I stand here today as one of many doctors who treat and care for patients who come into contact with the justice system. As doctors our duty of care remains the same despite their past, present and future. It seems however that the government does not share our view. Our patients are some of the most vulnerable in society, they have a significantly high rate of mental health issues and often have very poor general health. Many of them have gone through catastrophic experiences in their lives – abuse, torture, sexual assault, persecution. We cannot fix those problems, but we should be able to treat them as we would any other within the NHS– with quality care and compassion.
For many years now the forensic medicine committee chair has stood up here and spoken to you about the variations in the quality of healthcare available to patients held within secure environments. We have written countless letters, provided numerous speeches and lobbied for years to get parity of care for all individuals, but our voice seems to fall on deaf ears.
You will be aware of our longstanding campaign to see an improved and consistent standard of healthcare within police custody, equivalent to the NHS. One which we had high hopes would be achieved through the transfer of the commissioning of clinical forensic healthcare into the NHS.
Alas, our hopes were crushed late last year with the home secretary’s last minute u-turn, announcing their withdrawal permanently from the transfer. Again we wrote letters and pushed for reasons why, but the response has brought us little reassurance.
We have not given up though. We will continue working with NHS England and others to ensure the work that has been achieved so far, in the form of a national service specification, is completed and embraced by the Police and Crime Commissioners.
In other work the Chair of the Civil and Public Services Committee, Alan Mitchell and our colleagues working in the Faculty of Forensic and Legal Medicine are busy developing standards for health professionals working with victims of torture. We hope this will provide welcome support for our colleagues in Immigration Removal Centres and others who come into contact with victims of torture.
Our work, however also expands beyond secure environments and we remain committed to supporting our colleagues working within death certification, cremation and coronial areas with their concerns. Discussions with the Department of Health on changes to the way death is scrutinised and certified continue, and we are pleased to hear implementation is planned for 2018. In connection with this we are also urging the government to review its fees for pathologists working for coroners and acknowledge the very serious crisis happening within their profession.
As you can see our programme of work is fairly diverse. However we have hopes to broaden our work further to include doctors providing healthcare within criminal justice and immigration settings. This would include those working within police custody, prisons, immigration removal centres, sexual assault referral centres, forensic pathology, forensic psychiatry, crematoria and coronial services.
Now more than ever we feel it is crucial that doctors treating patients within these settings have a forum to voice their concerns and that the BMA is there to support them. RB, if any of you have an interest in these settings, or currently work within them, please do come and see us at lunchtime at out meet and greet session in the Foyer, Level 2.
Finally I would like to thank all the members of the committee and the staff team for their ongoing commitment and support – without them we could not achieve all that we have so far and all that we hope to do in the future.
RB, I move.
Dr Rachael Pickering, FMC co-chair
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