Prisons and Courts Bill (First sitting)

Liz Saville Roberts Excerpts

Committee Debate: 1st Sitting: House of Commons
Tuesday 28th March 2017 Public Bill Committees

[The Chair]

We will now hear oral evidence from the Prison Officers Association, Her Majesty’s inspectorate of prisons, the prisons and probation ombudsman and the Royal Society for the Encouragement of Arts, Manufactures and Commerce. Before I invite the witnesses to introduce themselves, I remind the Committee that questions should be limited to matters within the scope of the Bill and that we must stick to the timings in the programme motion that the Committee has agreed to: this session finishes at 11 o’clock.

[Liz Saville Roberts (Dwyfor Meirionnydd) (PC)]

I take this opportunity to declare an interest as the chair of the cross-party justice unions and family courts parliamentary group.

[The Chair]

That is noted, thank you. Will the witnesses please introduce themselves for the record?

Joe Simpson: Joe Simpson, assistant general secretary of the Prison Officers Association.

Nigel Newcomen: I am Nigel Newcomen, the prisons and probation ombudsman.

Rachel O'Brien: Rachel O’Brien. I lead the work of the Royal Society for the Encouragement of Arts, Manufactures and Commerce on prisons.

Martin Lomas: And Martin Lomas. I am the deputy chief inspector of prisons.

--- Later in debate ---

[Mr Gyimah]

Q Mr Simpson, I would like you to comment on professionalisation. We are consulting with the trade unions on the creation of 2,000 new senior positions across the estate, where they will be able to work at band 4 level in such jobs as self-harm prevention or mentoring, earning up to £30,000 a year. How could that help retain senior staff and professionalise the workforce?

Joe Simpson: I used to do that as a prison officer; I did not need promotion for that. It was part of my role and what I was paid for, but the service has long depended on prison officers and prison staff volunteering to do that extra work with no pay and no pay rise. Some 70% of prison staff have not had a decent pay rise in five years. That is when you get problems in the Prison Service. They feel forgotten and as though they do not count. With the 2,000, why not train the rest of them in that and make the Prison Service a truly professional service?

[Liz Saville Roberts]

Q I think I am correct in saying that the level of turnover among prison officers is something like 12%.

Joe Simpson: Yes.

[Liz Saville Roberts]

Could you tell us something about the impact of that degree of change? The underlying impact is that their salary is for ever starting at the lower level. Also, there is now regional variation in salaries. What is the impact of that—I have visited HMP Berwyn and I will be going to HMP Liverpool next week—on recruiting outside of south-east England?

Joe Simpson: In areas with high unemployment, you will get people wanting to be prison officers because it is paid work and they will want to be in work. The high turnover is not just down to salary; it is also about when people come in and see the reality of prison life. It is all right talking about when you go to the school; I attended Newbold Revel and went straight to HMP Strangeways, and that was a big eye-opener for me.

In fact, when the door closed behind me for the first time, the hairs on the back of my neck stood up. I nearly put my keys in and left—I didn’t. The high levels of turnover are for the simple reason that prison officers no longer feel safe in our prisons. Why would you want to come to work and earn £21,000 to be spat at, assaulted, have excrement and urine thrown over you, and be physically and verbally abused? No other profession would put up with that.

[Liz Saville Roberts]

Q Is the training perhaps not preparing new recruits? Would it be possible to adapt the training to prepare new recruits better for the reality of prison work?

Joe Simpson: I think you could get a training programme that will get them ready for prison life and for working in prisons, but they also have to go into prisons and work there. When I first started, I went into Durham prison for three weeks. I came back, did the rest of my training and then went into Strangeways. When I was at Strangeways, I had what I called a “buddy officer”, and I worked with him for 12 months. If I had a problem working there, I went to him to ask a question and he answered it. He was with me all the time. That no longer happens: because of the pressure on getting prison officers into prisons and getting a regime going in prisons, that is no longer there. I think that would help.

[Liz Saville Roberts]

Q May I ask one general question to everyone on the panel who might be able to respond? The Bill is proposing the purpose of prisons. What would you feel about including health, substance abuse and addictions while people are in prisons as a possible fundamental purpose?

Rachel O'Brien: Two of the purposes—if you are talking about progression—imply that you have to address the fundamentals, including mental health and drug use. In terms of holding governors to account, it speaks to a flaw in the prison reform agenda more widely, which is that this is only a part of people’s journey—for some people, a very short part of their journey.

