Defence Committee - Minutes of EvidenceHC 1100

House of COMMONS

Oral EVIDENCE

TAKEN BEFORE the

Justice Committee

OLDER PRISONERS

Tuesday 23 April 2013

Nick Hardwick, Peter McParlin and Nigel Newcomen CBE

Helen Boothman, Sean Humber and Dr Azrini Wahidin

Evidence heard in Public Questions 1 - 64

Oral Evidence

Taken before the Justice Committee

on Tuesday 23 April 2013

Members present:

Sir Alan Beith (Chair)

Steve Brine

Rehman Chishti

Jeremy Corbyn

Nick de Bois

Gareth Johnson

Mr Elfyn Llwyd

Seema Malhotra

Mike Weatherley

________________

Examination of Witnesses

Witnesses: Nick Hardwick, HM Chief Inspector of Prisons, Peter McParlin, National Chairman, Prison Officers Association, and Nigel Newcomen CBE, Prisons and Probation Ombudsman, gave evidence.

Chair: I welcome Nick Hardwick, the chief inspector of prisons, who is back with us, as well as Peter McParlin, the national chairman of the Prison Officers Association, and Nigel Newcomen, the prisons and probation ombudsman. This is part of our inquiry into older prisoners. Yesterday, some members of the Committee visited Albany prison on the Isle of Wight, which has a large number of older prisoners. Next Monday, a number of our members are going to Dartmoor to look at probably a different picture of how older prisoners are dealt with. I ask Mr Brine to open the questions.

Q1 Steve Brine: Good morning, and thank you for coming along to give evidence to this inquiry. You know the inquiry we are doing and have seen its terms of reference; we have lots of suggestions for things we might look into. Mr Hardwick, do you think there is even a problem on which we as a Committee should be spending our time?

Nick Hardwick: Yes, I think there is an issue to be addressed. You need to caveat that a little. First, it is important not to categorise all older prisoners as a homogeneous group with lots of problems. We meet many older prisoners who, like older people anywhere, are lively, active and alert and want nothing more than what all prisoners want-to be safe, to be treated decently, to have something active and useful to do and to be helped to stop reoffending. When we survey prisoners, which we do as part of every inspection, generally the responses we get from older prisoners are more positive than those we get from the prison population as a whole. Having said that, I think the title of the thematic paper that we did in 2004 and have used subsequently as a benchmark was well chosen: "No problems-old and quiet". I think there is an issue that older people are not likely to complain and raise issues. The Prison Service has to get to grips with the fact that older prisoners, particularly at the older end of the older prisoner spectrum, are the fastest-growing part of the prison population. The Prison Service is now a significant carer for older people with health and social care needs. While, generally, people are content, as I said, that is inconsistent. We think that the service will struggle to meet those demands as time goes on.

Q2 Steve Brine: Mr McParlin, can I ask you the same question? From a POA point of view, is there a problem?

Peter McParlin: You have heard the figures quoted by Nick. The number of over-60s is up by 142% in the last 10 years, which would indicate that there is a problem, but it is not the only problem within the prison estate. In this world of reduced resources and access to resources, where do you place your concerns, and where do you place those resources? There is a promise to the public of a rehabilitation revolution that involves preventing prisoners from returning to custody and giving them access to work outside and training within prison before they return to the outside world, but resources need to be allocated to drug and alcohol issues, of course. Where do you place those resources? Is it a problem? Absolutely. Is it a problem for my members? Of course it is. I have seen some of the evidence from prisoners, not all of which is critical of staff, but there were some criticisms directed at my members. We are in danger of having a situation where my members become, in that hackneyed old phrase, jacks of all trades and masters of none. That is a problem.

Going forward-you would expect me to say this, but it is worth remarking on, as it is a remarkable figure-the prison population peaked at 88,000 and is hovering around 85,000 now. Back in the ’90s, when the prison population was circa 45,000, we had more prison officers on duty. People will say, "That is efficiencies. Perhaps we are working in a smarter way." However, with the policies going forward of efficiency benchmarking, those staffing numbers will reduce even further. What do you want the prison staff-the carers-to do? Society and the politicians that represent society have to decide that.

Q3 Chair: You referred to the carers-the prison staff. We will come on to the legal ambiguity around this issue, but how does a prison officer preserve the boundary line between what he is supposed to do as a condition of his employment to make sure that an older prisoner gets out of bed in the morning and the need, in some cases, for a carer who can facilitate the old person getting out of bed and getting washed and dressed?

Peter McParlin: Absolutely. That was highlighted in your seminal work "The Role of the Prison Officer" and is a continuing problem we have to look at. Of course, that is driven from the top. Alongside "Are we warehousing or are we rehabilitating?" is "What is the role of the prison officer?" Is it a multitude of tasks? The main task on behalf of society is obviously to look after those sentenced by the courts-it is security. That is what is drummed into prison staff, and the public would expect that. However, you have to include the issues of caring, because the first person who unlocks that prisoner in the morning is a prison officer. Then we get into issues of training. Do they have the skills? Are we willing to invest in their being able to recognise mental deterioration?

Steve Brine: We will come on to that and probe a bit more. Suffice it to say that some of the prisoners we spoke to yesterday made the point that the cost of security was a huge cost in prisons and they were not the ones who needed so much security.

Chair: They would say that, wouldn’t they?

Q4 Steve Brine: That was our feeling. Mr Hardwick, why has the older prisoner population increased so dramatically in recent years? Can you give us some understanding of the technological advances that sit behind that? Do you expect that to continue?

Nick Hardwick: In a sense, this is not something we look at ourselves. Sentencing is not something we look at as part of our inspections, so I am relying on the work of others to answer that. My understanding is that it is not because people are doing longer sentences and, therefore, ageing in prison, and it is not because more crimes are being committed by older people. It appears to be because sentencing is tougher, particularly around sex offences. About 40% of the older prisoner population have committed sex offences. My understanding is that tougher sentencing is the reason behind it.

Steve Brine: Shall we move on? There is a lot to cover.

Q5 Nick de Bois: Can I clarify one statistic? When you gave your quote of, I think, a 500% increase over 10 years, were you thinking of older prisoners as over 50 or as over 60?

Peter McParlin: The figure was for prisoners over 60, as the fastest growing segment. Of course, I am aware that there is some academic discussion about where to pitch the age-whether it should be at 50, 55, 60, and so on.

Q6 Nick de Bois: All right, we will press on; I will not belabour the point, but thank you for that. I want to talk about the prison environment, if I may. Mr Hardwick, can I ask you specifically to what extent the age, condition and infirmity of older prisoners are and should be taken into account when deciding in which category of prison they should be detained?

Nick Hardwick: We would say that categorisation needs to be based on the circumstances and risks of a particular individual prisoner. If, for instance, someone is infirm because of their age and is less mobile, I would have thought that that must have some bearing on their security risk, for instance. Age in itself should not be a factor, but many of the characteristics that go with age should be.

Q7 Nick de Bois: If the environment in some prisons is considered quite unsuitable for certain infirmities or, as you say, it is less likely that someone over 60 will leap over a 30-foot wall or something like that, are you aware of whether that is actually taken into account?

Nick Hardwick: I have not seen any evidence of that. On the contrary, in prisons you go to, the physical needs, in particular, of older prisoners do not seem to be taken into account in the prisons. You often find them in very unsuitable locations.

Q8 Nick de Bois: Mr McParlin, do you think it should be taken into account? Could I ask you specifically if you have any views from a staff perspective-perhaps even reflecting a prisoner’s perspective-on whether it is preferable to hold older prisoners in one unit, separate from other prisoners? I am really talking in the context of the environment of the prison.

