The "physical and mental torture" of a disabled man in prison

Daniel Roque Hall was sentenced to three years in jail after drugs were found in his wheelchair. Since being sent to Wormwood Scrubs, his condition has deteriorated dramatically, say his mother and friend. Alan White investigates.

Last month, Private Eye magazine alerted its readers to the story of Daniel Roque Hall. He is a disabled man who was sentenced to three years’ imprisonment after being arrested at Heathrow airport with cocaine hidden in his wheelchair.

The sentence was passed despite the fact he confessed to his crime and probation reports found that he had been “groomed and manipulated”.  I have in my possession a letter written to Crispin Blunt, the prisons minister, by Roque Hall’s GP, on 14 August 2012. Among many other things, she says: “I feel that the disease from which he suffers has affected his judgment and also I feel he would be unable himself to hide the cocaine in his wheelchair.”

Roque Hall suffers from Friedreich’s ataxia, an inherited disease that causes damage to the nervous system. It limits the movement in his limbs, affects his heart and makes it hard for him to swallow. The full run-down of his health issues includes Type 1 diabetes, cardiomyopathy, hypotension, paroxysmal atrial fibrillation, leg and back spasms resulting in insomnia, a spastic bladder, and previous depression leading to two suicide attempts.

Daniel needs 24-hour care, including two carers to transfer him from chair to chair with a mobile hoist; insulin injections; five tests of blood glucose a day; toileting; turning in bed to avoid pressure sores; someone present when drinking to stop him choking; an exercise regime to prevent the development of contractions; the drug Warfarin; help with dressing himself; and manipulation and exercise to maintain muscle activity. He will die from his disease, but the exercises, in particular, help lessen his suffering. He is 29 years old and at best, he has 10 years to live.

Wormwood Scrubs, where Roque Hall is being held, promised that he would be adequately cared for once incarcerated. You might wonder, since that Private Eye story, how he’s getting on after a few more weeks in prison.

The answer is that he’s in the critical care unit at University College Hospital.

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Yesterday I went to meet his mother in the hospital’s relatives’ room – I’m not sure she was happy to leave his side, but there are two prison officers currently standing guard at his ward, and they won’t let me visit a prisoner. 

Personally I’m not sure I want to see my taxes deployed this way: it’s unlikely Roque Hall will suddenly recover from the serious condition he’s in, and then magically learn to walk, but I suppose you can’t be too careful. At the time of writing an application for interim relief is being considered – if successful these staff will be sent away.

Anne Hall, Daniel’s mother, is depressed, shattered, and a little ball of nervous energy. She tells me his story from the start, when Daniel had been found guilty, and was put under home curfew while awaiting sentence.

Daniel was sentenced on 24 June. The judge at Isleworth Crown Court said they couldn’t send him to prison unless the prison could meet his needs. Wormwood Scrubs received the relevant information from Daniel’s consultants: both his neurologist and endocrinologist said he’d deteriorate without constant, particular care.

The judge gave the prison two weeks to see if it could meet these requirements. Daniel’s barrister repeatedly asked the CPS if they’d had any word from Wormwood Scrubs, and they said not. Anne says: “We went into court on 6 July, and there were guards from Wormwood Scrubs sitting behind the CPS. Two minutes later the judge emerged and said he’d just been given an email confirming the governor of Wormwood Scrubs is ready to receive the defendant, and he therefore had no choice but to send him there. What he said after that shocked me: ‘I can’t say any more because the press are here.’”

Anne jumped up in court and said he couldn’t be taken to prison. Daniel was with his occupational therapist, who told the escorting nurse that he was having more spasms than normal. He had only been in the Scrubs’ health wing for two hours when, left alone on a medical examination couch, a muscle spasm caused Daniel to fall off and hit his head on the floor.

Consultant reports said the staff would need a hoist and two people to move him. Anne says: “A prison warder had to lift him up there, which is against all legislation. They weren’t prepared. When Daniel called, a doctor said he threw himself off the trolley deliberately and refused to call an ambulance.” Daniel said he said he needed to go to hospital: standard procedure for someone with his health issues. Anne spoke to Daniel, and then a prison officer, who assured her he’d be taken.

Private Eye described what happened next in its story:

“Instead of taking him to hospital, Scrubs staff for some reason decided to send him to a care home for the elderly and those with dementia. No one told the staff there that he had hit his head, or that he was taking blood-thinning medication. Instead security staff sat chained to him (how they thought he might escape is a mystery) until the care home later arranged a transfer to hospital.”

Anne’s friend called the care home, and told them the prison had to call an ambulance. He eventually went to Charing Cross Hospital, whereupon he was scanned and put on the acute medical assessment unit. On the Saturday he went back to the care home. There, Anne spoke to a duty governor from the prison and a senior nurse manager, both of whom accepted her point that he simply couldn’t be cared for in Wormwood Scrubs. 