If you are in prison for a matter of weeks, there is very little that even the best governor and staff can do, even with some of the training support. We know that deaths peak the week after custody, so the key that is missing is the integration question. How do we hold governors to account for something they ultimately do not own? What role within that is there for local authority substance misuse organisations, NHS providers and the CLCs? There is a need to look across the journey in the Bill and the wider reform agenda.

Martin Lomas: There is a balance to be struck. Who could object to an objective of supporting and promoting mental health and wellbeing? The issue is, how do you define them? What does “wellbeing” mean, for example? There needs to be a certain clarity about that. Another argument is, where do you draw the line? One of the advantages of the purposes as they are currently stated is that there is clarity about them. They are punchy, specific and particular. We could perhaps stand having another couple, but there is a point at which they stop being purposes and start being standards. It is really a question of balance.

Nigel Newcomen: I certainly endorse that. On, for example, the fourth purpose—

“maintain an environment that is safe and secure”—

I cannot imagine an environment that is safe and does not have adequate mental health provision, an adequate approach to healthcare and, indeed, a decent environment. Unless I have misunderstood what is intended in the list of four purposes, I think most of the suggestions you just made would be encompassed within them. I am with Martin in assuming that if we have an endless list, you lose some of the prescription, direction and sentiment that is intended.

[Matt Warman (Boston and Skegness) (Con)]

Q This question is probably as much for Martin Lomas or Rachel O’Brien as it is for the rest of the panel. The Bill enshrines the idea of rehabilitation and reform for the first time. In my constituency there is a category D prison, North Sea Camp, and I have seen how difficult that can be. Do you think that that is a symbolically important gesture, but also that it will make a practical difference across the prison estate? Is it something that you welcome as a whole?

Martin Lomas: That it is clearly articulated that the purpose of an institution is to help rehabilitate and reform the individuals that are sent there? I think that is pretty fundamental and empowering, and brings clarity.

Certainly, as an inspectorate, we are committed in the Bill to take account of the purposes of imprisonment, although our criteria—the expectations, as we refer to them—are independent and separate. When we were formulating our expectations, we saw resettlement, as we term it, as fundamental, one of four interconnected features of a healthy prison: safety, respect, activity—work, in other words—and resettlement. So yes.

Rachel O'Brien: I agree. Out there, there is a need to define some of that. What we do not need is a long list of a hundred items. When we talk about wellbeing, it is not far off, and there is lots of evidence to show that you can measure that. So it should flow through to the leadership models. For example, what are new group directors for? That is going to imply a whole new partnership approach with this core purpose at its heart.

It comes back to staff, as well. Too often it is people like me that get to do the nice stuff. I do not get spat at; I do not have the uniform; I have keys but I do not have to have that authority. Staff are being pushed into a role in which they are doing only the authority side, and lots of other agencies are doing what I call “the nice bits”. It may not be brilliantly funded. I would argue that, when we look at the core workforce, that is the core job. Yes, they still need to have that authority, but all the dynamic security tells us that it is about relationships they have; it is spotting that flame in someone that can be enhanced. If you do not have enough people or time, it is hard to do that. So I would slightly push out people like me and really focus on the core workforce.

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[Nick Thomas-Symonds]

Q Rachel, a moment or two ago, you were taking about what the prisoners themselves have to offer in this. I know that the RSA has spoken about things such as rehabilitation culture—I think “rehabilitation capital” is the phrase that is used by the prisons. Can I pick up on that and, in a general sense, ask you whether you think the Bill incorporates that sort of culture and those sorts of measures in the way you would like to see?

Rachel O'Brien: I am slightly nervous of the new HMPPS defining this thing. We know a lot about wellbeing: for example, we can measure people’s ability to make good decisions and their self-confidence—all sorts of things that are prerequisites for the resilience they will need going forward. We are working with a high-security prison at the moment to develop a community-wide strategy. The outcome is going to be great. It is about thinking about, in a very closed system, how you have a better relationship with the outside world, family and so on. Actually, it is about the process of engagement with those prisoners, when they are talking strategies and tactics. They would not necessarily agree to do desktop publishing, but they will do it because they are producing a newsletter to communicate. It is that kind of approach, and you can measure people’s progress—partly because they will tell you and partly because you see it. It is that kind of approach that we need to replicate. Prisons need to be able to do things themselves rather than outsource them, because that is how staff can get those really valuable relationships.

[Liz Saville Roberts]

Q Nigel Newcomen, you mentioned the dichotomy between supply reduction and demand reduction. There are aspects of this Bill that deal with supply reduction per se. To what degree do you and other members of the panel feel that the demand reduction aspect is sufficiently considered within the Bill?

