He gives a clear history of continuing pain in his back; this is so severe it has prevented him for exercising since the date of his injury. This is a major setback, since exercise for this man is vital to his mental health. When I examined his abdomen, I clearly observed that his Left kidney was enlarged, it was swollen to a larger size than it should have been. It was also tender – again a serious medical indication of major kidney damage.
Enlargement of the kidney, taking into account the clear history of haematuria, or passing blood in the urine for some five days after the injury, is entirely consistent with a diagnosis of bleeding internally. He requires urgent investigation. He may even require an operation to relieve the possible haematoma, or accumulation of blood within the capsule of the kidney.
Failure to record the least suggestion of traumatic kidney disease is obviously of the gravest medical significance. Happily, the legal processes enabled me to exercise the already fruitful medical relationship I have with this man, to elicit this potentially lethal symptomatology, hopefully in time to limit long-term damage to his kidney. I need scarcely add that were both kidneys to suffer such damage (of which I have no evidence to date) then the outcome could be dire indeed.
3 EVIDENCE THAT THE INJURY DAMAGE WAS CAUSED BY ASSAULT
Charlie clearly used his right hand to smash the window and the basin. He did not use his left hand for this. However, it is his left hand, especially his left thumb, which suffered most severely. Accordingly, this is a medical indication to look for a different origin for the injuries to his left hand. His Left thumb in particular, as his medical record shows, was split from top to bottom. When I examined him, there was a longitudinal scar running the full length of his left thumb. There would appear to be only one possible explanation for this, namely that his thumb was crushed, possibly under a boot. Certainly the scar I examine yesterday is entirely consistent with his thumb being powerfully stamped upon.
This conclusion is further bolstered, not only by the patient’s clear history of being assaulted but also of there being clear photographic evidence to confirm this. I was myself prevented from my explicit wish to photograph Charlie’s current condition. Nevertheless, several references have been given to me that photographs taken at the time clearly show boot marks on his head. I have not, as yet, seen these photographs myself, the urgency of the medical considerations means I am completing this report before seeing them, however I am assured that this is the case both by his wife who has seen them, and his solicitor also. There is only one way that boot marks can appear on the scalp.
4 IS THERE A SUB-CULTURE OF ‘AUTOMATIC PRISON BRUTALITY’?
I did not put this point directly to Charlie, but I am sure he would take it as read that his smashing up the shower room lead directly to his being injured. For the record, he tells me that on the day in question, he was told by staff that he would be denied his one hour exercise on that day because the locks were frozen. Later, he says, witnesses saw the locks being readily used without difficulty. He tells me that the staff said this in order to watch a TV programme.
He was frustrated by this, and smashed up the shower room. Clearly, this is an immature thing to do, but given his recent history, mentioned further below, then his manifest lack of making progress in the system must be taken into account.
Were Charlie’s allegation that his exercise hour had earlier been denied him on that day, then the staff should bear some measure of responsibility for his subsequent outburst – not 100 per cent, of course, but when dealing with violent and potentially dangerous pensioners, arbitrary changes of the rules should be avoided at all reasonable costs, as again I know full well from my five years’ work in Parkhurst Prison. And where they are changed, then care should be taken to explain fully the reason for this disadvantage to the prisoners, an explanation that should make at least some sense, otherwise an understandable air of grievance is likely to be raised.
He tells me again of his fear of being jumped upon whenever he is out of his cell. Indeed, this fear is of a size that means he is frightened of being killed. Given the extent to which he has already suffered kidney damage, perhaps this is not so far-fetched after all.
Again, a further happy outcome of the legal intervention in this case, is that his fear in this regard is now reduced by the certain knowledge that he will be able to invoke outside medical assistance of his own choice, backed, if need be, by High Court action. This greatly reassures him. It shows him that there is a wider authority that can be applied even in a Segregation Block than the say-so of the local prison staff.
MY OPINION AND RECOMMENDATION
I have had cause to examine this man on several occasions now, notably on 5 July 1991, and it really is little short of disgraceful how little has been done to rehabilitate him. I reported in May 2002 on a substantial change in his underlying personality problems, as evidenced also by his marriage to a highly supportive wife. Surely he should now be expecting to move on to conditions of more normal prison life, and eventually taking such steps as are necessary for his sensible eventual release.
As this particular episode demonstrates we have managed to build up a level of trust which is not easy given all the circumstances. This fact alone argues in favour of allowing me to continue to treat this man over a period of time. It is highly significant that as I was discussing his general situation, he spontaneously asked me if I would undertake to see him, say, monthly, in order to continue the treatment we had started many years ago, and which he has requested in writing on almost a yearly basis since.
He has clearly indicated his preference for me as his doctor. Does this preference have weight in law? A prison doctor would have a huge mountain to climb to reach the level of trust we now enjoy. We have a history of a developing relationship – a positive history. Sadly, the prison doctors he has met have a similar length of history, though rather less fruitful, as the present episode so clearly shows.
