When I sent in a freedom of information request, in October 2012, asking for the South London and Maudsley NHS Foundation Trust investigation report into an incident involving a massive police deployment that happened earlier that month at one of the Trust's mental health ward, I expected to receive the report within a few months. It took close to two and half years and involved sending a dozen of freedom of information requests to the Trust, the Metropolitan Police, the Independent Police Complaints Commission, Monitor and the Care Quality Commission as well as requesting many internal reviews and making several complaints to the Information Commissioner’s Office who issued two related decision notices.
Here’s a brief chronology of the reports I received from the Trust (the Metropolitan Police after many searches cannot find its own report):
The full report lists what the Trust and the Metropolitan Police have been covering up during all this time. My investigation has been written up in the Saturday 9 May editions of The Independent (pdf and below) and i (pdf). Note that, at the time of writing, the online version of The Independent's article is abruptly cut in the middle of the article (surprisingly where the text finishes on the first page of the article in the print edition, as if the online version was created from the printed paper).
By Paul Gallagher, The Independent, Saturday 9 May 2015
A mental health trust and the Metropolitan Police have been accused of trying to cover up alleged racism towards patients during an extraordinary night when 48 officers – some in riot gear – were deployed to deal with disturbances in a ward of vulnerable adults.
Campaigners have spent three years trying to uncover what happened at the River House facility at Bethlem Royal Hospital, part of the South London and Maudsley NHS Foundation Trust, on 1 October 2012.
Several days of disturbances escalated into a riot, the ringleaders of which were four patients, three black and one white. They had placed staff under siege which required police intervention before control could be regained.
The Met sent in 48 officers, including armed and dog units. More than 20 officers entered the ward including several Tactical Support Group (TSG) officers in “strict, compact riot formation” armed with Tasers, shields, visors and batons.
An independent report into the disturbances commissioned by the trust said: “According to staff statements, the police, after entering the unit, ignored the request of staff to treat Patient C (a white patient) the same way as they had treated the three black patients.
“Staff state that the police made no attempt to coordinate their actions with [hospital] staff as is standard practice during a siege, to gain information and to help them plan their strategy in order to minimise disruption to the unit.”
Police, assisted by hospital staff, escorted the three black patients (Patients A, B and D) to solitary confinement, handcuffing two of them. Officers also placed a clear plastic cover over Patient B’s head preventing him from moving his head and shoulders. “He was initially ignored by police until several promptings by staff,” the trust report said.
Patient C, the only white patient of the four, was not handcuffed and allowed to stay in the television lounge despite staff insisting to police he was also “a significant player in the disturbance” and that being left on the ward could lead to another disturbance – which it did.
Immediately after police left, around 3am, another patient, E, demanded an explanation as to why Patient C had remained on the ward. The report said: “Patient E believed that there was a racial motive which led to staff assisting the police to place three black patients in supervised confinement, while a white patient was treated more favourably.”
Despite explanations, Patient E became increasingly agitated and hostile and threatened to kill staff and patient C. “This led to a second siege when staff lost control of the ward for a second time. Police assistance was required again before staff could regain control of the clinical area,” said the report.
Eleven officers returned and “dealt with the situation promptly”. By 5am full control was restored.
A 111-page report was completed in May 2013 and a summary published that August. An “unreadable” version was only made public in May 2014 following Freedom of Information requests made by David Mery on behalf of the charity Black Mental Health UK. Almost all the allegations of racism and the patients’ ethnicity had been censored.
Mr Mery appealed and the trust was forced to publish the report again earlier this year detailing the accusations of racism as well as Scotland Yard’s refusal to engage with hospital staff. Around 30 pages remain completely redacted.
A paragraph initially redacted said: “It took eight weeks to secure material from the Metropolitan Police. Requests for further and better particulars have been unsuccessful, despite reminders on matters which were explored at interview with an inspector from Bromley borough police.”
Mental health campaigners say it was only luck that prevented staff or patients being injured that night.
The Met Police had previously been heavily criticised for their actions at the same hospital in September 2010. Then, Olaseni Lewis, a 23-year-old Kingston University postgraduate student, died after being forcibly restrained by up to 11 officers while seeking help as a voluntary patient. Five years on his family are still waiting to hear when an inquest into his death will be held.
Addressing the 2012 incident, Mr Mery told The Independent: “The cover up, with the trust releasing conflicting statements and deliberately attempting to avoid the release of its investigation report (and still refusing to name its authors), and the Metropolitan Police losing its own report, demonstrate that neither organisation is keen to take responsibility for what happen and ensure that it won’t happen again.
“Surprisingly, there doesn’t appear to have been a specific investigation into the racist behaviour described in the report. NHS trusts and police forces should have an obligation to publish reports into serious incidents publicly, promptly and in their entirety. However, the police have lost the incident management log for what they have classified as a critical incident.”
The police have said they were concerned that the staff on the ward that night were unaware of any contingency plan other than to call them on such an occasion. Operation Metallah, a new way of the Met to work with the mental health trust, was launched a few months later.