Nigel Newcomen: As I said, I impute from the purposes onward that some of the balances that we have been struggling to put across to you are required are implicit in the Bill’s structure. Demand reduction is a necessary partner of supply reduction. If you have only one, you are going to have only part of the solution. It is essential to have supply reduction, both for phones and for drugs, but you equally have to have work to mitigate the demand and the need for those illicit goods. Without that balance, I think we are on a hiding to nothing. There is nothing in the Bill that I can see that precludes that balance.

[Liz Saville Roberts]

Q Would you be prepared to suggest additions to the Bill that might make it less implicit and more explicit?

Nigel Newcomen: I am not sure I can think of any. It just seems to me that, unless we are misinterpreting it, the supply reduction issues are necessarily going to be balanced if you want a purposeful, rehabilitative prison. It is implicit that you have to do both. You cannot simply attempt to reduce supply if demand is insatiable.

Martin Lomas: I agree with that, but I would also make the point that there has to be a balance. One goes with the other. I make the observation that it is not perfect. How much is enough? We often report quite positively on some of the demand-side work that we see taking place within institutions, notwithstanding some of the other issues around it. In contrast, when we inspect we survey prisoners and one of the questions we ask is, “How easy is it to get drugs in this prison?” and although I cannot remember the exact statistic, the increase in positive responses in recent years has been striking. We comment on that routinely in our reports—that quite a lot of prisoners are telling us it is easy to get drugs in. Some of that will be over the wall, some will be an interpretation of the question around, for example, the diversion of prescribed medication, which is also an issue. So it is a complex problem and there has to be a balance. Questions of quantity will always be difficult to determine absolutely, but a balance is what is needed.

[Liz Saville Roberts]

Mr Simpson, what do you think?

Joe Simpson: On the demand side, the Prison Service has been very successful. When I joined, the drug of choice was cannabis; then, when they started mandatory drug testing, it went from cannabis to heroin and cocaine, for the simple reason that they stay in the body a lot less than cannabis. But we just punish prisoners; if they get a positive MDT, they are punished and that is the end of it. We are not doing anything to say to them, “Why are you taking it?” Why don’t we turn around and start educating them about the drug issue, rather than just punishing them? As long as we punish them, nothing is going to change, because they still want that drug; they will still want it inside.

As long as people are coming into prison and bringing it in—the supply side of it—they do go hand in hand. We have to stop the supply but we also have to start to reduce the demand as well, because if we reduce the demand, the supply will stop coming in because people will no longer want it.

How do we do that? When I was at Holme House we had a successful drug treatment wing there. We turned it on its head: it was run by the prisoners. They looked after everything; they made sure everything was clean and took over the duties of the prison officer. The prison officer was still there; we were still there supervising it and it worked. Then all of sudden, because we ran out of money, it went. We reduced the demand and then, once the money stopped, the demand went back up, because there was nothing there to get prisoners to take charge of their lives in prison. That is what is missing.

Rachel O'Brien: It is an interesting question, in terms of responsibility. I would raise a concern about that being just on the governor, not going any wider. It is interesting to ask about the responsibility to reduce demand and how you might show that. The other parts of the Bill that are important concern education, employment and health commissioning, because ultimately if we do not have more people working, more people getting the treatment they need, the supply will respond to demand. For me, a key question is whether that commissioning going to be more local, more sensitive and more productive. Many prisoners will tell you that they are either in their cell most of the time or they are doing another level 1 catering when they have done four as they have moved around the system. The intention, not so much as reflected in the Bill, but in the education strategy and so on, is to actually look at more progression for people.

Again, it comes back to the fact that a prisoner will tell you exactly how they want to progress, but what if that is not available? I really worry that while what is in the Bill looks like a decentralisation of commissioning, I am not clear that that is actually what is going to happen.

[Suella Fernandes (Fareham) (Con)]

Q I refer the Committee to my entry in the Register of Members’ Financial Interests. I am still in receipt of fees from the Treasury Solicitor for providing legal services to the Ministry of Justice and the Parole Board.

Nigel, I want to follow up on your point about the statutory purposes listed in proposed new section A1. There are four purposes set out and you said that an endless list would be unhelpful for professionals and for the inspectorate. Can you say a bit more about why you think that the current drafting hits the nail on the head and strikes the right balance?

Nigel Newcomen: I did not quite say that the current drafting hits the nail on the head. I said that an endless list would, I think, be unhelpful; I think Martin made the same point. If you are going to have a set of overarching purposes, they need to be relatively discrete, something managers can focus on and, in Rachel’s words, could run through a stick of rock. If it is an endless list, that is a very big piece of rock. This needs to be a means of gaining clarity for the organisation and the institution.

