Daniel Roque Hall chained to a prison guard on a visit to hospital. He remains in hospital pending a judicial review


The open letter was signed by our campaign

Powered by Guardian.co.ukThis article titled “Disabled prisoners’ lives put at risk by poor care and treatment in jail” was written by Eric Allison, for The Guardian on Tuesday 18th September 2012 17.00 Europe/London

Lawyers acting for a severely disabled prisoner who was rushed from jail to a life-support machine in hospital, are asking the high court to rule he should not be sent back to a prison that cannot meet his medical needs.

Daniel Roque Hall has Friedreich’s ataxia, a degenerative disease, that affects co-ordination of the whole body. It causes a heart defect which requires constant monitoring, and diabetes.

Hall, 30, is a wheelchair user with a life expectancy of 35 to 40 years. In July, he was sentenced to three years’ imprisonment, after pleading guilty to importing two and a half kilos of cocaine into Heathrow. The drugs, hidden in his wheelchair, had been smuggled in from Peru where Hall and a carer had been on holiday.

The judge accepted that Hall had been “groomed and manipulated” by drug dealers and, aware of his condition, sought assurances from the prison service that Hall’s complex medical needs would be met in custody. The governor of Wormwood Scrubs, in west London, assured the judge that the prison would provide the round the clock care and monitoring that Hall requires, as well as the complex stretching programme needed to keep him stable. This was despite prison inspectors last year finding “little progress in support for men with disabilities” and expressing particular concern over the “lack of systematic identification and help for prisoners with disabilities” at the prison. They described the inpatient unit (where Hall was held) as “an unsuitable environment for those recovering from physical illness”.

According to Hall’s family and lawyers, within hours of admittance to the prison he suffered a spasm and fell from an examination couch, sustaining a head wound. He was taken in handcuffs to a care home for elderly people. Staff there were not given full details of his medical requirements, which included Warfarin, prescribed to thin his blood.

Back in Wormwood Scrubs, Hall suffered further spasms and says he was constantly denied his full medication. The two constant carers he needs, in case of spasms, were not supplied, nor were the stretching exercises.

Hall’s condition deteriorated rapidly and in the early hours of 23 August he was rushed to University College Hospital, London, and placed on a life support machine. A consultant at the hospital said Hall’s heart had been “stunned” by his treatment at the prison. His GP says his life will be threatened if he is sent back to prison.

No longer on a life support machine, Hall remains in hospital while his lawyers seek a judicial review of his treatment, and campaigners, including the poet Benjamin Zephaniah and MP John McDonnell, have signed an open letter printed in the Guardian calling for him to complete his sentence at home.

Hall’s claims, though shocking, are not unique. Despite the Paralympics helping to challenge myths and raise awareness about disability, the neglect of disabled people in prison is well documented.

Estimates of the number of disabled prisoners vary. The prison service database records a figure of 5% (around 4,500 prisoners), but inspectorate surveys record 19% (around 16,000). A Ministry of Justice (MoJ) survey earlier this year, found 18% of prisoners interviewed had a physical disability of some kind. The dramatic rise in the number of older prisoners in the system over the last decade is likely to further increase the disabled prisoner population.

Yet a joint report by the Inspectorate of Prisons and Care Quality Commission in 2010 found an ageing prison population, where “disabilities were not being adequately dealt with and many prisons not having a disability policy”. It also reported that it was “rare to find any form of needs analysis or consultation with prisoners to help establishments carry out their duties under the Disability Discrimination Act”.

In 2006, the NHS took over responsibility for healthcare in prisons from the prison medical service. Governors were mandated to appoint a disability liaison officer (DLO) whose job it is to assess the prisoner’s needs and link him or her to the appropriate channels in the prison, but last year the rules changed and it is now up to governors to decide whether a DLO is required, or if existing managers and staff can do the job. The MoJ says it cannot say how many prisons have DLOs.

Many DLOs told former chief inspector of prisons Anne Owers that they did not have enough time, support or training to do their jobs. She also noted in her 2010 annual report that prisoners with mobility difficulties suffered considerable disadvantage because of the refusal by ordinary prison staff to push wheelchairs without training. “While some prisons had clearly identified schemes for assisting disabled prisoners in wheelchairs, some staff still declined to do so,” says the report.

None of this comes as a surprise to the Prisoners’ Advice Service (PAS), a charity that takes up prisoners’ complaints about their treatment inside prison. It says it is inundated with calls from disabled prisoners claiming they are not receiving appropriate treatment. Some case notes make harrowing reading: cells occupied by disabled prisoners with no wall bars and inmates having to drag themselves across the floor and falling frequently; PAS “having to make a fuss” to get inmates supplied with basic needs, such as walking sticks, which are then taken away when a prisoner moves prison; and an incontinent prisoner with mental health problems sleeping naked on a urine-soaked mattress.

PAS caseworker Nicola Gregory recalls visits to jails to meet disabled prisoners. On one occasion, a prisoner failed to turn up and an officer pointed to his lack of interest. However, the meeting room was on the fourth landing, accessible only up narrow spiral stairs, which seemed to escape the officer’s notice. PAS has advised a wheelchair user who lost privileges for not returning a library book to the prison library, which was on an inaccessible third-floor landing.

Disabled prisoners reported similar experiences of neglect to the Prison Reform Trust (PRT). In a 2010 report on older people in prison, one inmate said he could not get his wheelchair into his cell and had to “try to get from the entrance to my bed”; he had been told officers are not allowed to push him.

Another prisoner who uses two walking sticks says he couldn’t have a shower because “I might slip and there is nothing to hold on to, or chairs to sit on”. He adds: “Usually a friend helps me because there seems to be no officer or nurse willing to help.”

The PRT found few jails had a disability policy, or established ways to help staff identify the needs of disabled people, and that health and social care provision is patchy and often dependent on an individual officer or governor’s motivation.

PRT director, Juliet Lyon, says the justice system is putting punishment before humanity and common sense. “Locking up severely disabled men and women without proper treatment and care puts lives at risk. At best, imprisonment for the disabled amounts to a double punishment.”

On 8 September, campaigners calling for justice for Hall held a protest outside Wormwood Scrubs. They fear sending him back to prison would be as good as imposing a death sentence on him and want him to be allowed to serve his sentence at home. “He was given a three-year sentence, not a death sentence,” say the campaign posters.

The MoJ says: “The claimant’s allegations are currently before the courts and will be resolved in that forum.” As for the level of care provided to disabled prisoners, it says: “We have a duty of care to those sentenced to custody by the courts. As part of that duty of care, we ensure that prisoners have access to the same level of NHS services as those in the community.”

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