Written evidence submitted from Farah Damji (MHP0041)
"Abuse of power corrupts absolutely. Prisoners need to be treated fairly, respectfully, decently a n d given purpose a n d hope. "
Access to decent mental health services for people suffering is an inalienable human right. How then to access this, within a system that has zero respect for prisoners' human rights, a stony faced judiciary that does not act where it is meant to review the neglect or failure of government policy and the potential of being branded a troublemaker if a prisoner dares to complain and stand up for her rights? The right to life and safe custody are enshrined in international and national legislation - yet both fundamental human rights continue to be ignored.
Insightful questioning by members of the Committee of Public Accounts on improving access to mental health services in the 16th report of the session showed how little is known about the quality and cost of mental health services, not only by ministers and civil servants but also by the commissioners of those services themselves.
When questioned by Rt Hon Richard Bacon MP, Simon Stevens the Chief Executive of NHS England could only confirm that £493m was spent on health services in prisons. He could not say how much of that was spent on mental health services; he could not say how much of that was spent on services for women in the female estate. In 2014-15, the NHS spent a total of £11.7 billion on mental health services, some 12% of total spending.
One of the Committee's findings was that current structures and payment mechanisms do not incentivise commissioners and providers to deliver high quality mental health services for all who need them.....commissioners currently pay for most mental health services using block contracts that pay providers a fixed sum each year irrespective of the quality and timeliness of the services being provided and the number of people accessing services. These contracts lack transparency and provide few incentives for providers to improve the quality or efficiency of services.
An estimated 90% of prisoners have a diagnosable mental health problem or substance misuse problem with 70% having 2 or more recognised conditions.
The way prisoners are dealt with, particularly those with mental health disabilities make the prisoner the "other" to the man on the street. Although discussion of prison life is widespread in the cultural narrative of the country, public outcry remains deafeningly silent. How many more people need to take their own lives before we wake up to the truth that prison is not working, that the prison estate is neither decent nor safe and that mental health services for prisoners are not fit for purpose?
Ineffective Government policy with regard to criminal justice and the crisis in the prison system gives birth to a thousand screaming tabloid headlines. The shroud of mystery under which English courts operate, inconsistent sentencing policy and the Byzantine appointment of judges conspire to make the outcomes of criminal cases and what happens in the prison estate a no-go zone for decent, law abiding members of the public.
This submission deals with what prisoners and others who support our plight can do to challenge the Government's unlawful neglect of its legal responsibility to provide a decent mental health service within a safe custodial estate and describes the complaints process available to prisoners to ensure that they can access whatever services do exist. I strongly believe that change will come from within. Without clear procedures and the support of committees like the JCHR and the Justice Committee and Home Affairs Committee who can challenge the Government and force it to account for its failings, nothing will change. This will just be another well-meaning report, doomed to fail. Please don't let it be that.
This inquiry will produce a chorus of indignation and renewed good intentions from the same old same olds - the criminal justice charities with a financial interest in keeping the numbers swollen to justify their existence and gather donations by guilt; the prison reformers who mean well but are like the monkeys who see no evil, hear no evil and do a lot of evil by doing nothing but wringing their hands and leaving their conscience at the prison gate; the well-funded academics with little experience of what life is like inside but can hypothecate solutions to promote funding applications; the punishment-for-profit global corporations that answer to their shareholders; the private providers of services in prison and through the gate (post prison) and third sector organisations with whom they have become unnatural bedfellows - forced to share the crumbs from the punishment for-profit-pie when the private community rehabilitation companies were formed three years ago through Transforming Rehabilitation, another Grayling masterstroke.
These people don't have the answers by themselves. Nothing has changed for the better. Change will come from women inside challenging the awfulness of what we have to face daily, the lack of provision of mental health services, the chaotic sentence planning, withholding of medication because Virgin Healthcare is cutting corners, the daily abrogation of our human rights.
Where is the "user voice" of experience? What a great opportunity missed.
We know what the answers are, 195 coroner's reports from 2014 - 2016,Woolf on Strangeways, Carston, Lord KK Patel, Coates, the Bangkok Rules - to which the UK is a signatory, have in turn laid out robust route maps to a fairer, decent way of dealing with vulnerable women, with mental health conditions who are in conflict with the law. Successive governments have put ideology above humanity and the electorate has allowed this to continue, unchecked. Who is to be held accountable for the disorder in the prison system which is so unbearable that vulnerable prisoners would rather die than be subjected to another day of it?
The Prison and Courts Bill seeks to delegate responsibility away from the centre but this has not worked, previously. Governors have autonomy to choose their toilet paper provider? What does this change? There must be a root and branch shift in the culture of the Ministry of Justice which operates with no accountability and complete paranoia. It appears to seek to undo a lot of what Chris Grayling, former Justice Secretary inflicted on the prison service, deep cuts, £400million just from prison budgets, 7 000 less staff, the wholesale decimation of world class women's centres that were proving reductions in reoffending, with a woman entered whole person approach.
