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Monday, 28 February, 2000, 06:08 GMT
Treating a 'psychopath'
Ashworth Hospital
Ashworth Hospital feared a sniper attack on Brady
Ian Brady began his hunger strike after being moved without warning to a ward for patients suffering from severe personality disorders.

The BBC has learned that the move was prompted partly by concern that he might be considering suicide, but also fears about his vulnerability to attack from outside the hospital - possibly by a sniper.

After Brady complained about his treatment, and the decision to feed him against his wishes, the hospital commissioned an independent investigation.

It was conducted by Professor David Sines of South Bank University in London, and the BBC has obtained a copy of his report.

Professor Sines says that the hospital was right to transfer Brady, and also acted correctly in deciding to feed him. But he is critical of the way in which the move was managed. He says no warning was given to Brady and there was no attempt to explain why it was necessary.

The report, which runs to more than 15,000 words, provides an unprecedented insight into the treatment of the Moors murderer. Brady is described as having a psychopathic personality disorder - a severe mental illness that results in abnormally aggressive behaviour.

In 1995, he was placed in Jade Ward, where many of the patients are elderly or frail.

'Angry and distressed'

Privileges he used to enjoy have now been withdrawn, including direct access to senior managers. The gradual erosion of his special status is said to have left him angry and distressed, and concern grew among the medical staff that he might attempt suicide.

At the same time, the hospital's security staff became worried about him being housed in a ward on the edge of the hospital complex, visible through a wire perimeter fence. It was feared he could become a target for a sniper, taking aim from a nearby motorway bridge. The ward itself was considered to offer the potential for escape - or a break-in by an assailant.

So it was decided to transfer Brady to Lawrence Ward, which is inside the most secure part of the hospital, and hidden behind high walls. This is the ward where patients with the most serious personality disorders are treated.

To avoid any leaks to the media, Brady was not warned in advance, or given any explanation for the move. He was alone in his room when six members of the hospital's control and restraint team arrived on the ward. They were all wearing protective clothing, including balaclavas and helmets with visors, and two were carrying shields.

Brady was placed in head and arm holds, and was "walked" from the room. After being strip-searched he was taken to a van, still under restraint, and driven to Lawrence Ward.

Professor Sines says that while the decision to move Brady was correct, the way it was organised was "fundamentally flawed" because senior managers had failed to inform Brady or take reasonable steps to secure his co-operation. He had never shown any violence towards staff, and might well have gone voluntarily.

Opinions divided

Brady was so upset by his treatment that he began a hunger strike the same day, 30 September. A psychiatrist called in to give Ashworth a second opinion concluded that Brady was suffering from feelings of persecution, because of the circumstances in which he found himself. And because his refusal to eat was related to his illness, the hospital was entitled to feed him under the provisions of the Mental Health Act 1983.

By 29 October, Brady had lost a "significant" amount of weight, and when he refused to take food through his mouth, a plastic tube was passed through his nose and into his stomach. A feeding programme was begun and Brady began to regain weight, although opinions are divided about whether the hospital should have acted against his wishes.

Professor Sines makes it clear he thinks the hospital acted correctly, based on the expert judgment of doctors. But the report notes that a psychiatrist called in by Brady's lawyers to give an independent opinion said he thought that the 62-year-old killer was capable of making a rational and informed decision to refuse food.

That dispute, over whether Ian Brady is capable of making such a decision about his future, will now be argued in court. But while this is being seen as a "right to die" case, Brady's lawyers intend to use the hearing to question the way he has been treated at Ashworth since he arrived there 15 years ago.

In doing so, they believe it will re-open a wider debate about hospitals like Ashworth, and how we should be treating Britain's most dangerous hospital patients.

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