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28 March 2011: speech to the Women's Institute 'Care Not Custody' reception

  • Last modified date:
    1 April 2011

My message is quite simple really. As Ken said, we can and must do better.

Janice’s story is tragic in so many ways.

It was tragic for the young man himself, when you think about the desperate way in which he ended his life.

It’s tragic for the family coming to terms with what happened, the terrible grief that comes from the death of their son under these circumstances.

But it’s tragic on a broader level too.

Tragic in terms of what these stories say about the performance of our public services.

They dramatise, in the most desperate way, what happens when you have a divided system.

Now I’m not going to stand here and say ‘everything is awful’ because actually I think there’ve been some important developments in recent years.

The relationship built between the NHS and the National Offender Management Service, in particular, shows real promise for the future.

As do the excellent advances in prison IT –absolutely fundamental for connecting services and sharing information when someone moves between prisons.

But if this whole campaign – your campaign –  demonstrates one thing, it is that we can’t just tinker around the edges.

We do need wholesale and deep-rooted change in our public services.

We need to unify systems and unite professionals involved in offender care.

We need to streamline and scrap excess bureaucracy.

We need to align health, social care and criminal justice around the shared pursuit of better outcomes.

Above all though, I think we have to reflect on a harsh, perhaps unpalatable, truth for our society and public services.

Because when people with severe but manageable mental health problems end up in custody, it’s actually a judgement on all parts of the system.

It shows both the formal and informal structures of care and support have broken down and failed to protect them.

And in facing up to this truth, we cannot and must not fail them again once they’re within the criminal justice system.

So yes, public safety comes first.

Yes, in some cases, custody will be the only option.

But true justice for the most vulnerable is about drawing them into treatment, not pushing them away from the support they need.

Ken and I agree wholeheartedly about this, and  officials across our two Departments are working together in partnership to make it a reality.

We now have a genuine cross-Government strategy for mental health – launched in this very building earlier this year – which has some very clear messages.

- That people should get the same quality of healthcare services in prison as they do in the community.
- That we have to do more in early intervention, to support children and young people before they reach crisis point.
- And that, across all age groups, we need diversion services to be a cornerstone of better care and support for offenders with mental health problems.

Which is why, in this year, we will be putting £3 million into up to 40 diversion sites for adults, and £2 million for up to 60 sites for young people.

This is to kick start progress. It will help us to understand what works best to shape rapid progress to achieve, as Ken said, a national diversion scheme from 2014.

We’re also doing all we can to simplify and streamline the commissioning process.

The NHS will continue to be responsible for health care in prisons.

But it will be the national NHS commissioning board, rather than Primary Care Trusts individually, who take the lead and judge performance against indicators in the NHS Outcomes Framework.

What does that mean? It means greater consistency in commissioning. Clearer expectations around standards. Stronger clinical leadership to make sure policies are built on evidence.

But it also means respecting that different areas have different circumstances.

So the Commissioning Board will work closely with GP-led Consortia to understand and respond to their local and regional pressures.

And local authorities will support this too. They will take a key role as shapers of community health – again helping to bring people together to support local needs.

Finally, we will continue to work with the Home Office very closely, and stimulating closer working between the local NHS and the Police, and criminal justice agencies.

As well as improving health outcomes for detainees, this can help us to free up vital police time for other things.

So the message couldn’t be clearer.

We are listening carefully to what you’re telling us.

We are determined to bring a new impetus to improving offender health and wellbeing.

We do need to do better, to prevent future tragedies.

And, with your help, I believe we can.

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