History of the POA in Secure Health Care Services


The POA owes a considerable debt of gratitude to the forefathers of the Union based at Broadmoor Criminal Lunatic Asylum. Broadmoor opened in 1863 and played a pivotal part in the formation of the POA which became a recognised staff association in 1939.

The National Health Service Act of 1946 transferred ownership of Rampton and Moss Side to the Ministry of Health and the Criminal Justice Act of 1948 brought Broadmoor under the direct responsibility of the Board of Control and under the ownership of the Ministry of Health. The POA became active on all three sites and branches from both female and male sides were brought into the POA at Moss Side and Rampton. The POA was the only recognised trade union representing staff within Special Hospitals.

The establishment of a National Whitley between the Prison Officers' Association and the Department of Health occurred in 1948. This became the national negotiating forum for terms and conditions for staff working in the Special Hospitals.

Throughout the 1960's the Special Hospitals saw a huge increase in patients being referred to them. This resulted in overcrowding with reduced access within the resources available. These matters were raised by the POA at all levels of management and with the Government of the day.

The Special Hospitals continued to cause concern and although successive Governments were increasingly committed to the development of beds in Regional Secure Units, these did not materialise. Along with pressure groups the POA continued to press for better conditions within the Special Hospitals.

The POA continued to grow in strength and influence and began to use its ability to counteract the pressures placed upon its members from both internal and external sources.
Park Lane Hospital was commissioned and opened as the fourth Special Hospital in England in 1984. it was for male patients only, and was to assist with the overcrowding at Broadmoor. Park Lane introduced care and treatment on therapeutic community lines within the requirement of secure conditions. Park lane and Moss Side Hospitals amalgamated in 1990 to become Ashworth Special Hospital.

The POA within Special Hospitals continued to face huge pressure for change without the necessary resources being made available by Government and the Department of Health.

The Central Committee for Special Hospitals became the most prominent trade union forum within secure psychiatric provision.

A report on the Management of the Special Hospitals was published in 1989. This identified that the strength of the POA was such that one option to reduce POA input was for the amalgamation within the wider NHS and for the recognition of other NHS unions for consultation purposes. The Olliff report became the template of the Special Hospital Services Authority as the managing body of the four Special Hospitals.

Following a Channel Four programme in 1991 a public Inquiry was established to investigate complaints by patients at Ashworth. The Inquiry recommendations included the introduction of "24 Hour Care". This meant that no patients detained in a Special Hospital were to be locked in their rooms at night. The POA objected to this strategy until the correct resources were available.

Hospital Chief Executives ignored any objections and allowed all patients to be unlocked 24 hours a day. Patient treatment programmes were severely effected due to disrupted sleep patterns. There was an increase in both physical and mental abuse from patients. In 1997 a Judicial Review was established at Ashworth to deal with the failure of treatment programmes with patients suffering from Personality Disorder. The Inquiry covered all aspects of security and treatment, as well as conditions for patients. There was evidence of peadophile activity, Pornography, credit card and mail order fraud, use of illicit drugs and abuse of computer systems by the patient population. The management and management systems failure was also subject to review.

The SHSA attempted to reduce the influence of the POA in the High Secure Service. This Special Health Authority was established with an intended life span of 3 – 5 years. It lasted from 1990 to 1995. At a subsequent Judicial Inquiry in 1997/8, to which the POA gave evidence, it was clearly identified that many of the problems in High Secure Hospitals were due to a central mismanagement by the SHSA, and were they still in existence the Executive and Directors would have been accountable.

The POA have never opposed change. What we have always said is that change must always be properly resourced. If it is not then the consequences for both staff and patients can be extreme.

The POA remains the largest Union at the four Special Hospitals, Ashworth, Broadmoor, Rampton and the State Hospital at Carstairs in Scotland and has a growing membership in many Regional (Medium) Secure Units throughout the country. In recent times the name Special Hospitals was amended at Annual Conference to reflect the outstanding professional work that is delivered in the dangerous and violent environments. The term Secure Health Care Services is reflective of the work that is delivered on a daily basis. The members working within this setting have been effected by the NHS Agenda for Change which impacted on their terms and conditions.

The POA remains loyal to this section of the membership and continue to work with other partners and agencies and organisations to achieve change.