Y Pwyllgor Cydraddoldeb a Chyfiawnder Cymdeithasol

Equality and Social Justice Committee

14/11/2022

Aelodau'r Pwyllgor a oedd yn bresennol

Committee Members in Attendance

Altaf Hussain
Jane Dodds
Jenny Rathbone Cadeirydd y Pwyllgor
Committee Chair
Ken Skates
Sarah Murphy
Sioned Williams

Y rhai eraill a oedd yn bresennol

Others in Attendance

Dee Montague-Coast Triniaeth Deg i Fenywod Cymru
Fair Treatment for the Women of Wales
Dr Chantal Edge Asiantaeth Diogelwch Iechyd y DU
UK Health Security Agency
Emma Wools Dirprwy Gomisiynydd yr Heddlu a Throseddu De Cymru
Deputy Police and Crime Commissioner for South Wales
Joanne Hopkins Iechyd Cyhoeddus Cymru
Public Health Wales
Nicola Davies Gwasanaeth Carchardai a Phrawf Ei Fawrhydi
His Majesty’s Prison and Probation Service
Victoria Harries Gwasanaeth Carchardai a Phrawf Ei Fawrhydi
His Majesty’s Prison and Probation Service

Swyddogion y Senedd a oedd yn bresennol

Senedd Officials in Attendance

Angharad Roche Dirprwy Glerc
Deputy Clerk
Rachael Davies Ail Glerc
Second Clerk
Rhys Morgan Clerc
Clerk
Sam Mason Cynghorydd Cyfreithiol
Legal Adviser

Cofnodir y trafodion yn yr iaith y llefarwyd hwy ynddi yn y pwyllgor. Yn ogystal, cynhwysir trawsgrifiad o’r cyfieithu ar y pryd. Lle mae cyfranwyr wedi darparu cywiriadau i’w tystiolaeth, nodir y rheini yn y trawsgrifiad.

The proceedings are reported in the language in which they were spoken in the committee. In addition, a transcription of the simultaneous interpretation is included. Where contributors have supplied corrections to their evidence, these are noted in the transcript.

Cyfarfu’r pwyllgor yn y Senedd a thrwy gynhadledd fideo.

Dechreuodd y cyfarfod am 13:30.

The committee met in the Senedd and by video-conference.

The meeting began at 13:30.

1. Cyflwyniadau, ymddiheuriadau a dirprwyon
1. Introductions, apologies and substitutions

Good afternoon. Welcome to the Equality and Social Justice Committee. Before we take evidence from our witnesses today, I just wondered if there are any declarations of interest from Members. I don't see any. We've had no apologies; every Member is present.

2. Profiadau menywod yn y system cyfiawnder troseddol—sesiwn dystiolaeth 2
2. Women's experiences of the criminal justice system—evidence session 2

I'd like to welcome our witnesses for our inquiry into women's experience of the criminal justice system. This is our second evidence session, and I'd like to welcome Chantal Edge, who's a consultant in public health for the UK Health Security Agency, who's joining us in person; Dee Montague-Coast, who's the engagement officer for Fair Treatment for the Women of Wales; as well as Jo Hopkins, who's the programme director for adverse childhood experiences and criminal justice for Public Health Wales. So, welcome, all of you. If I could just start off the questions by asking you: 15 years after the Corston report, how well do you think the women's justice blueprint is addressing the issues that have been raised all that long time ago? Who'd like to start off? Shall I start with Chantal, who's in the room? Chantal.

Thank you. So, obviously, I'm here today speaking from the perspective of the UK Health Security Agency, which has quite a defined remit around health security issues in women's prisons. So, speaking from that perspective, and, again, working in an organisation that covers England, and not necessarily Welsh blueprint documents, but speaking from the perspective of health security and where we have moved to and where we have come from, I think it's fair to say that, in terms of health security infectious disease-related issues, we have made good progress in ensuring we have robust systems in place to tackle diseases that we know disproportionately affect people in prison, including women, such as continuing with our opt-out blood borne virus screening programme recommendations, recommendations around tuberculosis screening in prisons, and we've recently been working in partnership with the British Association for Sexual Health and HIV to design standards for prisons, not just for women's prisons, but all prisons, related to sexual health. So, I think there's a lot of work that's gone on in this space to make sure prisons in their entirety, across the estate, are well equipped to keep them, as we say, health secure, acknowledging that's just one remit of the health system.

Okay. Fine. We may want to come back on those statements. Dee or Jo, do either of you want to comment on this? You don't have to comment on every single thing if you agree with previous speakers.

I think, just from our perspective, until we looked into this, until I knew I'd be here today giving evidence, this wasn't something I was particularly familiar with. So, from that point, I think it would be quite interesting to get more disabled people involved with this kind of blueprint, with this legislation, and things like that, so that you can hear and you can get a wider viewpoint from those communities as well.

Very good. Jo Hopkins, obviously, the biggest issues for women in prison are both adverse childhood experiences, mental health and addiction issues. So, do you think that this blueprint starts to address those issues and the way we handle them?

I was actually working in the Home Office when the Corston report came out, so I have a slightly different perspective on all this, and it feels like a long time ago. So, in terms of progress, I think the first thing to say is that the Corston report was absolutely clear that the approach to women in any form of custody needed to be women centred. So, I think, in terms of the way that the blueprint has not only changed its name, it's changed its perspective, I guess, on understanding that point. So, I think, fundamentally, there's a very clear commitment from the blueprint to make sure that it meets that women-centred, integrated approach that was at the forefront of Corston, if I remember rightly.

The other thing is that I think there are really green shoots within the blueprint that address some of the other key aspects of the Corston report. One, in particular, is the experience of mothers. And I think one of the things that is probably a green shoot, I would say, at the moment, is the identification of programmes, projects, initiatives that support better women in prison who have children either at home still or are pregnant or all of that. There's so much more to do, but things like the Visiting Mum programme, which is one of the things that, in my role, in the blueprint itself, as a research and evaluation lead, I'm keen to understand what difference that's making. So, there are significant issues still to overcome, I think.

We're not going to be able to say today—or, I can't—that the blueprint has answered all the questions that Corston raised. But, certainly, there's a recognition within the methodology and within the ethos of things like understanding that trauma is at the root of many of the experiences of women, in particular brain injury as a result of domestic abuse, and the prevalence of that amongst the female population. But also there's that experience of why women offend—what has happened in their lives? Actually it's a very different experience to why men offend, and what we're really keen to understand and continuing to build on, through the blueprint structure, is getting that better evidence base to say, 'This is what the experience of women is in childhood', up to the point where they're often in a position where there's low-level offending, they are criminalised to a higher point than men are, but also that experience and why they do it— things like coercive control, things like trying to support a family, things like, basically, living hand to mouth need to be better understood, and so the prevention of the causes of women entering the criminal justice system needs to be thought about more. But what I'm encouraged about is that the blueprint is taking those steps, has identified those areas, and whilst it's not there yet, I think we can be encouraged by the direction it's taking.

13:35

The latest blueprint update was published in May—lots of fine aspirations, not a lot of detail about what's actually been achieved. So, I wonder, Jo, if you can tell us a little bit about how the Cordis Bright and ORS evaluations are actually influencing the work of the blueprint, because those haven't been published.

No, and, as Public Health Wales, I can't really take any responsibility for that decision to publish or not; they are the remit of His Majesty's Prison and Probation Service. As we all understand, that brings its own challenges in terms of what goes into the public domain. I did ask, because I anticipated that the committee would like to probably see those reports, so that is being considered by colleagues at HMPPS, if that's helpful.

From my perspective, I think one of the key questions for me in terms of the blueprint is exactly what you've just said, Chair, in terms of what is it that it's actually doing, and are those things making a difference. So, one of the things that we've just recently done is a workshop with all three blueprints, because there's a third one now—the violence against women, domestic abuse and sexual violence blueprint—to think about that theory of change. Question: why was that not done at a strategic level in the beginning? I wasn't there; I don't know. But I'm very encouraged to hear that people are now thinking, 'Let's be clear what the mission and the vision is, and how we articulate how we've achieved some of the activities and the outcomes that we want to see. So, hopefully, we will get all three blueprints into the same position in terms of understanding that and being able to articulate it.

On the Cordis Bright and ORS work, both would be very important in terms of informing the direction that we move towards in terms of thinking about where in the point of the blueprints are those things that we could measure, that we could understand what the impact is, and we could then create the narrative that you're looking for in terms of what difference it has made. The evaluability assessment, I think, and the Cordis Bright work both will be very important in identifying where the data gaps are, and particularly the data linkages, because in all of this work, because it's multi-agency, because it's cross-Government, there is always that challenge, isn't there, of who's got what data and how we put it together to give us that integrated picture. So, I think there is still some work to do. Those two reports are not the silver bullet in terms of, 'This is how we take things forward', but they are helping us to understand where the emphasis needs to be, what needs to be measured, and now how we go about doing so. I think they will be really important to ongoing discussions around the evaluation and the research element of this, which is where I sit, and thinking more about what it is that we can support the blueprints with from public health, to be able to evidence some of the things that work and the things that aren't working, because it's absolutely important that if something is not achieving what we anticipated or wanted, then we stop doing it and we focus efforts on things that make a difference.

13:40

Okay. So, I think my concern is about the pace of change for diverting women from ending up in prison, with all the upheavals that that causes for them and their family, particularly where very short sentences are involved, where it's completely pointless from a public expenditure point of view as there's absolutely no time to do any sort of rehab work if somebody is on a very short sentence. So, is there anything that you can optimistically say very briefly on this point before I ask some of my colleagues to come in? Chantal, have you got anything you're able to tell us about this?

Yes. Obviously, like I said, I'm speaking from the perspective of my organisation, which has, as I said, a very clear, defined remit, and for all organisations, I think, that have a role in the healthcare system within the prisons, it's difficult to deliver when people are revolving quickly through that door. So, from our perspective, again, from health security, you may identify a woman with hepatitis, but can you deliver treatment in that short stage? Possibly not. Will you see that woman again and again come back through the system, each time not with a length of adequate time to ensure that the treatment is completed? I think that does give us issues that are likely, I imagine, to be seen in other aspects of healthcare that's not the health security side. So, there's something about short sentences being problematic in your ability to make a difference for women that you come into contact with in the criminal justice system, because it is an opportunity to offer healthcare when people come through the prisons, and, as you say, the progress towards stopping these short sentences, we as an organisation would be very supportive of that. The organisation that really works in this area is NHS England's side and their role with the treatment requirements, so it's something that I can't comment on specifically, but I know there is work ongoing to try and make better alternatives for women than custody.

Okay. So, you don't have any specific knowledge of how the system works for Welsh women.

No, because, obviously, we're only on England's side.

Okay. Thank you for that. Can I call on Sarah Murphy to ask some questions now on the specifics?

Thank you very much, Chair. I just wanted to ask some questions on the potential of community-based provision, looking particularly for your views on the planned provision of a residential women's centre in Swansea, but also potentially other areas. As you know, the plan is for a pilot scheme, which will be opening in 2024, will have 12 beds, women will be there for up to 12 weeks, and it will be run by probation service staff. So, the question, really, is whether you value or not this model as an alternative to a custodial prison sentence, and for your views on its residential element. Dee, I'm going to come to you first because I can see you nodding along, if that's okay.

I do like to nod along, Sarah. Thank you. I think, from our perspective, this is something that we'd like to see, if it works, across Wales. We know that there's a postcode lottery when it comes to health, so we want to ensure that that doesn't replicate across the board. I will probably sound a little bit like a broken record today in terms of talking about making sure that things are accessible to anyone that needs to access them, and that they're inclusive. We need to ensure, I think, that accessibility is key. We know that disabled women are more marginalised than other women, and, I think, if you look after the most marginalised in society, you're well on the way to looking after everyone. 

Yes, I absolutely agree. Thank you very much, Dee. Jo, did you want to come in next?