I said in passing, I think, that the word “decency”, for example, was missing. It may be that there are bits of drafting that may be attended to as the Bill goes through. I think a relatively discrete statement of purpose and set of aims is useful. All experience of business management and organisational institutional change is predicated on having a relatively limited set of outcomes that you are seeking to achieve. I think these are pretty good and discrete statements. They could probably be improved, but I do not think I would like to see the list get that much longer.

Prisons and Courts Bill (Second sitting)

Liz Saville Roberts Excerpts

Committee Debate: 2nd Sitting: House of Commons
Tuesday 28th March 2017 Public Bill Committees

[Matt Warman]

Q But these are the greatest challenges for digital inclusion full stop, are they not? This is not a unique problem for justice.

Jenny Beck indicated assent.

[Liz Saville Roberts (Dwyfor Meirionnydd) (PC)]

Q What is very interesting about this discussion is that we seem to have become very polarised in favour and against. It strikes me that perhaps we need to take a step back and look at the other considerations that need to be brought in to make this effective and not a risk in terms of justice outcomes.

If I may, I will make this slight comparison. I used to be responsible for teaching through video non-traditional A-level subjects—through the medium of Welsh, as it happens—to widen their accessibility, to 15 secondary schools in Wales. Of course, we constantly had the check of the results and seeing how the students who were being taught by video performed in comparison with the conventional teaching method. There is great potential in technology, as is being discussed, but I think there are issues in relation to the vulnerable and there are age—generational—issues as well, without beginning to touch on the nature of technology in some of our rural areas.

What worries me, and what I would like your opinion on, is how we bring this in and have the checks and balances to assess the research—whether there are different outcomes to justice in terms of this—and that this is not a headlong rush into technology in which some participants will actually suffer or there will be unjust results because of it. This cannot be polarised; it has to be something that we discuss as we go along.

Professor Susskind: I accept that it cannot be polarised. You obviously invite people along who are likely to take a position, and my position is a position of change. I have been involved with this for 35 years, suggesting that technology should be used more in the court system. I cannot say for a second that anyone has ever been rushing in; it has been a very slow, arduous and sometimes painful process.

I travel the world, have spoken in more than 40 countries and visited courts. We are, in this country, falling behind other courts, so we cannot be accused of rushing in. I fully agree, however, that to jump ahead in a foolhardy way would be silly. I am simply pointing out, and will say again, that in the context of civil law the current system is inaccessible, unaffordable and unintelligible—full stop. It seems to me worth at least introducing some of these new procedures to offer access to people who would otherwise never have had it. I do not find that contentious; in fact, on civil, I do not think I have been hearing great opposition to it.

[Liz Saville Roberts]

Q Forgive me, but what would the checks be as we change from one very well established and familiar system to a new system? What will be the checks from day to day that they are operating properly?

Professor Susskind: Are we talking about the civil system or the criminal system? Because if we are talking about the civil system, I have to come back at you. You say that it is a very well established system, but my view is that it is a system that suffers from very serious difficulties.

The last research was shown to suggest that 1 million people every year have justiciable entitlements and do not, or cannot, pursue their rights in the civil justice system. We have vast numbers of litigants in person who really struggle to understand the system. If our system was great just now, I would be very hesitant about saying we should replace it with technology.

If this is taking a polar position, I am happy to take one—we have a civil justice system just now that is inaccessible for the overwhelming majority of citizens. I want to say to you that it is surely worth introducing, for some low-value claims, a new way of offering access to judges and then monitoring it very carefully—maybe that is the point you want a response on. I think it is vital that we do ongoing research. The point is well made that we need to understand the impact as we go along and we need be willing to change direction.

As for the evolution of technology in the private sector and the public sector, we are not architects. You cannot design the finished building and say, “Here is what it is going to look like.” It is a bit of a journey. If you are hesitant about starting the journey because we do not have the checks and balances in place—we need to have the checks in the place. I think you will find that most leaders, both in the public and private sector, have a sense of direction and say, “Let’s start this together, monitor carefully and ensure we are delivering the benefits.” It seems to me that the option of saying, “Let’s not change at all because we cannot be certain how it is going to unpack,” is not an attractive one. The discussion we should be having is how we ensure, with all these new technologies, that we are monitoring their impact, and that there is an appropriate hand on the tiller when it seems it is taking us in different directions.

[Liz Saville Roberts]

Q Could you recommend what form that should take?

Professor Susskind: I am bound to say this, because in part I am an academic by background, but I think we need to move beyond anecdote. I can tell you what I heard in the court room that I visited—it was nothing like what was heard over here—but actually, what each of us says as individuals is less important than engaging serious researchers to undertake attitudinal surveys and surveys of people who have been through the process. That is the kind of work that we have seen someone like Hazel Genn at UCL doing over the decades—understanding why people go to the law, how they feel when they have been through the process and whether they have confidence in the system.

