Forensic Science, 5 (1975) 229-241 0 Elsevier Sequoia S.A., Lausanne - Printed in The Netherlands
A GENERAL
PRACTITIONER
229
LOOKS AT VIOLENCE*
DOUGLAS I. ACRES Rochford,
Essex (Gt. Britain)
INTRODUCTION
Let me first confess to a certain degree of anxiety at the task that has been set for me. In the face of such a highly informed audience I am wide open to the charge of being a grand-matriarchal oval aspiration instructor, and I am reminded of the story of Hiram B. Goodchild who survived the Johnstown floods in Pennsylvania in 1889, in which some 2300 people were drowned as the result of a reservoir bursting. Hiram never tired of retelling his experiences, and became one of the best known bores in the state. This reputation did not pass unnoticed by St. Peter, for when he in due course arrived at the pearly gates and was asked if he had any special requests, the saint’s face fell when Hiram said that he would like to address a combined meeting of the archangels, cherubim and seraphim. After a moment the saint’s countenance cleared as he recalled that this sort of thing was the concern of the Archangel Gabriel, coming under the heading of “Communication”. Gabriel, too, was a little depressed at the request, but in the end agreed, and in due season the archangels, cherubim and seraphim were assembled in the Great Hall, with Gabriel occupying the chair. Just as Hiram B. Goodchild was about to address the congregation, Gabriel said, “I think it only fair to tell you that Mr and Mrs Noah and their family are seated in the front row”. Obviously I am no expert, and the view that I shall present is that of a generalist. I do not altogether apologise for this, for expertise can in itself present problems, as is well illustrated by what I am assured is the true story of a certain stipendiary magistrate, who regarded himself as something of an expert upon drugs. Before him was a defendant charged with illegally possessing cannabis resin, and the prosecution, being uncertain as to whether this was the genuine article or a mixture of sawdust, treacle, curry powder and glue, were seeking an adjournment to obtain an analyst’s report. The stipendiary would have none of this. “Pass it up here”, he said, “I know cannabis * Paper presented at an inter-disciplinary Inaugural Symposium on Violence arranged by the Midland Institute of Forensic Medicine and held at the Haworth Lecture Theatre, University of Birmingham, on 28th and 29th March, 1974.
230
when I see it”. His request was met, and he proceeded to subject it to a number of examinations, first sniffing it, then scratching it with a fingernail, and subsequently examining it with a magnifying glass before going on to touch it with his tongue and finally somewhat ostentatiously paring off a minute portion with a penknife and chewing it. “That’s cannabis”, he declared. “Carry on with the case”. The first witness was the arresting officer, who said, “We arrested the defendant, and searched both his clothing and his person. It was not until we had summoned medical assistance that we were able to discover the whereabouts of the drug”. So if I find a certain satisfaction in not regarding myself as an expert, I trust that you will understand. What I have to say to you can better be described as a “generalist” looking at violence, rather than a “general practitioner” doing the same thing. I trust, Mr Chairman, that you will pardon this slight deviation from my brief, because I am not at all sure whether the view that I have obtained of the problem of violence, seen entirely from the G.P.‘s point of view, would be of sufficient interest to this distinguished audience. The fact is that I do not seem to see a great deal of it in my particular practice, so I propose to extend the scope by adding the views of a J.P., a member of a Board of Visitors of a girl’s borstal, and the chairman of governors of a large comprehensive school. I have been able to do this without stirring from my seat, as I happen to wear these three additional hats. You will observe that I have the bulk to combine these four functions, and badly need the protection of the additional headgear. THE DISTRICT
The district involved in what I have to say is the Petty Sessional Division of Rochford, which encompasses the Urban Districts of Benfleet, Canvey, and Rayleigh, and the Rural District of Rochford. As you will see from Table I, the population has risen from approximately 109 to about 148 thousand between 1963 and 1973. The area is largely a residential one, with little local industry and many workers travelling to London and to Ford’s plants at Dagenham and neighbouring Basildon. The division separates the denser connurbations of Southend-on-Sea and Basildon. Canvey Island has a large num-