Thank you. I'll try and keep my answers a bit briefer; I've already started with my long-winded ones. So, from a Public Health Wales perspective, we have been really supportive of the approach to try and do this in Wales. I think we have a strong evidence base from other parts of England, actually, where women's residential centres have been hugely successful. When I say 'successful', how do we measure success? It's in terms of women being able to return to the community and not returning to criminal justice, and getting the help and support that they need, I think, from our perspective, we've been doing a lot of work, particularly in the ACE hub, around trauma and a trauma-informed approach—every time I come to a committee, I have to get that in somewhere—but the trauma framework and the wider understanding of what the community aspect of this is. So, where women return the community, how do we ensure that that integrated model doesn't just sit within the residential centre and that they aren't then facing those same pressures, whether they're environmental, whether they're at home, or whatever is the root cause? So, really keen to look at this as a whole-community response, not just a building and a facility.

And that leads me to—. Our position is to support and to try and help and evaluate, if we can, if that would be helpful, this pilot, but also to really be clear that the conversation with the residents, the conversation with the community in which this centre will sit, is as important, almost, as providing the centre in the first place. And I think, perhaps, a little more thought needs to be given to the understanding of the wider community in which these facilities may be placed, around who these women are, what their experience is, and to take away some of the fear that communities may have. I think we can learn from examples such as Trevi House in Plymouth, where this has been done very successfully and these facilities are just part of the community itself, so that we don't 'other' people, label people or accidentally, without intention, create something that wasn't there before and just keep going with the generation of a lack of understanding of the experience of these women and what supports them most.

13:45

Absolutely. And just a follow-up question to you, Jo—sorry, Chantal, before I come to you—but what conversations has Public Health Wales had with the local authority and the cabinet member for health and social care or the local health board about how this provision or any extra provision that they need in terms of health or substance misuse would be provided? And also, crucially, who would be covering the additional cost of that?

So, Public Health Wales is part of the programme board structure of the blueprint, but, as far as I'm aware, we haven't had any direct conversations with the local authority or with the councillor. However, we are part of that overall team. So, when drawn upon for any advice or information, we would be very happy to give it. I think one of the things that we are very clear about, in terms of a commitment to public health and wider health boards, is that we understand that this pilot, if it is successful, will be of real benefit to the women in our community. So, from that perspective, I think that's the overall driving force: to be as helpful as possible. But I can't comment on any direct conversations that may or may not have happened.

Thank you. Sorry, this is just sparking another question for me around this. I absolutely agree with you about being trauma informed and, actually, when we visited Eastwood Park, it was good to see that, really. There has definitely been a kind of switch to that, and it does make a huge difference, I think, to women in these systems. But, that's quite specialist, really, isn't it, to have that training and experience of working in a situation like that and having that trauma-informed training? And do you know what's being put in place or what kinds of jobs, really, would need to be advertised to be able to provide that? Because I don't think it's something that the probation service would necessarily have the expertise in. Is that right?

So, I think there are a number of levels of trauma informed. Here in Wales, what we've advocated, through the framework that was published in July, is that trauma informed is a way of being, and then there are practice levels within that, which I'm sure you're aware of. So, I think there is a lot of work going on at the moment across the criminal justice system and policing to be sure that anybody working in those institutions is at least trauma aware, so at the more societal, universal level, and then going up to the more specialist therapies, which I think is what you're talking about. So, I think there is a need to understand, first of all, what the capacity levels are around this, because most, if not all women who enter the criminal justice system will have had some form of trauma—we can't get away from that—but their particular individual needs may be very different. So, in terms of training, I don't think everybody needs to be trained in everything, but we really need to make sure that the demand is met by the capacity of the system.

There is some work that's been going on at the moment to train staff in trauma-informed approaches and gender sensitivity as well, which has been really important. One of the things that we're doing as Public Health Wales is evaluating that training. It's not specialist specialist, but, I think, no matter if you are psychiatrist or you're the person that sits on the reception, that sort of overall understanding is important for everybody, and then we can layer up the kind of levels as required. I think it does take a whole view across, and I'd like to defend the probation service a little bit here, because they have been part of what we call the Early Action Together programme, a few years ago in Wales, which was thinking about how we equip policing, criminal justice in terms of trauma-informed approaches, and prisons and probation were part of that and continue to be part of that. So, there's more to do, but I think there is a level of understanding that this is important, and that we need to invest in it going forward.

13:50

Thank you. And I'll just ask my last question on your views on the provision of women's centres that don't have the residential element to them. So, we've heard recently that Anawim in Birmingham is particularly good, and the Nelson Trust at Gloucestershire is particularly good. They don't have that residential element to them; it's more about the prevention before women would go into the criminal justice system really, and also then to support them when they come out the other side. So, Chantal, if I can come to you first then on this one: your views on that distinction between the two types of women's centres.

Sorry, I missed the very first half of the question; it sort of broke up a little bit. 

All right. Just to say about the distinction between the rehabilitation centres, which have the residential element to them, and then the women's centres that are there to help women before they get to the point really where they end up in the criminal justice system, and then, to help them when they come out the other side of it. So, just the distinction between the two really, and, I suppose, your view on both or either of them.

Yes, sure. So, we don't have responsibility for oversight of them within my organisation, although I'm aware that the evidence base, full stop, for women's centres is very supportive, as has been mentioned already. I don't therefore have a view on which is better or what works better for why and what reason, but I would urge the committee to keep an eye out for the publication of the national women's prison health and social care review that has been jointly commissioned by NHS England and His Majesty's Prison and Probation Service. It's due to report in autumn, so we are one of the agencies that have been involved in the work of the review, although it's not our review. And I know from being involved in that work that women's centres is something the review will be considering in the whole. So, there's likely to be more in-depth information on that, when it comes out, about what models work or why.

I just wanted to touch back though on the points you just mentioned around the trauma-informed and the gender responsive. And, I think, again, that's something that all organisations in England are hearing more and more; it's definitely something we consider in our work and our policies—the need to be trauma informed for anyone involved in delivering services we have an interest in or oversight of. And, then, just around the gender side, so, again, in the department I'm in, in health equity and the clinical governance department, we have specific duties and aspirations around health equity inequalities, and the need to make sure that vulnerable groups are considered with targeted information on specific policies.

So, one of the things we're looking at is around prisons and transgender, for example. So, we have a sexual health registrar in our team at the moment who's going to be looking at transgender health standards, thinking potentially with a European-wide lens about people in prison, and, of course, that can go in all directions—you can have trans men in female prisons and vice versa—so, it's really considering that the needs can be quite complex and diverse. So, we are considering that under our health equity lens at UKHSA, and we also have a project, for example, that another registrar is going to be running, looking at what works for sexual health messaging for LGBT groups in inclusion health settings.

So, I know, sorry, that's straying off the question a bit, but, like I said, I don't have in-depth information on the women's centre side, but just going back to those points to say that they are really important to us as well.

Okay. Is there anything you can elaborate on as to why these residential centres have been successful in England, as Jo said?

No, I don't have the reports to hand on those, because they're not something our organisation is responsible for, because we're more about the policy, advice and guidance around the health security issues. So, it's not a topic that I am as familiar with.

Okay. No worries. Okay, thank you. Can I just ask Jane—? Oh, sorry, Sarah, did you want to add to that?

13:55

Yes, I'd like to hear from Dee and Jo about their views on the different types of women's centres—the ones where they're in residential and the ones where they're not. Jo, do you want to come in on this?

Yes, very briefly. Similarly, I don't have huge amounts of evidence to weigh one up against the other. However, I think one of the things that's important about taking a public health approach to this, which I think we are, and I hope we continue to do, is that we need to test and we need to test in Wales, because having used an example of Trevi House in Plymouth myself, actually would that work in a particular community in a particular area of Wales? There is a question, I think, around understanding the needs of individuals and whether it would better for them to be in a residential centre, or not. And there also needs to be a question around how that sits within the community and what services are available. So, it's back to the point of what we don't want is for this to become 'either/or'. It's got to be based on the needs of the women and what would support them the most. I'd be keen to test and pilot both approaches and to think about how that might work. So, a residential centre might be much better suited to an area of Wales that is well served with community-based services around it, and close to the health board ,et cetera. How does that work in rural somewhere—? I don't know; I don't want to pick on a county, but west Wales somewhere, where it's a slightly different model. 'How could we adapt and change what we know works in England to make sure that it does the same in Wales?', would be the way I would look at this. I think that's something we could think about, going forward.

Yes, thank you. Dee, did you want to come in on this as well?

What the others said, but also I think there's an aspect here—. Something that we talk about within our work a lot is about a lack of data, and I think that's something that we're probably seeing here as well. It would be amazing to have and to see and to learn from, but I'm with Jo; I think there is a lot that can be adapted to different communities, but also to the needs of the people who need it as well.

Thank you very much. We seem to have lost Jane Dodds. Is that right? So, can I go to you, Ken Skates, to talk about adverse childhood experiences? Hopefully Jane will rejoin us shortly.

Thanks, Chair. Jane's Wi-Fi has dropped out, but she will rejoin us as soon as she can. We've already heard about trauma-informed services, but I was just wondering whether the panel could give some more views on what they think the national trauma practice framework for Wales will have, and what research on experiences of ACEs for women right on the cusp of the criminal justice system is telling them.

I think that's me, then—I'm unmuted. Thanks, Ken. We're now at the point of trying to ascertain how we're going to implement the trauma framework. This is a really, really crucial point in terms of having got a document that sets out the practice levels, as I mentioned, and sets out the overall ethos of what we're trying to do, which is at a whole-society level. It's not just, 'Let's be a bit more trauma informed over here and cross our fingers over there.' It's really about culture change and it's really about thinking about how we instil the values and the principles, not only of the Well-being of Future Generations (Wales) Act 2015, but also looking at what we have excluded prior to this point, intentionally or unintentionally, and I won't comment on that, but things like the experience of racial trauma and discrimination, or the experience of people who are neurodiverse, for example. All of that is vitally important to be included and inclusive.

So, we've got a big job, but the plan is that we continue to implement the framework in the same way as we developed it, so it's co-production, co-delivery. It's not one organisation that's going to take it forward. We're working with Welsh Government colleagues at the moment to identify what funding might be available to support it, but I'm of the view that actually this isn't about money. This is about bringing people together that can make significant change. So, we'll start to see, hopefully, in the next few months, some real traction around taking that framework forward.

But your specific question around women on the cusp of the criminal justice system is really pertinent, because we are literally about to publish a report next week, which we'll make available to the committee, which is looking at exactly that: the experiences of adversity in its broadest sense. So, not just the ACEs that are identified as part of Mark Bellis's research, but a much broader understanding of the experience of women who have entered the criminal justice system but only in terms of the fringes, and really trying to ascertain what could have been done that wasn't done earlier in order to prevent those women even coming into contact, perhaps, with policing or low-level custody experiences.

What we're finding from that—we've already touched on it a little bit today—is that significant prevalence of domestic abuse and violence against women in the lives of women who are ending up undertaking criminal activity, and, again, the significant prevalence of trauma and head injury within that group as well. We've also got experiences of—. Human survival, I think, is the way to describe it—when there is almost no choice. I think some of that is playing into the wider environmental factors of do we understand the financial pressures on women, do we understand the gender inequality that then causes them to be unable to exist without feeling they have to turn to that, and then the link—as Chair pointed out at the beginning—between mental health, substance misuse, all the factors that come into play when people are struggling and aren't able to get the help that they need.

So, hopefully that report will—. I don't think it'll tell you anything you don't already know, but it brings it together in a way that really, I hope, sets forward the argument for prevention, and looking more keenly at preventative services for women in particular and their individual experience, as well as the need to be very inclusive of that as we go forward in the implementation of the framework.

14:00

Thanks, Joanne. That's really timely. Will the report highlight any best practice at all, or do you have any views on best practice that you might be able to share with us from elsewhere?

It's doesn't highlight best practice. The experience of the women is more about things that didn't work so well. However, you can infer from that that if there had been someone who had been more understanding of those particular issues of adversity in childhood, the longer term and life-course impact, that sort of thing—. There is, I think, still a need for education and awareness about that universal level and then funnelling to the more specific interventions. Because it seems from the report, the findings and the interviews—. And we're very grateful to the women who participated in that, actually, because they consented to tell their story, and they consented to say—. In some cases, there were individuals, people that they met, that they felt they trusted and made a difference to them, but overall, the system wasn't co-ordinated. You find good people and people in life that really understand, but not everybody does. Where that person is lost, they fall into the system that is less supportive. So, I think, overall, this is about a system-wide approach. It has to be integrated, and those good people that are within it we should support and encourage to spread that word amongst their colleagues and workforce.