I have been strongly advocating, even for the civil system that I have recommended we introduce, that we should not rush in. We should think big, but start small. We should start small, monitor, evaluate, undertake serious academic empirical research, report back, invest where things seem promising and be prepared to accept if developments do not work out. We do not have the evidence yet so we have got to kick-start it somewhere. This, for me, is a call for an incremental—the technology would say an agile—modular step-by-step approach. If I was getting the sense that the Government were advocating a big bang—one single system, architect in advance—I would be very critical of that, but that is not the approach being taken.

[Sir Oliver Heald]

Q I was hoping we might move on to clause 47—the cross-examination in family justice. I was hoping to ask Polly from Women’s Aid, who is sat very patiently, one or two questions about this. Polly, could you give us a sense of the harm caused by victims being cross-examined in person by alleged abusers in the family courts?

Polly Neate: It is hard to overstate how harmful it is, actually; it is genuinely traumatising. In particular, it makes it very difficult for the family courts to play the role they should play, which is to put the child’s best interests first, when usually the mother of the child is not able to advocate adequately because she is being questioned by somebody who has put her through abuse—sometimes, years of abuse.

The other thing that is really important to understand about this—this is what is worrying about judges’ understanding, if I may say so—is that domestic abuse is not all about incidents of physical violence; it is all about control, and coercive control. The family courts are being used, if you like, as an arena for perpetrators to continue to exert the control over their partner or former partner, and in particular they are using child contact proceedings as a way of continuing to exert that control.

So it is not only that the person might be overtly abusive towards the survivor in the court, although that happens unfortunately. It is also that there are like trigger words and almost code words that a perpetrator can use when talking to the victim, which will mean something to her that is extremely traumatic but to anyone listening it would not necessarily appear to be abusive, on the face of it. That is why we say that the practice just has to be banned, because as an onlooker you cannot necessarily tell the meaning of what is being said between those two people, particularly—this often happens—after years of abuse and coercive control of all kinds, and psychological control in particular.

Prisons and Courts Bill (Third sitting)

Liz Saville Roberts Excerpts

Committee Debate: 3rd Sitting: House of Commons
Wednesday 29th March 2017 Public Bill Committees

[Michael Tomlinson]

I have listened carefully to the Minister and am grateful for his considered response to my amendment. All I ask is that when Lord Farmer’s report is widely disseminated, he does not close his mind to the possibility of the amendment’s wording being in the Bill. Obviously that will depend on timing. At present I am content not to press the amendment. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Liz Saville Roberts (Dwyfor Meirionnydd) (PC)]

I beg to move amendment 4, in clause 1, page 1, line 14, at end insert—

‘(e) provide for the wellbeing and healthcare of offenders, including treatment for drug and alcohol misuse and assuring access to continued relevant support upon release.

(f) liaise with the Probation and other relevant services to ensure coordinated rehabilitation of offenders.’.

This amendment ensures that it is within the purpose of a prison to ensure offenders receive the appropriate physical and mental healthcare, as well as necessary rehabilitative support upon release.

[The Chair]

With this it will be convenient to discuss amendment 12, in clause 1, page 1, line 14, at end insert—

‘(da) maintain and promote physical and mental health of prisoners.’.

This amendment requires the purposes of prisons to include the wellbeing of prisoners.

--- Later in debate ---

[Liz Saville Roberts]

The amendment concerns the wellbeing and healthcare of offenders, the relationship with bodies such as probation and the co-ordinated rehabilitation of offenders. Despite reforms, the evidence is clear that the physical and mental healthcare we offer our prisoners still needs to be addressed. The purpose of prisons is undoubtedly to protect the public, rehabilitate and keep prisoners safe and prepare them for a life outside the institution. I welcome the inclusion of those concepts in this part of the Bill. However, it seems to be an obvious omission not to recognise specifically prisoners’ healthcare needs, both mental and physical. Equally, although the need to prepare offenders for life outside of prison is stated in the Bill, there seems to be somewhat a lack of foresight when it comes to expressing how prison should ensure a smooth transition into our communities by liaising with external organisations.

Let me inform the Committee of the statistics on healthcare: prisoners are 12 times more likely to suffer a personality disorder and 16 times more likely to suffer from psychosis; 10% to 14% of prisoners suffer a major depressive illness; two out of three have a personality disorder; seven out of 10 have alcohol abuse issues; and a third have a drug addiction on entry. I shall raise hepatitis C specifically under a later amendment.

