All Party Parliamentary Group on Mental Health

Meeting on ‘Professional boundaries in mental health – after Kerr Haslam’

12^th June 2007, 7 Millbank, House of Commons

Lynne Jones MP opened the meeting and introduced the speakers:

Phil Wills MP;

Kathy Haq (Staff Nurse, Sunderland Royal Hospital);

Jonathan Coe (Chief Executive, WITNESS against abuse);

Lord Hunt of Kings Heath, Minister of State for Quality, Department of Health.

Phil Willis MP paid tribute to WITNESS which had been actively involved in the Kerr Haslam inquiries, providing support to witnesses. The Kerr/Haslam inquiries had revealed systemic abuse by two psychiatrists (William Kerr and Michael Haslam). 36 women in Phil’s constituency had come forward in the late 90s in response to a letter he had written, tracing old patients of William Kerr and Michael Haslam (?). The women reported that when they had told their doctors, lawyers and families of their experience of abuse, they had not been believed.

In 2000, court proceedings were issued against William Kerr and Michael Haslam; William Kerr was convicted of one count of indecent assault and Michael Haslam of four counts of indecent assault. Following the proceedings, the Government set up an independent inquiry into the way the NHS in Yorkshire handled the allegations about the performance and conduct of William Kerr and Michael Haslam.

Phil Willis described the Kerr/Haslam inquiry as exemplary. Nigel Pleming QC, who chaired the inquiry, started his work from the stand point of believing the stories of abuse. The Clear Boundaries Project, which was set up in response to the Kerr Haslam, Ayling and Green inquiries, would not have been initiated, but for Kerr/Haslam inquiry. The White Paper ‘Trust Assurance and Safety – the Regulation of Health Professionals’ was a response to the recommendations of the Kerr/Haslam inquiry.

Kathy Haq

Although Kerr/Haslam occurred over 25 years ago, the abuse suffered by victims had serious long term effects. The Kerr/Haslam inquiry had made 72 recommendations, including that improved support should be made available to victims in the future and that better training/education was required on what victims should expect from staff.

Abuse occurs in a range of health care settings not just mental health. There was still a need for staff in the range of health settings to better understand how to deal with disclosures of abuse by patients. The Clear Boundaries Project had highlighted that improved staff training was needed on how to handle complaints by patients.

Jonathan Coe

Kerr/Haslam was the biggest inquiry into the abuse of psychiatric patients to take place in the UK. The problem of abuse is much bigger than previously thought and this is acknowledged in the Government’s Safeguarding Patients paper. It was important that there was greater clarity on the size of the problem.

The Clear Boundaries Project was a step forward and the Department of Health should be congratulated for funding the project.

It was crucial that service users were asked for their views on how abuse should be prevented. Jonathan Coe suggested that a national study of service users’ experiences could be carried out and that the National Patient Safety Agency (NPSA) could assume an oversight role. Statutory regulation of health professions needed to progress quickly and WITNESS supported the Government’s efforts in this regard. Implementation of the recommendations of the inquiries into abuse by health professionals and ensuring effective support was made available to those reporting abuse were vital. There was a need for more joint working and greater collaboration between health organisations in order to promote a culture in which abusive practices are not acceptable.

Lord Hunt of Kings Heath

The inquiry into Kerr/Haslam was a model inquiry. The challenge was to learn the lessons of the inquiry and implement the recommendations that emerged from the inquiry. Lord Hunt noted that as Minister for Safety, Quality and Regulation, this debate fell squarely within his remit. He acknowledged that the majority of health professionals had regard to the highest ethical standards.

More could be done to identify cases of abuse earlier. The lessons that had been learnt included the need for robust, proportionate investigations into allegations of abuse, improved sharing of information between health organisations, and the need for a system of adjudication to protect patients. The key themes were: early action and the need for a system to deal with concerns quickly; information sharing (organisations need to share information on concerns about professionals); building up intelligence on professional behaviour; and separating adjudication and regulation. Clear standards and ensuring consistency across care settings and implementation of guidance was essential. Support for mental health patients who wish to make a complaint was important and the system for dealing with complaints needed to operate efficiently and have the capacity to deal with multi-faceted complaints.

Lynne Jones MP noted that some of her constituents had experienced abuse. It was clear that progress could be made when health professionals were challenged.

Adrian Delemore (Justice in Health) noted that there was a need for improved dialogue between health organisations who wish to raise issues of concern and the Department of Health. He believed that a “clearer pathway” to the Department of Health was necessary.

Professor Julie Stone (Council for Healthcare Regulatory Excellence Clear Sexual Boundaries) expressed concern that patients were not approaching mental health services because they had experienced abuse by mental health professionals. Lord Hunt noted that GMC recognised that this needed to be addressed. He believed nonetheless that most health professionals operated according to the highest ethical standards.

Paul Fletcher (CCHR) indicated that statutory provision should made be so that health professionals who have intercourse with their patients are charged with a criminal offence. Ian Hall indicated that provision to this effect already existed in the Sexual Offences Act 2003 and the Mental Capacity Act 2005.

The importance of allowing someone to make a complaint of abuse on behalf of a vulnerable person was also noted.

Lynne Jones closed the meeting, thanking the speakers.

Attendees

Members

Lynnes Jones MP

Sandra Gidley MP

Richard Taylor MP

Baroness Barker

Baroness Murphy

Observers

Jonathan Coe, WITNESS against abuse

Jane Gardiner, WITNESS against abuse