Jane Dodds, I don't think you missed too much of the initial question, so please ask what you wanted to ask before we lost you.

I'm so sorry; my Wi-Fi went down. I think you've covered a lot on trauma-informed approaches and ACEs, so I wanted to ask something completely different, if I may, Chair. There are these massive different views on residential centres. The Howard League and the Prison Reform Trust actually don't support residential centres. But I'm also very interested in whether you've got any really good, excellent practice on how women can have a better experience, both of the justice system and of the prison system. Ken has asked specifically on trauma-informed, but is there anything, anywhere we should be looking, where we will see a fantastic Rolls-Royce system that approaches women on the cusp of criminal justice, and also when they're in the criminal justice system? It can be, 'Yes, I've got this' or 'No, I don't know anyone'. Chantal, shall I turn to you as you're in the room? It can be, 'I don't have anything'—that's fine.

Like I said, the centres themselves aren't an area I'm as familiar with; it's not under our responsibility. On the general idea of who does this well, I don't know that we know who does this very well. It doesn't mean some people aren't, but that's something where we would probably need to establish wider contact with other countries. For example, we know Scandinavia tend to do quite well with their prison system, but I don't know what they do specifically for women. On the bit that you said around interacting with women before they hit the criminal justice system, we have very strong acknowledgement that inclusion health groups, as we call them—people who often aren't included in the health response in the way the community is—often tend to have overlapping domains of exclusion. People who come into contact with the criminal justice system may well have experienced homelessness or worked in the sex trade or had substance misuse issues. And so, it's about making sure we don't just target prison specifically, but we think about where we may come into contact with people who are more likely to potentially have contact with the criminal justice system and take those early opportunities in wider sets of services that reach out to these groups that can be quite vulnerable and may not present to health services until things get extreme but may respond to outreach specialist services. So, I think it's just about thinking broadly where those touch points might be and acknowledging there is overlap with other very vulnerable groups.

14:05

Thank you. Dee, do you have any—? If you don't, that's fine. Thank you. Jo.

I was going to perhaps suggest that we take the criminal bit off this. I think there are some really, really good examples in Wales of organisations working at community level—again, I have got another report if you'd like to see it that identifies some of these—where we're not looking at families and young people as potentially, 'Let's try and save you from prison.' We're looking at what is going on in their lives and how can we support better some of the things that are those factors that are introduced then and increase the risk and the likelihood of people entering into what we would term health-harming behaviour, but some of that then becomes criminal activity, largely through the coping mechanisms that people go to when they haven't got that support in place.

There are some really fantastic organisations across Wales, but the latest communities report that we've just published highlights a number in Cardiff that might be useful to have a look at. Because I firmly believe that if we are providing the right support for whatever the need is within the community and the family, then we are preventing violence. I think, as well, it's worth looking at the work that the violence prevention unit are doing at the moment. They're doing a youth violence consultation for a framework—another framework. We're very clear that all these things need to join up, so they shouldn't be frameworks out on their own. But that's a consultation that's going on with children and young people at the moment, including them in a co-production. Some of the things that those young people have said are the things that they need support with and things they need help with. That's where we need to be listening, that's where we need to be thinking about how do we do that, because those young people are going to grow up into their adulthood, and if we haven't got things in place that support them now—.

But it's very interesting; the reason I raise that is because I mentioned this morning on a webinar that, as a 45-year-old white woman, I have an idea of what I think children and young people in Wales might need, but it's actually very different to what they say they need. I've had a couple of times now to step away from a conversation and think, 'I've got that completely wrong.' I just think we need to do that more often. We need to engage with people and say, 'What is it?' Because some of these things—. One of the young people said, 'I want to feel valued, I want to feel part of my community. I feel excluded.' There's nothing criminal about that, not yet, there may never be, but if we don't listen, we don't hear and we don't act, I think that's where the problems start. So, there are some fantastic organisations that are doing great work. I can reel off a few, but if I send that report, it might just be quicker.

Very good. Thank you very much. Can I bring Sioned Williams in now?

Diolch, Gadeirydd. Dwi eisiau edrych yn benodol ar y ddarpariaeth yn y ddalfa i fenywod. Rŷn ni wedi sôn tipyn bach am hyfforddiant ond dwi eisiau gofyn pa gamau sydd angen eu cymryd o fewn y ddalfa i ddeall anghenion menywod amrywiol. Dwi ddim yn gwybod pwy sydd eisiau dod i mewn. Dee, roeddet ti'n nodio yn fanna.

Thanks, Chair. I wanted to look specifically at custodial provision for women. We've discussed training a little bit, but I wanted to ask what steps need to be taken within custodial circumstances to help various women. I don't know who wants to come in. Dee, you were nodding.

I think, just like elsewhere in society, really, many custodial environments are not really built with female health in mind. This might be a bit strange, bringing this straight in, but if we look at things like menstruation, this is something that most women are going to experience, and it's ensuring that their basic needs are met. For us, we think that if the Welsh Government's period dignity strategy doesn't cover custody then it needs to. Like I say, it's ensuring the basics are met, that there are period products, that there are accessible toilets and things like that. But, there are other issues linked to menstruation, and those issues can become so significant that they can cause impairment—things like endometriosis, heavy bleeding, conditions impacted by hormones, things like PMDD. Those impairments can become such that women will become disabled. That might happen before custody, it might happen during, it might happen after. But, just like elsewhere in society, women can experience belittlement, they can not be believed, and there can be a lack of empathy and a failure to understand and recognise their impairments and the issues that they cause. So, across this spectrum, but in relation to your question as well, Sioned, I think we need a broader understanding of disability and especially impairments that are thought of as invisible or dynamic. Women are typically conditioned to push through things, whether that be trauma, whether that be pain, whether that be physical conditions and impairments. So, I think we just need to have a better understanding and accommodation of those women and the experiences that they face as well.

14:10

Diolch. Efallai y gallwn ni ei ehangu fe ychydig yn yr ymatebion eraill hefyd i—. Fe wnaethoch chi grybwyll yn fanna, Dee, efallai fod angen ystyried rhai o'r pethau hyn cyn dedfrydu hefyd, o ran yr adroddiadau cyn dedfrydu. Jo, ydych chi'n moyn dod i mewn?

Thanks. Perhaps we could expand that a little bit in further responses to—. You mentioned, Dee, how we should perhaps consider some of these things pre-sentencing, in terms of the pre-sentencing reports. I don't know whether, Jo, you'd like to come in.

Just briefly. I'd completely agree with what Dee has said. One of the things that we in Public Health Wales, from a health point of view, in terms of health provision, really want to do is learn from the experiences of prisons in England and custodial arrangements, so that we don't replicate the problems in Wales. It's things like understanding the fact that women in custodial places may still need to have access to pregnancy testing, may still need support around abortion and contraception and things like that. It doesn't stop just because somebody is in a facility. I, likewise, agree with Dee around period dignity. Menopause is the other one that I think really needs to be focused on. 

We in Public Health Wales feel that this is an opportunity to do that from the start, but also recognise that—[Inaudible.]—if we're going to really have an integrated service, then, why should it be any different from the experience that women would have in the community? These things are really fundamental rights, aren't they? So, that is where we are hoping to really make a difference in terms of residential centres coming to being, making sure that all these things are thought about from the outset and, as you say, pre-sentencing if we can, looking at those reports, looking at those opportunities to share information, where there is consent to do so, so that the right things are put in place for women from the very beginning. I think there's very little, actually, from the list that I just gave you, that wouldn't necessarily need to be thought about for anyone, because this is about supporting people who are traumatised, as we said, and enabling them to rehabilitate and to come back into the community. So, that's where we would hope this would be achieved. 

Diolch. Ydy Chantal yn moyn dod mewn?

Thank you. Chantal, would you like to come in?

Yes, just picking up on that point around the specifics around women and abortions and pregnancies that don't end in live births. As an example of a piece of work that we're doing in support of our partnership with NHS England, I am again supervising a registrar—it's a very specialist area; it's a sexual health registrar who has particular expertise in this area—to work with the national maternity transformation team in England to review the guidance for best practice around the different categories of pregnancies that don't end in live births. That could be through choice to terminate the pregnancy, or it may have been a miscarriage, for example. It will look at what best practice is, full stop, for these in terms of NICE clinical guidelines, plus to go out and consult through lived experience and engagement to understand what women say they need when they are in a prison setting if experiencing these, including the attitudes of staff, or support from staff that we required, with the aspiration, eventually, once this audit tool is formed, as I said, in partnership with NHS England, women's prisons in England will be asked to complete that audit tool, with support from our registrar, if required, so that we can then understand what people are doing and where the gaps are. We've also contacted, for example, the abortion lead at the Office for Health Improvement and Disparities. So, it's always very much a partnership approach to looking at these issues, but I think you have to take community guidance, but then you have to add that prison lens. And as has been reiterated throughout this, that prison lens comes from women who have had experience of being in prison. We can't do these things in isolation. That's just one example, but I think it shows the importance of, yes, getting baseline understandings of what's going on around these very important areas—as you say, they don't stop when women are going into prison—and making sure that we do look at them with a prison lens, because I imagine it's a very different experience going through one of these situations in a prison than going through it at home.

14:15

Diolch. Dwi eisiau sôn tipyn bach yn benodol nawr, te, am un peth rŷn ni wedi'i drafod yn barod y mae nifer fawr o fenywod sydd yn y ddalfa yn ei brofi, sef problemau camddefnyddio sylweddau, neu broblemau iechyd meddwl cymhleth ac anodd. Felly, pa gamau sydd angen eu cymryd i wella cymorth i'r menywod yma sydd yn y ddalfa ac yn profi'r problemau hyn? Hoffwn i hefyd ofyn eich barn chi am raglenni adsefydlu preswyl yng Nghymru.

Thank you. I wanted to talk a little bit now about something we've already discussed, that a number of women in custody are prone to substance abuse, or have difficult and complex mental health problems. So, what steps need to be taken to improve the support available for these women in custody who are experiencing these issues? I'd also like to know your opinions on the rehabilitation residential centres in Wales. 

Pwy sydd eisiau mynd yn gyntaf?

Who would like to go first?

I'll just take this off; I'm getting an echo. The residential centres in Wales I don't have knowledge of specifically, because, as I said, we cover England. The responsibility for substance misuse provision is with NHS England in our prisons in England, and the responsibility for assurance and monitoring sits with the Office for Health Improvement and Disparities. So, it's not something that comes directly to us, although we did, in our submission to the committee, include evidence OHID had given to us for the committee to review in relation to substance misuse. I agree that it is an extremely important area in women's prisons to get this right, and, coming back to what we've heard so many times, that these services need to be gender responsive and gender specific, as they do for any other services, we see in women's prisons we too often apply models from the male estate into women's prisons for many things, and that's not the right way to do it. And, again, just to go back on a point I said a minute ago, the real way to know what women need is to ask women. It's not for us to sit and decide what that might be without their input. Again, I know that the women's health and social care review, when that is published, has a standalone chapter on substance misuse for women's prisons. It hasn't been published yet. I was part of the working group, but it is not my chapter or information to share—that sits with NHS England and HMPPS. But there will be a lot of information coming out in that around what works for substance misuse for women, having engaged with women as well.

Diolch. Jo, wyt ti eisiau dod i mewn yn fanna?

Thank you. Jo, would you like to come in there?

Thank you. Yes. I think, as I said before, the mental health, substance misuse, the experience of domestic abuse, all of these things are almost the symptoms of what's gone before, so we need to think about why is it that these women are struggling with their mental health, or taking substances or whatever, and not just treat what's in front, and take the time to understand that experience of trauma and what needs to be put in place. There's a lot of issues around particularly the experience of women in terms of short sentencing, in terms of putting the provision in place and following it through when they return to the community. For me, the biggest risk is that, actually, you might receive a set of services in prison, you might be geared towards a set of services, because you have to reach a certain threshold to be able to access them and, actually, that might not be what you need. There may be a much lower level of support that's required, but, because that's not available, then there's a risk of people being geared towards and labelled as being having a disorder or something, when, actually, it's a normal reaction to a traumatic experience.