The Government’s own regulator on the standard of healthcare in prisons, the National Guideline Centre, which is funded by the National Institute for Health and Care Excellence, said last year that it had become clear that healthcare provision in prisons was typically poorer than in the general community and not sufficient to meet prisoners’ needs. If we do not recognise that most basic of obligations, healthcare in prisons is likely only to slide. That in turn will mean a risk of significantly worse outcomes, both for offenders in prison and those leaving prison. By not recognising the need for a prison to cater for the basic needs of its inmates, we will continue to fail to address key issues that contribute to criminal and disruptive behaviour inside and outside prisons, which of course will only burden the state further in the long run.

The amendment would add new paragraph (f) to proposed new section A1 of the Prison Act 1952; that relates to the need for prisons to look outwards as well as inwards, to properly reintegrate offenders back into communities. The Bill indicates that it is entirely within the prison that an inmate will become proficient in skills and learn to deal with demands in the way that reintegration requires. The reality is of course very different. A prison must liaise with a plethora of organisations across the public, private and third sectors to ensure that offenders have the best possible chances of reintegrating. New paragraph (f) would ensure that that reality was reflected in the Bill.

I recognise, of course, that clause 1 could become a list as long as my arm; however, I feel that the two relatively modest additions in the amendment would reflect the necessity and reality of the way modern prisons function, which is not, of course, in isolation. I will not press the amendment to a vote now, but I hope that the Government will give it proper consideration and a full response.

[Mr Gyimah]

The Government are very aware of the serious challenges that mental health, drug and alcohol issues pose for offenders and the prison system. The Ministry of Justice is committed to working closely with my colleagues at the Department of Health, NHS England and Public Health England, to help to provide the right support and healthcare in prisons.

There is already a statutory underpinning to the health of prisoners; ensuring that prisons are safe is already one of the aims contained in the statutory purpose. Our duties under the Human Rights Act 1998, which, as I have said already, incorporates the European convention on human rights, are also relevant to prisoner wellbeing and healthcare. For instance, under article 2 we must take active steps to prevent suicide and self-harm in custody. Under article 3 prisoners must be detained in conditions compatible with respect for their human dignity and not be subjected to distress or hardship that goes beyond the suffering inherent in detention; the article also requires that, given the practical demands of imprisonment, prisoners’ health and wellbeing should be adequately secured.

There are also already many processes and protections in place in prisons to protect prisoners’ health. For example, health needs assessments help to ensure that accurate information is available on the provision of healthcare needed in each prison; and we are introducing new training for prison staff, including awareness training on supporting prisoners with mental health issues, so that governors and staff better understand the mental health issues of the prisoners they are helping to support.

As set out in the National Health Service Act 2006 as amended by the Health and Social Care Act 2012 and regulations, healthcare in English prisons is commissioned directly by NHS England. That is important because it is right that healthcare in prisons should be delivered by clinical experts. Governors do not have the qualifications or the capability to make clinical decisions about patients, so it is right that responsibility for those decisions should lie with those professionals who can ensure that patients receive the best care.

Governors are already under a legal duty, under prison rule 20, to work in partnership with local healthcare providers to secure access to the same quality and range of services as the general public receive from the national health service. Part of that involves making sure that governors facilitate access to the healthcare provided by NHS England, including giving security clearance to the right people and providing escorts to appointments. However, as set out in the Government’s “Prison Safety and Reform” White Paper in November 2016, we want to go further.

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[Mr Gyimah]

I thank the shadow Minister for her points; I will make a couple of brief points in response. I agree that the level of violence—particularly violence related to the use of new psychoactive substances such as spice and mamba—is too high. In September, we rolled out a new drug test for psychoactive substances—the first and only such test in the world—so we are aware of the issue and we are dealing with it.

We are all aware that prisons are difficult places with some very difficult people to manage. The question is whether we need provision in the Bill to manage these issues. I contend that we need effective practice. When it comes to mental health, for example, we should ask whether processes work well in every prison and whether our prison officers are properly trained to identify how people present when they have mental health problems. I spoke to one of the people who works in our prisons about these issues, and they said that when a prisoner has a mental health problem or is considering taking their life, they enter a dark place and seek to cover their tracks and not really show what is happening internally. These are issues that we really need to train people on the ground to deal with.

I suggest that the amendment be withdrawn. This is about effective practice on the ground. We are alive to these issues, and we will get to grips with them by empowering governors to work closely with the agencies that matter, rather than by adding another list to the Bill.

