Motion made, and Question proposed, That this House do now adjourn.—(Gavin Barwell.)
Vincent Morgan died on the night of 28 December 2012. He was found hanging in his prison cell in A wing of Northallerton prison. He had also swallowed a plastic knife that was found in his oesophagus. Vincent Morgan had committed suicide at 29 years of age.
There has since been an investigation by North Yorkshire police, a report by the prisons and probation ombudsman, a verdict of death by misadventure, and a coroner’s report from which flowed a couple of regulation 28 letters to the Department of Health and the Ministry of Justice. There has been a great deal of activity with practically no light thrown on the central issue, which is why we deal so badly with young people who have mental health problems. How little respect we pay to the wishes of parents in the way we treat these young people in our criminal justice system.
Vincent Morgan was involved in a serious road accident when he was four years old. It was suspected then and is obvious now that this damaged his brain in a way that would become more pronounced as he grew older. However, it was not until 2005 that he was finally diagnosed with chronic long-term psychotic illness—schizophrenia with daily auditory hallucinations—and was prescribed drugs to deal with his conditions. In April 2012 Vince went out with his parents to a local pub and when they returned home he assaulted his father. The community psychiatric nurse allocated to Vince said that his behaviour that night was a response to a new drug he had just been prescribed. The police were called. They advised Vincent’s parents to press charges against their son as the only way to get the medical help he needed. Mr and Mrs Morgan reluctantly signed statements and the case went to court.
The mental health care co-ordinator—the mental health professional—advised against a prison sentence and said that a hospital order would be more appropriate. However, a so-called independent expert, with no knowledge of Vince Morgan and without even examining him or meeting him, said that his mental health condition could be managed in prison. What I can only describe as a vicious sentence of 18 months’ imprisonment was handed down and Vincent Morgan found himself separated from his loving parents for almost the first time in his young life and placed in a prison cell.
Mr and Mrs Morgan came to see me in the summer of 2012 and together we tried to get Vince released on a home detention order. His parents had redecorated his room. Having cared for their son in the eight years since his condition was diagnosed, they wanted him home for Christmas. This was refused, but the date for release was set for 28 January 2013, only a few weeks into the new year. After liaising with various parts of the NHS, Vince Morgan was receiving the mental health treatment he needed in Hull prison and his parents continued to prepare for his release.
Then two things happened. Without any consultation the probation service wrote to this vulnerable young man in his prison cell. Vince, who had a mental age much younger than his years—some have said he had a mental age of eight, some have said 10—and was known to be passive and acquiescent to any request, was told in that letter that upon his release he would not be going home, but to a bail hostel. Vince told his parents about this in a letter from prison dated 5 November. This is important because the Minister will probably have been briefed that this is not the case, but I can tell him quite categorically that the probation service has got this totally wrong.
Incidentally, I wrote to Humberside probation trust on 22 November 2013, just after the coroner’s report, which is the only time I could get seriously involved in these issues. I wrote to the Secretaries of State and all the local agencies, and they all responded within weeks. Humberside probation trust replied to my letter of 22 November 2013 on 27 March 2014—over four months later. In a case such as this, with a young man killed in his cell, and when we are trying to get to the bottom of lessons to be learnt and reasons it happened, one might have thought that the probation trust would take it more seriously.
The probation trust stated in its letter, “No, that’s quite wrong. Vince’s parents were informed of the intention to release him to a bail hostel when he finished his sentence.” It should be borne in mind that I had been campaigning on their behalf to get him released early, but now he was being told that he would not be able to go home, even at the end of his sentence. In a further letter to me, the trust’s chief executive stated:
“Vincent Morgan’s parents were involved in a telephone discussion as early as 6th November 2012 about the possibility of placing him in an Approved Premises. This intention was confirmed at a MAPPA meeting on 21 November 2012 and communicated to Vincent Morgan at the meeting in the prison on 7th December 2012.”
That is entirely wrong. I have the letter from the prison trust given to Vince Morgan in his prison cell, and it is dated 24 October 2012.
With regard to 6 November, I have the postmarked letter that Vince Morgan received—dated 5 November—and that was sent to his parents’ home in Hull to inform them that he had just received a letter stating that he would be going into a bail hostel. The reason they spoke to his parents on 6 November is that the parents had rung the probation trust to ask, “What the hell’s going on? Our son has just told us that he won’t be coming home at the end of his sentence.” That was entirely wrong. I was also told that the parents had been informed in the telephone call, but that was as a result of them ringing the probation service. That was a real failing on the part of the probation service.