My pattern of counselling or treatment has a measure of uniqueness in itself – every psychotherapist, like every artist, brings his or her own unique flavour to what they do. Charlie Bronson has clearly stated that he likes my ‘brand’ – perhaps some legal way may be found for me to answer his continued requests.
It is my considered opinion that Charles Bronson suffers from severe injuries, notably damage to his Left kidney, and his left ear.
My recommendation is that these two medical conditions be given urgent and expert medical attention from an ENT specialist, and from a renal expert. If these are not undertaken within seven days, then I would have no hesitation in advising my legal team to return to the High Court for assistance.
On the wider issues, it is clear to me, and has been for some time, that the current policy of moving him on, at random, with no notice from one maximum-security wing to another, for shorter or longer periods, apparently at whim, is entirely counterproductive. This is not only on medical grounds, or humanitarian grounds, but also on simply pragmatic grounds.
This man states that his recent marriage has helped stabilise him. Has the prison service capitalised on this? Has it encouraged this family relationship to flourish? Have they expedited increased contact between this husband and his wife and stepdaughter?
Surely it is time to combine humanitarian strategies with prison security strategies. It must be obvious that to build a measure of permanence into this man’s prison stay together with increased contact with his new family must surely make the prison staffs’ job easier.
Is this a case where legal, penal and medical strategies can come together to stabilise this man’s condition for the first time in his 26 years in custody?
If I can assist in any other way, I should be more than happy to do so.
Dr Bob Johnson
Dr Johnson continues with his specialist work and has recently written a book, Emotional Health (ISBN: 1904327001), which can be purchased from the James Nayler Foundation at PO Box 235, York, YO1 7YW, UK, for the price of £14.99 (includes
P+P) or further details from website of: www.TruthTrustConsent.com.
BRONSON VS. THE SYSTEM (IV)
What follows is further evidence on my behalf in supporting what I claim, a skeleton argument for the High Court constructed by my legal team. When you see what the Home Office are like in respect of my treatment and ignoring many, many requests by my solicitor and legal team, then you will understand where I am coming from. Let what follows speak for itself and for all those prisoners in the future who may need to follow the same path … let it be of help to them.
IN THE HIGH COURT OF JUSTICE
QUEEN’S BENCH DIVISION
ADMINISTRATIVE COURT
Between The Queen
(on the application of Au Ahmed, formerly Charles Bronson)
Claimant
- and -
The Secretary of State for the Home Department Defendant
Skeleton Argument of the Claimant
URGENT APPLICATION
1. The Claimant seeks judicial review of the refusal of HMP Governor of Whitemoor to allow the Claimant access to urgently needed medical examination and treatment in accordance with the recommendations contained in the medical report of Dr Bob Johnson dated 7 February 2003 (Appendix 3, doc 1) and the addendum thereto (App 3, doc 7).
2. In spite of oral requests made on 7 March to the Prison General Manager by the Claimant’s solicitor, Mr Richard Mallett, and subsequent letter to the Governor dated 11 March sent by fax (App 3, doc 2), the Governor has not responded. Such response is treated as a refusal for the purposes of this application. The effect of no response is of course tantamount to a refusal in terms of its impact.
3. Solicitors on behalf of the Claimant were only instructed in this matter on Sunday, 2 March 2003. In an attempt to exhaust all remedies before issuing this application they wrote to the Directorate of High-Security Prisons on Wednesday, 12 March requesting a response within 48 hours (App 3, doc 3). At the time of lodging this application, no response has been received. The Directorate has also received a copy of the Letter before Claim.
FACTUAL BACKGOUND
4. The Learned Reader’s attention is drawn to the Chronology at Appendix.
5. The Claimant was transferred from HMP Wakefield to HMP Full Sutton in or about January 2003. On 4 January he was assaulted by prison officers and sustained serious injuries. Earlier that day he had been denied his one-hour exercise period and, frustrated by this, he had smashed up the shower room in the Segregation Block. It was following this incident that he was assaulted. On 16 January, Humberside Police were instructed to investigate the assault. The outcome of those investigations are not yet known.
6. On 9 January, the Claimant was visited by his former solicitor, Mr Peter Boddy. A request was immediately made to the Governor for the Claimant to be seen by Dr Johnson. According to Mr Boddy, this was strenuously refused by the Prison (see correspondence at App 3, doc 4). Dr Johnson was eventually given access to his patient on 7 February after threatened High Court proceedings.
7. Having examined the Claimant, Dr Johnson concludes that not all of his injuries were sustained as a result of smashing up the shower block: ‘A second entry dated 05.01.03 records extensive injuries to his head. There is no record of where these came from. Obviously they are unlikely to have arisen from the patient’s own actions … the medical record is incomplete, and seriously so. The reason why it is incomplete is readily deduced – were the prison doctors to document actions entailing staff violence, then the doctor’s working life would become decidedly difficult.’