So, there's a lot of stuff to work through there, but, for me, the biggest issue, I think, is, when women come out of custodial arrangements into the community again, they're going back to the circumstances that they were in before, and, without anything changing and anything different, even if they've come a long way in terms of perhaps their substance misuse or something like that, there is a real risk of returning to that if there aren't the right things in place in the community. I think, in terms of the rehabilitation model that is required in a residential centre, the same thing applies. You can't have a gold standard and then just rip the carpet out from under people's feet, because that's just—. It's almost like dangling something in front of you and then taking it away again, and I think that can do more harm than good in some cases. So, absolutely, maintaining that gender-sensitive, gender-responsive understanding and what Chantal said about the experience of women informing this, but let's also think more broadly about that community base and what needs to be there. 

14:20

Do, fe glywon ni—. Rydym ni wedi bod ar ymweliad â charchar Styal ac Eastwood Park, ac fe glywon ni yn Eastwood Park, yn sicr, ynglŷn â'r ffaith bod y ffin yma rhwng Cymru a Lloegr, o ran y gwasanaeth iechyd, yn creu gwahaniaethau ynglŷn â'r hyn sydd ar gael i fenywod o Loegr sydd yn y ddalfa yn Lloegr a menywod o Gymru sydd yn y carchar yn Lloegr o ran hyn yn benodol, o ran camddefnydd cyffuriau, o ran y feddyginiaeth sydd ar gael, y math o substitutes sydd ar gael iddyn nhw, ond hefyd o ran y llefydd ar gyfer adsefydlu a phwy sy'n ariannu hynny. Achos clywon ni yn Lloegr fod y gwasanaeth iechyd yn Lloegr yn ariannu hynny, ond dyw'r gwasanaeth iechyd yng Nghymru ddim yn ariannu'r llefydd preswyl yma ar gyfer menywod sydd yn y carchar yn Lloegr. Felly, beth yw'ch barn chi ynglŷn â beth sydd angen ei newid yn hynny o beth yn benodol? 

Yes, we did hear—. We went on a visit to Styal prison and Eastwood Park prison, and Eastwood Park, certainly, mentioned the fact that this boundary between Wales and England, in terms of the health service, creates inequality in what's available for women from England who are in custody in England and women from Wales who are in custody in England, specifically in terms of drug misuse, in terms of medication, in terms of the substitutes that are available to them, but also in terms of the rehabilitation centres and who funds them. Because we heard that in England the health service in England was funding that, but the health service in Wales wasn't funding these residential centres for women who are in custody in England. So, what's your opinion on what needs to change in that effect? 

I think from basis we need to see this as an integrated system and we need to understand how better to share information, how to share data, how to make sure that we are putting the women at the centre of the work. That's easier said than done. We know that this problem around people being located in England and returning to Wales or whatever is not just for women in custodial settings; there are a lot of issues around people getting the right support for their needs. But I think, if we continue to strive towards that more integrated position and using the blueprint methodology—the blueprint gives us the way of working that should help to overcome some of these barriers—it won't be happening overnight, but I think if we maintain that ethos of, actually, this isn't about Westminster and Welsh Government, this isn't about whether somebody has the right to get something if they live here or there, it's about saying, 'What does this woman need? And how do we facilitate that?', I still hold out hope that this way of working will provide us with some of those answers. 

Diolch. Dwi ddim yn gwybod, Dee, os ŷch chi moyn dod mewn fanna. Mae gen i un cwestiwn olaf yn benodol i Chantal. Ydych chi moyn dod mewn ar y pwynt mwy eang neu ŷch chi'n hapus gyda beth sydd wedi cael ei ddweud? 

Thank you. I don't know whether Dee would like to come in there. I do have one final question, which is specifically for Chantal. Would you like to come in on the broader point or are you happy with what's been said? 

Yes, I'll come in. Diolch, Sioned. I think, just from obviously the specific perspective of disabled women—we're talking about substance misuse, mental health, custody—we know that disabled women often will self-medicate, and that may be due to long diagnostic delays and things like that; it may be coping mechanisms that they've picked up through their lives. That can become an issue. Jo had talked about domestic abuse as well, and I just wanted to highlight that as well, that, among disabled women—. So, there's already a very high risk for women to experience domestic abuse, but that doubles for disabled women, and then there are multiple issues there. For a start, many refuges aren't accessible to them, so they don't have that escape route, if you like. But also we're talking about understanding disability here now as well. Across society, there's a commonly held trope for disabled people and their partners—so, the disabled person is a burden; the person caring for them, their relative or whoever that might be, is considered heroic for putting up with that disabled person. Therefore, when disabled women try and access help, they may be dismissed, they may be unheard, and that can come into policing as well. There's often not that understanding of what's going on, and sticking up for the abuser, if you like. So, then that becomes very difficult. That can obviously then impact mental health as well, and, as I said, that self-medicating aspect might be something there as well. But I think, yes, that we just need to look at—again, it's that data, and it's co-production.

I'm really pleased to hear everyone else talk about the need for co-production and really centering that lived experience as part of how we make improvements, because this is what we see in the work that we do, specifically in health, that that is what makes the difference. We can come to these organisations, we can come to the NHS, we can come to Welsh Government and say, 'Look, between us, we have x amount of years of this system and not getting diagnosis, or not getting the support that we need. Here's what we think could make it better.' That, to me, is the key that unlocks all of this and makes it a lot more inclusive and a lot better for people.

14:25

Diolch. Un cwestiwn olaf cyflym i Chantal. Rŷch chi wedi sôn tipyn yn eich atebion hyd yma ynglŷn â'r adolygiad yma sydd ar fin dod mas o iechyd a gofal cymdeithasol mewn carchardai. Rŷm ni'n edrych ymlaen at ddarllen yr adroddiad. A gaf i ofyn i chi a yw'r adroddiad yma wedi ystyried anghenion menywod Cymru yn benodol?

Thank you. One final question, very briefly, to Chantal. You have mentioned in your responses so far about this review that's about to conclude, the national women's prisons health and social care review. We are looking forward to reading that review. Could I ask you whether this review has considered the needs of the women of Wales specifically?

Thank you. So, like I said, it's not our review. We are a partner in the review, which has been very multi-disciplinary. I haven't seen, personally, specific information around women from Wales. However, it doesn't mean that it hasn't been considered in other working groups that I was not a member of. So, I wouldn't like to say definitively—. I haven't seen it, but others may well have. So, it's probably something to go back to the review team and enquire about whether it has been considered.

Iawn, diolch. Diolch, Gadeirydd.

Okay, thank you. Thanks, Chair.

Okay, just to clarify, this is the report that you said was due to be published in the autumn. Is that right?

Yes. I haven't been told of any specific dates, but as a team—

Okay. We'll follow it up. The autumn comes to the end of this month, in my book, but it has been known for things to slide. Before we move on, I just want to ask two specifics. One is on why it is that women in Wales who've been using buprenorphine to manage their addiction and hold down jobs—being an injection, you know—. And once they go to prison in England, that's not available. Equally, there's the lack of access to the 12-step programme, which is only available to men from Wales in English prisons. So, I wondered if either Jo or Chantal Edge can just describe to us how it is that such a level of discrimination against Welsh women has been allowed.

I can add—. Again, it's not my organisation. So, NHS England commissions substance misuse services. So, why they do things differently in male or female prisons, you need to enquire directly with NHS England. I do understand, from the wider public health context that I work in, that buprenorphine, in general in England, is not commissioned in every region. So, you have to be careful—if people are released, they will be going back to an area where they may or may not be able to get it. So, I think that it's an evolving landscape, but it's on bigger drug commissioning policies for England that that is dependant. That, again, is something that probably OHID, which has the overview of substance misuse services, can provide you, again, with better information on.   

No, other than to agree that this is something, I think, that we all need to look at. Because, whilst we haven't got the power to make the change in terms of England, I think that we do have a responsibility in Wales to put the case forward. Hopefully, the work that we are doing and continue to do will be able to influence and change that. I do understand what Chantal was saying about needing to be very careful about where things are able to be provided after release and things like that. But I think that there's a slightly different conversation around sending someone to somewhere where they cannot access something that they are able to access in Wales and are, in my view, entitled to.

14:30

Yes. I just wanted to come back, Jo, because thank you so much for highlighting Trevi House in Plymouth. Whilst we've been on here, I've done a bit of quick research myself, and it does, it looks wonderful. But I think this is sometimes where, in this inquiry, things can get a little bit confused, because that is also called a women's rehabilitation residential centre. But for me, it's very much comparing apples with oranges in terms of what is happening there and what is being proposed here in Wales. So, for an example, now called Jasmine mother's recovery detox, there are 10 beds, most of them en suite, and they get to keep their children with them, and they then go on an average stay of 24 weeks while they go through an intense detox and therapeutic and trauma-informed support and therapy, and whilst they're in those therapy sessions, the children go to a creche, which again is very trauma informed, to help those children. And as well as that, it is run by a very experienced charity that comes under the care quality commissioner. Now, if we compare that to what they're proposing there's going to be in Wales, that would be 12 beds, two would have the ability to have children with them, a minimum up to 12 weeks, and run, as I've said, by the probation service. For me, it's so, so different.

And then on top of that, what they have in Trevi House is the wonderful sunflower centre where the women go from one into the next, and the probation service are all there, the DWP is all there, all under one roof, and they continue to get that support so that they don't go back into the system. I've read through it, and there is a wealth of evidence to support that this is a wonderful model. The UK Government gave them £400,000 to continue providing that model, so why, then, I suppose, are we not pushing for something that is exactly like that instead of what is being proposed in Wales as a pilot scheme where there isn't any evidence to support that? And I suppose my question is: is there, at this stage, any more that we can do to try to push this so that we get more of what Trevi House is, rather than what is being proposed for the women of Wales?

I'm not sure that I can answer the first bit in terms of why is there a difference. I do know that there have been a number of visits to Trevi House to be able to take the best bits. The reason I raised it was: is there a Rolls-Royce kind of example? I think there are probably more than Trevi House, but that's the one I'm familiar with, and I know that the director general from HM Prison and Probation Service only recently has visited, and there have been a number of different things.

Why are we not doing the same? I think that question is something that's worth asking and continuing to be asked. I think one of the things is that we're trying here to introduce something that is almost completely new for Wales, and I think from a public health perspective, like I said about let's not make the mistakes of missing out things that we really need to consider to be built in to whatever we're doing—and I listed period dignity and the other things. Actually, is there more that needs to be shaped in the years to come around what this is going to actually deliver? I think we're at the stage at the moment of simply trying to secure a building, aren't we? I think there's a lot more to do in terms of what actually is provided, and I think I would hope and encourage any kind of support in terms of what that might look like based on the evidence and the learning from wider. 

Thank you. Can we turn now to Altaf Hussain, who's got some questions about the impact on parenting?

Thank you. I know you're looking at the time, and there's a lot of overlap around the questions and answers. My question is: could the panel outline what action is needed to support pregnant women and those who have babies while in prison, including those who are in treatment for substance misuse? And, for Jo especially, it would be interesting to know about the progress in implementing the reform that was, I think, announced by the Ministry of Justice in 2020 after reviewing mother and baby units. Thank you. 

Do you want to go first, and then we'll bring in the other two?

I'm not sure I can update you on the progress of reform. I think one of the things that we're very clear about from a public health perspective is that the experience of motherhood in custody, whatever that may look like, whether it's pregnancy, whether it's actually having the child or whether there are children at home who need to maintain access, at the moment, with women being placed in prisons in England, it's not working for women. So, I think we're still some way away from understanding how we sort that out in terms of Welsh women who are in that situation.

The Visiting Mum service, one I mentioned earlier, again, needs to be formally evaluated, but it's certainly showing good signs in terms of the experience of women who have got access to their children, not just for the women—let's not forget the children themselves—. This is an adverse childhood experience, isn't it? And actually, in terms of who they are looked after whilst the women are in custody is a real question as well, and concern. So, this is a broader point, really, than simply saying, 'How do we support women better in custodial arrangements?' 