Peter McParlin: Your first question was about whether it should be taken into account. In an ideal world, of course it should, but the head of NOMS, Michael Spurr, is on record as saying that he lives with-"supports" is perhaps not the right word-institutionalised overcrowding in our prisons, despite the fact that they are closing prisons at what I would say is an alarming rate, which is making the overcrowding even worse. I would say that the issue should be taken into account, but the institutionalised overcrowding to which he refers makes it virtually impossible to do that.

You asked whether they should be held in one unit. The idea certainly has merit. There is no joined-up thinking or policy that I can see, but there will be some examples where they have tried to put them together or had an area where they could meet during the day. Of course, it comes down to the fabric of the buildings and what you are able to work with.

Nick Hardwick: May I add something very briefly? First, there are some prisons that, because of their age and design, are not suitable for older prisoners, particularly those with mobility problems. However, generally older prisoners should be treated in the way in which older people might be treated in the community. They should not be cut off from the population as a whole and should be in prisons with prisoners of other ages, but they should have places within those prisons to go where their specific needs can be met during the day. Many prisons now have a day centre-type facility. That seems to me to be a good thing. Perhaps a wing could be set aside for older prisoners where it is quieter and they can escape some of the hurly-burly that you might get on a general wing. I would not have specific prisons for older prisoners, but I would have facilities within the prison estate as a whole that meet their needs, and I would say that some prisons are not suitable for older prisoners.

Q9 Nick de Bois: While we are on that subject, are there any other changes that you would suggest should be made to the physical environment in which older prisoners are held? That is my final question. I will open it to all three of you, but perhaps Mr Hardwick would like to offer some more suggestions.

Nick Hardwick: I will look at some of the good practice I have seen. For instance, I quoted in our submission the example of Leyhill, which has a significant proportion of older prisoners. There was a very good day centre facility there, where older prisoners could go during the day and have some activity. I think they were easier to manage there than in other places. I do not think that was a particularly expensive or resource-intensive thing to do. Other prisons have set aside wings that are quieter. In particular, prisons should think about where they place older prisoners, so that they can have easy access to things like showers and toilets; if they are up on a landing with a flight of stairs, they cannot easily move. A bit of thought about those sorts of practical physical adjustments is sometimes important.

Nigel Newcomen: Good morning. Perhaps I could add a couple of words. Obviously my perspective is from the mournful responsibility of having to look into deaths in custody, so it is difficult to generalise about, for example, the particular needs for reasonable adjustment that apply to the broader older prisoner population, but there are all too many occasions when my investigations have recorded and recommended that there should be better reasonable adjustments. For example, the provision of mattresses that can prevent bed sores and of some very basic reasonable adjustments is not consistently applied. In various investigations, I have recommended that that should be the case. Equally, some of the social care provision the Committee may come on to is also inconsistent. That is one of the overarching messages that comes through both from my individual investigations and from the more general learning lessons agenda that I have sought to establish. Things have improved, and it is generally recognised that the adequate care of older prisoners is a problem and a growing issue, but the response remains inconsistent. It is the outliers that are the real concerns in the investigations I undertake.

Q10 Nick de Bois: We are coming on to that. I was thinking more of the physical environment. Mr McParlin, do you have anything to add?

Peter McParlin: Once again, in an ideal world, we would want accommodation that provided wheelchair access; we might even look at lifts, where necessary. I would argue that we will probably not get that in the older part of the estate, but there is a new-for-old policy. There are positives and negatives from that. You would like to think that they would take account of those issues, if we accept that it is a problem. Perhaps initially a directive could go out that they should avoid sending prisoners to certain prisons where the fabric of the building is inappropriate for their needs. That goes back to overcrowding, the issues of allocation and the pressures on the system.

Q11 Nick de Bois: Presumably, you would welcome any opportunity to input these points of view into any new builds. It is important to do that as well.

Peter McParlin: Yes. Arguably-depending on the nature of the offence-given the age and infirmity, if I can use that word, of certain groups of prisoners, it will not be that staff-intensive.

Q12 Seema Malhotra: I am thinking about the prison regime and staff training. The MOJ has said that it is committed to providing a regime "which includes age appropriate activities". However, as has been alluded to, that requires that staff have specific training in dealing with older prisoners. In your opinion, do prison officers receive sufficient training to support older people in prison?

Nick Hardwick: No, I do not think so-not on a consistent basis. Frequently, we find occasions where prison officers simply are not alert to or aware of the needs of older prisoners on their wing. For example, as Mr Brine will be aware, we quoted an example at Winchester prison of two older prisoners with very significant mobility needs. The officer who worked on their landing, who knew those prisoners and was responsible for them, had not thought about the difficulties they would have getting opportunities to shower, so they had not showered for some period of time. That was a question not of any in-depth training but of helping that officer think through the needs of what was becoming a different population, perhaps, from the one she was used to. I do not think this is some huge great exercise-it is an awareness point. There may be some need for more specialist training-the development of champions-in prisons where there are a significant number of older prisoners and things such as mental health and dementia may be issues. That might need a particular skill set. For most officers, it is about awareness as much as anything else.

Q13 Seema Malhotra: Mr McParlin and Mr Newcomen should feel free to come in. The MOJ has been saying that the availability of guidance and information is more important than training. Do you believe that that is the case? Do you believe that would be sufficient?

Nick Hardwick: I do not think it is an either/or thing. Guidance and information would be helpful, but you do not know what you do not know. Unless prison officers are encouraged to be alert to the needs of older prisoners and to think about how these things might be different, they will not look at the guidance and information that will be available. So I think it is both.

Peter McParlin: I come back to the point I made earlier. What do we want? Do we want a professional Prison Service or do we want a fly-by-night operation in which staff stumble along and may have had some documentation pushed in front of them to say that they should be aware of that and it is common sense? A lot of prison officering is common sense, but, if we are saying that this is a problem and we want them to recognise it, you have to give them the tools. They can recognise issues with mobility, but, if they have to start recognising issues with dementia and Alzheimer’s, perhaps we need a little bit more input from the centre in the training modules than just a bland piece of paper that says, "Perhaps you should be aware of this." I think that would prevent some problems going forward. From the point of view of prison officers and the POA, there seems to be a marked reluctance to invest in training staff.

Nigel Newcomen: Can I repeat my previous point about inconsistency? I think that it applies in this context as well. There are some examples of quite good training for staff. For example, in the north-east prison cluster, the Prison Service, the NHS and the Macmillan cancer charity have to date trained some 90 health care and prison staff in palliative care, which is a pretty specialist area of care. That means that there are now some good examples-champions, if you like-of the sorts of care needs that will be required going forward being addressed by training.

Q14 Seema Malhotra: You make a very good point about health care and the specific training that those involved in it receive. There is also a question about the extent to which there is a joined-up approach to dealing with older prisoners’ needs. There is one example of a prisoner who described that, when nurses did an assessment of his health and needs, they said that he must not work in workshops or any place where he was in danger of falling, and that he should be put in education. The wing officers put him in a workshop and said, "If you don’t go to work, you will lose all privileges." To what extent do you think that that is a common experience and that there needs to be a reorganisation of how a prisoner is dealt with as a whole person across the different departments?

Nigel Newcomen: As I said, it is hard for me to generalise from my particular responsibilities now, but I would stick with my previous point that I find inconsistency too frequently in investigations that my office undertakes. For example, I think the ability of staff to intervene in the appropriate places is stymied by a lack of training and of consistent understanding of some of the needs that prison staff are now being required to manage in 21st-century Britain.

