Crimes of Violence

Part of the debate – in the House of Commons at 12:00 am on 4 August 1961.

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Photo of Mr Kenneth Robinson Mr Kenneth Robinson , St Pancras North 12:00, 4 August 1961

The House is grateful to the hon. Member for Brighton, Kemptown (Mr. David James) for raising this very important subject of psychopaths, which is one of the thorniest problems with which we have to deal. At the outset he made some remarks about the confusion between sanctions and medical treatment in this field. That confusion is to some extent illustrated by the fact that we have the Under-Secretary of State for the Home Department and the Parliamentary Secretary to the Ministry of Health both on the Front Bench.

If I have drawn the right conclusion from the signs which I have detected, the Under-Secretary of State for the Home Department will reply to the debate. With great respect to the hon. and learned Gentleman, I think it is the wrong Minister, because I take the view that this is primarily a medical problem and not a penological problem. The Royal Commission on the law relating to mental illness and mental deficiency grasped this nettle and made very firm recommendations that psychopathic disorder should be treated as a form of mental disorder. It would have been all too easy for the Commission to sidestep the problem, because we all agree that it is extremely difficult. To some extent it did sidestep it by suggesting that it should not be defined, but the Government, in my view, in their wisdom, decided that it would be impossible to make provision for psychopathic disorder in a Statute without defining it, and in the circumstances they produced a pretty good definition, which was read by the hon. Member for Kemptown.

This indicates that the problem of the psychopath should be regarded as a medical and psychiatric problem. I think that the hon. Member himself to some extent fell into the confusion to which he drew attention because he kept talking about indeterminate sentences. One does not sentence a sick man to medical treatment. Nor do I think that medical treatment, or training, whatever it is called, should be regarded as appropriate to this type of offender within a prison setting.

It is unfortunate that, although it is nearly two years since the Mental Health Act was put on the Statute Book, that is about as far as we have gone. There are no new provisions of which I am aware for treating psychopaths under the National Health Service. There are, of course, existing provisions; there are the special hospitals at Rainpton, Broad-moor and Moss-Side, to which I suppose the great majority of psychopaths who are subject to compulsory detention and treatment are being sent at present.

In this connection, I agree very strongly with the conclusions of the Minister's working party on the special hospitals, which indicated that these should be regarded as very much a last resort, appropriate only for those types of offender who cannot be accommodated in other hospitals—in special units with perhaps slightly less security precautions than these hospitals have.

The Working Party recommended that regional provision should be made for setting up psychopathic units. I advocated this many times during the discussions on the Mental Health Act. It is vital that there should be at least one purpose-built unit for treating psychopaths in every hospital region in the country. They need not be large. In fact, there is much to be said for them being of perhaps no greater capacity than 30 or 40 patients, at any rate in the early stages, but unless we set up such units we shall never learn anything more about this problem.

The problem has been set out for the first time by the definition in the Mental Health Act. For the first time we have an opportunity of categorising these people and studying them. As far as I can see, this opportunity is not yet being grasped. Will the Minister tell us how many regional boards in the country are planning any such provision of this kind, in accordance with the recommendations of the working party and, I think, in accordance with the wishes of the Minister of Health? In respect of the special hospitals. I hope that he will give a time when, like the old mental hospitals, they will have withered away because newer, better and more appropriate provisions for treating this type of patient will have been made. In the meantime, they include most of the psychopaths under detention.

I was very disturbed by the reply which I received yesterday from the Home Secretary to a Question about those patients in the special hospitals who had applied for discharge to the mental health review tribunals. Some of us had a great struggle during the passage of the Mental Health Act to persuade the Government to allow access to those tribunals to those patients, many of whom will be psychopathic, but eventually the Government gave way, with one proviso. The proviso was that in those cases in which there is an order restricting discharge—in other words, those in which the responsibility for discharge rests on the shoulders of the Home Secretary and not on the medical staff—access to the tribunal would be granted but the tribunal's recommendations would be only advisory.

I asked the Home Secretary how many patients in Broadmoor—because I gather that there has been no application from Rampton and Moss-side—had applied to the tribunal. The answer was that so far 88 had applied, and in 84 of those eases the tribunal had not recommended discharge. In four cases, however, it had recommended discharge. This independent tribunal, set up under the Act, consists of lay elements, legal elements and psychiatric elements, but in two of the four cases the Home Secretary has rejected the advice of this independent tribunal and in the other two he has not yet made up his mind.

This is not good enough. When we set up machinery which in effect is appeal machinery, and appeals are allowed, using the jargon of the courts, in four out of the 88 cases, it is very disturbing to have the Home Secretary's veto on the successful appeal in the only two cases in which he has yet reached a conclusion.

I wish to raise one other point about the problem of treating psychopaths. Under construction at present is Grendon Underwood Prison, which was planned 25 years ago as a psychiatric prison. It was originally called the Hubert-East type of institution because of Norwood-East and Dr. Hubert's report on the appropriate methods of treating this kind of offender. Because of the war, the plans to build the hospital had to be shelved, and it was only about 18 months ago that the Home Secretary laid the foundation stone. But the prison is going ahead. As far as I understand, the original plans have not been modified to a great extent. We are now going to have a psychiatric prison designed to the requirements of twenty-five years ago I do not think it is exaggerating matters to say that the Home Office does not know what it is going to do with it when it has got it. This prison was planned at a time when nobody thought that hospital treatment was appropriate for the psychopathic offender. Criminological ideas have changed since then. Indeed, psychiatric ideas have changed very much in twenty-five years.

It seems to me wholly inappropriate to have a hospital provision which we hope to see extended in a network all over the country for psychopaths, many of whom will come from the courts, who will be the subject of a hospital order, perhaps with an order restricting discharge, and alongside that a prison which is presumably going to be staffed—I would hope, at any rate, that it will be well staffed—with psychiatrists giving presumably the same kind of treatment within a prison setting for psychopathic offenders whose offences are exactly the same as or certainly parallel with both types of case.

I hope the Joint Under-Secretary of State will be able to say something about the Government's intentions, or at least his right hon. Friend's intentions, about Grendon Underwood. I believe that it has not been thought out sufficiently closely or sufficiently recently. The best solution, if it is not too late to alter the design, would be to hand over Grendon Underwood to the Minister of Health and make it not a psychopathic prison but a psychopathic unit for the training and treatment of persons suffering from psychopathic disorders and who have been awarded a hospital order through the courts.

I sum up by saying that this confusion about the proper way to treat the psychopathic offender ought to be cleared up here and now. Are these offenders sick people who require treatment, who are susceptible to treatment and to that extent not wholly responsible for their action—that is what I believe—or are they to be treated, as they have been treated in the past, as tiresome offenders who are going to disrupt almost any institution in which they are detained and, therefore, should be sent to prisons to undergo the ordinary prison regime plus such psychiatric assistance as may be available? I do not use the word "treatment", because there is very little psychiatric treatment in the prison service at the moment.

I believe that to send them to prison does no good at all. There is not much agreement about psychopaths and psychopaths, but the one thing on which almost everyone agrees is that prisons make them worse. It is on this note that I am afraid I must disagree with the hon. Member for Kemptown, who suggested indefinite sentences in prison. The appropriate course is that they should be treated and trained under medical supervision for as long as is necessary, and that is not the same thing as an indeterminate sentence. I hope that we shall have from the Joint Under-Secretary some clarity of the Government's thinking about what I believe we all agree is one of the most difficult social problems of our time.