TABLE I Population and total cases dealt with Year
Estimated population
Adult cases
Juvenile cases
Total cases
1963 1973
109,060 148,720
7,036 18,022
431 540
7,467 18,562
231
ber of visitors during the summer months, many of them day trippers or staying in a very extensive caravan park. I work in a group practice, each of the five principals having an above average list, and my own is 3,500. Employment does not present great problems, and the age distribution of my patients is around the national average. IMPRESSIONS
OF VIOLENCE
A discussion with the local headmaster, the borstal governor, other members of my practice, and experienced members of the bench revealed an unanimous opinion as to how the pattern of violence had changed over the past decade. Without exception all agreed that violence against the person and damage to property had both increased to an alarming extent. I decided to make an attempt to quantify this, and sent a questionnaire to all the other 35 members of the Rochford bench. The first, as you will see from Table II, asked for an evaluation of the seriousness of a series of 10 offences against the person, damage to property, and four non-violent offences. Another sought an opinion as to the most appropriate penalty for each of the violent offences, and yet another an estimate of the increase or decrease in their incidence. They were not asked to allow for population changes. All of the magistrates responded to the enquiry, though only 24 were prepared to give an estimate of the changed incidence of violence. As you will see from Table III the average age of the magistrates is 50.1 years (taking their ages at 1.1.74), there are 12 women and 24 men. With
TABLE
II
Concensus of opinion as to the relative seriousness of 10 offences against the person, damage to property, and four non-violent offences. The lower figure indicates greater seriousness 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Homicide (including murder, attempted murder, infanticide Rape and attempted rape. Assault occasioning grievous bodily harm. Causing death by dangerous driving. Robbery. Wounding. Assau.lting a police officer in the execution of his duty. Assault occasioning actual bodily harm. Indecent assault. Common assault. Theft of $50 from employer. Damage to property. Careless driving Indecent exposure. No television licence.
and manslaughter).
232 TABLE III Composition
of the Rochford
Bench
A. Years of appointment Year
Number appointed
1954 1955 1956 1957 1958 1961 1963 1965 1966 1968 1969 1970 1972 1974
1 1 2 1 1 2 3 1 7 1 5 3 4 4 Total = 36
B. Average age (as at 1.1.1974) 50.1 years C. Sex distribution 12 women; 24 men D. Political allegiance Conservative 22 Labour 10 Independent 4 E. Votes cast at 1970 General Election Conservative 41,589 23,684 Labour 6,811 Liberal
regard to politics - 22 are Conservative, 10 Labour, and 4 owe no political allegiance. Eleven (including myself) were appointed in 1963 or earlier, and were asked to give their impressions of the cases dealt with by the bench, the remaining 25 were asked to record the change in violence in the district as it appeared to them. Finally they were divided into two groups of 18, half being given the national statistics for violence over the past 10 years and the remainder being told that, “Most people agree that there has been a substantial increase over the past 10 years”. They were paired for age, sex, political persuasion and experience.
233 TABLE
IV
Criminal
Statistics
for Rochford
P.S.D.
1963
and 1973
A. Crude figures 1973
1963 Adult
Juv.
Total
Assault (A.B.H.) Assault (C.B.H.) Assault police Causing death by D.D. Common assault Damage to property Indecent assault Homicide Rape and att. rape Robbery Wounding
23 5 7 1 5 12 20 3 0 0 4
5 0 0 0 0 14 9 0 0 0 0
28 5 7 1 5 26 29 3 0 0 4
Totals
80
28
12 68 80
Total Total
damage to property violence to the person
B. Percentage
change (with figures adjusted Adult
Adult
Juv.
Total
21 6 7 1 1 36 12 3 0 0 3
11 0 0 0 0 14 0 0 0 14 0
32 6 7 1 1 50 12 3 0 14 3
108
90
39
129
14 14
26 82
36 54
14 25
50 79
28
108
90
39
129
for population
%
Juvenile
Assault (A.B.H.) Assault (G.B.H.) Assault police Causing death by D.D. Common assault Damage to property Indecent assault Homicide Rape and att. rape Robbery Wounding
8.7 20.0 0 0 -800.0 +300.0 - 40.0 0
Total Total
+300.0 (+ 119.5) - 20.6 (43.6)
damage to property violence to the person
+
-
0 0 25
increase
(33.5) (14.0) (27.1) (27.1) (-854.0) (+119.5) (56.0) (21.6) ( ( (-
0) 0) 43.7)
+120
Total
(+61) 0 0 0 0 0
( 0) ( 0) ( 0) ( 0) (-27.1) (-Inf.)