Q15 Mr Llwyd: Good morning. In Wales, prisoners receive their health care via local health boards, which have a continuing responsibility for prisoners within the estate-directly with three prisons and indirectly with another, where there is a commissioning arrangement. The Prison Reform Trust has said that it is not yet clear how the new commissioning arrangements for prison health will work for those needing specialist care. Do you wish to comment on that?

Nick Hardwick: The Prison Reform Trust is correct in saying that it is not clear at the moment how all these arrangements will work in England. The new NHS Commissioning Board with responsibility for offender health has been in place only since the beginning of this month, so there is still a lot to be worked out about how that will happen. As in the population as a whole, the connection between health and social care and how those borderlines are dealt with is still a very acute problem. There are issues in a prison context, particularly on the social care side. If, for instance, the principal local authority is responsible for social care, the danger is that the prisons will no longer feel responsible for that, so their responsibility will be taken away, whereas for the social care provider there is a risk that it will be out of sight, out of mind, and prisoners will be low down the list of priorities. There are risks, in terms of social care, of older prisoners slipping through the gap. Any changes to the arrangements need to be thought through very carefully. In both health and social care, it is still early days.

Q16 Mr Llwyd: Mr McParlin, do you have a view on this? I can see you writing away furiously.

Peter McParlin: I am often in danger of reflecting back and looking through rose-tinted glasses; I apologise for that. I will not say that everything was wonderful in the past, when we had prison health care; of course it was not. However, we did have something called the prison officer nurse, who was a trained prison officer who specialised in nursing and went away for what my memory tells me was a two-year course in nursing. Of course, they were then able to do the security aspects and to care for prisoners. They took that away and said, "We have to replicate what we have in the community"-health care inside should be the same as health care outside. I have to say that, to date, despite some well-meaning staff and some great effort, I wonder whether we have achieved that. There is a counter-argument to that. If I want a medical appointment with my doctor, I will probably have to wait a week, whereas in prison you would probably have access to a doctor on a daily basis. Obviously there are issues with more specialised treatment-dentists, opticians and so on. At the moment, I think it is a bit of a mess.

I will pick up on what Nick has said. The governor of a prison is unsure of where he sits and what his responsibilities are. There is the issue of the national health service outsourcing certain aspects of care, which is causing a problem. Who is responsible for them? If something goes wrong within the prison, where does that sit with the investigations and so on? At the moment, we are falling a little bit between two stools. There is work to be done.

Q17 Chair: Can I clear up a factual point with Mr Hardwick? It slightly anticipates something Mr Chishti will refer to later-what the future arrangements will be. The understanding we gained yesterday is that in a number of prisons-perhaps most prisons-there are no carers. Personal social care, if it is provided at all, is provided as an adjunct to what the prison officer is doing or by hospitalising people in a prison hospital and using the nursing service in the hospital. Some prisons appear to have professional carers doing that kind of work, but many prisons do not have them at all. Is that correct?

Nick Hardwick: That is correct; that is what I understand. Nevertheless, generally the prison understands it is responsible for the social care of the older prisoners it holds. How well and effectively it does that is a different matter. In some cases, prisons do it well; in others, they do it badly. My concern is that, if prisons feel that that responsibility has been removed, we will go backwards rather than forwards. There is a risk that, if there is an external provider, with pressures on their budgets and resources, prisoners whom they do not see, with whom they are not in regular contact and whose families are not harassing them, may be very low down their list of priorities. My point is not that that should not happen but that it needs to be thought through and planned very carefully.

Q18 Mr Llwyd: To what extent do elderly prisoners receive an equivalence of care to what they would have if they were out in the community? Mr McParlin has referred to that particular matter. If you have a different view from him, perhaps we could hear it.

Nigel Newcomen: I refer the Committee to a couple of reports I passed on. One was a thematic report looking at natural-cause deaths that were investigated by my office; this was published last year. Going back to my thesis that things are improving but in a very inconsistent and piecemeal way, one of the interesting points that the theme suggested on quite a substantial sample of 402 deaths was that there was a statistically significant correlation between the length of sentence and age of the prisoner and the equity of care that was provided. We have clinicians who jointly investigate deaths with my investigators and make a formal assessment of the equity of care with that in the community. It appears that there is some evidence that, as you get older in prison and get ill in prison, access to health care starts to improve and starts to become equitable. However, as I said at the beginning, it remains variable. Certainly, I am looking through a particularly mournful prism-only at those cases where death has occurred, when one would expect there to have been a medical intervention on the route.

Chair: At this point, I turn to Mr Johnson, who will look at some of the issues that you have raised.

Q19 Gareth Johnson: You as ombudsman carried out an investigation, finishing last year, into end-of-life care. What kind of response have you had to that investigation? I think you looked at the number of people who had died in prison and broke it down statistically in terms of age, groupings and so on.

Nigel Newcomen: In terms of response from, for example, the National Offender Management Service, there has been very little, but, in terms of more generally trying to put on the table some learning that, I hope, will gradually be undertaken by the Prison Service and the other authorities that I investigate, I hope it will have a lengthy shelf life and be a slow-burner in encouraging improvement and change. The end-of-life thematic is different from the one I have just referred to. It was still quite a substantial sample-200 or so cases where reasonably foreseeable death was likely to occur. Again, it was interesting that the clinicians who helped to investigate those deaths concluded that, in the majority of cases, there was equitable care with that which would have been expected in the community. However, there were a large number of cases where provision was not consistently good. End-of-life care planning, which is the mechanism by which you get a holistic approach to end-of-life preparations, was absent in a quarter or so of cases. Involvement of the family-something that prisons are still not really familiar with-was poor. There was insufficient early application for compassionate release, so the possibility of dying in the community was not adequately explored. The issue that did not totally shock me but certainly raised my concerns was that there has been an inadequate response to the shackling or restraining of terminally ill prisoners, which needs to be addressed. I hope that this learning lessons thematic and associated materials will encourage change and a positive response, but I fear that it will take time.

Q20 Gareth Johnson: As a result of your investigation, is there one lesson that you think the Prison Service needs to learn about dealing with end-of-life care? Is there one crucial thing that needs to be done that is not being done at the moment?

Nigel Newcomen: Better and more comprehesive planning, so that end-of-life care planning is applied in all appropriate cases.

Q21 Gareth Johnson: That is interesting. Mr McParlin, in your role, can I ask you a question about a controversial issue-the use of restraints on anybody who is receiving medical attention, but on older prisoners in particular? There is obviously a balance to be struck between dealing with people in a respectful, sensible manner and security aspects. What is your opinion on the use of restraints? Where, if anywhere, are we going wrong at the moment?

Peter McParlin: Staff-prison officers-used to have discretion in these matters. They were able to make a judgment when they got out to a hospital and would have discussions with the medical staff. Obviously they would have a look and do a risk assessment of the building as well, but they would be able to use their discretion. It is some years since that discretion was taken away from them. Decisions on restraint come from management, and management is risk averse in this situation. Certainly, NOMS does not want to see any escapes whatsoever, in the tick-box culture that it has. If ever someone escapes, it will have to answer questions from Chris Grayling or Jeremy Wright at the Ministry of Justice, who do not want to see any escapes on their watch and the attendant publicity that goes with that, depending on the type of offence the prisoner has committed. Hence, prison officers have no discretion whatsoever to remove restraints at a hospital bed.