[Liz Saville Roberts]

I thank the Minister for his comments. I note that he referred exclusively to NHS England. Healthcare is devolved in Wales; prisons are not. That in itself raises the question: to what degree are we consistent in our approaches, and does this issue really need to be raised?

Others eloquently made the point that mental health problems and alcohol and drug addictions are so significant among the prison population that their treatment is surely critical to both rehabilitation and reducing reoffending. The Bill refers to prisons aiming to

“maintain an environment that is safe and secure.”

That does not seem to fully reflect the gravity of the situation, which we need to respond to. I hope that the Government will consider that. However, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Amendment proposed: 12, in clause 1, page 1, line 14, at end insert—

‘(da) maintain and promote physical and mental health of prisoners.’—(Yasmin Qureshi.)

This amendment requires the purposes of prisons to include the wellbeing of prisoners.

Question put, That the amendment be made.

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[Yasmin Qureshi]

I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Liz Saville Roberts]

I beg to move amendment 5, in clause 1, page 2, line 12, at end insert “and

(b) steps taken in relation to meeting health targets specified by the Secretary of State on—

(i) blood borne viruses, and

(ii) substance abuse,

including the provision of testing and treatment for hepatitis C.”

This amendment ensures that the Secretary of State’s annual report on prisons includes targets on blood borne viruses and substance abuse and analysis of whether they are being met.

This probing amendment seeks to create an obligation on the Secretary of State to include in the annual report on prison governance an analysis of progress in meeting health metrics on blood-borne viruses and substance abuse, including the provision of testing and treatment for hepatitis C.

Hepatitis C is a blood-borne virus affecting the liver that can cause fatal cirrhosis and liver cancer if untreated. Around 214,000 people are chronically infected with hepatitis C in the UK. Around 90% of cases arise through injecting drug use, although there are other potential causes including overseas medical care, tattooing and receipt of a blood transfusion in the UK prior to 1991. People are able to live without symptoms for decades after infection, but untreated cases can lead to severe liver problems. Liver disease is one of the five big killers in the UK, and the only one of those where mortality is rising, and hepatitis C is the third most common cause of it.

Why are prisoners particularly at risk? Hepatitis C disproportionately affects disadvantaged and marginalised communities, and around half of people who inject drugs are estimated to have the virus. With around a third of the people in prison having injected drugs, rates of hepatitis C infection are particularly high among prisoners. A 2012 study from Scotland estimated rates of hepatitis C among prisoners to be almost 20%, and we might expect that rate to be similar in other prisons. Offering testing and treatment for hepatitis C is therefore a highly effective way of contributing to prisoners’ rehabilitation; indeed, by allowing them to focus on improving their health and wellbeing it is often found that they are better placed to address other issues contributing to their offending, such as substance misuse. It is also essential that this is carried out if prison governors are to meet the commitment to improve health outcomes.

In October 2013, the UK Government agreed to implement blood-borne virus opt-out testing in prisons. Testing rates for hepatitis C in prisons have improved as a result, rising from 5.3% in 2010-11 to 11.5% in 2015-16. That figure is still too low, however, and progress needs to be made on fully implementing the opt-out testing policy.

The prison environment is an ideal one in which to test and treat people who lead chaotic lives and may not have previously been in contact with healthcare services. With new oral drug treatments becoming available in recent years, which have considerably shorter treatment durations and markedly fewer side effects than previous treatments, the opportunity to treat people in prison is greater than ever before. Achieving a cure for hepatitis C can be a trigger for long-term addiction recovery and help people to take control of their lives. Offering treatment for hepatitis C can therefore be an important step in helping to prepare prisoners for their release.

I prepared that speech with the help of the Hepatitis C Trust, and I would very much like to hear the Minister’s response.

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[Mr Gyimah]

This is a probing amendment concerning a duty on the Secretary of State to include as part of her annual report to Parliament the steps taken to meet targets on blood-borne viruses and substance abuse.

Healthcare in prisons is provided by NHS England, which already uses health and justice indicators of performance and other data to report the performance of substance misuse services and blood-borne viruses. Those data inform NHS practice in commissioning and providing healthcare to prisons. For example, Public Health England, NOMS and NHS England introduced opt-out testing for blood-borne viruses for people in prison in the first national partnership agreement published in 2013. Full implementation across the whole adult prison estate in England is planned by the end of the 2017-18 financial year.

Data on the offer and uptake of testing and referral for treatment are measured through the health and justice indicators, which are based on information provided directly by healthcare teams in prisons to NHS England and shared with Public Health England. Additionally, data on people treated for substance misuse in prison and in the community are collected by Public Health England through the national drug treatment monitoring system.

