Medical assessment of restraint

Article 39 has obtained a copy of the Independent Medical Assessor’s rating of different restraint techniques and scenarios applying to:

  • children in custody;
  • children escorted to custody; and
  • children being deported on aircraft.

This is the first time this information has entered the public domain. We elicited the information through freedom of information request to the Ministry of Justice, prompted by the Government’s announcement that escorts taking children to secure children’s homes would now be using the Minimising and Managing Physical Restraint (MMPR) techniques. One-third of the MMPR techniques rely on officers deliberately inflicting pain.

The Guardian newspaper has reported our findings.

Staff working in secure children’s homes are prohibited from deliberately inflicting pain during restraint. Children in secure children’s homes can be as young as 10. In May 2016, the same month escorts taking children to secure children’s homes started using MMPR, Ofsted issued advice on children’s homes inspections which states:

“Ofsted does not condone or support any method of restraint that inflicts pain or any care arrangement that is abusive or emotionally harmful.”

The deliberate infliction of pain during restraint in child prisons has been criticised by many bodies including the UN Torture Committee, the UN Committee on the Rights of the Child, Her Majesty’s Inspectorate of Prisons and the UK’s four Children’s Commissioners.

Each restraint technique and scenario (there are 66 in all) is rated according to the likelihood of harm occurring to children, and to the level and type of harm potentially suffered.

28 of the 66 techniques / scenarios are rated as 2 out of five for the likelihood of children’s airway, breathing or circulation being affected – with the potential consequence of death or permanent severe disability.

Moving a child who is wearing the ‘waist restraint belt’ through a doorway is given a 3 out of 5 risk rating for breathing difficulties that could cause catastrophic harm (death or permanent severe disability).

Children being taken to hospital is rated a “minor” consequence of restraint and hospital admission is rated “moderate”. Only hospital admission that carries a risk to the child of long term disability is rated as “major”.

Children strip-searched on the floor while held under restraint is rated as having a 4 out of 5 likelihood of fracture/dislocation and ligament/tendon damage requiring hospital attendance.

Many scenarios are more likely than not (rated 3 out of 5) to result in a child having to attend or be admitted to hospital.

The document includes a risk assessment of children being held face down on the floor and inflicted with pain. There is also reference to the waist restraint belt being applied to a compliant child.

The medical assessment does not consider the likelihood of children suffering psychological harm.

GeoAmey holds the contract for escorting children to secure children’s homes and child prisons.

We are now considering how the law may be used to protect vulnerable children taken by escort to secure children’s homes.