Q22 Gareth Johnson: But, if you give the prison officers discretion, do you not then get an inconsistent approach?

Peter McParlin: That is potentially an issue. However, it would be useful to have a look at the figures, if the Ministry of Justice or NOMS were able to produce them, to see the incidences of absconds/escapes from hospitals-we will use that example-of people who may be in there because they are seriously ill or at the end of life. I agree with you. I assure you that prison officers are placed in an invidious position when they are in a hospice or hospital and are told by management that the restraints cannot be removed when those prisoners are being visited by family. It is an awful situation for my members, but that decision is taken out of their hands. They have no discretion whatsoever. Otherwise, if something went wrong or there were some issue, they would be the ones who would lose their jobs. Also, when they are visited in that situation by a managerial grade, if those restraints are not applied, they face disciplinary action that, more often than not, leads to dismissal.

Q23 Gareth Johnson: Finally, I will pick up on something that was mentioned by Mr Newcomen-the potential of using more early release decisions to cater for end-of-life care. I suppose there are some obvious concerns that the court of public opinion will have about releasing people who were given life terms, because of the interests of the victim and so on. Do you see any additional barriers to using early release in more instances for people who have terminal illness? Mr McParlin, would you like to comment?

Peter McParlin: I am sorry; is that question to me? I thought you said it was for Mr Newcomen.

Gareth Johnson: I should have been clear about that. I was just referring to something that Mr Newcomen said earlier about increasing the instances of early release for people with terminal illnesses. Do you think there are any additional barriers to doing that, apart from some of the obvious situations?

Peter McParlin: I imagine that there is an issue due to the notoriety in certain cases. We had a great train robber released some years ago, didn’t we? We were told that he was at the end of life, and I understand that he is still going strong, God bless him; we wish him all the best. You would like to think that a compassionate approach would be adopted by the people who make those decisions. It would be remarkable to me if someone said that we did not adopt a compassionate approach and did not judge each case on its merits. In fact, I would be horrified if that were not the case.

Q24 Jeremy Corbyn: I go back to Mr McParlin’s point about the use of restraint on prisoners and your concerns about this, particularly for older prisoners. Has this been raised at national level with the Home Office, because of the threats of disciplinary action against your members?

Peter McParlin: Yes, we have certainly had those discussions, but the message from the employer is clear-there is no discretion whatsoever. You have to follow the last instruction, which is the risk assessment that was made. It is an all-embracing risk assessment that restraints will not be removed, unless a decision is made back in the prison. However, that can take time, may need a visit from a manager and so on. In an end-of-life situation, in particular, that is appalling.

Q25 Jeremy Corbyn: At a practical level, do senior managers or governors ever attend the interface between a family visit and a prisoner under restraint, when the prison officer is presumably getting it in the neck from the family because of the condition in which the prisoner is being held? Is that kind of support level given?

Peter McParlin: If you are in a hospital situation, which is classified as an escort, I would expect there to be a visit from a senior manager, but it would happen infrequently. It is there to attempt to catch the staff out-to see whether the staff are doing something that they should not be doing. As a trade union leader, I would say that, wouldn’t I? We do get visits from managers, but they are infrequent.

Q26 Chair: Mr Hardwick, did you want to say something?

Nick Hardwick: Our experience is that, if you have a situation where someone is in end-of-life care, governors will often meet family and relatives as part of that process, for genuinely humane reasons. They are less likely to be involved if you have a sudden emergency-for instance, if somebody is injured or becomes ill very suddenly and has to go to hospital. The governor is less likely to be present at that sort of incident when the question arises of whether the prisoner will be required to be in restraints. However, we have seen governors present at longer-lasting incidents and for more positive reasons than talking about restraints.

Q27 Mr Llwyd: What has just been said quite shocks me. We have not learned much since the ’92 Parliament, when pregnant women were shackled to beds when they were being delivered of babies. God! Excuse me. I have one final question for Mr Hardwick. Why have prisons been rather slow to respond to your recommendations and those of the national service framework for older people? What do you think they should prioritise?

Nick Hardwick: We think that they need a national strategy for dealing with older prisoners. We said that in our reports in 2004 and 2008 and have repeated it again now, but they turn their face against that. In particular, given the growth of the older prisoner population, the changes that are happening to the prison estate and the changes that are happening to staffing levels, I would have thought that trying to take a strategic view of the issue would enable them to use resources more efficiently than they are doing at the moment, would be the right thing to do and would be an effective thing to do. The critical thing to prevent this inconsistency of provision is to have a proper strategy to deal with the changes that are happening in the demographics of the prison population.

Q28 Rehman Chishti: I return to the question of social care. I know all my colleagues on the Committee have touched on it briefly already, but I have a few specific questions. First, in your experience, how would you describe the current provision of social care to older prisoners?

Nick Hardwick: I think it is inconsistent. We see very good examples at Leyhill, but we also see examples of things that are very concerning. The other day, I was in a prison where no care was provided for a prisoner with severe mobility problems. As a consequence, he was having to make his own arrangements to get other prisoners to fetch his meals for him. He was then being bullied and intimidated by the people he was asking those favours of. There was no formal social care for him, so that ad hoc arrangement was placing him at risk. We see very good things and very bad things.

Nigel Newcomen: I can endorse that. We see exactly the same in the investigations we undertake. For example, there are occasions when prison officers display remarkable fortitude in terms of the social care provision that they are prepared to undertake. In some cases, it is a formal provision by local health authorities. In other cases, it is dependent on individual prisoners. In my last annual report, I recorded a case where a prisoner complained of being completely traumatised by the approach that was required of him to look after the continence needs of a dying prisoner. I think provision is inconsistent and lacks coherence. It needs to be looked at in a way that draws in community health providers, the Prison Service and, indeed, staff associations as to what is going to be provided in what is going to be an increasing area of demand in the prison context.

Q29 Chair: Yesterday, we found that there were positive aspects to those prisoners who were able to help other prisoners doing so, but there is also a very significant supervision requirement, not least because in this prison generally you were dealing with sex offenders.

Nick Hardwick: That is absolutely right. Prisoner buddies or orderlies providing support in a properly regulated and supervised scheme is a very positive thing; we have seen examples of where it works well. My concern was that an informal arrangement, where an individual older prisoner has to go to whoever happens to be on the wing and beg favours of them, exposes them to real risk.

Q30 Rehman Chishti: Would you not agree with what has been said by the Prison Reform Trust-that there is a lack of clarity of responsibilities and "confusion over provision of daily living aids, personal care and occupational therapy"?

Nick Hardwick: Exactly. One thing is that local authorities now have safeguarding responsibilities for older or other particularly vulnerable prisoners. We now look at what prisons are doing to ensure those arrangements are in place. Almost nothing is happening with regard to that responsibility. That is a big gap.

Q31 Rehman Chishti: I move to Mr McParlin. How confident do prison officers feel about providing social care?

Peter McParlin: I will pick up a word that seems to be popular-they feel inconsistent, if that is the proper word. Very few prison officers do not want to do their best. They want to do their best for society and for the prisoners in their care, but they need to know what they are expected to do and to be pointed in the right direction. They need that support and, I believe, proper training.

Q32 Rehman Chishti: Do you agree with the Government’s proposed approach to resolving these issues, which is to give local authorities a statutory responsibility for assessing the needs of, and providing services to, prisoners?