Using those data, under the programme of co-commissioning that the Government are implementing, prison governors will be able to work with NHS England to commission healthcare services that meet their individual prison’s needs. That, of course, can include elements that provide testing and treatment for blood-borne viruses and substance misuse. I hope I have provided sufficient assurance to the hon. Member for Dwyfor Meirionnydd that placing this requirement on the face of the Bill is unnecessary, as a programme of work is already under way in this area.

[Liz Saville Roberts]

I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Question proposed, That the clause stand part of the Bill.

[Mr Gyimah]

We have had a full and detailed debate on clause 1. It will not surprise hon. Members to know that in drafting the clause, the Government thought long and hard about what it should contain in view of the fundamental changes it makes to the current legislative framework.

The clause reforms the framework of the prison system, providing aims for the system as a whole to unite behind, clarifying the role of the Secretary of State and sharpening accountability. It modifies the Secretary of State’s overarching responsibility for prisons, removing the outdated duty to superintend prisons. The clause also reforms and modernises the Secretary of State’s accountability to Parliament for the performance of prisons. It replaces the existing archaic requirements to report on operational detail, such as hours of work completed in each prison and number of punishments, with a requirement to account to Parliament for the extent to which prisons are meeting the statutory purpose created by the clause.

[Yasmin Qureshi]

We have raised our concerns about the issues we think are important and should be covered in the clause. We hope that the Minister will reconsider some of those things on Report.

Question put and agreed to.

Clause 1 accordingly ordered to stand part of the Bill.

Clause 2

Her Majesty’s Chief Inspector and Inspectorate of Prisons

[Liz Saville Roberts]

I beg to move amendment 6, in clause 2, page 2, line 18, leave out “a” and insert “an independent”.

This amendment ensures the person appointed as Her Majesty’s Chief Inspector of Prisons has the necessary independence from Government and associated bodies.

[The Chair]

With this it will be convenient to discuss amendment 15, in clause 2, page 2, line 18, at end insert—

‘(1A) Before Her Majesty makes an appointment under this section, the Chair of the Justice Committee of the House of Commons shall recommend for Her Majesty’s consideration an appropriate person who in its view could satisfactorily carry out the functions of the Chief Inspector by moving a name on the floor of the House.”

This amendment provides that the Justice Select Committee should make a recommendation on the appointment of the Chief Inspector of Prisons.

[Liz Saville Roberts]

At the moment, there is no statutory obligation for the person appointed as Her Majesty’s chief inspector of prisons to be independent of Government and associated bodies, and I think we would all agree that it is essential that the chief inspector of prisons is independent. There are provisions in the Bill to empower prison governors to deliver on extra responsibilities, so it is more important than ever that independent chief inspectors of prisons are able to scrutinise and hold prison governors, as well as the Ministry of Justice, to account in a way that is beyond any question of bias.

We already have the Independent Police Complaints Commission, which in legislation is clearly stated to be just that—independent. In the Police Reform Act 2002, through which the IPCC was created, there are stringent tests precluding candidates with particular backgrounds, which might bring into question their independence, from becoming a chairman or member of the commission. The Government must recognise that that imposed, and legislated for, distance between any appointee to the IPCC and a body that that person might investigate is required also for senior prison inspectors. The inspectorate is already advertising itself as an independent body. Surely now is the time to enshrine this common-sense policy in law, both transparently and explicitly.

I will not press the amendment to a vote at this stage, but I hope that the Government will give a detailed answer explaining why they have not chosen to include this wording in the legislation and whether on reflection they might be amenable to a more specific and stringent statement.

[Yasmin Qureshi]

We support any attempt to ensure the independence of the inspectorate from the Government, so we support this amendment.

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[Liz Saville Roberts]

It is right, I am sure everyone will agree, for the chief inspector of prisons to be beyond any doubt in relation to the independence of his role and of his judgment. It seems to me that this should be stated explicitly in the Bill. Amendment 15 would make changes to the appointment procedure. That would put what is proposed into effect and on to a robust footing. There would then be no doubt in that respect. I have some difficulty in understanding the Minister’s response, particularly in relation to the explicit use of the terminology of independence. None the less, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Amendment proposed: No. 15, in clause 2, page 2, line 18, at end insert—

“(1A) Before Her Majesty makes an appointment under this section, the Chair of the Justice Committee of the House of Commons shall recommend for Her Majesty’s consideration an appropriate person who in its view could satisfactorily carry out the functions of the Chief Inspector by moving a name on the floor of the House.”—(Yasmin Qureshi.)

This amendment provides that the Justice Select Committee should make a recommendation on the appointment of the Chief Inspector of Prisons.