I think, again, it comes back to the fundamental of: do we put pregnant women in prison? I still don't think we've got to the bottom of what we think about that, and how we address it. I think from a public health perspective and from an adverse childhood experience perspective, that's a conversation that needs to continue to happen. I'm not going to come down hard one way or the other, but I think my own personal view is that you are criminalising two people, and you are placing a trauma on a family if we don't consider this more carefully. I think that's all I'll say.  

14:35

Chantal, some women enter the prison system not knowing they are pregnant, and that only arises afterwards. Is there anything you are able to add on how well we accommodate pregnant women? 

So, again, it's a difficult area for me to answer specifically on because, obviously, pregnancy tests, pregnancy care is our NHS England responsibility—not 'our', sorry—it's our NHS England's partner's responsibility as the one that delivers the care that will deliver pregnancy tests and look after women throughout. So, they are the ones that can give you the specifics around that, and I'm aware that they have a perinatal working group that specifically deep-dives on that area. So, NHS England will provide you with the in-depth advice. 

In terms of our perspective on the health security side, it is important to know if a woman is pregnant. If we had a case of rubella, for example, in a women's prison, we'd be very concerned about knowing who was pregnant and whose babies were potentially at risk—unborn babies. In terms of the pandemic, we've dealt with outbreaks continuously over the past few years of COVID. Women's prisons were hit just as badly as men's, and we would be very mindful of the effects on pregnant women if we had an outbreak in a unit where there was a mother-and-baby unit, for example. In our outbreak control meetings, we would wrap particular care and caution around the specific circumstances of the outbreak. So, if there were pregnant women there, we made different recommendations depending on the situation. 

So, we have a real vested interest ourselves in knowing whether women are pregnant, and making sure that anything in relation to their security or protection from diseases, et cetera, is considered in that round. The more general question is one for NHS England.  

Okay. Back to you, Altaf. 

All right. Thank you very much. The next question, really, is: is enough being done to mitigate the impact of parental imprisonment on children at both UK and Wales level? And also, I'd be interested to know if there's any data in Wales to help us understand the different impacts of the imprisonment of either mother or father, or both on the children. Will they have any contact with them, knowing that, in Wales, mothers are imprisoned in England in a hostel or somewhere far away? What will be the effect of that?  

Lots of research on this, so if you could all be brief in your answers. Who wants to go first? Chantal, do you want to go first? 

I don't feel that I'm the expert in the room here with this one. 

Fine. Okay. Dee, do you have anything that you want to add on this? 

Not specifically on that. I think, well, probably the same answer as before—there probably is a lack of data; I'm making an assumption, but that's something that we see quite a lot. 

I just wanted to say, just to reiterate, really, about the impact that pregnancy can have on some women in terms of either exacerbating impairments or bringing in new impairments—things like gestational diabetes, perinatal mental health, things like that. So I would agree with Jo in that, if you are putting somebody in prison with their child, or apart from their child, that's surely—. We talk about breaking the cycle quite a lot in our realm, and I think, yes, it's that risk of traumatising another person as well and causing issues for them as well. So, yes, definitely just wanted to highlight the issues around disability for pregnant women as well.

14:40

Very briefly, because you'll be cognisant with this research, but the parental separation and incarceration of a parent is an adverse childhood experience, as set out in the 10 ACEs in Professor Mark Bellis's research and the broader international research on it. So, it's clear that it is an adversity in childhood. What is also clear is that, if a child has experienced that adversity, they are likely to also be experiencing a range of other things. For example, if we move away from the 10 research ACEs, what financial impact does that have on the family? What impact does that have, perhaps, on that child going to school and being called out because they've got a parent in prison? What impact does that have on their friendships, on their relationship with that parent? I think it's hard to say whether or not the impact in terms of an adverse childhood experience is different if it was male or female—I think there's probably a bit more work that needs to be done there—but we know that, when women are put in prison, it's back to that point of who's looking after the children. When men are put in prison, women predominantly carry on that role. When women are put in prison, then it falls, it seems to me—and I think there's some work from the Prison Reform Trust and others on this—that it's less likely to be the father; they're in the wider family circle, perhaps with grandparents, or whatever, or we're talking about care provision.

So, this is wrapped up into a number of different adversities that are more likely to happen if that experience of incarceration happens. And I think it's all back down to what are the protective factors that are around that child, around that family, to help them to overcome what they're facing. It's very, very difficult if you're not able to see that parent, particularly if you're a young child and then you end up into a different system or a different care arrangement because you've lost that relationship. So, things like encouraging visiting, maintaining contact, is probably the best that we can do in an environment where you are separated in that way. I'm not saying that divorce and different kinds of separations are also not impactful—they are. But I do think that, in this particular instance, there is an increased likelihood, because of the circumstances around criminalisation, that there will be wider adversities, and we know the cumulative impact of that for mental health and wider issues.

Fine. Sarah, a brief intervention, before I go back to Altaf.

I'm conscious of the time, Chair. Thank you very much.

Yes, just a really quick question to Chantal, if I may. This is more about the life of the children, and whether they live if they're born in prison. In September 2019, a newborn baby died at HMP Bronzefield; another baby was stillborn in HMP Styal, in June 2020. But the Ministry of Justice does not routinely collect or publish data on miscarriages, stillbirths and neonatal deaths, so the number of deaths of babies born to imprisoned mothers may be higher. So, as the Health Security Agency, how often do you request this data from the UK Government, the Ministry of Justice? And of course, as I understand it, the role is to really try to predict where things may go wrong, so could you give us any information that you have on this data, or lack of, please?

So, I don't think it's data that we would specifically request, because it's probably data we don't need to know actual numbers for in the Health Security Agency. But if you were to try and request this data, the most likely source would be NHS records. So, it would be recorded, if it is known to the NHS, within the health record. So it would be through that route that you would request it if you had a need to know it. I think the thing to bear in mind, the wider context—and we see this whether someone's reporting an infectious disease or, potentially, whether someone's reporting a pregnancy or a miscarriage—is that people have to decide that they want to tell someone, so numbers will only ever be as accurate as confident as women feel to disclose information. So, obviously, a pregnancy may become more apparent if it ends in a stillbirth, but a miscarriage may go unknown, unless a woman reports it. So, the NHS would hold data, but whether that data is complete we don't know, because it will depend on what women tell us.

14:45

But obviously with deaths, they're going to be very aware that that happened, so who is recording that? Whose role is it to oversee this?

Anything that has a health-related repercussion will be recorded by NHS England. Again, they have work streams; I would enquire with them direct around deaths in custody. I would imagine they will consider, given, as you said, the very tragic circumstances with the babies, not just adult deaths. But that is something very much in their remit to enquire with them about.

Okay. Wonderful. Thank you very much. That's very helpful. Thank you, Chair.

I'm just going to ask if we can extend the discussion by literally a couple of minutes. For a start, Chantal, you mention in your written evidence that Bronzefield has the highest number completing treatment to become drug free, whereas in contrast HMP Eastwood Park has a very large number of women in treatment. What is it that Eastwood Park is not learning from Bronzefield?

I feel as if I'm being unhelpful when I point towards other organisations, but again, this was the data from the Office for Health Improvement and Disparities that agreed to put in in one submission. It is their data, and they are the ones who oversee the substance misuse treatment, including alcohol dependency, so would have a better understanding of what or why the differences are.

Okay. Thank you. If there's one thing that you would recommend for improving the current situation, what would it be, each of the witnesses? Who'd like to start? Dee.

In addition to the trauma-informed training, we would love to see mandatory disability awareness training that incorporates female health, the social model of disability and unconscious bias, to tackle attitudinal issues. That training must be co-produced and co-delivered with people with lived experience as well.

In a similar vein, on top of the trauma stuff, I think as well we need to really think about the marginalised groups—obviously disabled people, but also how people like Gypsies, Roma and Travellers are represented within the populations in prisons, and how people of colour are represented. I think we haven't got enough research going on on that at the moment. And really think about how we address the diversity of experience within this group that we haven't touched on that much today. For me, that's the fundamental here. We can't just be trauma informed; we've got to really understand the different trauma that people experience.

The overall preference would be to send fewer women to prison, but if we continue to see women in prison, it's about making the best of the opportunity to engage, and offer what we can in terms of health intervention, when women are within those services. And, as Jo alluded to, coming back to that: to understand whether we're offering the best, and that comes back to having better data a lot of the time. I know in some of our UK Health Security Agency data sets, it can be hard to identify people who are prisoners, because in the past people were not keen to flag someone as a prisoner, but now we understand we made need to look in more detail at these people. So, improving that data, so we can evidence whether we are doing our best when people do come into contact with these services. I think it's all wrapped up into one.

Very good. Thank you very much, all of you, for your evidence and for your time today. Jo, I wondered if you could send us the link to the report you mentioned on looking at this from the whole-family perspective—that would be really helpful. Otherwise, all three of you will get a transcript of your evidence, and this is your opportunity to correct anything that you haven't said but has been misheard. Otherwise, thank you very much indeed for participating in this inquiry. You'll  obviously get a copy of the report in due course.

The committee will now take a short break, and we'll resume with our next evidence hearing on this subject at 3 o'clock.

Gohiriwyd y cyfarfod rhwng 14:49 ac 14:59.

The meeting adjourned between 14:49 and 14:59.

14:55
3. Profiadau menywod yn y system cyfiawnder troseddol—sesiwn dystiolaeth 3
3. Women's experiences of the criminal justice system—evidence session 3

Welcome back to the Equality and Social Justice Committee. We're continuing our inquiry into women's experiences of the criminal justice system. For our third panel, we've got Nicola Davies and Victoria Harries from His Majesty's Prison and Probation Service, and Emma Wools who's the deputy police and crime commissioner for South Wales and chair of the women in justice in Wales group. Welcome, all of you. I just wanted to start off the scrutiny session by asking you: fifteen years after the Corston report, what progress are we making? How enthusiastic should we be about the progress that's being made in the women's justice blueprint? Who'd like to go first? Emma.  

15:00

Thank you, Chair. As you said, I'm Emma Wools. I'm the deputy PCC, and I'm the senior responsible officer for the women's justice blueprint. I think you pose a really valid question. Corston, in essence, called for a co-ordinated and joined-up working arrangement between all agencies involved in women who are affected by the criminal justice system, and I think that is what we have been able to achieve in terms of the implementation of the blueprint. It recognises very much a shared vision between Welsh Government and UK Government in wanting to transform services for women here in Wales, and also reflects joint leadership across all criminal justice organisations and wider non-government partners in delivery of the key six work strand priorities we have as part of the blueprint.

I think what we have achieved to date is a very clear vision about what we are seeking to achieve, which is to reduce the number of women coming into contact with the system in the first place, so very much focusing on that prevention agenda, but equally then being able to reduce the number of women who get sentenced to custody, particularly short-term custodial sentences. I think with that shared vision we have been working over the last two and half years collectively in terms of developing partnership strategy, policy and delivery on the ground in an integrated way.

I know the committee have been furnished with a number of written submissions from colleagues here as well, outlining some of the detail, but it may be useful and helpful to the committee just to illustrate some of the progress and impact that has been made to date. I think, first and foremost, whilst again the Chair reflects very well that 15 years ago there was clear evidence that something different needed to be done, here in Wales the blueprint has sought to further build on that—what does that actually mean in terms of evidence of need for women in Wales in particular, recognising that women in a Welsh context may have distinct needs from those in other areas of the country. We have committed, through the six work strands, to making sure that we're developing our insights and building a specific repository of evidence in relation to what works and what is needed.

You will have been furnished with a number of detailed examples, but just to give you an idea of some of the work that we've been doing, we have been looking into adverse childhood experiences as it pertains to women in the criminal justice system, and trying to build our evidence base about the distinct needs of ethnic minority women within the system. There's been evaluation of our whole-system approach, which I think is our operationalised vision for how we want to see services working for women going forward. We have very much applied a lot of effort and energy into making sure that we have got an understanding of what gender-informed skills training and requirements are needed, and, very much importantly, an involvement model is being developed so that we understand from women themselves exactly their experience and what they require.