Nick Hardwick: As I said, I think that needs to be dealt with very carefully. My fear is that, if, at a time when there is pressure on resources in prisons, the prisons feel that that responsibility has been taken away from them, they will not do anything. We know how difficult it is to get local authorities to provide appropriate care for people who are living in the community and have relatives actively working on their behalf, so there is a danger that, with prisoners, it will be out of sight, out of mind, and the situation will deteriorate. That is an issue that needs to be approached very carefully. The risks I have just spoken about need to be thought through and addressed.

Q33 Rehman Chishti: We also have a view from the Prison Reform Trust, which said, "We would like the local authority in which the prisoner is located to hold responsibility for commissioning social care in that prison, as currently happens with health care."

Nick Hardwick: As I said, I would be cautious about that. I do not agree with what Mr McParlin said earlier about health care. I think that, as a whole, the arrangements for health care have improved health care for prisoners, but the social care issue is different.

Nigel Newcomen: I feel there is a repeated theme-that we must seek to avoid the risk of inconsistency. The possibility and prospect of at least having a formal responsibility offers some glimmer of hope of consistency but, in the context of the competing pressures that will be found in the different authorities, we may not move much further forward. I fear that this is an area that will continue to grow in the context of prisons.

Q34 Rehman Chishti: The Prison Reform Trust says "as currently happens with health care". It would not say that unless it had looked at the issue and decided that health care provision by way of local authority commissioning works.

Nick Hardwick: I am not saying it is wrong; I just think it needs to be thought through carefully. If you have a health care complaint, generally speaking that is a visible or obviously demonstrable problem and there is a place you can go to-a health care centre where that issue will be attended to. The problem with social care is that it is not provided in one location-it is something that the whole prison needs to be involved in providing at one level. Sometimes, the needs are not as obviously visible as they might be for a health issue. That is why I think that, if the responsibilities are not really clear, there is a danger that things will fall through the net.

Q35 Chair: They are not clear now, are they?

Nick Hardwick: No, they are not, but at the moment it is clear that the governor of the prison has a responsibility to provide care for all of the prisoners he or she is responsible for. The risk is that, in a time of resource constraints, if you say to the governor that somebody else is responsible for providing care for this group of prisoners, they will say, "All right, I will shift my resources to where the responsibility is solely mine." However, the local authority, which is responsible for this group of prisoners, may not be as on top of, and aware of, their needs, because they will be out of sight and more difficult to have access to, and because the local authorities themselves are under pressure. I think there is a risk-I do not see it as more than that-in these new arrangements, if they are not thought through carefully, of prisoners falling between the cracks.

Chair: Thank you very much. We are grateful for your help this morning. We have some further witnesses.

Examination of Witnesses

Witnesses: Helen Boothman, Secretary, Association of Members of Independent Monitoring Boards, Sean Humber, Partner, Leigh Day, and Dr Azrini Wahidin, Reader in Criminology and Criminal Justice, Queen’s University, Belfast, gave evidence.

Q36 Chair: I welcome Helen Boothman, the secretary of the Association of Members of Independent Monitoring Boards-what we used to call prison visitors, which was a lot easier to say; Sean Humber, who is a partner in Leigh Day; and Dr Azrini Wahidin, who is reader in criminology and criminal justice at Queen’s University, Belfast. We are very grateful to you for coming in to help us with this inquiry. To what extent is it possible or appropriate to treat older prisoners as a distinct group rather than as individuals with different kinds of needs?

Dr Wahidin: It is important to consider two things. First, we have an ageing prison population that is growing rapidly-faster than any other cohort within our prison population. Currently, we do not have a national strategy to deal with this group. We do not have age-specific guidelines within our prison estate. The first issue is to have guidelines and provisions that are age-specific, as we do in other jurisdictions. I have been working in this area since 1996, on both sides of the Atlantic, and have just come back from Australia. I have been looking at palliative health care that deals with older offenders with specific health and social care needs. The units begin at the age of 50 to 55, because we are well aware-the research demonstrates this-that our older prisoners are suffering from what is known as accelerated biological ageing. That means that they are 10 years older than their peers on the outside. On one level, we have to deal with them as a homogeneous group, but we must also have specific regimes that deal with individual offenders and relate to their specific needs.

Q37 Chair: Of course, you have to bear in mind that the phrase "ageing prison population" is slightly misleading. It is not that we just have so many people in prison for so long. We have some people in that category, but a very significant proportion of the population we are talking about are people who have lived in the community for most of their lives and have been arrested and given substantial prison sentences for very serious sexual offences, which means that they come new to prison in an older age range. That is one example of a group that might require looking at differently than people who have been in and out of prison all their lives and have come back again.

Dr Wahidin: Or those who have grown old in prison. As we know, our over-50 population comprises roughly 11% of the prison population-just under 10,000. You are quite right that we have those who are coming in as older offenders for the first time to serve a very long sentence. However, we need to have some type of framework in place that deals with our ageing population and older group, because currently they are invisible.

Q38 Chair: When talking to both prisoners and staff, we have found that there are differences of view among older prisoners about whether they want to be in an older prisoners’ unit or whether they want to have some younger people around. Do you have views on that issue?

Helen Boothman: I do not think there is one size that fits all. You can look at the pros and the cons, but IMB reports up and down the country show that there are more positive comments about being together than about being integrated into the mainstream population, the reason being that often mainstream prison wings are very noisy. More mature men tend to like quieter places. Even things such as running in the corridors, which came up at an older prisoner forum that I attended the other day, have become an issue; that is why they wanted something where they could all be located together. I know you have talked about the physical side of prisons, but, if they are in a unit together, the physical provision can be provided much more easily. It can also be located in a place that gives them access to visits or the library. Again, it just reduces the feeling of isolation that they often have. Generally speaking, I think there are more pros about being together than cons.

Sean Humber: I agree. Obviously, older prisoners are not an entirely homogeneous group, but none the less they tend to have many common features-health issues, disabilities, vulnerabilities and so on. A common strategy is required to look at those. From talking to clients, I do not think they have to be completely separate; you do not want to have prisons simply for older prisoners. However, we should be going in the direction of having distinct parts of prisons where they can go and associate with older prisoners-day centres and so on.

Dr Wahidin: I endorse the views of both previous speakers. From research that I and a colleague of mine, Professor Ron Aday in the States, have conducted, we have both come to the conclusion, with practitioners in the field, that older offenders, both male and female, favour integration, with special designated facilities for older offenders to access.

Q39 Jeremy Corbyn: My question is for all of you, but I guess that Mr Humber will probably want to answer first. To what extent does the provision provided to older prisoners by the Prison Service comply with equality and human rights legislation? It would be helpful to us if you have any experience of taking cases beyond the UK orbit-to the European Court of Human Rights, for example-on older prisoners’ conditions.

Sean Humber: Unfortunately, our experience is that many prisoners do suffer unlawful discrimination. Historically, it was on the grounds of disability and their failure to participate fully in many aspects of prison life, so that they lived a very isolated, excluded existence. The age provisions are newer and have been in effect only for the last generation of services, but it is likely that there will be an increased number of claims of age discrimination on the basis of older prisoners not being able to participate fully in prison life.

My experience of disabilities over the last 10 years-which is instructive, in a way, when we look at the issue of age discrimination now-is that there has been a real lack of strategic analysis of disabled prisoners within the prison estate. I have had a succession of prisoners over the last decade who have suffered problems. There has clearly been a failure to make any reasonable adjustments and, frankly, we would say, an ignorance of the law-of what is required. The problem is that it has always been done on something of an ad hoc basis and there has been very little strategic oversight even of the number of disabled prisoners, the types of disability and the number of disabled facilities.

