London, 31 July 2018: Within the space of a few days, new reports highlight the degradation of all aspects of the criminal justice system by successive governments. The FFLM calls upon regulators and policymakers to turn their immediate attention to the shocking information contained in these reports and take appropriate action.
The Independent Office for Police Conduct (IOPC) has released their annual statistics on deaths during or following police contact in England and Wales (1). In the financial year 2017/18, the IOPC recorded a total of 283 deaths following police contact. There were 23 deaths in or following police custody, the highest figure recorded in the past 14 years, and an increase of nine since last year. Four people who died in or following police custody were detained under the Mental Health Act. Seventeen of the people who died in or following police custody or other contact were restrained or had force used against them by the police or others before their deaths. Twelve of the 23 people who died in or following police custody had mental health concerns, and 18 had links to drugs and/or alcohol.
The FFLM understands that some of these deaths may be attributable to the often-poor quality of healthcare in police custody. With our colleague organisations, the United Kingdom Association of Forensic Nurses and Paramedics and the College of Paramedics, and the Forensic Science Regulator, we have been campaigning for minimum standards of qualification for healthcare professionals working within police custody, appropriate supervision and the transfer of commissioning to the NHS. Commissioning of healthcare in custody was to have been placed within the NHS, but this move was stopped for unexplained reasons in April 2016 by the then Home Secretary despite several years of planning for the transfer. We call again (as did Dame Elish Angiolini as one of her recommendations (2)) for this transfer process to be re-commenced immediately. There can be no logical reason why such a process should not be undertaken to improve the safety of such vulnerable individuals within the police custody setting.
The Ministry of Justice also released the latest statistics on safety, deaths and self-harm in custody (3). These data show that levels of self-harm and violence in prison continue to escalate in a dramatic way, and may even be under-reported. Many of these detainees will also have been seen by FFLM practitioners in police custody. FFLM healthcare professionals (doctors, nurses and paramedics) recognise that some of those patients seen in police custody may be transferred to prison custody. The FFLM is regularly alerted by such practitioners of their major concerns about the health, welfare and safety of this vulnerable population and whether they will remain safe wherever detained.
It is clear to FFLM members that inadequate physical and mental health care in custody contributes to both morbidity and mortality and that the criminal justice system is inadequately staffed, trained and funded to deal with the wider social problems of mental and physical ill heath, alcohol/drug misuse and poverty.
This view is supported by the House of Commons Justice Committee which just issued a report on Criminal Legal Aid (4), and summarises:An effective criminal justice system is one of the pillars on which the rule of law is built; effectiveness also demands that the fabric of the criminal courts is maintained. The under-funding of the criminal justice system in England and Wales threatens its effectiveness, so undermining the rule of law and tarnishing the reputation of our justice system as a whole, which is widely admired. We conclude that the under-resourcing of the criminal justice system undermines the prospects of successfully promoting our legal system abroad, a stated Government objective.
The Committee goes on to state:
We therefore recommend that the Government conduct an urgent cross-departmental review of funding for all elements of the criminal justice system, with the aim of restoring resources to a level that enables the system to operate effectively. The details of the review should be published in advance; its timetable must ensure completion in time to influence the conclusions of the 2019 Spending Review.
The FFLM will be urgently contacting the relevant Ministers within the Ministry of Justice, the Home Office and the Department of Health to ensure that part of that review focusses on health and patient safety aspects of the criminal justice system and appropriate funding.
We will reinforce our message to the National Police Chiefs Council and the Association of Police & Crime Commissioners that relevant minimum standards are already agreed for healthcare professionals working in police custody. As responsible bodies, they should ensure that their respective memberships enforce such standards to better protect the vulnerable detainees in their care.
For further information, contact:
Faculty of Forensic & Legal Medicine, firstname.lastname@example.org .