I'm keen for colleagues to be able to come in and expand, but, again, there are just a couple of examples of service design, commission and delivery we've been able to achieve and deliver over the last two and a half years. In 2019, very early into the blueprint, we launched our whole-system approach service, which effectively delivers that integrated, end-to-end—so, from arrest through to resettlement—joined-up service provision for women across the south Wales and Gwent area. We have managed to establish a psychologically led model, so again recognising the need to be trauma-informed in this space and to design what that trauma-informed looks like for women particularly in the criminal justice system. We have established—

15:05

Can I just—? We are going to run out of time and other Members have got very specific questions, and I'm sure they'll come back to you on these issues. Thank you, Emma. 

No problem. Thank you. 

Victoria and Nic, is the blueprint the solution after 15 years of talking about it?

Good afternoon. I'm Nic Davies. I'm the regional probation director for Wales, and I'm here representing HMPPS in Wales. I think it's fair to say that the blueprint has been an excellent platform for us to continue our commitment to the recommendations of the Corston report, albeit it 15 years ago. It's given us an opportunity, as Emma has just mentioned, to work collaboratively with partners and commissioners to develop the services that should be there for women in custody and coming out of custody, but also as community sentences. 

So, in Wales for example, out of a 15,000 case load of people on probation and licence, 1,500 are women. One thousand and thirty-seven of those women are on community-based sentences, and, of course, our attention today is on the smaller number, thankfully, and diminishing number, of women going into custody. We currently have 193 women in custody, with 237 women on licence. And working with them in a bespoke way has really been the thing that I can see that has helped the most in terms of working collaboratively with our commissioners. 

We've been very serious about getting the blueprint up and running in Wales, and, in HMPPS in Wales as a directorate, of committing resource into this field, through Victoria Harris, our head of blueprint, and she's committed to working within the women's field in particular. Our people on the ground are in women-only teams. They work hard to maintain the whole-system approach that Emma discussed, and working with partners to get the best that they can for the women coming out of custody and on community sentences. 

I think we have got a way to go. I'm sure you'll be hearing shortly about our commitment to working better in the future with devolved and non-devolved services, particularly in the field of accommodation and health. But we do have a very strong foundation now, through the blueprint, to be able to do that. 

We know that we can't do this alone as a single agency, as a probation service or HMPPS in Wales. We've always worked in partnership, but this has given us a formality to the commitment that we need to bring to resource our services properly into the women's field. So, we have women-only commissioning in Wales as a result of this. I think that's been really important. And we are responding to the complexity of working with women when they come out of custody well with our partners. As I say, we have a way to go. We know it's a joint responsibility with devolved and non-devolved partners, but, personally, I think that the blueprint has been the first step to ensure that we can achieve our aims. 

Okay, very good. So, it's a work in progress. To what extent can women who may be in, or at risk of entering, the criminal justice system access a consistent level of support regardless of where they come from in Wales?

I think one of the factors of the blueprint which has been really useful is that, in Wales, we've got quite a broad landscape, a very varied landscape, but we have also got a lot of really enthusiastic statutory and third sector organisations and individuals who want to work with women, who want to bring the recommendations of the Corston report to all of the women of Wales. And the blueprint has been really useful in creating harmony and consistency between our aims, making sure we're all working towards the same agenda, making sure that the women remain at the heart of what we're delivering, and that all of our work is based on established research. So, we're able to share the learning that is coming out of the research that is happening, we're allowed to get a broader picture of what all the services that are being delivered look like, where the gaps in statutory devolved and non-devolved services exist where we can support women to be able to access services where they may be in hard-to-reach areas or they may have difficulties in accessing services. So, the blueprint is a really useful tool for all organisations to be able to identify services and work towards the same objectives.

15:10

Okay, thank you for that, and thank you for your very comprehensive paper. You're recommending that the women's pathfinder whole-system approach and the 18-25 service need to be expanded across Wales. Could you tell us whether there's buy-in on that whole-system approach model for the whole of Wales amongst all the stakeholders you're having to work with, given that criminal justice is not a devolved matter?

If I could take accommodation as an example of that, we are working hard with our local authorities, for example, to secure accommodation through our CAS3 option of accommodating people—women, in this instance—coming out of custody. We know we've got a big problem with housing stock across Wales, and we're working with local authorities to help solve that problem. We have got in-principle agreements with most of the local authorities, so we're working to resolve this. As of Friday, we have got agreements with four of the local authorities in Wales to work together to house women as they come out of custody. And, as I say, there are about 16 agreements currently in train, looking to do that across local authorities as well. It is a difficult situation to be in, isn't it? I think we're all in agreement that people need to come out of custody into secure accommodation. However, when there are no bricks and mortar for people to go into accommodation, then it's always going to be a difficult decision to make.

In the male estate, we have worked with our police colleagues to secure housing—portable houses that we can build on specific land, which have proven to be quite popular. We're hoping we'll maybe be able to have that conversation with regard to women, and to develop some sort of bespoke housing for them. It is always going to be a difficulty to cross over that devolved and non-devolved responsibility with regard to local authorities ensuring there is proper housing stock for women, but I think we can work together, through working through this CAS3 proposal with them. So, we have got buy-in, I think it's fair to say. I think the will is there; it's finding the way to do that to turn this goal into a reality.

Yes, just in relation to the question you posed around the whole-system approach and 18-25. Yes, in relation to buy-in, we do have buy-in from key stakeholders and commissioners, and we're currently in discussions about how we take the south Wales and Gwent model to its next iteration and then look to expand that into the Dyfed-Powys and north Wales areas, so very much engaging with His Majesty's probation service, Welsh Government and PCCs about how we do that, and also looking to see how we look at the MOJ grant funding that's come down for women in terms of how we might sensibly and intelligently use that in order to knit and create additional aspects of that whole-system approach, particularly in north Wales and Dyfed-Powys.

Just briefly from me—last question—Nic, you mentioned that we've got 193 women in custody at the moment. Are you able to give us a comparative figure with the numbers who used to be locked up, prior to all these different interventions?

I do, if you can give me one second. Where are our figures?

Okay. You can let us know by e-mail after the meeting.

Oh, right. That's fine, yes.

I think it's important that we've got some indicator of how well things are working. Emma.

Just to expand on that, we do have some indicative data, so I think it's probably fair to say that it's too early to attribute, for certain, impact and outcome, but we do have a number of really good indicators as part of areas of the system where numbers have been reducing in the right direction—so, from a custodial point of view, court sentences, et cetera. I'm happy to provide that in writing. 

15:15

Yes, just to say that we're happy to provide more information, but, as a snapshot figure, on a single date in October 2021 there were 226 women in custody. So, we're seeing a gradual decline. 

Thank you. That's really helpful information. Moving on now, Sarah Murphy, would you like to come in at this point?

Yes, thank you. Just whilst you've got those figures up, can I just ask, of the 226, do you have the numbers of how many of them have children, because I've been asking but we haven't been able to get this data anywhere?

The numbers that we've got within our current data show that we've got eight women in custody at the moment who are recorded as having dependent children. I would say, though, that our record of dependent children sometimes excludes those women who have children who don't actually live with them, and so the number is actually higher than that, but it's about the recording. But, at least eight of those women have dependent children.  

Okay. Again, I've asked this a few times, but why isn't that recorded, how many of them have children, even if they're not dependent?

It's on the recording system. So, what we do tend to record—. We will record things like women who are involved with social services and that kind of thing, and we will have wider data that we can read into to show women who have children, through looking at every individual record to show their contact with their children and that kind of thing. But it's not an easy piece of data that you can pull out. So, it's not a reported piece of data, but we can find out from individual records. 

Okay, thank you very much. And, sorry, as well, just to follow up on—. You just mentioned this money that has come from the Ministry of Justice—you said that there's money sitting at the moment waiting, I suppose, for you decide where it's going to be spent. Is that right?

Not my decision specifically, but MOJ money that is going to be administered under two different categories out to our third sector partners or PCCs as leads. Again, what we've done in terms of the blueprint is ensure that, when stakeholders are bidding for the money, they keep in mind the priorities that the blueprint are working to so that they're aligned. As I said, that won't be a decision for us locally, but HMPPS are very much engaged in the selection around that grant funding. So, again, we get a local representative in terms of that panel selection and what those priority requirements are.  

And, sorry, just to follow up, then, how much is it that has been allocated for Wales, and is it just for women?

I'll defer to my HMPPS colleagues, because, off the top of my head, I can't remember. However, we can provide that in further detail to you outside of this session, if that would help.

Yes, if you wouldn't mind, because it is chunked up into different pots of money with regard to commissioning. So, I can get you a total figure and see what that looks like across Wales. 

That would be wonderful. Thank you so much. So, to move on to the questions looking at the residential women's centre that's being proposed in Swansea, could you just really clearly, I suppose, because this is where I think we've been tying ourselves in knots a little bit—. What is the value of this model as an alternative to a custodial prison sentence? What is the difference?

So, the aim of the residential women's centre is influenced by some of the findings of the Farmer report, where women are being sent to prison who may not pose a risk of harm to the public but may find it difficult to engage with services in the community because of a complex need, particularly around accommodation. So, the target group that we are looking at to support with the residential women's centre would be that low and medium risk of harm group of women who may have committed an offence that meets the threshold of a custodial sentence but don't actually require a custodial sentence to protect the public. But, what we tend to find is that women with complex needs find it difficult to access services in the community because of the fact that they don't feel safe. So, what we're trying to do through the residential women's centre is to provide a safe environment for women who may otherwise be very vulnerable to give them an intensive support to engage with a community sentence. So, it may be women who've failed to engage with community sentences before, so women with a history of breach, or women with a history of short-term prison sentences, where they may not have engaged with that.

So, it's really front loaded, so that we can provide them with safe accommodation so that they can address their other needs that contribute to their offending behaviour; so, it could be that they need to address areas of mental health, thinking and behaviour, substance misuse. So, what we've found by looking at the research of what works to support women on probation to complete probation orders is that you really need to kind of sequence their support well, because, obviously, if there's a woman who isn't living in safe accommodation, who may be experiencing domestic abuse, or may have significant mental health issues, it's going to be very difficult for them to address their offending behaviour until those needs are addressed. So, the residential women's centre is seeking to support women to be able to address their offending behaviour whilst giving them a place to address other areas of criminogenic needs. 

15:20

No. It's purely a residential facility, so it would be more akin to supported accommodation, so they're free to come and go as they like. They would be risk assessed, so they're not women who are assessed as posing a risk of harm to the public. They may well be vulnerable or experiencing complex needs, which the centre would address, but it's entirely not a secure environment, apart from the fact that it's a safe environment, where we will control things like visitors or people coming into the centre.

Okay. Thank you much. Emma, did you want to come in?

Yes, just to add to Vicky's overview. Just to say that we've engaged with a lot of women themselves who are participants of other residential models across the country, and, having spoken to those women, they will feed back and say that that opportunity for a safe space for that meaningful intervention has been the difference between them being able to make meaningful changes, whereas, previously, they may have been on a rotation or that cycle of re-incarceration on short-term sentences.

The evidence—that I've heard, anyway, when we spoke to women in Eastwood Park prison, though—was that, if they're there for up to 12 weeks, it's not long enough, really, to help them with substance misuse issues. And the example that we had in Public Health Wales earlier on was the Trevi House in Plymouth; they do an average stay of 24 weeks for somebody to do a thorough detox. And we've also heard that it's very hard, for some reason, for Welsh women to be able to go into rehabilitation centres afterwards, when I'm very aware that there are definitely beds in the rehabilitation centres. So, just focusing, I suppose, as you bring up the example of the substance misuse, what are your thoughts on this?

So, what we would be doing as part of the stay at the residential centre, what we're hoping to do, is to be able to support women to access services in the community, which is why the centre will only be for women from the local area. So, we would be looking to engage them with local services, whether that be a statutory substance misuse service, whether that be a local health board substance misuse service, help them to stabilise, but then allow them to access it as a member of the public or a member of the community under their own steam whilst we support them, because I think the danger is that, if you support somebody under an artificial environment, they really struggle then when they're out independently to be able to access those services. So, actually, the 12-week period is supported by research that shows that that's the optimum level to support someone intensively before allowing them to access services by themselves. So, you're empowering them to be able to access services, rather than trapping them in a cycle of support where they really struggle, then, when they're out on their own trying to do it.

Would it be possible to share that research? Having been—. This is my background in substance misuse, being a trustee for a charity; it would be wonderful to see that. I just—[Interruption.]