I can see that problem recurring now in relation to older prisoners. Some prisons are doing a better job than others, but there is no real analysis. I refer to the issues discussed by the previous witnesses. Should this prisoner even be starting off in this prison in the first place? Should it be up to that prison to try to duck and dive and to do deals to work out whether the prisoner can go to another prison? Where is the strategic overview? That is the context. It is not all absolutely about resources, but it has to be said that there is a lack of disabled facilities across the prison estate. However much that can be better managed, it is a fundamental problem.

Q40 Jeremy Corbyn: Have you taken out any cases on this under equalities legislation?

Sean Humber: Yes. For the last decade, we have regularly brought claims under the Disability Discrimination Act and, more recently, under the Equality Act in relation to unlawful treatment of clients and the failure to make reasonable adjustments in relation to disability needs. Age discrimination is relatively new.

Q41 Jeremy Corbyn: Have the cases you have taken, for example, resulted in any kind of systemic change by the Prison Service?

Sean Humber: There have been a number of cases. One exposed a failure of prisons at a higher level-by the Prison Service-to look at the needs of disabled prisoners and produced a policy in relation to that, which accepted, I think for the first time, that not all prisons could address the needs of all disabled prisoners and there was a need for prisoners to be allocated elsewhere. I have to say that sometimes, regrettably, there is a feeling that you are solving the problems on a case-by-case basis. Your clients’ needs are subsequently addressed, which is the primary purpose of bringing these legal proceedings-it is not about money but about getting their needs addressed-but I have to say that I am less convinced that that led to a change in the attitude of the prison or of the Prison Service generally.

Helen Boothman: I endorse Mr Humber’s view. Even with Prison Service order 2855, on disabilities, you find that prisons are not conforming to that. A classic example-bearing in mind the length of time that a lot of prisoners are now in their cells-is hard chairs. Older prisoners with back problems or who need lumbar support are sitting on old-school refectory wooden chairs; I cannot see any examples here. That really goes against any form of disability recommendation in terms of lumbar support and everything else. That is a very small example, but it can be taken further. You were at Albany yesterday. I wonder how many of you talked about the slopping out that still happens. For an older, more mature man with bladder problems, prostate problems or whatever, one questions why that has not been addressed even now, although it has been aired and reported on for some time.

Q42 Chair: The old lags’ slopping-out procedure is not what they do. Integral sanitation is provided by portable facilities, isn’t it?

Helen Boothman: It is in some cases. In other places, it is by electronic means. If it is in the middle of the night, you can ring your bell, but sometimes there is a time delay. If an older prisoner has bladder problems, obviously there are accidents.

Q43 Jeremy Corbyn: Do you have any assessment of the effect of the legal aid changes on the ability to pursue equality cases?

Sean Humber: I certainly do. They are likely to have a chilling effect on prisoners’ ability to enforce their rights.

Q44 Jeremy Corbyn: Were all the cases you have taken legally aided?

Sean Humber: Yes, they were nearly all legally aided.

Q45 Jeremy Corbyn: As far as you are aware, would the same be true of other firms?

Sean Humber: It is predominantly legally aided work. The problem will be this. These are currently just proposals-they have gone out to consultation at the moment-but it seems to be proposed that legal advice for some treatment and care issues will be withdrawn. Whatever one’s views of prisoners, they are a legally vulnerable section of society where there are clearly problems. We are talking not about Daily Mail problems of "I have not got Sky Sports in my cell" but about people who have not had a shower for a year, are not able to use the toilet because they do not have a booster seat, are not able to work because no simple adaptations are being made or cannot get their meals because they cannot physically walk to the servery or cannot walk back with a meal in one hand. We are talking about serious problems. Report after report by the regulatory authorities and eminent NGOs say that there is a problem. The issue is how those prisoners will be able to have the legal advice and assistance they will need-which, after all, is not to obtain compensation but to get those rights enforced. It is a desperate thing, unless your starting point is that they are prisoners and therefore do not have these rights. If they do have these rights, it is illusory if they cannot enforce them. I have to say that I despair.

Chair: I think we get the point.

Jeremy Corbyn: We have got your desperation.

Q46 Mike Weatherley: My question is on the same point and is addressed to Ms Boothman. As Mr Humber was just saying, some people consider prison as a punishment or as rehabilitation; you can have those two things in there. You made the comment earlier that it is disconcerting to have people running around outside your cell, but a lot of my constituents say, "Well, they are in prison." I take the point absolutely that we do not want to increase someone’s suffering and to inflict some sort of torture on a person, if a seat is really giving them extra problems, but where do you draw the line between what would be more comfortable-quite frankly, most people would say they are in prison and should put up with running around outside their cells-and serious additional care that they need and are not getting?

Helen Boothman: For me, it is about the individual and how you would want them to be treated if it were your father, your brother or your son who was in prison. The physical needs are part of the duty of care that a prison needs to support. Whether that is the adapting of cells, making sure that they have access to showers or making sure that they can get to the library and all the facilities they need to get to, the prison must supply it. In terms of how far it goes, most older prisoners you talk to get three meals a day, are warm in the winter, by and large, and get access to fresh air. It is absolutely fair to say that some probably have a better life, because they also have social involvement, but you question some others who express absolute frustration about not being able to move in the system.

I go back to legal aid, although I know you have probably moved on from that. There is a classic example of an indeterminate sentence prisoner in his 80s-I am not just using this as an example-who has to be seen to be reducing his risk by doing offender programmes. He is not accepted on to those offender programmes because he has memory loss, and he has been stuck in the system for over four years. It does not seem right to me that we should treat anybody like that. I know that it is hard to draw a line between public opinion and what is right and proper, but I think it is about fairness and justice. That is what IMBs are all about.

Q47 Mr Llwyd: Mr Humber and Ms Boothman referred to the whole issue of fragmentation of health services throughout the prison estate. I know it is early days, but what do you think will be the impact of the changes to commissioning arrangements for health services that came into effect this month? Do you think that they will reduce fragmentation? The question is open to all three of you.

Helen Boothman: I think it is too early to say yet. The early signs are that at the moment they are just talking about a bigger picture and not talking about specific needs of specific groups of prisoners. Some fantastic best practice has been going on, but what are the guarantees that it will carry on in the future? Manchester prison seems to have excellent leads, follow-through on screenings and everything else. It is really following through on the NHS framework for older people. I hate to repeat this, but of course there are inconsistencies. In other places you do not have a lead and are not getting the regular screenings, so you are getting postcode prisons.

Dr Wahidin: The move is a move in the right direction, in that it will encourage innovative practices and, hopefully, bring together best practice that can be evidenced in the work of HMP Norwich, Leyhill, Frankland and Downview, which is the women’s prison. Yet again there is the caveat that we need to have the political will. We need to have champions and to highlight the issues, problems and challenges that older offenders bring to a closed institution.

Sean Humber: I do not want to be more downbeat, as I agree with what the two previous speakers have said, but we need to look back at the last decade or so. In the very bad old days-and they were very bad old days-the Home Office was responsible for the Prison Service aspects of health care. That led to some kind of health care apartheid, if you like, where people said, "It is health care that is different from but equivalent to what those in the community receive under the national health service." Clearly, it was not equivalent.

It must be said-and the Committee should be aware-that nearly everybody welcomes the transfer of health care to the NHS. The problem was that it was transferred to the primary care trusts dotted up and down the country, which were responsible for the prisons in their area. It is fair to say that some did a good job but some did a less good job. It is not all about resources, but it is partly about resources. Some of them felt that they received something of a hospital pass with a very needy section of society but did not have the resources to deal with that.

