John, Reid our
lips: A change has got to come
Twenty years separate the Ritchie and Rocky Bennett inquiries. Each inquiry investigated the death of a black man in a psychiatric hospital. But had governments implemented Ritchie recommendations, Rocky Bennett inquiry might not have been necessary.
Similarly, if John Reid, the health minister, implements Bennett recommendations, the need for future inquiries into deaths of black people in psychiatric hospitals might not arise.
The trouble is Reid, like his predecessors, will resist implementing Bennett recommendations.
Campaigners for changes in the way mental health patients are treated can overcome Reid’s resistance only by changing the focus of their campaign.
Before seeing how campaigners can over Reid’s resistance, let us look at the circumstances that give rise to the Ritchie and Bennett inquiries.
Michael Martin, 22, had no criminal record when doctors sectioned him under the Mental Health Act 1959. They sent him to Broadmoor Norfolk House, a hospital for the “criminally insane” in November 1979 (Sivanandan 1991:41).
In July 1984, Michael died after a violent struggle with six nurses. He choked own his vomit (Sivanandan 1991:51).
A coroner court returned a verdict of “accidental death aggravated by lack of care” in October 1984.
The post mortem, however, had revealed Michael’s body was imprinted with signs of “lack of care” indicative of, if not murder then, manslaughter. For example, the bruising around his neck was consistent with a neck hold, which might have prevented the vomit from escaping in the usual way. And as a result, he choked on it.
The Ritchie inquiry into Michael’s death rejected the use of neck holds as a method of restraint. It found that the “use of a neck hold [on Michael] was dangerous and should not have happened”. Furthermore, the neck hold “caused deep and extensive bruising and may have contributed to [Michael] vomiting and aspiration.”
Ritchie recommended nursing staff should be given “ ‘compulsory and regular training in control and restraint techniques’” (Sivanandan 1991:41).
As to the use of force when restraining patients, Ritchie recommended, “it should be the minimum required to control the violence” (Sivanandan 1991:41).
Twenty years on the restraint method used by nursing staff featured in the death of David Rocky Bennett at Norvic Clinic, Norfolk, on October 31,1998.
During “a big scuffle”, five nursing staff restrained Rocky by pinning him to the floor. In spite of him complaining that he could not breathe, staff continued restraining him. They released him when he had stopped breathing. He was dead.
Restraint in a “prone position” was a contributory factor in him dying.
The period of restraint was also a causal factor of death according
to Dr Harrison, who carried out the post mortem examinations. He said
the period of restraint, between fifteen and twenty minutes, was “far
At his inquest held in May 2001, the jury unanimously decided the
cause of death was
“restraint asphyxia”. They returned
the verdict of “accidental death contributed to by neglect”.
Bennett recommends that first-aid and CPR training should be mandatory (Blofeld 2003:67). Staff should also be aware about the importance of not “medicating patients outside the limits prescribed by law” (Blofeld 2003:68).
With regards to restraint, Bennett recommends: “Under no circumstances should an patient be restrained in a prone position for a longer period than three minutes” (Blofeld 2003:67).
Reid and nursing staff unions dismiss the three-minute limit when restraining patients (1).
Why is Reid and nursing unions reluctant to implement Bennett recommendations? Two reasons are apparent: cost and criminal culpability.
Reid fears the cost of having specialist teams trained in restraint and control techniques in every secure unit.
While if Reid implements the three-minute restraint limit, the Nursing and Midwifery Council will fear its members will become culpable for any breaches of the limit that resulted in patients’ deaths.
Therefore from both Reid and the Council’s prospective the current ad hoc set up is cost effective, albeit deadly.
Besides ethnic minorities represent a disproportionate number of patients who die in psychiatric hospitals. Bennett finds “institutional racism” within the NHS impacts on the quality of treatment ethnic minority patients receive.
Race is a factor that diminishes any urgency for reforms. Reid dismisses the existence of “this festering abscess [racism], which is at present a blot upon the good name of the NHS” (Blofeld 2003:58).
Sashi Sashidharan, a consultant psychiatric on the Bennett inquiry, said: “We can’t leave it to the department [of health] any more. According to Dr Joanna Bennett, Rocky sister, “it’s a disgrace lessons have not still been learned” (2).
It is apparent faith in Reid’s willingness to carry out reforms is spent.
What is to be done to force Reid’s hand? First, campaigners seeking reforms in the treatment of mental health patients should shift the focus of their campaign from national to international.
Reid does not react to calls for reforms because deaths in psychiatric hospital do not pose a political threat to the government. That is because those dying are black. And the government has done much to neutralize any possibility of public sympathy by dehumanizing blacks.
Anyone wanting to see how the government dehumanizes blacks need look no further than to the content of speeches made by David Blunkett, the home secretary. Blunkett revels in inciting racial hatred by characterizing ethnic minorities and asylum seekers as criminals. Consequently, British race relations are akin to apartheid: uk-apartheid.
The government promotes uk-apartheid by suppressing information about the scale of racism in the NHS. For three years the Department of Health has “buried” a Lemos & Crane survey that revealed abuse and racial harassment of ethnic minority staff by their colleagues and patients (3).
Confronted by uk-apartheid, anyone seeking national support for reforms engages in an act of futility. The 1960s American civil rights movement and South African anti-apartheid struggle have shown that it is only when campaigners have international support that national governments feel shame about their racist practice.
The United Nations has been the forum in which the persecuted have found an international platform on which to campaign for national reforms. The ANC used the UN to good effect in its struggle to end apartheid (Bunting 1986: 528; Barber 1999:163).
Rather than petition Messieurs Blair, Blunkett and Reid, campaigners
would do better to petition the European Union and UN. It is via these
organizations Blair lies to the international community about British
liberal democracy and respect for human rights.
The world should know deaths in psychiatric hospitals are the products of successive governments failure to implement recommended reforms.
It is only by mobilizing international opinion against British domestic human right violations will reforms stand any chance of happening.
Twenty years is too long for the body count to keep rising without action to end the primary cause of deaths in psychiatric hospitals: state sponsored racism. It is too long to campaign for reforms in vain.
A change has got to come: the campaign for reforms must be internationalized by petitioning the European Union and United Nations.
“Now is the time to lift our nation from the quicksands of
racial injustice to the solid rock of brotherhood…Now is the
time to make justice a reality” (Martin Luther King).
Ezra Goldstein ©Blaqfair 1984
Sivanandan, A (1991) “Deadly Silence: black death in custody”
Blofeld, John (2003) “The Independent Inquiry into the Death
of David Bennett”
Bunting, Brian “The Rise of the South African Reich” International Defence and Aid Fund 1986
Barber, James (1999) “South Africa in the Twentieth Century” Blackwell
(1) Carvel, John (07/02/04) “Official to resist NHS racism findings” The Guardian
(2) Carvel, John (13/02/04) “Sympathy no promises from Reid” The Guardian
(3) Carvel, John (13/02/04) “NHS racism: long history, little change” The Guardian