15:25

Sorry, I was just going to add on then that, after the 12 weeks, they would still be subject to support from the centre and from the probation service, so there's an ability to come back and access services as well. Sorry.

Okay. When you say, then, this is only for women in the local area, so you have planned it will be in Swansea, can you be specific? Is that the Swansea local authority, which health board, exactly who is this? What is 'the local area'?

It's the Swansea Neath Port Talbot local delivery area.

Right. What conversations have you had with them about this and the services that will be provided? Who will be providing them?

We've had conversations with local stakeholders, obviously without having the centre agreed as a place, so it is still a theoretical model, because the planning hasn't been agreed. But we've been in significant discussions with local service providers—so, local substance misuse providers, our local commissioned services, our police partners, local authorities—to discuss what kind of impact there would be and what kind of need there would be, and there's an operational design model in place at the moment that, again, is theoretical, because the centre hasn't been agreed yet. But the design model would look to commission a portion of services from local service providers, but also look at what women are statutorily entitled to as well and help them to link in with those services.

Yes, of course. Can  I just—? I'll move on from this then, Chair, I promise, but—

I do think we need to move on, because we're nearly halfway through—

I think these are coming under some of the other areas—

Okay, right. I just want to remind Members and participants that we only have an hour allotted for this session. Can you take up the questioning, Ken Skates?

Thanks, Chair. I'll ask some questions, if I may, about working with courts and, in particular, sentences, and to begin with, if I may, asking what extent there is, in sentences and partner organisations, agencies, including the police—? Are they willing and able to adopt a non-punitive approach? Do they have the knowledge and do they have the options available to them, for example, the use of out-of-court disposal orders?

Perhaps if I start with policing and then hand over to colleagues in terms of the work with courts and sentences. So, from a policing in Wales perspective, I think both PCCs and chief constables are very understanding of the vulnerabilities that underpin women's offending and, therefore, the need at times for that early intervention, an intervention and non-punitive approach. So, for example, from an operational perspective, there are diversion or out-of-court disposal services across all four forces, of which I think it's over 2,000 women have been referred into those services, principally through policing, over the course of the last two years, so, demonstrating that understanding that when, as perhaps a woman who's a first time entrant or a low-level offender, it's perhaps the complex vulnerabilities that need addressing, rather than a more punitive approach. I think that the volume of women referred into these services and the investment reflect that understanding and support from a policing perspective.

Can I just ask then, just moving on to my next question, why there is such inconsistency across Wales in terms of prison sentences, when and how they're given? In Wales, in some areas, we see prison sentences given far more frequently than others, so what sort of actions are being taken to address this inconsistency?

So, one of the things that we've done as part of the blueprint is to develop a pan-Wales women's partnership report, which actually tracks sentencing trends by individual courts, as well as areas. So, we disaggregate that down to our women, and we can provide a number of cross-referenced data there. So, what we are able to do as a result of that is to investigate those discrepancies. So, where there is a discrepancy in the number of custodial sentences, we're able to reach out to individual courts and find out what is different in those areas, so what extra work we need to do.

As part of the blueprint, we did a series of targeted engagement events with sentencers last year, which looked at custodial sentences for women and provided some evidence about how they can be ineffective if they're not necessary and trying to raise the profile of community sentences and alternatives to custody and how they can be more effective. There was some really useful evidence from people with experience of the criminal justice system talking about their experience of going to custody and that kind of thing to try and raise the profile with sentencers of some of those issues and some of those experiences and what those alternatives are.

So, what we have got in place at the moment as a result of scanning the horizon for discrepancies in custodial sentences is things like passports for information for women. So, we've targeted a couple of individual courts that seem to have higher than the national average rates to track the women through. So, we're able to provide information at point of arrest that then follows them through, so that we can be more proactive at accompanying them into court and providing court assessments to be able to be more likely to ask for pre-sentence reports, and provide assessments that recommend community sentences rather than them being sentenced without reports.

15:30

Can I just ask if Jane Dodds wanted to follow up on that?

Yes. Sorry, Chair, I'm just really interested. How are you monitoring the short sentences, things like sentences for a week, et cetera? Who's monitoring that and how do we get that data? Thank you. Thank you, Chair. Thank you, Ken.

HMPPS monitor that data. I can send that over to you, if that would be helpful. What we're trying to do is break the cycle with sentencers on actually imposing these short-term sentences. It was why I raised my hand earlier, actually, because what we have found in our sentencing engagement events is there is a genuine need by most sentencers and a want for women to have good services and to be diverted out of the criminal justice system. There is a belief that by imposing a short-term sentence that that can be achieved, and we're trying to dispel that myth and trying to divert the thinking into community-based sentences.

So, for example, when we launched the mental health treatment requirement in Swansea, a community-based sentence looking specifically at mental health services and what's needed for our people on probation, 30 per cent of those mental health treatment requirements were actually women, and that is significant, I think, for us. We're trying to get to a space with sentencers where we can say, 'Actually, we do effective work in the community with our women, we do not need those sharp shock treatments of getting people into custody, we are actually trying to turn that tanker around.' And I think sentencers are listening.

Can I just ask—sorry, Chair—just really briefly then, is confidence in sentencers an issue? Do they have the confidence to be able to promote alternatives and to use alternatives to—?

Yes, absolutely. I think what we are trying to do now is to build our community provision for women. So, obviously, through the Corston report, one of the concerns was that women were being subject to the same sentences as men and the same interventions as men, when actually what we should have been doing was providing bespoke services for women. So, I don't think we're 100 per cent there yet, but we are definitely a long way towards providing effective community provisions for women, which are robust, which are engaging, which are gender informed, trauma informed and delivered in a gender-informed way, in women centres, which allow them to engage. I think a lot of community sentences have been difficult for women to engage with, because their needs haven't been taken into account, but we are definitely committed to providing women's sentences now through the interventions, through the commissioning of services for women.

15:35

Just to build on Vicky's point, so where she's described that intense sentence or engagement, I think we've already started to see some indicative data that shows that custodial sentences have dropped, started to reduce, since that intensive engagement, so I think that reflects sentencer confidence is there when they are fully informed and furnished with the information about the options available to them.

Thank you very much, Chair. We're talking about intervention, prevention and community-based solutions. Could the panel members outline whether enough is being done to intercept and divert women away from the criminal justice system in Wales?

Which of you want to start? Emma, do you want to start first?

Yes, happy to start. So, I think, as I mentioned to the panel earlier on, there is significant engagement from commissioning partners across Wales in terms of investment in diversion services—so, pathways away from the system into early intervention and support. There's the whole-system approach model that is a feature in south Wales and Gwent, and there are two separate diversion models being operated in the north Wales and Dyfed-Powys areas, all of which, all those diversion providers, are aligned to share best practice about what works and what needs to be improved. 

As part of the blueprint, we have a dedicated early intervention and prevention work stream. So, whilst we have focused very much at this stage on early intervention at point of arrest or for those who have stepped in to the criminal justice system as a first-time offender, we have recently commissioned a piece of work that's been done, with the support of Public Health Wales, to look at primary prevention options—so, looking at understanding those key drivers that build at a very early stage that contribute to increasing a women's risk of entering the system. And so, from our perspective, that's going to be a forward priority for the blueprint programme. So, how can we get in, educate and support our wider universal services—so, as we've talked about, mental health, accommodation, social services, et cetera—around those key indicators that present and put women at a vulnerable risk of entering the criminal justice system? 

Thank you, Emma. Earlier you said—. Are there potential gaps in north Wales and in rural areas, and are there opportunities to provide additional centres in the rest of Wales?

It's definitely one of our priorities. So, as part of our community sentences work stream, one of our objectives is to scope and launch women's centres across Wales, which can provide co-located services for women. That would be available for women who are participating in diversion schemes, women who are serving community sentences, women from the community who want to access services to support them, and women leaving prison. So, we are hoping to be able to build on the success of other women's centres—so, examples of women's centres that exist in Cardiff and in north Wales—to build on their success and from their lessons learnt, and to invest resources into developing those. That's a really big part of our priorities going forward, and we're hoping to be able to build that into our joint commissioning model as well, so that will be part of the services we provide.

Great. My last question, Chair: do you have any views on what action is needed to ensure services are trauma informed and are able to meet the needs of vulnerable women and families by adverse childhood experiences?

15:40

There's been quite a significant amount of time and resource invested in developing a gender-informed, psychologically-led model, which we've provided for partners to benchmark themselves against good practice in implementing gender and trauma-informed principles, and, also, we've developed and rolled out a multi-agency gender-informed training package, which is delivered by Welsh Women's Aid on behalf of the blueprint, which is available for all professionals working with women, who are either in the criminal justice system or at risk of entering the criminal justice system. So, that's currently under evaluation by Public Health Wales. But we've had really excellent feedback on that, and the aim is to provide all people working with vulnerable women across Wales with this gender-informed training to allow them to take a trauma and ACEs-informed approach.

Thank you, Chair. Maybe I'm allowed to ask just one last question about whether there is a centre elsewhere in the UK from where we can learn about best practices, which could be utilised in Wales.

All right. I think we'll come back to that, if we've got time at the end. Could we now move on to Sioned Wiliams?

Diolch, Cadeirydd. Roeddwn eisiau gwybod am y ddarpariaeth sydd yna yn y ddalfa i grwpiau gwahanol o fenywod. Roeddech chi'n sôn fanna am drais domestig, er enghraifft, ac rydym ni'n gwybod bod 60 y cant o fenywod sy'n troseddu wedi cael profiad o gam-drin domestig. A yw'r cynghorwyr annibynnol ar drais domestig ar gael i fenywod o Gymru sydd yn y ddalfa yn Lloegr? Ac a yw pawb sydd angen y gefnogaeth arbenigol yna yn ei chael?

Thank you, Chair. I wanted to know about the custodial provision for different groups of women. You mentioned domestic violence, for example, and we know that 60 per cent of women who offend have experienced domestic abuse. Are the independent domestic violence advisers available to Welsh women in custody in England? And does everyone who needs that specialist support receive it?

I'm afraid, Chair, I'm not picking up the interpretation, so I didn't quite catch the question.

All right. Could you just summarise your question, Sioned?

Yes. Do you have interpretation now? No. Okay. Just talking about domestic abuse, and we know that 60 per cent of women who have offended have suffered domestic abuse. So, are the IDVAs available to women from Wales who are incarcerated in England? And are all women who are in need of specialist services with regard to domestic abuse trauma receiving that support? 

As part of the blueprint, we've introduced IDVA provision into Eastwood Park to make that support available for Welsh women returning to Wales, and to provide that support and interface then with other community services locally, as needed.

Okay. Anything, Victoria or Nic, you wanted to add on that? 

Yes. Just to add, on the back of that, that we work in partnership with lots of our violence against women, domestic abuse and sexual violence support groups, and one of our objectives has been to facilitate support services for women who may have complex needs. We had some feedback in the early stages of the blueprint that women on probation were finding it difficult to access refuge support, because of their complex needs or their previous offending behaviour. So, we were able to link in then to support refuges to take women with complex needs, so that they wouldn't be excluded from services, and, as Emma said, we've also provided an IDVA service into Eastwood Park, which also provides some support for Styal prison, which takes our women from the north of Wales, and we're working with all of our custodial estates who'd be able to support women who may be victims of domestic abuse, so that we can support them on release.

Thanks. I just wanted to ask then about people with mental health problems. What steps are being taken to meet their needs in prison?

15:45

So, one of the services that we provide at the moment is called the offender personality disorder pathway. So, they support high-risk-of-harm and complex-needs women that meet the criteria in Eastwood Park and back into the community. They work with the Nexus unit in Eastwood Park for those women experiencing mental health difficulties to go in and be able to support them, and that is an HMPPS service. They're able to make direct referrals into community mental health treatment and forensic mental health services, into Gwent and into secondary care.

With the wider group of women with mental health needs, as Nic has already said, the mental health treatment requirement pilot, which happened in Swansea, has had a really significant impact on our female case load. So, as she said, 30 per cent of the MHTR case load have been women, when you compare that to 10 per cent of the case load overall. We're looking to roll out that service into the whole of Wales at the moment, so that is a new initiative that is happening in the near future. We've also developed a health and justice co-ordinator role in Wales, which is in the early stages, but will be based in each local authority area and will support women back into primary and secondary care treatment.