There has been a change again, with primary care trusts being abolished. You have one type of procedure for those in the community and a slightly different one now for those in prison. There is a possible downside to that. The good thing when the primary care trusts were responsible for both was that it was very stark, if you like, what treatment those outside the prison walls and those inside the prison walls were getting. That may be slightly further away now that there are slightly different commissioning arrangements, but it is too early to tell. The good side is possibly that we will get slightly more strategic management of it, in the sense that not all primary care trusts did a good job.

Q48 Mr Llwyd: Mr Humber, in your firm’s submission to the Committee, you argue that the criteria for early release do not sufficiently take into account the needs of elderly prisoners. In your experience, what proportion of older prisoners who seek early release are given it?

Sean Humber: I am afraid that I have not got the facts and figures at my fingertips. The first point to make is that many do not get the assistance to make that application in the first place. Many come to us having languished, we would say; they would have been able to make the application far earlier if they had not. The second point to make is that there is a very-

Q49 Mr Llwyd: Can I interrupt you there? I am not being awkward-I just want to know who you think should be there to assist in that process of identifying a potential early release candidate and assisting him or her to process the application.

Sean Humber: I do not necessarily think it should be solicitors or lawyers. There needs to be somebody in the prison who is able to look at those issues, particularly the health and disability issues, and how well they are being met. It is a relatively reactive process. It should not involve their needing to go through the hurdles and hoops of getting solicitors in the first place. This is not touting for work. All I was going to say is that it is a real problem before we even get to that question.

Mr Llwyd: I am sorry that I interrupted you when you were answering the question. Please carry on.

Sean Humber: That is fine. I do not have the facts and figures at my fingertips, I am afraid. What I would say is that the Prison Service takes quite a strict view, if you like, of the criteria for early release. Actually, if you look at the policy-what it could do-it is slightly broader, but it is treating it as applying to those who are terminally ill and within three months of death. That is unduly restrictive and goes beyond the Secretary of State’s powers and the Prison Service policy. It needs to be broadened out, as the policy suggested it should, to those the Prison Service cannot adequately care for. The question should be asked, would they be better cared for in the community? In our experience, that is not being done.

Dr Wahidin: As far as I am aware-I am sorry that I do not have the figures to hand, but I was looking at them over the weekend-the numbers are really negligible. That raises the question of why the numbers are so negligible when we know that there are prisoners who are languishing in prisons. Why aren’t we considering the use of early release and compassionate release earlier and sooner, as in other jurisdictions and other countries?

Helen Boothman: You asked who should be responsible. I want to flag up that in most prisons there is a disability liaison officer. Under "Fair and Sustainable"-this wonderful whole new world of budget cutting-that post looks like it will be part of the equalities officer post. There is a fear that, with budget cuts and restrictions, the responsibility and, probably, the role of championing of older prisoners to develop individual care plans could easily go.

Q50 Chair: I am sorry for interrupting, but one has to ask why there should be a particular impetus for early release. If the court has given a sentence to someone who has carried out a very serious offence or, maybe, many very serious offences, such that they have not yet served their offence or gone successfully through an IPP procedure to be released, unless the judgment is that the amount of resource necessary properly to look after that person in prison is not available and would be disproportionately difficult and expensive to provide, what is the public policy argument for releasing that person from prison?

Helen Boothman: Compassionate grounds, I would say, because we are a compassionate society. If a prisoner who may have some time left to serve is not given the choice about where he wants to die, to be near his family and in surroundings that might be more suitable than a prison environment, I question the role of society in that.

Q51 Mr Llwyd: Could I move on to the Government’s proposed approach to reform of the provision of social care-in other words, to devolve it to local authorities? Do you think this will improve matters? Given the situation local authorities appear to be in currently, will they step up to the plate and deliver as is hoped?

Helen Boothman: Social care is not mentioned at all with IMBs up and down the country. Only one IMB report just recently, on Frankland, mentioned social work even being visible in the prison. A classic quote from people at Dartmoor is, "Social care is being done by wing staff." I think we are at a place where it can only be improved, but I have questions and concerns about more co-commissioning. The first panel of witnesses raised the issue of responsibility and accountability. We are seeing that it is harder for the governor to have overall responsibility and accountability with so many third-party contractors on his site and delivering. If we have central commissioning, it must be really clear who is accountable for what and who is responsible for negotiating between the various bodies, because the bit that sometimes falls down the middle is the multi-agency reviewing of an individual case. Without the disability liaison officer, who will be responsible for co-ordinating all the various agencies and bodies around this prisoner? I am not clear about where that would fall.

Q52 Chair: Is it not preferable to a situation in which nobody accepts responsibility to provide personal care-that is really what we are talking about-for a prisoner who, basically, cannot function without it?

Dr Wahidin: I reiterate the points that the previous speaker just made, with the caveat, yet again, that there has to be the political will and drive to implement the legislation in order for it to work. It is a move in the right direction, and the Prison Service has a duty of care to provide all prisoners with adequate provision to assist with daily living.

Q53 Nick de Bois: I have two questions for Mr Humber. You made a very detailed submission; thank you for that. Clearly, you have a commercial interest and a growing business. Can you let the Committee know what size of business legal claims from prisoners now are?

Sean Humber: I am afraid that I do not have the facts and figures. I can tell you about my practice, which consists of me and two other lawyers-

Q54 Nick de Bois: So we do not have a percentage figure, but it has grown.

Sean Humber: Yes, it is fair to say that.

Q55 Nick de Bois: You were kind enough to describe many of the common problems faced by the firm’s older prisoners-for example, failure adequately to assess their health problems when they first arrive, failure to contact the community GP and obtain medical records, and delays and practical difficulties in seeing a nurse or a GP. Have you actually taken legal action on behalf of prisoners over those issues?

Sean Humber: Yes, they have been components of cases we have brought.

Nick de Bois: You have brought cases on that.

Sean Humber: They have been components of cases that we have brought on a multitude of issues.

Q56 Nick de Bois: You might understand some of my constituents’ frustration-particularly if the cases were funded by legal aid-as these are problems that we face outside prison as well. I wonder whether you could put some context into that. If you are prepared to let the Committee know the size of the business, that would be helpful.

Sean Humber: Of course.

Q57 Gareth Johnson: Could I ask Dr Wahidin to build on some of the comments that Mr Humber made earlier in relation to disability issues specifically with older prisoners? I understand that you have stated that, generally speaking, prisons do not comply with the Disability Discrimination Act 2005. What instances do you have of that being the case? What evidence have you seen of anything being done to challenge that?

Dr Wahidin: I am drawing on some recent research from about a year ago for a prison in the north of England in the women’s estate. There was a failure to provide adequate facilities for disabled female prisoners in this particular prison, so much so that a prisoner was unable to work. There was only one cell that had disabled facilities such as an accessible shower, an accessible toilet and a wide enough door to enable the wheelchair to pass through. At times, she was unable to move because there was no buddy system in place or prison officer able to wheel her from one part of the prison to another. With an influx of prisoners, a number of disabled prisoners had entered this particular prison. She ended up having to share her bathroom facilities with other prisoners because of the lack of provision at this particular prison, which therefore failed to comply with the Disability Discrimination Act and the Equality Act. It also brings us within the remit of article 8 of the European convention on human rights.

Q58 Gareth Johnson: Do you accept that in a prison establishment, by its very nature, there will be additional difficulties in catering for people with disabilities, compared with general society?