8. The learned Reader’s attention is drawn to page 6 of the Report. It lists the injuries suffered by the Claimant as a result of the assault:
1. a swollen left kidney indicating major damage of a life-threatening nature:
‘He requires urgent investigation. He may even require an operation to relieve the possible haematoma or accumulation of blood within the capsule of the kidney … Failure to record the least suggestion of traumatic kidney disease is obviously of the gravest medical significance.’
2. deafness in the left ear necessitating a full ENT evaluation with inspection of the eardrum and a full set of hearing tests
3. a left thumb split from top to bottom ‘entirely consistent with his thumb being powerfully stamped on’
The doctor concludes that the Claimant: ‘suffers from severe injuries, notably damage to his left kidney and his left ear. My recommendation is that these two medical conditions be given urgent and expert medical attention from an ENT specialist and from a renal expert’ (p. 9).
9. Photographs of the Claimant’s injuries are exhibited at App 3, doc 5.
10. 15 February; the Claimant was further assaulted by prison officers sustaining injuries to his back and neck. The incident was recorded on CCTV and a copy of the video requested by his former solicitors. A copy was not provided. Mr Boddy was informed that the footage had been sent to the Directorate of High-Security Prisons.
11. In early March 2003, the claimant was transferred to HMP Whitemoor. He has not been seen by Dr Johnson or any other external doctor since his transfer. However, Mr Mallett has been informed by the Claimant’s wife that the Claimant was recently visited by the prison doctor, Dr Nandi. Dr Nandi has confirmed to the Claimant that his injuries need to be seen by an external specialist but that this course of action had not been approved by the Governor.
12. Mr Mallett is unable to provide this court with first-hand information on the well-being of the Claimant as he has been unable to visit him. This is because HMP Whitemoor have stipulated that the Claimant may only be seen on a ‘closed visit’ basis. The Claimant has refused to see Mr Mallett in those conditions as he regards them as claustrophobic and is confident that he would not be able to hear Mr Mallett through the glass partition due to a combination of his ear damage and the physical impediments provided by the closed hearing conditions.
THE LAW
13. It is established law that governor’s powers are amenable to judicial review in their own right: Leech v Deputy Governor of Parkhurst Prison [1988] 1 All ER 485. Leech concerned a governor’s disciplinary powers but it is submitted that no distinction should be made between disciplinary and punitive powers and a governor’s general discretionary powers including the power to grant independent medical examination of a prisoner.
(A) THE PRISON RULES
14. The decision whether or not to grant the Claimant access to medical examination by a doctor outside of the Prison Service is a matter purely within the Governor’s discretion.
15. Rules 20–22 of the Prison Rules 1999 provide for two situations when a prisoner may be allowed to be seen by an external doctor – (a) where he has not yet been convicted (rule 20(5)), and (b) where he is a party to any legal proceedings (rule 20(6)).
16. No personal injury claim has yet been instituted on behalf of the Claimant although it is in the process of being drafted by his new solicitor in the difficult circumstances that prevail. However, the Governor has been supplied with a copy of Dr Johnson’s report: he should be aware from Mr Mallett’s requests for preaction disclosure of the Claimant’s medical records and other documents that proceedings are contemplated (App 3, doc 6).
17. In the interests of justice, the Governor should allow access under rule 20(6) even though no formal proceedings are under way. His obdurate reluctance to allow independent examination in the face of the critical medical circumstances attested to by Dr Johnson is unjustified. In the absence of any reasons, the only logical inference is – at worst – that he is seeking to obstruct any investigation which might expose the actions of officers at HMP Sutton. At best, he is acting capriciously with a complete disregard for the medical wellbeing of the Claimant. We state this robustly as on current information we can see no other reason why he is refusing a man basic medical treatment deemed essential by a senior doctor. This refusal comes against the historical refusal of his counterpart at HMP Full Sutton – all requests have been met by a wall of silence.
18. In these circumstances, his refusal amounts to an abuse of power. At the very least the Court is invited to conclude that his continuing refusal is patently irrational under the conventional three-fold division of Lord Diplock in Council of Civil Service Unions v Minister for the Civil Service [1985] AC 374 at 410.
HUMAN RIGHTS
19. A convicted prisoner retains all civil rights that are not taken away, either expressly or by the fact of his imprisonment: Raymond v Honey [1982] 1 All ER 756.
20. The right to life, Article 2 of the European Convention on Human Rights and Fundamental Freedoms 1950 (ECHR), is relied upon by the Claimant. It is clear from Dr Johnson’s report that he is suffering a renal injury that may be life-threatening unless he receives urgent specialist medical attention. The Court’s attention is further drawn to the addendum from Dr Johnson received shortly before lodging this application (App 3, doc 7). The Governor has not indicated whether this specialist medical attention has been given to the Claimant. From the anecdotal evidence of the Claimant’s wife it would seem that it has not been given. Even if it has been given, it is argued that the Claimant requires independent assessment for the reasons set out in Dr Johnson’s report – namely the conflict of interest that arises where prison medical officers are asked to examine injuries caused by prison officers. The difficulties which this situation poses are vividly illuminated in Dr Johnson’s report and are not rehearsed here.
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