On 7 July, Daniel was taken to Hammersmith Hospital, almost unconscious with hypoglycaemia. His consultant endocrinologist said he had a high level of thyroid toxicity; a result of the heart medication he takes. When Anne saw him, he was still cuffed to a guard with a security officer standing over him. She describes Daniel as looking ill and agitated.

Two days later he was taken back to Wormwood Scrubs. The intention was for him to continue serving his sentence.

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The staff at Wormwood Scrubs had been given a clear description of Daniel’s required care, in detailed consultant reports, which I’ve seen.

Anne claims that none of these needs were met. Daniel has to exercise in order to maintain his muscle mass, because his diaphragm muscles are compromised by his neurological disease. However, she says that staff were either unwilling or unable to carry out these extensive exercises. Anne also says he reported being in pain due to the lack of exercise – the evidence borne out by his now much-reduced muscle mass.

Daniel’s routine has to be flexible, but his medication – Warfarin - has to be given at the same time, every day. Anne claims they’d give it at differing intervals of eight or nine hours. He told her he was kept in a cell that was overwhelmingly hot, with no air conditioning.

Anne even says even his basic rights were denied: “There was no adaptive toilet for him – they had to bring a commode in and everyone passing by could see him because they weren’t allowed to shut the door.” She says no one helped him use a phone – which he’s unable to use himself – until his solicitor insisted.

Daniel was spasming so much that, when sat on a shower chair, he cut his feet – a risk described in the endocrinologist’s report, with ulcers being a particular risk. He also suffered abrasions on his foot due to his prison slippers. When Anne phoned a member of the prison staff, she was told “it would be a protracted process to get alternative footwear”. It would be a different story if Anne could bring some slippers to the gate – or, in the staff member’s words, “facilitate a solution”. “The language,” she says, “is often amazing.”

Three weeks ago, she visited Daniel in prison and was horrified by the state in which she found him: “They brought him out with his wheelchair wrongly configured. It was completely in the wrong position. He was sliding out of the chair in terrible pain. When I saw him he was struggling to breathe and I told the governors he was in tachycardia. I said the symptoms had to be investigated and managed. For two weeks he asked to see the doctor, rather than the visiting GP.”

Anne made a fuss in the prisoners’ hall, but the warnings weren’t just coming from her. In the aforementioned letter from Roque Hall’s GP on 14  August she describes Daniel’s condition in great detail, and concludes there is “a risk he will have hypoglycaemia resulting in a coma” and that his incarceration “will result in his demise”.

A week after Anne’s visit, he told the staff he had atrial fibrillation and needed to see a cardiologist. She says: “The nurses would take his heart rate and say it was high but wouldn’t say how high.”

On Monday 20 August, Daniel Roque Hall fainted during a meeting with his solicitor.

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Kaleem Naeem is a young, bearded man, who has been one of Daniel’s carers for several years. He has quiet manner, and is well spoken. He was with him at Queen’s Park school, and went on to become a full-time carer for his friend: “As a carer, you probably won’t get any sleep because you constantly have to move his legs. The prison staff told me I couldn’t do it when I saw him – but they weren’t doing it.”

When he visited Daniel, he was shocked. “I’m someone who believes if you do the crime you do the punishment – and Daniel’s the same because he doesn’t want people to think he’s using the wheelchair to get away with it. But when I saw him it was appalling. His face looked different. He was thin, he was sweating - you could tell he was going through an ordeal.”

Daniel had now been saying he was in tachycardia for two weeks, and needed to go to the hospital. Kaleem told Anne about his concerns. She rang a member of the prison’s staff, and said they’d have a dead body on their hands. He told her he’d only been joking and laughing with Daniel a minute ago. “The depravity of their lies is amazing,” she says.

On Wednesday 22 August, staff from the prison took Daniel to University College Hospital in London, queued up at A&E - not as an emergency - and said he’d been generally unwell. According to Naeem, he came handcuffed, screaming to the nurses to get him away from the prison staff: “That two-week wait will possibly have caused irreversible damage. They played Russian Roulette with his life,” he says.

He had an ECG, and the doctors found he had vast, unstable, atrial fibrillation.

The next day, lawyers were fighting for him to be released from prison while his medical needs were assessed. Wormwood Scrubs submitted to a judicial review that an outside doctor was not needed. At the time, Roque Hall was lying in UCH, in intensive care. His family and lawyers had not been told.

Anne says: “I only found out that Daniel was in the hospital on 4.30am on the Friday morning because he deteriorated when he was in intensive care. When somebody’s dying the family have to be informed. The governor told me that.”