0
(
-1nf.
+Infl) 0
+
%
0)
[+Inof!) (
in brackets)
0)
0 (-27.1) 78.6 (+30)
%
+ -
12.5 14.0 0 0 -800.0 + 92.3 - 58.6 0
(16.6) (14.0) (27.1) (27.1) (-854.0) (+ 40.3) (69.6) (26.6)
0 +Inf. - 25.0
( 0) (+Inf.) (45.0)
f -
92.3 (+ 3.6 (-
40.3) 31.1)
234 AN ENQUIRY INTO THE ACTUAL ROCHFORD P.S.D.
CASES INVOLVING
VIOLENCE
IN THE
Having sent out the questionnaires I made a detailed study of the cases of violence against the person and damage to property as recorded in the court register of the Rochford Petty Sessional Division, abstracting the figures for both adult offenders and juveniles in the various categories for both 1963 and 1973. The rather surprising results you will find in Table VI. After allowing for the increase in population, all offences against the person, with the exception of robbery, showed a downward trend, in total in the region of 30% whereas damage to property increased by over 40%. A few of these figures warrant some comment. You will see that the total offences of robbery amounted to 14, all committed by juveniles in 1973. At first sign this appears quite alarming, but a study of the individual cases showed that all of these were concerned with intimidation in schools, and in no instance was the sum involved more than 2p! The court hearing revealed a high degree of social disturbance, and in these cases 4 supervision and 10 care orders were made. It is interesting that the figures for damage to property revealed no change in the actual numbers involving juveniles, and after allowing for population changes an actual decrease of just over 27% whereas there was an increase of over 90% in the adult cases. In part this is probably accounted for by the change in philosophy of the Children and Young Persons Act of 1969, with proportionately fewer cases being dealt with in the courts, and a rather similar effect from the introduction of a police Juvenile Liaison Scheme. Support for this theory is given by the total figures for cases dealt with, which show a far greater increase for adults as compared with juveniles. PENALTIES
An examination of the penalties shows a remarkable similarity for the two years. There was an understandable tendency towards somewhat higher fines in 1973. The tendency to award a custodial sentence for adults was similar, though 14 care orders for juveniles were made in 1973, with no fit person orders or approved school orders in 1963. With sentencing exercises it is usually noted that penalties tend to be higher than those actually imposed in court when there is the opportunity of seeing the defendant and studying reports. The present study confirmed this trend, with several opting for imprisonment for assaulting a police officer in the execution of his duty and for actual bodily harm. In the event no prison sentences were imposed for either of these offences in the two years in question, although 3 were committed to the Crown Court or to Quarter Sessions (1963) for sentence. It was of interest to find that magistrates appointed after 1963 were nearly 4 times as likely to suggest a custodial sentence as were their more experienced colleagues appointed before 1963.
X963.
ass.
Totals
Wounding
Robbery
Rape
Homicide
ass
Damage
Ind.
D.D.
ass.
by
1
7
5
2
13
2
6
I
4
J
J
1
A
CD.
11
7
3
A
A.D.
A
1
1
1
J
J
A
C.D.
A.D.
Penalties
D.D.
ass.
P.O.
Comm.
Death
Ass.
G.B.H.
A.B.H.
B. 1973.
Totals
wounding
Robbery
Rape
Homicide
Ind.
Damage
V.
by
P.O.
Comm.
Death
Ass.
G.B.H.
A.B.H.
A.
TABLE
2
2
J
85-
Fine
5
A
8
1
7
2
3
A
of
of
J
15-
Fine
16
1
24
6
3
5
A
1
2
2
J
11
10
4
9
1
16
A
1
A
6100
A
J
sup. A
4
1DC
J
3
1
1
1
J
A
10
4
2
4
J
5
4
1
3
D.C.
or SUP.
Prison
1
or
A
9
Prob.
4
3
1P
2P
A
4
1
1
J
C.C.
to
26
3
3
3
10
1
5
A
commit
22
4
3
7
1
2
1
A
1
J
Q.S.
4
1P
A
Commit to
1
3
J
D.C.
2P
Over
J
8100
1
$50~8100
A
Over
2 2
3
8100
1 DC
2
7
A
so-
3
620-650
J
820-$50
or
6
J
85-820
6
4
4
2 4
A
J
d5-$20
PriSOIl or
Prob.
