not have been anticipated. I am satisfied that the prison authorities acted in good faith on this issue, but the fact remains that Mr. Campbell's mother was not informed of the position. That raises a question mark about the right approach in these difficult matters with regard to notification of families, and the possible issue of further guidance to establishments on how to deal with balancing considerations is now under active consideration within the Prison Department.
I turn to the details of Mr. Campbell's illness. The evidence that he was mentally ill is substantial. The police who came in contact with him at the time of his arrest thought that his conduct gave cause for concern. The court at which he appeared evidently agreed, because they asked to see social and medical reports on him before sentence. The medical staff at the remand centre concluded that he was mentally ill, and diagnosed schizophrenia. The Ashford medical staff have considerable experience in the assessment of mental disorder and the senior medical officer holds postgraduate qualifications in psychiatry. Moreover, this diagnosis was confirmed by an independent consultant psychiatrist from an outside hospital. Finally, Richard Campbell's own probation officer, who visited him on 19 March, gave evidence at the inquest that Richard had been obviously deluded when he had seen him. In the face of that body of evidence, I do not think that credence should be given to the alternative explanations that have been offered, such as that unfamiliarity or the difficulties of communicating with him had led the authorities to exaggerate or to misunderstand his condition.
I turn now to an aspect of the case that I readily accept is plainly unsatisfactory. In my view, no member of the prison service can be blamed for what 1075 happened. By 21 March it had been confirmed that Richard Campbell was not eating, and he had been examined by one of the psychiatrically qualified medical officers at the remand centre, whose diagnosis was that Richard was suffering from schizophrenia. The appropriate arrangements were therefore made to enable the court to make an order under section 60 of the Mental Health Act 1959 transferring him to a psychiatric hospital.
As hon. Members will know, this procedure requires the recommendation of two doctors, and accordingly a consultant psychiatrist from Queen Mary's hospital, Roehampton saw Mr. Campbell at the remand centre and confirmed the diagnosis on 21 March. By this time his physical condition was causing concern and his weight had fallen from 62 kg on reception to 58 kg. On Sunday 23 March he was found in a collapsed condition on the floor of his room. The medical officer on duty arranged his immediate transfer to Ashford general hospital.
While at the hospital, Richard Campbell was aggressive towards members of the staff, and he was placed in a side room off one of the wards. At about a quarter to midnight he attacked the officer who was escorting him, causing him head injuries. The hospital authorities therefore immediately transferred him to St. Bernard's hospital, Southall for urgent psychiatric care. However, the duty doctor there stated that he could find no evidence of mental illness, and he would not agree to his admission. In the circumstances, the prison staff had no alternative but to take Richard Campbell back to the remand centre.
The doctors at the remand centre next tried to have Mr. Campbell transferred to Queen Mary's hospital before his court appearance, this time using the procedure under section 73 of the 1959 Act. The problem now was that he was seriously ill, both physically and mentally. The consultant psychiatrist said that the nursing staff at his hospital could not be expected to deal with Mr. Campbell's physical illness. Equally, it was known that the nursing staff at Ashford general hospital had found it difficult to cope with the effects of his mental illness. It was, therefore, not possible to secure a 1076 transfer to hospital, and Mr. Campbell had to remain at the remand centre.
By 26 March, Mr. Campbell's weight was down to 46.9 kg and it was decided that there was no alternative but to feed him by tube. The decision to resort to artificial feeding is entirely a clinical matter for the doctor concerned. It was obvious that Mr. Campbell was no longer capable of making a rational decision about whether to eat and drink, and the doctors therefore regarded it as their duty to do what they could to save his life. Over the next few days it appeared that they were having some success. His weight rose steadily to 57 kg—a substantial increase—on 30 March, but on the morning of 31 March, the day that he was due to appear in court, he was found dead in his cell.
There are several aspects of the whole matter which require comment. I have said earlier that I am quite satisfied that Mr. Campbell was mentally ill, from the evidence that has come to my attention. It seems, therefore, that the most likely explanation of the refusal by St. Bernard's hospital to admit him was that at the time he was examined by the duty doctor there—to whom, as the House will recall, he was taken in an emergency situation—he appeared to be having a lucid interval and must, therefore, have seemed normal. But it is obviously quite unsatisfactory that a combination of mental and physical illness should apparently preclude a patient from being admitted to a hospital with proper facilities for dealing with either type of illness.
The reluctance to admit Mr. Campbell to hospital was, I am afraid, an example of the general difficulty which is experienced by the prison service in attempting to effect the transfer to National Health Service hospitals of prisoners who are mentally disordered. Most hospital wings within Prison Department establishments are neither intended nor equipped to deal with the most seriously ill patients. The Home Office and the Department of Health and Social Security have been in the closest touch at both official and ministerial levels about this over a long period, but the problem is a long-standing and peculiarly intractable one, going far wider than this case. However, I certainly assure the 1077 House of my personal efforts and intentions to continue persevering in dealing with this intractable problem.
As the staff at the remand centre had no alternative but to deal with Mr. Campbell as best they could with the facilities at their disposal, I am satisfied that they did all that they possibly could and cannot fairly be criticised.
This brings me to the final aspect of the case. The Surrey coroner was informed of the death and an inquest was formally opened. This resumed on 10 July. Mr. Campbell's family was represented by counsel. Evidence was heard from all the principal participants in the events I have described and from the pathologist who had performed the postmortem. His findings had been confirmed independently by a second examination, which was carried out at the request of the family.
There was no evidence to suggest that Mr. Campbell had been subjected to any violence while in custody, and the cause of death was stated to be dehydration brought about by acute schizophrenia. The jury returned a verdict of death by self-neglect and added a rider expressing its concern at the lack of specialist care facilities, both in staff and accommodation, which had been available to Mr. Campbell.
Reference has been made today to the inquest. The coroner is an independent judicial officer who is solely responsible, within the framework of the law, for the way in which he carries out the duties of his office. The verdict can be set aside only by the High Court, to which application must be made by, or with the authority of, the Attorney-General. The 1078 High Court may order a fresh inquest if it is satisfied that this course is in the interests of justice—for example, because of irregularity of proceedings, insufficiency of inquiry or the discovery of new facts or evidence. It would not be right for Ministers to express a personal view on the verdict brought in by a coroner's jury. But what I can say is that all the relevant evidence in this case was heard at the inquest and that counsel for Mr. Campbell's family had the opportunity of cross-examining witnesses.
Against this background, I am afraid that I cannot agree that it would be right to set up a further special inquiry. I have drawn attention to the points of serious concern about this case, but there has been an inquest in public with counsel involved. I have no reason to think that any information about the case has been concealed or covered up. My noble Friend has done everything possible to meet legitimate public concern by providing information about the points that have been raised since Mr. Campbell's death, and if any new points emerge I am sure that he will continue to do so.
§ Mr. Deputy Speaker (Mr. Bernard Weatherill)
Before I adjourn the House at the end of a long and somewhat difficult week, perhaps I may wish hon. Members a restful holiday. Perhaps I may express our thanks to the staff of the House, who serve us all so faithfully. They, too, have earned a good and restful break from their duties.
§ Question put and agreed to.
§ Adjourned accordingly at one minute to Three o'clock till Monday 27 October, pursuant to the resolution of the House of 4 August.