Mr Mery said: “The tactics that resulted in the deployment at a mental health unit of armed officers, dog units, and TSG officers with Tasers drawn are clearly wrong. Such tactics cause distress to the vulnerable individuals housed there. The apparently racist behaviour of TSG officers involved is unacceptable.
"It is lucky this time no one died or was seriously injured. Olaseni Lewis and Sean Rigg [whose death in police custody in Brixton, south London, in 2008 led to widespread campaigns on how officers treat suspects with mental health issues] were not so lucky.”
A trust spokeswoman said the report had been redacted on legal advice "for reasons of patient and public safety, and patient confidentiality… to maintain security arrangements used in a forensic mental health facility and to protect patient and public safety”.
She said: "The report published on the trust website provides a clear and independent account of what happened on 1 October 2012. The trust's intention was to publish the report in the interests of transparency while using the correct application of the FoI Act to ensure that the identity of patients and their security was not compromised.
"Following the investigation in 2013, the trust has taken action to address all recommendations made in the report to prevent a similar incident recurring.
A Met spokeswoman said: "The location is known to officers as housing high-risk mental health patients. There was a serious threat to staff safety, and some patients, whose medical history was not known to officers, were unsupervised and believed armed with furniture and access to a kitchen area containing knives.”
She said the response was based on "using the widest range of resources available during a highly charged incident by deploying resources appropriate to bring the situation under control, while ensuring the safety of staff and patients. The Metropolitan Police Service has received no complaint in relation to the incident. Should any complaint be received it would be thoroughly investigated."
She added that since the May 2013 publication of Lord Adebowale's report into how the Met responds to mental health incidents: "The MPS has fundamentally looked at how we work as an organisation, and with partner agencies, to improve services, share information and better understand the needs of people with mental ill health.”
The fudge report: Crucial details obscured
[NB xxxx represents details such as names mentioned in the copy but redacted in the ‘Final 10th May 2010 Report’]
‘Staff under siege’
Incident 1: escalated to a riot (as defined by BDP CAG – Major Incident Protocol and Procedures, February 2012), involved xxxxxxxxx who opportunistically placed staff under siege in the nursing station which required police intervention before nursing staff could regain control of the clinical environment. The antecedent to this incident stemmed from one patient, xxxxxxxxx. This incident resulted in damage to property but no physical injury to staff. Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx. The fourth patient, xxxxxxxxx, was initially left on the ward, despite concerns raised by staff that this could lead to further disturbance.
Incident 2: followed on almost immediately from the first incident, when xxxxxxxxx approached staff demanding an explanation as to why xxxxxxxxx had remained on the ward. Xxxxxxxxx believed that there was a racial motive xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx. Notwithstanding explanation from staff, xxxxxxxxx became increasingly agitated and hostile and threatened to kill staff and xxxxxxxxx. This led to a second siege when staff lost control of the ward for a second time. Police assistance was required again before staff could regain control of the 12 Independent Report – Norbury incidents, night of 1st October 2012 clinical area. This incident also resulted in damage to property. Xxxxxxxxx sustained minor injury to his hand. There were no physical injuries to staff.
‘Threatening and abusive’
Xxxxxxxxx had, by this time, calmed down considerably and although remained verbally threatening and abusive, obeyed police instruction, sitting on the floor with his arms above his head allowing the police to handcuff him. Xxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx. He was initially ignored by the police until several promptings by staff. He was escorted by xxxxxxxxx on Norbury Ward.
Here are my previous posts about this incident:
Autistic British journalist/author and advocate Lydia Andal has just published an epic interview of Mark Lever, Chief Executive of the National Autistic Society. It is a revealing interview. Mark Lever admits ‘I think we’ve got to get much better at communicating with, engaging with autistic people. And I know that sounds crackers – it’s the National Autistic Society, but I’m just being honest.’ You can start with a guide to the six parts.
The first instalment is about the Ask Autism training programme, created by autistics. In it, Lydia Andal questions Mark Lever about contributors to Ask Autism not having been paid and not having been given access to these modules. To provide a reality check to Mark Lever’s answers, this section includes a case study of my experience of being video recorded for one of the training module:
What Happened Next?
During the Interview: When asked if he will commit to sending the autistic contributors to the Ask Autism programme an access code – Mark says he will.
After the Interview: Mark did not deliver on this commitment.
Instead the NAS subsequently issued the following statement: “Everyone who developed the modules has been offered free access to Ask Autism.” (bold emphasis added).
This statement highlights that in contrast to Mark’s commitment in the interview – access continues to be restricted to the small number of people who actually developed the training materials – a policy which was already in place at the time I met Mark.
As such the rest of the autistic contributors continue to be barred from accessing the online training programme they helped to create.
During the Interview: Mark states several times that he is committed to ‘significantly reducing’ the price of the Ask Autism programme so that those most in need of the training tool – autistic people and their families – are not priced out of accessing it.
