The scandal of seriously ill prisoners denied basic healthcare | Eric Allison: Daniel Roque Hall's horror story exemplifies how inmates are seen as prisoners first and patients very much second
As those who know the prison system well will tell you, jail is the last place you want to be if you are seriously ill. My memory bank – along with the annals of Inquest, the charity that works with those bereaved by deaths in custody – is crowded with horror stories of medical negligence: sick prisoners wrongly diagnosed, mistreated, or just plain ignored.
Prior to being taken over by the NHS, in 2005, medical care in jails was administered by the Prison Medical Service. Medical staff then were simply screws with basic medical training. They had a screw's mentality towards illness: namely, that prisoners faked it to get out of work (even in jails where there was no work to get out of).
When the NHS took over, it was hoped that treatment of prisoners would improve dramatically. But old habits die hard and inmates who are ill are still seen as prisoners first and patients, very much, second. And so the horror stories continue to be played out.
This is one: the worst I have ever come across.
Thirty-year-old Daniel Roque Hall suffers from ataxia, a rare degenerative condition that results in a lack of co-ordination of the whole body. He has been wheelchair-bound for many years and has a life expectancy of 35-40 years. He has type 1 diabetes and a weak heart, which requires constant monitoring. He suffers frequent spasms.
His medical needs are complex. They include round-the-clock care by two carers, on whom Hall is totally dependent; the use of conventional and standing wheelchair, the use of a hoist – and staff trained in its use – a pressure mattress, saddle seat, shower chair and medi-motion machine. He needs to undertake vital stretching exercises several times a day and is on masses of medication.
In July, at Isleworth crown court, Hall was sentenced to three years' imprisonment for importation of cocaine. Even for a man with no previous convictions, it was a lenient sentence; the judge accepting Hall had been "groomed and manipulated" by drug dealers.
Prior to sentencing – and clearly concerned about Hall's medical needs – the judge asked the governor of Wormwood Scrubs for written assurances that Hall's complex medical needs could be met by the prison. Astonishingly (for those of us who know the standard of medical care in prisons) the governor assured the judge that all Hall's requirements would be met and he arrived at the Scrubs on July 6.
The account given by his family and his lawyers is harrowing. Within hours, Hall suffered a spasm, fell from an examination couch and sustained a head wound. He was taken, in chains, to a local care home. Staff there were not told about the head wound, nor given full details of Hall's medication, including Warfarin, a blood thinning agent. Later, he went to Charing Cross hospital, then back to the care home where he remained for a week, chained to a prison officer.
Back in the Scrubs, Hall suffered further spasms and says he was constantly denied his full medication. The standing wheelchair, which his family had delivered to the prison, was never used, because staff did not know how to operate it. The required two constant carers, in case of spasms, were not supplied and the vital stretching exercises Hall needs to maintain stability were neglected. Hall's condition deteriorated rapidly and, in the early hours of August 23, he was rushed to University College Hospital in London and placed on a life support machine. And although the prison could not supply the staff to look after Hall's medical needs, they had no problem finding the numbers to look after his security. Four prison officers have been at UCH "guarding" Hall since he arrived, working eight-hour shifts. A total of 12 officers every 24 hours, watching over a man who cannot walk and is so traumatised he can barely speak. A consultant at the hospital said Hall's heart had been "stunned" by his treatment at the Scrubs.
Hall's condition has now stabilised, though he remains very ill and has a lung infection. At one stage, staff at UCH asked medical staff at the Scrubs for information on Hall. They could/would not provide it and doctors had to go to Hall's GP for more details. The GP has written a letter saying she "fears for his – Hall's – demise if he sent back to prison."
As usual, the Prison Service say they "don't comment on individuals". Then: "We have a duty of care to those sentenced to custody by the courts. As part of that duty of care, we ensure that prisoners have access to the same level of NHS services as those in the community." Really?
This Friday, a high court judge will be asked to declare Hall's treatment unlawful and in breach of his human rights. In effect, Hall's lawyers will be asking the judge to keep Hall out of the clutches of the prison system that has cruelly neglected him. With the best will in the world, there is not jail in the country that could cater for this man's medical needs and the governor of Wormwood Scrubs should have realised that in the first place. If the high court sides with the system on this, the judge in question ought to don a black cap when issuing the court's findings. For, to send this man back to prison would be as good as imposing a death sentence on him.