Dr Wahidin: Obviously the environment is a factor, but we have information that details the person’s age, mobility and health and social care needs. Within that, we should be allocating prisoners to appropriate facilities to cater for their particular needs in order to fulfil the mission statement-the vision-that the Prison Service upholds.

Q59 Gareth Johnson: You said you would like to see prisoners allocated to where there are facilities and so on. In addition to that, is there anything that you feel we should be doing in the prison establishment that is not happening at the moment? Do you feel that there are things that are not being done at the moment that could reasonably be done for prisoners with disabilities?

Dr Wahidin: One is to make sure that the prisoners are allocated to an appropriate prison to cater for their needs.

Helen Boothman: The national strategy that was spoken about earlier is very lacking with regard to location. Wandsworth had to relocate all of its VPU recently, and many went to Brixton. Of course, Brixton did not have any ground-floor cells that were appropriate for those with mobility problems. Another example-it will be fascinating to hear your response after Monday-is Dartmoor being converted to a 100% VP prison. Dartmoor is one of the least accessible prisons in the prison estate, and one of the hardest to adapt for mobility problems. It has spiral staircases, great big, thick walls and very narrow cell doors. One wonders what the logic is behind adapting that to a VP prison that, by its very nature, will have older prisoners. That is where the lack of the national picture and the strategic view seems very apparent.

Sean Humber: There seems to me to be a lack of rigorous assessment of disability needs when the prisoner gets to prison. On reception, there is a questionnaire they can fill in that talks in one-word terms about whether they have disabilities. There is often a health care assessment a few days later that looks at health care issues, hopefully in more detail. However, often there does not seem to be joined-up thinking about how it will impact on what you can and cannot do if you have reduced mobility. Will you be able to get to the library or to visits? Will you be able to use the gym? Will you be doing this, that or the other? There does not seem to be follow-through from the initial one-word assessment and the health care assessment about how that impacts on a day-to-day basis.

Q60 Gareth Johnson: What is frustrating is that there is at least a perception that victims of crime in my constituency, because of disabilities that they have, cannot get to the library, cannot get the necessary health care and do not have the gold standard, if you like, that they need. Would you not agree that there is at least a perception that we can put all the emphasis in one direction, which leaves victims of crime feeling that we may have our priorities wrong?

Sean Humber: I do not see it as an either/or issue. It seems to me that this is not really gold-plating. As I said, often these are cases of people not being able to shower for a year or whatever. You say either that the state has responsibility for, and a duty of care towards, those individuals and they should have these fairly basic standards or that it does not. To go back to my earlier answer, either they are entitled to that protection under the law or they are not.

I accept that there is a public perception issue. To a certain extent, that is unfair and is brought about by misrepresentation of a small minority of cases. There is a real problem of a lot of disabled and elderly prisoners-the "old and quiet" issue-from whom you never hear a peep. Solicitors never hear a peep from them. They want to keep their heads down, are scared in the prison environment, do not want to kick up a fuss and are grateful for ad hoc assistance, to the degree that they get it, from other prisoners and the kindness shown by individual officers. Often that is where they are, and they are too scared to move from there.

Q61 Gareth Johnson: Please do not misunderstand me. I am not saying that that duty of care should in any way be lacking. I fully appreciate that the punishment of prison is the incarceration and that humiliation should not be added on top of that. We want to rehabilitate people so that they come back with a good view of humanity, not a bad view. However, I come back to this problem that, if society, Government, the prison establishment or other establishments are putting the emphasis on ensuring that there is better quality for those in custody and more access to things people that on the outside do not always have access to, there is a sense that there is an imbalance that needs to be corrected. Would you not agree that there is at least that perception, if not the reality?

Sean Humber: I accept that there is that perception, but you need to look at why there is that perception. I think that sometimes it comes from the misreporting of certain cases.

Q62 Chair: Can I move on to the issue of resettlement? It is related, in a way, because much of the emphasis of the prison system is on trying to equip people for living a useful, constructive life when they are eventually released. This group of prisoners tends to be categorised as a group who are unlikely to be released until they are even older-at a very advanced age-so resettlement is not a priority. In that respect, they fare less well than other prisoners, as the inspectorate has pointed out more than once. Do you see any signs of improvement on resettlement?

Helen Boothman: There are little gems of good practice, but that is usually where third-party agencies such as RECOOP and Age UK have been involved, either through the day clubs or by helping people with pension planning, will writing and so on. Given the budgetary situation, I cannot see that it will be improved in terms of thinking about a release plan and helping a prisoner who has lost his home or will be living on his own to learn to cook, to wash and to manage his personal hygiene. That will take an awful lot of individual resource that I am not sure will be available. Given the very nature of the crimes committed by a lot of older prisoners, housing is inevitably a major problem, as sex offenders are-

Q63 Chair: Because of the public security and protection issues.

Helen Boothman: There is that. Very often, local authorities and private housing agencies also have blanket rules that they will not accept sex offenders, whether they are low-risk or high-risk sex offenders. Until that changes and there is more education, it will be a major problem when it comes to locating these more mature men out in the community. It is an issue because, as we know, all the people in prison, bar a handful, will be returned to the community. It therefore does need managing. As we all get older, problems tend to be more exaggerated. Last week, I was having a conversation with an 84-year-old prisoner who just burst into tears because he had had to sell his house since coming into prison, was being released in October and had no idea what was going to happen to him when he was released. That is a classic example of the lack of communication to individuals. If you were in the community, you would go and find the information. There are not the places to go to seek that information and the reassurance that an individual needs. I think that is a worry.

Dr Wahidin: The role of third-sector involvement, working in partnership with certain prisons in the prison estate such as Norwich, Frankland and Styal, has improved the provision, but again it is ad hoc. It is very much dependent on the resettlement officer, the PO and the SO. However, this particular cohort brings their own particular challenges that prison officers and resettlement officers find it difficult to deal with. The prime example is the one that you have given of an older male offender who is about to be released. If a hostel or local authority refuses to take him on board, what do you do? How do you cater for the needs of older offenders in that category?

Sean Humber: I agree. I will not repeat everything that the two other speakers have said, but I will make two points. One goes back to the issue of disabled prisoners being able to do the offending behaviour courses and adaptations being made to enable them to do that. While there are undoubtedly examples of good practice, there are many cases where they just do not do the course. The second point is very specific but is worth mentioning to the Committee. There is a particular problem with hostels and how compliant they are with disability requirements. Often, prisoners are not able to be released to hostels because the hostels are not able to take them.

Q64 Chair: One problem we have not mentioned, which was referred to us yesterday, is the problem of prisoners who are in denial about historic sex offences. Some of them may actually be innocent, but there are significant numbers who cannot complete courses because, even if they agree to take part in them, before they get very far they get engaged in the kind of discussion in which, effectively, they are refusing to co-operate. Do you have any thoughts about how that should be dealt with?

Helen Boothman: Looking at sex offenders and the treatment programmes generally, deniers or those in denial of their offence or conviction will not be accepted on to the current range of programmes available within the custodial setting. There was talk that NOMS was going to produce a new SOTP to which deniers could have access, which would help them to reduce their risk and progress through the system. In the annual report on the prison I monitor, we raised that last year. It was going to come out during the year that has just been, but there is still no sign of it. I do not know whether that is down to budgetary cuts and the segmentation project, which means that all low-risk prisoners, even the sex offenders, will not have any offender treatment programmes. That comes back to the public perception of rehabilitation within the prison setting.

Chair: Thank you very much. We are very grateful for your help this morning.

Prepared 26th June 2013