Prisons: Pregnancy Healthcare

Lord Keen of Elie Excerpts

Thursday 31st October 2019 Lords Chamber

[Baroness Hussein-Ece]

To ask Her Majesty’s Government, following the death of a newborn baby in HMP Bronzefield, whose mother reportedly gave birth alone in a cell with no medical care, what action they are taking to ensure that vulnerable pregnant women have access to good-quality healthcare, and are safe, in prison.

[The Advocate-General for Scotland (Lord Keen of Elie) (Con)]

My Lords, the incident at Her Majesty’s Prison Bronzefield was tragic. Ongoing investigations, including by the police, mean that it is not appropriate to comment on the details. While the police investigation has primacy, we have asked the Prisons and Probation Ombudsman to conduct an overarching investigation. This distressing incident is a rare occurrence. Every step is taken for women to give birth in hospital but, for a small number, this is not possible due to the unpredictability of labour.

[Baroness Hussein-Ece (LD)]

I thank the Minister for that Answer, although it is not satisfactory. It seems that lessons were not learned at Bronzefield Prison as there were two such incidents in the past year, one resulting in a stillbirth. Will the Minister say why, despite the Government’s commitment in the female offender strategy to reduce the number of women in prison, the figures show that they are going up? Why is it that the Government—or the Prison Service—have no figures at all for how many women in prison are pregnant? Surely an urgent and immediate audit is needed to ensure that that is rectified. In addition, the Minister said that the Prison Service is responsible for pregnant women, but surely it is also responsible for their unborn children. This Victorian incident of a woman giving birth alone in a prison cell illustrates the lack of care and support for pregnant women in prison, many of whom should not even be there. Can he explain this, please?

[Lord Keen of Elie]

My Lords, I cannot accept all the propositions advanced by the noble Baroness. As at 3 pm on Monday, 47 women in custody were identified as being pregnant. In 2018, collection of local data identified that there were fewer than five cases in which a woman in custody had given birth in prison. Every effort is made to ensure that suitable midwifery and perinatal care is available for all women taken into custody. Indeed, the guidance document Working with Women in Custody and the Community, published in December 2018, includes an entire section on caring for perinatal women in prison. This was a most unfortunate incident. As I say, it is not appropriate for me to go into the detail of the incident, given that there is an ongoing police inquiry, but I can assure the noble Baroness that, apart from the guidance I have just referred to, the National Prison Healthcare Board has a principle of equivalence of care for prison healthcare in England to ensure that the same standard of perinatal care should be available to those in custody as to those in the community.

[Lord Beecham (Lab)]

My Lords, we have a situation where 600 pregnant women are confined. While this raises questions about sentencing, it surely also underlines the need for those in charge of women’s prisons to provide proper care. There are 11 investigations currently under way. Given the shocking failure of Sodexo in this case, what sanctions will the Government impose on the company? Will it transfer the management of women’s prisons to public sector or non-profit-making management?

[Lord Keen of Elie]

My Lords, the guidance that I referred to applies equally to public sector and contracted prisons. With reference to Her Majesty’s Prison Bronzefield, I observe that the most recent report from the inspectorate, published in April this year, identified Bronzefield as an “overwhelmingly safe prison” and an “excellent institution”. It found that pregnant prisoners in Bronzefield were identified and immediately referred to midwifery support. Clearly, we need to look at this incident and learn lessons from it. We are intent on doing so.

[Lord Garnier (Con)]

My Lords, I declare my interests as a trustee of the Prison Reform Trust. Will my noble and learned friend not only take on board the points made by the noble Baroness opposite in respect of the example at Bronzefield but widen the inquiry he has spoken about to cover all medical services provision in the prison estate in England and Wales, be it for mental or physical health? An increasing cohort of elderly, geriatric and end-of-life prisoners is underprovided for in terms of adequate medical care. Will my noble and learned friend ensure that this Government make sure that there is proper provision for all prisoners, throughout the prison estate?

[Lord Keen of Elie]

My noble and learned friend makes a very good point. It is essential that we provide medical care across the board for those in custody. As I mentioned, that is why the National Prison Healthcare Board has produced its principle of equivalence of care for prison healthcare in England. That followed a report by the House of Commons Health and Social Care Committee, published in November 2018, which recommended that the board should work with stakeholders over the next 12 months to agree a definition of equivalent care and indicators to ensure that they can measure that there are no health inequalities for people detained in prison. Of course, that includes mental health, which is a major issue, particularly in respect of women’s custody, with more than half of women in custody recorded as reporting or suffering from mental health issues. I agree that that needs to be addressed.

[Lord Ramsbotham (CB)]

My Lords, when I suspended my first inspection of HMP Holloway after discovering that women were routinely chained while in labour, I was very disturbed to discover that there was nobody in Prison Service headquarters responsible for the overall direction and co-ordination of women’s prisons. Could the Minister tell the House who in Prison Service headquarters is responsible for the co-ordination of the delivery of services to pregnant women in prison?

[Lord Keen of Elie]

My Lords, that ultimately rests with the director-general, who in turn takes steps to deal with those concerned at a regional level. That remains the position. I am pleased to say that the director- general of the Prison Service is always in communication with prison group directors regarding all these issues. I am also pleased to observe that we have moved on significantly since the days when the noble Lord, Lord Ramsbotham, made the discoveries he referred to. Matters have improved. Indeed, my understanding is that Holloway prison is no longer open.