The second thing that happened was that Mr and Mrs Morgan received a phone call from Vince to tell them that he had been moved to Northallerton prison. Nobody had informed them. In a statement to the coroner, the offender supervisor at Northallerton, Phil Reeve, said that nobody knew why Vince had been transferred and that
“we wanted to get him back to Hull because we knew his parents were his main visitors and that they might find the travelling to Northallerton difficult.”
Perhaps I should mention at this point that Sharon Morgan, as well as being Vince’s mum, was his registered carer. They did indeed find the travelling difficult, but they were at least pleased to discover that Vince was sharing a cell on C wing with a prisoner who became a mentor to him and who was, together with other prisoners, watching out for his welfare.
It was at Northallerton on 7 December that Vince was told again that he would have to go to a bail hostel, rather than home, when his sentence ended. As was the case with the original sentence, the mental health expert, in the shape of Vince’s care co-ordinator, expressed the view that release to an approved hostel would cause him to reoffend and that, in her view, the preferred option was for him to be returned home.
The ombudsman asked the senior officer in charge of the residential unit at Northallerton whether she knew that Vince had been told that he would not be going home to his mother and father when he finished his sentence. She replied that she did not know. She told the ombudsman that she definitely should have known
“because I know right now that if I’d known that, I wouldn’t have made the decision that I did.”
What decision was she referring to? That is the final act in this tragedy. On Boxing day 2012, Vince Morgan was removed from C wing, from the mentor who had watched over him, and, once again without any contact with his parents, was transferred to what was, in effect, solitary confinement in A block, where he hanged himself two days later.
As was related again and again in the ombudsman’s report and to the coroner, prison officers wondered what Vince Morgan was doing in prison. Health service professionals disagreed with the decision to place Vince in a bail hostel. The offender supervisor at Northallerton said in a report to the coroner:
“Another thing that was discussed in the meeting was the accident that Vince had when he was a child and this might be a cause of his learning difficulties. I couldn’t understand why that link hadn’t been made earlier and why the report hadn’t been completed for court. However I was told that it was done for court but none of it came to the judge. My question, based on my knowledge from working in courts was, why wasn’t a hospital order made against Vince rather than a prison sentence?”
It was not just a prison sentence but an 18-month prison sentence. I echo that: why indeed? Why were not Mr and Mrs Morgan kept fully informed and involved in all the decisions that affected their son? Where is the mysterious report that never came before the judge?
Northallerton prison no longer exists. That is why the ombudsman made no recommendations—there is no prison to make recommendations about. The Humberside probation trust folded in May. The chief executive is now retired somewhere.
The case of Vince Morgan is a tragic example of the appalling way mental health is treated as a poor relation not just of the NHS, as many say, but of every other public agency. The mental health professionals sit round a table with the probation service and others, and their views are discarded: they are overruled. I want to meet the Minister to discuss this case further. I hope the Government use the case of Vince Morgan as the clearest example of how to get things wrong so that we can start to get things right.
Finally, I want to read an extract from a letter that Trevor Morgan, Vincent’s father, wrote to all the various agencies on 27 December, the day before his son died. He had spent the whole of Christmas composing this letter. He says:
“My son is a gentle giant and is well liked by everyone who knows him. Before he became ill…he had a job as a van drivers assistant, which he loved. Since his illness started 8 years ago, my wife, Sharon, and I have looked after him ourselves. Vince very rarely leaves the house, he is a very quiet man and keeps himself to himself. What happened on that night”—
the night he attacked his father—
“was very out of character for him. But, if Vince had been having the right medication at the time, it would never have happened in the first place.”
He ends by saying:
“Please forgive me if you think I sound bitter, my wife and I have never lived for so long without our son, who we love and care for so much. Please, let our son come home on the 29th January 2013. Don’t put him in a hostel, which will be rife with drugs and where Vince would be at risk from others. Once again”,
he says in closing,
“I beg you to let Vince come home to us, the people who love and will look after him.”
If that simple request had been granted, Vincent Morgan would be alive today, and he would be in the care of his devoted parents who remain completely devastated by his death.
Let me begin by thanking the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson) for securing this debate, which raises some very important issues. First, I would like to offer my profound condolences to Mr Morgan’s parents, Sharon and Trevor, and his whole family.
Every death in prison custody is a tragedy for that individual and their family and friends. Let me assure the House of how seriously the Government take such deaths, which are all independently investigated by the prisons and probation ombudsman and a coroner’s inquest, as the right hon. Gentleman said.
I would like to offer a few comments on Mr Morgan before turning to some of the wider issues highlighted by this very sad set of events. Mr Morgan was serving concurrent sentences of 18 months for actual bodily harm and four months for battery—offences that he had committed against his parents. Initially remanded to Her Majesty’s Prison Hull in April 2012, he served several months there after his conviction before transferring to HMP Northallerton in November 2012 as a standard progressive move. HMP Northallerton was a specialist resettlement prison that has now closed.