After the Interview: The following enquiry was sent “Can Mark confirm the new pricing policy for Ask Autism for members? There was talk of it being free or at a heavily discounted rate during our discussion.”
Five weeks later the NAS provided the following statement:
“Prices for the Ask Autism service can be downloaded from our website here: http://www.autism.org.uk/our-services/training-and-consultancy/ask-autism/online-modules.aspx
Members are able to claim a 20% discount for individual modules. There are on-going discussions about how the modules could be further discounted for members and others where price is a significant barrier to accessing them.”
The 20% member discount was already in place at the time of the interview and remains unchanged. At time of writing (six weeks after the interview) – the pricing policy remains unchanged.
This article will be updated if and when the NAS change their pricing policy – until then it could be considered that Mark has not delivered on his commitment to reduce the pricing of Ask Autism.
During the Interview: Mark states he wasn’t aware that some contributors had not been paid.
After the Interview: The following enquiry was sent “Can Mark confirm how many of the 70 contributors to the Ask Autism training modules have been paid.”
The NAS subsequently confirm the following “28 of the 74 contributors to the Ask Autism training modules were paid. Others contributed via Survey Monkey and so were not paid.”
The above NAS statement seeming to confirm that only those who contributed to Ask Autism via Survey Monkey have not been paid does not seem to be accurate as Ask Autism contributor David Mery explains below.
Ask Autism Contributor Case Study
“In August last year  I was contracted as a ‘consultant’ to be filmed for an Ask Autism training module. As this module has still not yet been published, I will not mention its topic. It is an area where much training is required so I am very keen for this module to be completed and for it to be of a good standard. When I was initially contacted to be asked if I was interested in participating in this module, I was told that the Ask Autism budget was stretched and that the NAS could only pay expenses. I expressed my unhappiness about this, but this was not open for negotiation although it was suggested there may be some money for reviewing the module.
The impression I got was that the Ask Autism staff was not given a budget to pay contributors and did not have the power to get one. The contract I was sent offered only expenses. I did reluctantly accept it as I very much want training on this topic to be widely disseminated, but it was a difficult decision. An hour was scheduled on August 12th to do the filming. Two NAS staff and two videographers were present, probably paid.
After an initial editorial interest in the topic of the module, all the emails I received were about administrative issues. The most time spent was on negotiating usage permissions for the video for which I was asked to give away many rights that had little to do with Ask Autism and its promotion. As I was volunteering my time and expertise, I was not willing for the NAS to make more money outside of the sales of this Ask Autism module without any sharing. I wished the same amount of energy spent by NAS arguing this release form had been spent discussing the editorial content.
When in September I received a reminder to send in my travel expenses – which I had said I would waive as I had travelled to the filming by bus and on the way back by foot – I asked if this was an invitation to re-open the discussion about a fair payment for my time, and was told ‘In regards to payment for your time, unfortunately we are unable to do this as discussed before the interview and noted in your contract.’
I was not given access to any of the existing Ask Autism modules, which would have been useful to ensure consistency of style across the modules; I have been promised access to the module I contributed to when it is published.
In March I was eventually invited to a closed testing of the module and I discovered I was the only interviewee in this module. There were some serious editorial issues on which I provided feedback and I believe these are being worked on before the module is finalised, but communication has been limited. With some other autistics, I was promised in January, independently of my discussions with the Ask Autism team, that all the 70+ contributors to Ask Autism would be given access to all the modules; this has not yet happened and the only module I’ve seen so far was the one I was given five days to review.
I regularly volunteer for several other charitable projects and am very happy to do it for the good of the community. However when income is generated as part of the activity it should be shared fairly. For example, one of the charities I volunteer for also occasionally has paid events; for these the charity pays ‘volunteers’ a very reasonable one-off fee. As the Ask Autism training modules are a commercial offering of the NAS, even for its members, I would have expected some payment.
The NAS has in its vision a world where an autistic ‘lives with dignity and as independently as possible’, along with a mission to ‘involve, inform and empower people living with autism’. For the NAS not to pay fairly all its autistic contributors to reflect their expertise and the work they have done, to help them make a living and have an independent life is hypocritical as it goes against the NAS mission and vision.”
The sixth and last instalment touches upon the NAS position on the proposed autism marker on the Police National Computer:
Mark Lever: ’I know there’s talk about markers on some databases so that they can provide better support to people. […] I imagine [the information is] going to be self-disclosed, it would have to be self-disclosed I would think. I know there is talk in some systems about having autism flags so that they can better support people with autism but that would have to come from self-disclosure I would think.’
I wrote a detailed analysis about this proposed autism marker in the post Police marking of autistics.
It is well worth reading the full interview and what happened after, when Lydia Andal was checking information with the National Autistic Society’ PR team. In one of the changes to a quote by Mark Lever requested by the PR team (in part 5), they asked to remove
‘[W]e’ve never been a bio-med type charity […] people on the spectrum deserve to have all the support they can get to achieve their potential. That’s where we come from and that is no different to anybody else actually that they should have the right to get that support to achieve their potential.’