The National Preventive Mechanism of the United Kingdom

By John Wadham, Visiting Senior Research Fellow at the Human Rights Implementation Centre (University of Bristol) and NPM Chair.*

john wadhamThe National Preventive Mechanism (NPM) describes the network of independent statutory bodies that have responsibility for preventing ill-treatment in detention.[1]  In every jurisdiction of the UK – England, Northern Ireland, Scotland and Wales the bodies in this network have the job of inspecting or monitoring every place of detention to try to prevent the ill-treatment of those detained. The inspection and monitoring bodies provide essential protections for anyone detained anywhere in the UK, many of whom are vulnerable.  Whether a person is compulsorily detained in a prison, an immigration detention centre, a psychiatric hospital, or as a child in a Secure Training Centre there is an organization designed to ensure that no ill-treated will be tolerated.

In 2014, NPM members decided to appoint an independent chair from outside the membership of the NPM to strengthen its governance. The UK NPM is unusual among its counterparts around the world in that it is made up of 20 different bodies, so introducing the role of chair was seen as a crucial next step to strengthening the UK’s fulfilment of its OPCAT obligations. I was very pleased that I was selected as the NPM chair and particularly so because it was made by NPM members themselves.[2]  Often, the selection process for posts like this are made by government ministers.[3] As chair I will work part time and have been appointed for an initial fixed term of two years. The chair will represent the UK NPM in meetings with members, government, and international bodies.

My job is to advise and support the NPM and its members to fulfill its OPCAT mandate.  My responsibilities are to chair the meetings of the members, support members in developing their work and fulfilling their NPM responsibilities, and to represent the NPM in public and with external stakeholders, including the United Nations and the OPCAT Sub-Committee. 
A key task for the future will be to ensure that the different mandates, duties and powers of the twenty organisations work collectively and individually across the four jurisdictions of the United Kingdom to reduce ill-treatment and ensure the best possible systems are in place to prevent its occurrence.

The Optional Protocol to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT) is the international human rights treaty designed to strengthen the protection of people deprived of their liberty by requiring National Preventative Mechanisms to be set up in every country.[4] OPCAT’s adoption by the United Nations General Assembly in 2002 demonstrated a consensus among the international community that persons deprived of their liberty are particularly vulnerable to ill-treatment and that efforts to combat such ill-treatment should focus primarily on prevention. OPCAT embodies the idea that prevention of ill-treatment in detention can best be achieved by a system of independent, regular visits to all places of detention. OPCAT entered into force in June 2006. There are already 80 countries parties to OPCAT, and 62 designated NPMs across the world – all designed to prevent ill-treatment in their places of detention.  The UK ratified OPCAT in December 2003 and designated its own NPM in March 2009.

In order to carry out its monitoring role effectively, the NPM must:

  • be independent of government and the institutions it monitors;
  • be sufficiently resourced to perform its role; and
  • have personnel with the necessary expertise and who are sufficiently diverse to represent the community in which it operates.

The NPM must have the power to:

  • access all places of detention (including those operated by private providers);
  • conduct interviews in private with detainees and other relevant people;
  • choose which places it wants to visit and who it wishes to interview;
  • access information about the number of people deprived of their liberty, the number of places of detention and their location; and
  • access information about the treatment and conditions of detainees.

Twenty individual bodies now make up the UK’s NPM.

Isolation

Last year the UK NPM focused its joint work on isolation in detention and found:[5]

Prisons

“The number of instances where prisoners are informally isolated, and in many cases in conditions that amount to solitary confinement, over long periods of time is of great concern. Governance of the basic regimes or of unemployed prisoners does not provide safeguards against the impact of isolation or solitary confinement, and the lack of specific health care reviews could leave prisoners at risk. The extent to which prisoners are isolated and even in solitary confinement as a result of restricted regimes and staff shortages warrants greater attention.”

“NPM members have frequently raised their concerns about the number of vulnerable prisoners who are formally segregated, and the numbers of deaths that have occurred in segregation units are a reminder of the serious risks.”

Young people and children

“The conditions under which children were isolated varied considerably. In the YOI included in this review, boys held in a separation and care unit were in a poor environment, with an inadequate regime. Although some improvements had been made, the exercise yards were bare and austere, and there was little evidence of any constructive activities. Some boys had been allowed to exercise together, but all of the boys that the NPM member spoke to said they had spent most of their time locked in their cells.”

“As children have not fully developed cognitively, mentally or emotionally, the possibility that isolation or solitary confinement could cause lasting harm cannot be dismissed. This provides a rationale for rigorous scrutiny of practices that amount to isolation and solitary confinement by NPM members. Children should not be isolated as a punishment, and should never be held in conditions that amount to solitary confinement.”

Patients

“In one instance a detained patient was kept in a locked area of a secure ward on a continuous basis for over five years. The hospital defined this practice as ‘low stimulus’. Although the patient was isolated, efforts had been made to ensure regular contact with staff who attended
to his personal care and meals, and encouraged him to leave the area and
 join other patients on the ward. The NPM member was satisfied that the patient was able to do this on request, and noted that his case was subject to regular review by multidisciplinary teams and regular risk assessments. The nature of the person and the situation and oversight meant that the seclusion was deemed appropriate and considered to be used as a last resort.”

Care settings

“In England, two distinct categories are recognised: ‘seclusion’ and ‘long-term segregation’ (LTS). Secure hospitals in Scotland use ‘seclusion rooms’, usually monitored via a window. Patients are normally allowed out of the room for personal care, using the toilet, and exercise where appropriate.

In some settings, patients are given ‘time out’ in their rooms when their behaviour has escalated. This essentially isolates the patient, and is more common in places where there is no seclusion room, or as a step before formal seclusion.

NPM members also come across cases where an area is separated off in a ward as a self-contained area for an individual patient.

Voluntary isolation or isolation ‘at own request’ also occurs, as a way to reduce stimuli on wards that could provoke aggressive behaviour. Such isolation must also be subject to frequent review.

In care homes, NPM members identified residents who had become isolated as a result of disproportionate measures taken to address perceived risks (for example, falling from their wheelchair).”

HRIC logo

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* John Wadham collaborates with the activities of the Human Rights Implementation Centre.

[1] http://www.nationalpreventivemechanism.org.uk

[2] See list of current members at the end of this blog.

[3] See my critique of such arrangements, https://johnwadham.com/2015/06/

[4] http://www.ohchr.org/EN/HRBodies/OPCAT/Pages/OPCATIndex.aspx

[5] http://www.nationalpreventivemechanism.org.uk/wp-content/uploads/2015/12/NPM-Annual-Report-2014-15-web.pdf

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NPM members in England and Wales are:

Care Quality Commission

Care and Social Services Inspectorate Wales

Children’s Commissioner for England

Healthcare Inspectorate Wales
HM Inspectorate of Prisons

HM Inspectorate of Constabulary

Independent Monitoring Boards

Independent Custody Visiting Association

Lay Observers

Office for Standards in Education (Ofsted)

 

NPM members in Scotland are:

Care Inspectorate

HM Inspectorate of Constabulary for Scotland

HM Inspectorate of Prisons for Scotland

Independent Custody Visitors Scotland

Mental Welfare Commission for Scotland

Scottish Human Rights Commission

 

NPM members in Northern Ireland are:

Criminal Justice Inspection Northern Ireland

Independent Monitoring Boards (Northern Ireland)

Northern Ireland Policing Board Independent Custody Visiting Scheme

Regulation and Quality Improvement Authority

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