That, of course, raises a question for the parents. Vince was 28 coming up to 29, so he was an adult, but everyone knew that his severe, chronic mental health problems meant that, in effect, he was acting like a child. Why would the prison service not consult his parents—his mother being his registered carer—about the need to transfer him from one prison to another? How could the transfer of such a vulnerable prisoner go ahead without the parents being consulted?
The right hon. Gentleman raises a proper issue about the way in which the families and carers of people with mental health issues are treated generally in our society. Very similar issues have been raised in my constituency. If he will allow me, I will go back, make further inquiries at the Ministry of Justice about that specific point and write to him following this debate. I absolutely understand the very important issue that he properly raises.
Mr Morgan’s conditional release date was 29 January 2013, and planning for his release was under way. However, on 28 December 2012, Mr Morgan was, tragically, found hanging in his cell. The emergency response was prompt, but Mr Morgan was pronounced dead.
Mr Morgan suffered from schizophrenia, and his treatment for this condition continued during his time in custody. As with all prisoners, he was assessed on entry to custody, where he was referred for assessment by the prison mental health in-reach team, and considered for any risk of self-harm or suicide. Staff kept an eye on his behaviour and potential vulnerability to bullying. An assessment for learning disabilities was requested. At the time of his death, Mr Morgan had recently moved wings and a few weeks previously had been informed that he would be required to live in an approved premises, rather than return to his parents house, when he left prison, though that aspect of his release planning continued to be kept under consideration by Humberside probation trust and the multi-agency public protection panel that considered his case.
The coroner’s inquest into Mr Morgan’s death concluded in November 2013. The cause of death was hanging and the jury’s conclusion of death by misadventure noted that there was a failure in the system of transfer of information from health care staff to discipline staff, and that, consequently, problems regarding Mr Morgan’s behaviour were treated as a discipline issue rather than medical.
The coroner made two recommendations to the Secretary of State for Justice. The first was on the involvement of health providers where prisoners requiring in-reach mental health support are to be transferred between prisons. There is a “clinical hold” system in place, which can be used where there are concerns about the suitability of health care provision in the receiving prison. The second was on the information flow from and to prison officers within HMP Northallerton. As has been said, HMP Northallerton has since closed, but a review was undertaken at HMP Hull.
The prisons and probation ombudsman completed his report on Mr Morgan’s death in May 2014. It identified some deficiencies in communications between staff at Northallerton about Mr Morgan’s management, but concluded that it would have been very difficult to foresee Mr Morgan’s action and prevent his death. No recommendations were made.
I reiterate my profound condolences to Mr Morgan’s family. As I have already said, every death in custody is a tragedy for that individual and their family and friends. Safety, decency and security will always remain the priority for the National Offender Management Service. However, every year a number of people die in prison—some through natural causes and some self-inflicted. In 2013, 215 people died in prison custody. Of those, 123 were as a result of natural causes and 74 were self-inflicted.
As the House may be aware, the number and rate of self-inflicted deaths in prisons in England and Wales increased in 2013 and the Government are committed to understanding the reasons for that rise and are seeking to address it. We have put additional resources into safer custody work across prison establishments; this issue affects the whole estate of public and private prisons. The rise comes after a period of some years during which the rate of self-inflicted deaths has been relatively stable, at its lowest level in the last 25 years. In recent years, better treatment of prisoners with drug-use problems and the use of safer cells, with reduced ligature points, have contributed to the reduction in the number of self-inflicted deaths.
There has been recent comment about whether population pressures, organisational changes in prisons and reductions in the number of prison officers have contributed to the rise. However, the picture is not so straightforward, and there is no clear correlation between the existence of such pressures and prisons where self-inflicted deaths have occurred. Known factors appear in a number of deaths. For example, the early days of custody are known to be a period of higher risk. Self-inflicted deaths in custody occur most often in males aged 30 to 39, and most occur by hanging. However, overlaying these known factors are reasons for each self-inflicted death, which are as individual as the person involved. It is therefore essential to support prisoners as individuals—many of them have complex needs, as the right hon. Gentleman outlined in this case—by identifying whether they have particular risk factors, and if so, responding appropriately.
Prisons use the ACCT—assessment, care in custody and teamwork—system to keep prisoners safe. Individual ACCT plans should be opened and closed in line with the assessment of an individual’s risk of self-harm or suicide, and their needs. It is a dynamic process.