She went to see him: “He was in an appalling state. He’d lost all of his speech by that point. I asked the doctor if the confusion would go, and he didn’t know. Daniel had heart failure. I cried when I saw him. The nurse asked me to kiss him, and they took me out again. There was a good chance he wouldn’t survive.”

Daniel was critical but stable. He was on a ventilator and came off it yesterday afternoon. He has two warders now. “I asked the nurse to put him out of their sight because when he woke up and saw them he was very upset,” says Anne.

She claims a member of the prison staff once told Daniel no one cared about his plight. “It’s physical and mental torture. I want them – from the governor to the so-called prisoner health team – never to do this to anyone again.”

Naeem says: “Yes he did wrong, but what he’s received is torture. Funny thing is they had a solution - they had him under curfew at home and that would have been an adequate punishment. He’s an outgoing guy and being held there would hardly have been a bed of roses.”

In the final paragraph of the letter from Hall’s GP to Crispin Blunt she says: “I am not trying to contradict the law but I do feel that we are a humane and democratic society and that the health service is there to provide care for those in need and danger.” More fool her. Perhaps the cruellest twist is that, by a strange quirk of fate, the opening ceremony for the Paralympics is taking place as I type this.

UPDATE 30/08/2012 13:30:

A Prison Service spokesperson said:

"We don't comment on individuals. 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."

Wormwood Scrubs, where Daniel Roque Hall is being held. Photograph: Getty Images

Alan White's work has appeared in the Observer, Times, Private Eye, The National and the TLS. As John Heale, he is the author of One Blood: Inside Britain's Gang Culture.

Photo: Getty Images
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There are risks as well as opportunities ahead for George Osborne

The Chancellor is in a tight spot, but expect his political wiles to be on full display, says Spencer Thompson.

The most significant fiscal event of this parliament will take place in late November, when the Chancellor presents the spending review setting out his plans for funding government departments over the next four years. This week, across Whitehall and up and down the country, ministers, lobbyists, advocacy groups and town halls are busily finalising their pitches ahead of Friday’s deadline for submissions to the review

It is difficult to overstate the challenge faced by the Chancellor. Under his current spending forecast and planned protections for the NHS, schools, defence and international aid spending, other areas of government will need to be cut by 16.4 per cent in real terms between 2015/16 and 2019/20. Focusing on services spending outside of protected areas, the cumulative cut will reach 26.5 per cent. Despite this, the Chancellor nonetheless has significant room for manoeuvre.

Firstly, under plans unveiled at the budget, the government intends to expand capital investment significantly in both 2018-19 and 2019-20. Over the last parliament capital spending was cut by around a quarter, but between now and 2019-20 it will grow by almost 20 per cent. How this growth in spending should be distributed across departments and between investment projects should be at the heart of the spending review.

In a paper published on Monday, we highlighted three urgent priorities for any additional capital spending: re-balancing transport investment away from London and the greater South East towards the North of England, a £2bn per year boost in public spending on housebuilding, and £1bn of extra investment per year in energy efficiency improvements for fuel-poor households.

Secondly, despite the tough fiscal environment, the Chancellor has the scope to fund a range of areas of policy in dire need of extra resources. These include social care, where rising costs at a time of falling resources are set to generate a severe funding squeeze for local government, 16-19 education, where many 6th-form and FE colleges are at risk of great financial difficulty, and funding a guaranteed paid job for young people in long-term unemployment. Our paper suggests a range of options for how to put these and other areas of policy on a sustainable funding footing.

There is a political angle to this as well. The Conservatives are keen to be seen as a party representing all working people, as shown by the "blue-collar Conservatism" agenda. In addition, the spending review offers the Conservative party the opportunity to return to ‘Compassionate Conservatism’ as a going concern.  If they are truly serious about being seen in this light, this should be reflected in a social investment agenda pursued through the spending review that promotes employment and secures a future for public services outside the NHS and schools.

This will come at a cost, however. In our paper, we show how the Chancellor could fund our package of proposed policies without increasing the pain on other areas of government, while remaining consistent with the government’s fiscal rules that require him to reach a surplus on overall government borrowing by 2019-20. We do not agree that the Government needs to reach a surplus in that year. But given this target wont be scrapped ahead of the spending review, we suggest that he should target a slightly lower surplus in 2019/20 of £7bn, with the deficit the year before being £2bn higher. In addition, we propose several revenue-raising measures in line with recent government tax policy that together would unlock an additional £5bn of resource for government departments.

Make no mistake, this will be a tough settlement for government departments and for public services. But the Chancellor does have a range of options open as he plans the upcoming spending review. Expect his reputation as a highly political Chancellor to be on full display.

Spencer Thompson is economic analyst at IPPR