Fallon inquiry: Ashworth run by inmates not staff

Fallon inquiry: Management blamed for `therapeutic nihilism' that allowed unit to become awash with hard-core porn

A TELEPHONE call from Dirty Harry's bar in Amsterdam in September 1996 triggered the Ashworth inquiry that reported yesterday. On the line was Stephen Daggett, a convicted paedophile and Ashworth inmate who had absconded days earlier while on a shopping trip to Liverpool. What he had to say lifted the lid on one of the worst scandals to engulf the top- security mental hospital.

Daggett, 38, claimed the hospital was awash with pornographic literature and videos, that inmates had a ready supply of drugs and alcohol and, most damaging of all, that an eight-year-old girl had made regular visits and been allowed to play, in a garden next to a ward, with a patient convicted of sex offences against children.

Daggett, who spent 12 years in Ashworth after being convicted of three indecent assaults against girls, promised to return to the hospital on one condition - that his claims would be investigated. He had absconded, he said, because it was the only way of drawing attention to a situation that had been ignored by the hospital authorities.

Last night Peter Clarke, the acting chief executive of Ashworth, said significant changes had already been made in both the security and governing of the hospital.

"There are a catalogue of events in the report that should not have occurred," he said. "What did occur here is appalling and is not acceptable. The report also appears to highlight our repeated failure to learn when things have gone wrong. In the past we seem to have investigated and drawn up documents and plans and failed to implement them."

After publication of the report, Paul Lever, the chairman of the Ashworth Hospital Authority for the past three years, resigned. Mr Clarke said he had done so in the "spririt of accountability".

When Daggett, who had managed to withdraw pounds 1,500 from his building society account and then give his nurse the slip, was picked up in Canterbury and returned to Ashworth on 7 October, he set about producing an account of his claims entitled "My Concerns". The hospital authorities dismissed his version of events.

Only when Alice Mahon, the Labour MP whose constituents in Halifax include Daggett's parents, produced a 60-page dossier based on his account did ministers take notice.

The allegations related to the Personality Disorder Unit, a block of five locked wards that housed some of the most intractable cases at Ashworth. By common consent among psychiatrists, offenders with personality disorders are the hardest, if not impossible, to treat. This "therapeutic nihilism" fostered a policy of containment rather than treatment - and what emerged was that the unit was effectively run by its 115 inmates rather than the staff.

As ministerial anxiety about Ashworth grew, in the light of Ms Mahon's claims, a raid was ordered on Lawrence ward, part of the Personality Disorder Unit, on 17 January 1997. What it disclosed beggared belief. One of Britain's three top security mental hospitals, housing some of the most dangerous offenders in the land, had become a centre for the circulation of hard- core pornography.

In the ward shop, 41 hard- core porn videos were on sale. More than 800 other videos were found on the ward, 700 of which had been recently wiped or carried traces of pornographic recording. Some of the videos depicted bestiality, sado-masochism and child abuse and video machines were used to copy the tapes. One patient's room was found to contain 225 videos alone. Some of the material was locked in a medical cabinet to which staff had no key. The raid also uncovered quantities of women's and children's underwear. Another patient ran what the inquiry team described as a "computer consultancy business".

Routine searches at the hospital were farcical. One case involving Jim Corrigan, the nurse who escorted Daggett, recorded how he would sit on a patient's bed reading a pornographic magazine before leaving and marking it down as a search. He was later dismissed.

Two weeks after the raid, the eight-year-old daughter of a former inmate of Ashworth was taken into care. The father, known as Mr Y, had regularly taken her into the hospital and was also the main source of the pornography in the hospital, which he had brought in by the car-load. In the chilling words of yesterday's report the girl was being "groomed for paedophile purposes" although there was no evidence she was abused. She had access to one patient who had a history of molesting young girls, including indecent assault and attempted rape, and also visited another who had kidnapped, tortured, sexually assaulted, mutilated and murdered a 13-year- old boy.

A few days later, on 7 February 1997, Stephen Dorrell, the then health secretary, announced the inquiry into Ashworth under judge Peter Fallon, which was published yesterday. Five members of staff were suspended, including the chief executive, Janice Miles. She resigned in July 1997 after being cleared by an internal inquiry. Her successor, Dr Hilary Hodge, resigned a year later, in July 1998, after senior doctors expressed "grave concerns" about her management style.

The history of the scandal-hit hospital had brought many to the view that it was beyond rescue, long before yesterday's recommendation by the Fallon inquiry that it should close. Ashworth, Broadmoor and Rampton, Britain's three top-security hospitals, have been criticised for more than a decade for being too big, too crowded and too isolated, professionally and geographically.

Sir Louis Blom Cooper, the QC who chaired an inquiry into Ashworth in 1992 that uncovered evidence of a brutal, dehumanising regime, said yesterday the hospitals were "unmanageable" and the Government should have begun dismantling them years ago. He had found a penal, oppressive regime dominated by the Prison Officers' Association, to which most of the nurses belonged. Speaking on BBC radio, Sir Louis said: "They are much too big ... [and] they carry around the terrible legacy of the criminal lunatic asylum ... they never actually got rid of the idea that they were partly a prison."

Mind, the mental health charity, echoed his views. "We want a national network of smaller, more manageable high-security units rather than these massive institutions that are trying to treat people with a huge range of mental health needs," said a spokeswoman.

There had been earlier signs of improvement. A report by the Health Advisory Service in 1996 said there had been "major advances" in the running of Ashworth and that "a great deal of progress had been made in addressing the unhelpful aspects of the previous hospital culture". It appears this progress was subsequently lost and, according to yesterday's report, weak management was to blame. Frank Dobson, Secretary of State for Health, described it as "a systematic shambles".

Last night Daggett, who is now at Rampton, spoke of his vindication. "I do not expect to be thanked for what I did," he said. "At first I was ridiculed because people simply could not get their head around what I was telling them."

The first hospital appeared on the Ashworth site in 1878 - a convalescent home, Moss Side House, for children from Liverpool workhouses. By 1914, it had been taken over by the Red Cross and established a reputation for treating shell-shocked soldiers from the First World War.

Moss Side became a special hospital in 1933. In the 1970s, overcrowding at Broadmoor resulted in further expansion and the construction of Park Lane Special Hospital on land at the facility.

Park Lane opened in 1974 and was gradually expanded until 1984 into a high-security psychiatric facility operating independently of Moss Side. In 1989, the two hospitals were amalgamated to become Ashworth Hospital.

In March 1991, a television documentary alleged that a patient had died after being beaten by staff. A subsequent inquiry led to a big shake- up.

Report's Plan for Change

ASHWORTH has been given four months to develop an action plan to implement urgent changes.

Four NHS employees named in Fallon report and still employed at Ashworth are to be disciplined.

Arrangements for dealing with people with personality disorders to be reviewed.

pounds 4.5m to be invested in improved security at Ashworth, including x-rays, metal detectors and sniffer dogs, and a further pounds 1.5m for extra security staff at all three special hospitals.

Visits by children other than relatives of patients banned since September 1998.

Review of all aspects of security, including the use of post and telephones, at all three special hospitals to report directly to NHS chief executive, Sir Alan Langlands.

Social Services Inspectorate to conduct inquiries into social work aspects at the three special hospitals.