As those who know the prison system well will tell you, jail is the last place you want to be if you are seriously ill. My memory bank – along with the annals of Inquest, the charity that works with those bereaved by deaths in custody – is crowded with horror stories of medical negligence: sick prisoners wrongly diagnosed, mistreated, or just plain ignored.
Prior to being taken over by the NHS, in 2005, medical care in jails was administered by the Prison Medical Service. Medical staff then were simply screws with basic medical training. They had a screw's mentality towards illness: namely, that prisoners faked it to get out of work (even in jails where there was no work to get out of).
When the NHS took over, it was hoped that treatment of prisoners would improve dramatically. But old habits die hard and inmates who are ill are still seen as prisoners first and patients, very much, second. And so the horror stories continue to be played out.
This is one: the worst I have ever come across.
Thirty-year-old Daniel Roque Hall suffers from ataxia, a rare degenerative condition that results in a lack of co-ordination of the whole body. He has been wheelchair-bound for many years and has a life expectancy of 35-40 years. He has type 1 diabetes and a weak heart, which requires constant monitoring. He suffers frequent spasms.
His medical needs are complex. They include round-the-clock care by two carers, on whom Hall is totally dependent; the use of conventional and standing wheelchair, the use of a hoist – and staff trained in its use – a pressure mattress, saddle seat, shower chair and medi-motion machine. He needs to undertake vital stretching exercises several times a day and is on masses of medication.
In July, at Isleworth crown court, Hall was sentenced to three years' imprisonment for importation of cocaine. Even for a man with no previous convictions, it was a lenient sentence; the judge accepting Hall had been "groomed and manipulated" by drug dealers.
Prior to sentencing – and clearly concerned about Hall's medical needs – the judge asked the governor of Wormwood Scrubs for written assurances that Hall's complex medical needs could be met by the prison. Astonishingly (for those of us who know the standard of medical care in prisons) the governor assured the judge that all Hall's requirements would be met and he arrived at the Scrubs on July 6.
The account given by his family and his lawyers is harrowing. Within hours, Hall suffered a spasm, fell from an examination couch and sustained a head wound. He was taken, in chains, to a local care home. Staff there were not told about the head wound, nor given full details of Hall's medication, including Warfarin, a blood thinning agent. Later, he went to Charing Cross hospital, then back to the care home where he remained for a week, chained to a prison officer.
Back in the Scrubs, Hall suffered further spasms and says he was constantly denied his full medication. The standing wheelchair, which his family had delivered to the prison, was never used, because staff did not know how to operate it. The required two constant carers, in case of spasms, were not supplied and the vital stretching exercises Hall needs to maintain stability were neglected. Hall's condition deteriorated rapidly and, in the early hours of August 23, he was rushed to University College Hospital in London and placed on a life support machine. And although the prison could not supply the staff to look after Hall's medical needs, they had no problem finding the numbers to look after his security. Four prison officers have been at UCH "guarding" Hall since he arrived, working eight-hour shifts. A total of 12 officers every 24 hours, watching over a man who cannot walk and is so traumatised he can barely speak. A consultant at the hospital said Hall's heart had been "stunned" by his treatment at the Scrubs.
Hall's condition has now stabilised, though he remains very ill and has a lung infection. At one stage, staff at UCH asked medical staff at the Scrubs for information on Hall. They could/would not provide it and doctors had to go to Hall's GP for more details. The GP has written a letter saying she "fears for his – Hall's – demise if he sent back to prison."
As usual, the Prison Service say they "don't comment on individuals". Then: "We have a duty of care to those sentenced to custody by the courts. As part of that duty of care, we ensure that prisoners have access to the same level of NHS services as those in the community." Really?
This Friday, a high court judge will be asked to declare Hall's treatment unlawful and in breach of his human rights. In effect, Hall's lawyers will be asking the judge to keep Hall out of the clutches of the prison system that has cruelly neglected him. With the best will in the world, there is not jail in the country that could cater for this man's medical needs and the governor of Wormwood Scrubs should have realised that in the first place. If the high court sides with the system on this, the judge in question ought to don a black cap when issuing the court's findings. For, to send this man back to prison would be as good as imposing a death sentence on him.
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