Legitimate protest about overcrowding, unsanitary conditions, lack of access to healthcare and mental health facilities and unlawful conditions are described as "riots" in fake news put about by NOMS. There is a legitimate right to protest, when a prisoner is being treated unlawfully.
Until the day that the Executive (The Ministry of Justice as a department of the Government) and the Judiciary accept that prisoners have inalienable rights and PSOs (Prison Service Orders) are not just bits of paper that clever and cost conscious Governors can opt out of on a whim nothing can change.
The time has come to hold the judiciary and the relevant and responsible Government Departments accountable. Governments have not had the courage and the public has not challenged anarchic prison policy. This joint dereliction of duty has allowed the estate to fall into the crisis that shames British society today. We have the highest reoffending rates of any western European Country. We lock up more women per capita than Iran or North Korea.
Liz Truss, with no experience of law, justice or reform makes grand gestures that cause dissension (pay increases for Grade 3 Prison officers - and fresh entries but nothing for seniors or specialists) , with zero consultation and no understanding of the systemic issues that blight the system. She states her only duty as Secretary of State for Justice is to warehouse women in prison. She wants to change all that. This document seeks to challenge the narrow definition of her perception of the responsibility as Lord Chancellor and Secretary of State.
Various international treaties and 40 of the 43 recommendations of Carston which were accepted by the Government in 2007 bind in law our forgetful Secretary of State for Justice to provide a decent, safe place to rehabilitate women. But appearing on the Sunday news and politics programs with her inexperienced sidekick RT Hon. Sam Gymiah MP Minister for Prisons and Probation makes a good breakfast soundbite and makes her look as if she is doing something. The £100 million for 2 500 new prison officers (now we are only 5 000 down from the original figure before austerity) she has found is just a band-aid - the Ministry of Justice still has to find £400 million of cuts from its budget this parliament.
Many women who come to prison do not know their rights and cannot deal with complex legal issues. Legal Aid cuts leave them abandoned in bandit land with solicitors who do not want to work for legal aid rates. Many disputes that arise in prison life are no longer funded by legal aid. This is not justice; this is potentially a breach of Article 5. Not having sufficient or adequate access to mental health services can cause conditions to exacerbate, lead to violence or disorder and potentially extra days added onto a sentence. If women in prison are denied knowledge and access to our basic rights and how to challenge this, how can we extract fairness? Mental health becomes a luxury in the battle to survive prison life.
The system is already stacked against those who don't suffer mental health conditions; I have found it labyrinthine and inaccessible. I am considered literate, educated and articulate. I suffer from two conditions recognised under the Mental Health Act and depression at 97% on the recognised scales used by learned forensic psychologists, and severe anxiety at 87%. I am receiving no support from the contracted provider, CNWL NHS Foundation Trust although I have been repeatedly referred to them. I have felt suicidal.
I have complained about this lack of provision of mental health services. In order to force access to materials for art therapy, I sought Judicial Review. It was refused by Mr Justice Lavender as being totally without merit.
After my criminal trial, I needed to write up grounds for appeal on sentence for new solicitors and grounds of appeal of the conviction for the Criminal Cases Review Commission. I have appalling handwriting, the result of an expensive private education. I am supposed to be allowed to have an Access to Justice Laptop to manipulate over 7 500 pages of case papers and 5 weeks of trial hearings I obtained through a Subject Access Request. According to PSO 16(7) I should be allowed to access sufficient time and IT to deal with outstanding civil and appeal matters where I am a litigant in person. HMP Bronzefield made this particularly difficult. This matter was also considered to be without merit by Mr Justice Lavender.
We are women and we are born with inherent rights that no one, no matter how determined, in the finest £1000 leather trousers and killer kitten heels, or powdered wigs and red silk robes can ever take away. But we have to know our own power to deploy it.
My responses to the inquiry are focused on vulnerable women with mental health conditions in conflict with the law and a call to action - help us to hold this Government to account by summoning the Permanent Secretary and Ministers to account for their constant breaches of Corston, the Bangkok Rules and the ,the Human Rights Act, UNDHR and ECHR. Let's enact Corston and give the fragrant Lord Chancellor a handbook concerning her responsibilities. If every breach of PSOs was brought for Judicial Review the Ministry of Justice might do more to ensure that they are implement throughout the estate.
There are a few heroes within the system who fight the good fight, particularly Mr Crean at the Prison and Probation Ombudsman Service, Sally Berlin at the Criminal Cases Review Commission, Flo Krause the public law and human rights barrister whose friendship extends beyond, the Prison Reform Trust and above all Tulip Siddiq MP for Hampstead and Kilburn and her remarkable caseworker Jack Boardman who have helped me to fight my corner. Whilst I may have "had my chance to get help", according to HHJ Timothy Lamb QC, I hope my experiences and observations help other women in conflict with the law to fight for their rights and empower them to stand together against a system designed to demoralise, debase and destroy the very best within us.
April 2017