The Minister is a decent man, and I appreciate that he has come to the Chamber with a brief. It was kind of him to offer to write me a letter, but there is no need for that if he will give me a meeting. We need to discuss these matters in more detail. I have read all that stuff about wraparound care and all such really good stuff. We said the same thing in government, so this is not a party political point. Vince Morgan is a perfect example of how all of that means nothing when it comes to a vulnerable young man, whose parents were concerned but were ignored, and specifically when it comes to the decision not to let him go home at the end of his sentence.
I am sorry that this is a long intervention, Mr Deputy Speaker. The Minister says that Vince Morgan was told of that decision a few weeks before, but I now have absolute proof—from a letter sent to this mentally ill young man back in October—that he was told in his prison cell. All that puts a new complexion on the case, and I would be very grateful if the Minister met me to discuss it.
Of course I will meet the right hon. Gentleman. If he contacts my office after this debate, I will make arrangements for us to meet as soon as possible.
I want to respond to a point that the right hon. Gentleman made about Vince’s move to A wing. I think that the right hon. Gentleman referred to it as solitary confinement. Vince was moved to a single cell, but not to solitary confinement. He was deliberately placed near the wing office, and the move was for his own well-being. Prisoners on C wing had complained about Vince, so there were genuine concerns for his safety. It is important to put that on the record.
It is through such individual assessment that staff can be alive to the often overlapping and interconnected factors that may contribute to an individual’s distress, and which can on rare occasions lead to suicide. Those factors may include mental health needs, addressing any disabilities or disadvantages, or simply being sensitive to potential trigger or pressure points that they may experience during their time in custody.
As is well known, the prison population is not representative of the general population in a number of ways. The prevalence rates for personality disorder, psychosis, attention disorders, post-traumatic stress disorder and self-harm are notably higher than in the general population, as are problems with substance misuse and alcohol. Almost 50% of adult prisoners suffer from anxiety and/or depression, compared with 15% of the general population. Experts estimate that prisoners with a learning disability or difficulties may represent as much as 30% of the prison population.
Liaison and diversion services are a vital way in which the Government seek to ensure that when someone first comes into contact with the youth or adult criminal justice system on suspicion of having committed a crime, their health needs are identified, assessed and provided for by appropriate treatment services, and that the police and courts are enabled to make informed decisions about charging and sentencing.
We are investing £25 million in a trial scheme that will place mental health professionals in police stations and courts, and improve identification, assessment and referral services, so that access to health care and social care interventions are improved. That is not about individuals avoiding the appropriate sanction from the criminal justice system, but about tackling some of the underlying issues that can cause people to offend.
For some prisoners with severe mental illness, the most appropriate treatment setting will be a secure hospital. About 900 transfers are made from prisons to secure hospitals each year. However, not all serious mental illness needs to be treated in a secure hospital, and most serious mental illnesses are treatable within prison under the care of a consultant psychiatrist. Prisoners are considered for transfer to secure units only when a prison cannot provide appropriate treatment in the judgment of a responsible clinician. In such circumstances, good liaison between health care teams and other prison staff is essential to ensure that events and decisions that could affect a prisoner’s risk of self-harm or suicide are considered and are known by others.
The whole-person approach to individual case management continues into release planning. The most serious offenders are subject to multi-agency public protection arrangements, which ensure that relevant statutory partners and interested organisations are properly involved in pre-release planning.
I would like to say a few words about families, about which the right hon. Gentleman rightly spoke. We know the importance of family contact and support to prisoners. Phone calls and visits with family and friends make a huge contribution to prisoners’ well-being. Close family members who are on low incomes can apply for assistance towards visits. The support of families and friends is an important component in helping someone to avoid re-offending when they are released from prison. Wherever possible, families are involved in the decision-making process when a prisoner’s accommodation post-release is being considered by the MAPPA panel.
I know that Members will share my concern about every death that happens in prison custody. The prisons and probation ombudsman, to whom I spoke this afternoon, has conducted a lessons learned review of deaths in custody and will publish his report next month. I look forward to seeing the report and to reviewing the recommendations fully so that we learn every possible lesson from what he has to say.
We must remember that prison staff save lives, sometimes through swift intervention when a vulnerable prisoner is literally on the verge of taking his own life and sometimes—this is less easy to know about but is no less real—through the careful and caring management of some of the most vulnerable individuals in society, who have been placed in custody because of the harm they have caused to others in society. That, of course, is no consolation to the family of Mr Morgan, whose death no one was able to prevent.
I am grateful to the right hon. Gentleman for securing this debate, which has allowed us to consider the complexities of such cases. I may be new in post, but I share his determination to learn the lessons of this tragic incident and similar incidents of this nature so that we can reduce the number of self-inflicted deaths in custody as much as possible.
Question put and agreed to.