Can I just ask about the effect—we talked about it a bit earlier—of short sentences on the kind of support that can be provided in prison and also beyond, on release? We heard in Eastwood Park, for example, that the average sentence, the average stay, was 42 days, and we also heard evidence—although I accept that perhaps the data is showing that this is becoming less regular—but we heard evidence in Eastwood Park of a week sentence, which was then, obviously, about three days served, in essence, because transport was actually 24 hours of what someone was sent to custody for, which obviously is going to impact—. We were told that person will lose their house, may lose their children, and will not have enough time to have any effect as regards the support that could be available, both in prison and afterwards. Could I ask your opinions on that, whether you think that is something that is detrimental?

Thank you. I absolutely do think it's detrimental to the women we're talking about. I think that is what is driving us with regard to our sense of engagement, because what is, I'm sure, coming from the right place in trying to get women help and putting them onto shorter sentences is not actually, you know, achieving the result. We do absolutely want to continue to push towards community-based sentences. What I will say is, from a statutory point of view, even if a woman serves a day sentence in custody, she will have statutory support from the probation service. So, she will be given a prison offender manager and a community offender manager, depending on the length of sentence. That person will be in discussion with her about her needs and what she needs to do to come out successfully into the community and rehabilitated into the community.

It does, from the probation service's point of view, make it harder for us if we haven't got enough time to work properly with the woman we're talking about. We would not want to increase sentences as a result of that. That is a probation service problem, and we will do everything we can to work with the rehabilitative needs of the person on probation or the person on licence. But we most certainly are trying to desperately influence sentences to say that, actually, the provision of service is there now, whether they're on community-based orders or custodial sentences, so please could we turn that tanker around, as I said earlier, and give women community-based sentences when appropriate, particularly for non-violent offences?

To add to that as well, one of the things that we are able to do in Wales through the blueprint is that our partnership integration co-ordinators carry out women's case conferences. They're particularly useful where we are trying to co-ordinate services for women, either already in the community or coming into the community, and by inviting our statutory and third sector partners to those meetings we can formulate a release plan around an individual woman where we can pick those particular needs up. But obviously, as you've said, the short-term sentences make it difficult. So, we have implemented a bespoke women's resettlement plan as well, which our probation staff work to, where we are aiming to try to reach women at earlier stages of their sentences to give a longer period to prepare them for release, which doesn't solve the problem of really, really short sentences, but we are working to get in earlier to provide a longer preparation time.  

15:50

Thanks. It actually was striking that one of the main concerns that the women we spoke to in Eastwood Park was anxiety around accommodation on release, many of them being released homeless, and the trauma that that can create in and of itself. So, just thinking about the support available for women on release after they've completed their sentence, however long or short, in your evidence, Emma, you talked about work on accommodation solutions, working with stakeholders, for instance, Llamau, but you mention HMPPS have pushed back against including service users to inform that work. Could you just explain a bit more about that and what impact you think that will have?  

Apologies. I might need to get further information about that last point that you mentioned. But, just to expand on the point around the piece of work that we've commissioned jointly as a blueprint around Llamau and Glyndŵr University, that's aimed at mapping what's available in terms of current provision to ensure that what we've commissioned in place is appropriate and supporting women's needs, whether there needs to be reconfiguration of those services so that they're targeted towards the right cohorts, whether including criteria is appropriate to presenting need as we're seeing it, and that there's more of a joined-up commissioning approach. So, that independent piece of research from both academia and, as you've mentioned, Llamau, as an expert provider, I'm hoping will report towards the end of this year with recommendations about how we will design and test an accommodation solutions model that will complement a number of aspects of the accommodation pathway work that HMPPS, both independently and in collaboration with Welsh Government, have been doing, particularly enhanced through the pandemic. I don't know whether colleagues from HMPPS may want to expand on that. 

So, to address the point around the emerging issue around homelessness upon release from custody, Emma is right. Back in COVID, during the pandemic, the MoJ pulled together the homelessness prevention teams across England and Wales, where we looked to house people being released from custody who were eligible for housing, housed them quickly and securely on their release from custody. I mentioned when I was giving evidence earlier about the CAS3 scheme, which is the community accommodation services 3 scheme, which again is jointly funded with Welsh Government to provide 84 nights' accommodation for eligible offenders when they're released from custody. So, we are really keen to work with local authorities to this effect. I mentioned that, as of Friday, four local authorities have signed up for this, and there are around about 16 further agreements in place as we speak, trying to get to a point where we can offer that accommodation. 

We have worked with people coming out of custody. So, we've worked with women themselves in our engagement programme and asked them what they want. Women in custody tend to have a different slant to men in custody, in that they begin thinking about accommodation quite early on into their sentence, where men tend—I don't want to over-generalise—to think about it closer to release stage. And women are particularly concerned when they want to go back to live near their families, even if they're not going to have a child within a household with them. They want to be near their children nonetheless to build those relationships up. And the way in which the system works currently is that you start looking at accommodation at a point in time, because you can't hold properties for x period of time because you would have voids in properties, which we will accept on a principle level. However, the important bit, I think, is to help women, particularly if they've got anxieties, concerns around building back those relationships with their families, to start working with them earlier on into their sentence, to talk about what exactly is the process for an accommodation pathway, what will happen to them, to give them more peace of mind. I went into Eastwood Park personally a couple of months ago and spoke to a large group of women who were all anxious about accommodation, and it was because of the unknown. And we really ought to—. We are trying to work with them at a much earlier stage. The short-term sentences, as I mentioned earlier, is making that difficult for us, because the engagement has to be immediate, and it's quite difficult, really, when people are just feeling really anxious, particularly if women have been on remand for a period of time. So, we are working with the unconvicted, as we now call them, to start looking at their accommodation at an earlier point. So, technically, they're not on statutory supervision with the probation service, but we have arrangements in place to work with them to this effect.

We're also developing packages of being a good tenant with the homelessness prevention team. I think that's really important as well, because gaining a tenancy is one thing but maintaining a tenancy is another, particularly for those women who want to be good tenants, to get access back to their children and their families. It's going to be an incredibly important development for them as well. So, those are a few of the things that we have in place and we know we need to further develop as a probation service in Wales.

15:55

Thank you very much. I have the last questions. You're all very experienced—I can hear that. So, we'd love to hear from you what you think best practice looks like and where can we find it? So, where have you seen really good practice in relation to women's experiences of the criminal justice system, and imprisonment as well, and how can we grab that evidence and information? So, Emma, would you like to go first—is that okay?

Yes, that's fine. I think there's lots of good practice across the UK in terms of working with women, much of which we've drawn upon to inform the work that we've done in the blueprint—obviously, diversion models that may have started in certain areas of England, particularly our colleagues in Manchester, and we've drawn on learning to inform work in Wales. The trauma-informed practice, we've taken that evidence base from Public Health Wales and internationally, in terms of how we look to work with women. And as Nic and Vicky have already described, we've made sure that we've gone around and visited lots of women's centre models, so both those with residential components and the broader community-dedicated women's centres, to make sure that we can take away those elements of best practice—so Willowdene, 218, Trevi centre—understanding different cohorts of women who come from different referral pathway so that we can give some real cognisance to who are the women who need those specific services and intervention.

I will say that, in Wales, we have done a lot of the foundation and groundwork in terms of building an evidence basis. The women's pathfinder, which was the trailer to the blueprint, which was commissioned by the then National Offender Management Service, was really the leading light, the trail into testing and trialling aspects of provision for women, which is what we've built on in terms of how we're looking to scale up services now. So, I wouldn't want to hide Wales's light under a bushel in that I do feel that a lot of people have come to us in terms of best practice.

Thank you very much. And, Emma, have you got any really good practice in relation to women and children, mothers and their children, anything around really good practice there, and maintaining links—just one thing, if you can just say, 'Yes, that's a great place', or, 'That's a great practice'?

The PACT Visiting Mum service that's being delivered here in Wales.

Thank you very much. And Vicky and Nic, the same question to you: so, if you can just give us really good practice, in your view. And also, I'm just really interested in that: mothers and their children—what's good practice, where is it, how can we make sure that we bring that to Wales, if it's not here?

I'll ask Vicky to come in to talk about Visiting Mum. But, certainly, my idea of good practice is working with women, solely with women, in a place where they feel safe. And what we do know is, in a co-located space with partners—we are working currently with HMPPS in Wales, and with Welsh Government, and with our police  and crime commissioner colleagues—working with people who properly understand the needs of women and the complexities of women, and allowing them that place to come in and feel safe and work through those real issues they have, not just around accommodation, not just around tangible things, but emotional things, 'How am I going to get my relationship back up with my children? What can I do?'—

16:00

Can I be a bit provocative, given that we've got very limited time? Where is that happening? Tell us where that's happening.

I'm personally seeing that in the Cardiff offices; I think Vicky would come in and say this to you, because it's a location based away from the general probation office, which is really important, because when these women are reporting in general probation offices, they're quite often reporting maybe at the same time as their ex-partners—

Cardiff is a really good place. We can provide you with more information about that. But it's back to basic principles, though, of common sense, of working with women in a place they feel safe.

Yes. Very briefly, I've worked in probation for a really long time, and I think it's about that incremental learning about what works with women. So, you pick up bits of good practice from all sorts of places. We work with our colleagues in all sorts of environments. I visited a fantastic facility called Gellinudd in Neath, which works with women with mental health issues—a residential centre—and their approach to trauma-informed environments is absolutely brilliant.

It's called Gellinudd, a mental health facility run by Hafal in Neath. So, that's the residential centre. And it's great for us to go around—we've been to Eden House, which is a women's-approved premises in Bristol—and just pick up ideas about things that are evidenced, to work with women, with things that support women that are trauma informed. I was involved in the women's pathfinder at the very inception, when it came out in Cardiff, and just the very start of it, the idea that women could come in and feel safe and feel involved, putting women in a group as well, although there are some nuances to that, putting women in a group, women will support women, and having those groups where women can talk to each other about their experiences and feel supported is really, really positive. The Visiting Mum project is a fantastic project, and I've heard first-hand from women who've really learned a lot about how to engage with their children. The mother-and-baby unit in Eastwood Park as well is another fantastic example of how we can support women who've had really, really difficult times, who've not had a good example of how to be a good mum—you know, learn from other people of how to engage with their children and feel supported.

That's really helpful. We've all been to see different places, but it's really good to hear your viewpoint on this as well, so thank you very much. Chair, back to you. Diolch yn fawr iawn.

Thank you. We've run out of time, but your evidence has been very useful. If there's anything further we want to follow up on, is it okay to e-mail you?

Yes, of course.

I think, in particular, I'd be interested to see a list of all the women's centres that exist in England or Scotland, for example, or, indeed, Northern Ireland. That would help us understand Altaf's question, which was where is the best practice. So, Altaf, is there anything you wanted to add to that, because we are out of time? But if we can get the information, we can then follow it up through the research service.

Certainly. Will do.

Okay. So, you will be sent a transcript of your evidence, and please do make sure that it's accurate and we haven't misheard you. And in due course, obviously, you'll get a copy of our report. So, thank you very much indeed for your time, and the committee will now continue with other business. Thank you very much indeed for your assistance.

4. Papurau i’w nodi
4. Papers to note

If the committee could now note the three items of correspondence that have been received. Is everybody content to do that? Fine.

5. Cynnig o dan Reol Sefydlog 17.42 i wahardd y cyhoedd o weddill y cyfarfod
5. Motion under Standing Order 17.42 to exclude the public from the remainder of the meeting

Cynnig:

bod y pwyllgor yn penderfynu gwahardd y cyhoedd o weddill y cyfarfod yn unol â Rheol Sefydlog 17.42(vi).

Motion:

that the committee resolves to exclude the public from the remainder of the meeting in accordance with Standing Order 17.42(vi).

Cynigiwyd y cynnig.

Motion moved.

So, now, moving forward, a motion under Standing Order 17.42 to exclude the public from the remainder of the meeting. Are we agreed? Fine. Can we go into private session, please?

16:05

Derbyniwyd y cynnig.

Daeth rhan gyhoeddus y cyfarfod i ben am 16:05.

Motion agreed.

The public part of the meeting ended at 16:05.