14
10
CJJ
4 CD
J
Other
J
Other
2
2 B/O
A
4
1 s.60
1
2 B/O
A
236 PREDICTION
OF TRENDS
IN VIOLENCE
It might have been expected that magistrates appointed before 1963 would be in a better position to assess trends than those appointed later, and that those who were given the national figures for the increase in offences of violence would make a higher prediction than those who were not. In point of fact neither of these expectations proved true, the less experienced magistrates being equally good (or bad) as the ‘old hands’ and those who were given the figures gave no different reply to those who were not. There was a general tendency to assess the increase of offences against the person too highly and of damage to property too low. THE VIEW OF THE SERIOUSNESS
OF OFFENCES
There was some variation in the assessment of degrees of seriousness of the various offences. The average opinion is to be found in Table II. It will be noted that those offences involving violence against the person were placed at the top of the list, followed by theft from an employer, damage to property, and the other three non-violent offences. No difference in attitude to the offence of ‘theft of $50 from an employer was demonstrated as between those of different political allegiances, and there was an almost identical opinion with regard to both indecent assault and indecent exposure as regards male and female magistrates. It has proved difficult to relate each individual magistrate’s view of the relative seriousness of the offence with his or her concept of the most appropriate penalty, but the general impression has been that there has been a reasonable degree of consistency. SOME OBSERVATIONS
IN GENERAL
PRACTICE
Table VI gives details of cases of non-accidental violence against the person that I have encountered personally in the two years under review. It will be seen that the figures are roughly comparable, and the size of the list remained constant for the two years. Only one actual case of non-accidental injury to a child was encountered in the two years, but in three other cases in 1973 I was concerned for the possibility of such an injury. In each case the assistance of the Social Services was invoked, and no injury ensued. The change may have been partly due to my increased awareness of the problem, and partly to the greater readiness with which mothers now seem to be prepared to share their fears. Violence between spouses heads the list, though there was no change in the figures for the two years, I have no statistics to back my view, but I feel that appearance in court for an assault on a spouse is highly undesirable, and does much to deepen the rift. However, on two occasions I have been a party to making a probation order for this type of assault, and in both instances
237
TABLE Violence
VI encountered
in practice
of 3,500 1963
1973
Non-accidental injury to children Husband assaulting wife Wife assaulting husband Other assaults
0 4 2 3
1* 3 2 3
Totals
9
9
* Plus three tion.
cases in which violence
appears
to have been averted
the result was good, there being no apparent repetition orders were terminated on account of good progress. VIOLENCE
by social work interven-
of violence
and both
IN SCHOOL
Unfortunately I have not been able to obtain figures for corporal punishment for violence for the year 1963, since the school in which I have an interest changed from secondary modem to comprehensive in 1967. However, figures for 1967 and 1973 are given at Table VII. It will be seen that there has been a slight drop in the number of violent offences, and a somewhat greater drop in the actual use of the cane. The school population has remained constant at about 1250, but with the change from a selective to a non-selective intake there has been a consequent change in the nature of the pupils. Violence is not a substantial problem, and it may be felt that this, though largely due to the locality, is in part due to an emphasis on pastoral care. There is a vertical system of tutoring, with the school divided into 6 houses,
TABLE Corporal
VII punishment
in a comprehensive
school
of approx.
1,250 1967*
Punishments Punishments Punishments
for offences for offences for offences
against the person involving damage to property against discipline other than above
Totals * Figures
for 1963
not available
due to change
of type of school
1973
4 5 14
2 4 7
23
13
238
each with a housemaster in charge and 7 or 8 multi-year tutor groups. This has resulted in many children having the same tutor throughout their school lives, with the opportunity for a deep personal knowledge and an ability to develop an early warning system for signs of emotional disturbance. I attach great importance to this care. VIOLENCE
AT BULLWOOD
HALL
Bullwood Hall is the only closed borstal for girls in England and Wales. The impression of both the Board of Visitors and the staff is that the trainees that have been received into the borstal have tended to be younger and more disturbed, but I have no figures to support this impression, and it may be that they are as erroneous as magistrates’ impressions of the incidence of violence. What is certain is that the average daily occupancy has increased between 1963 and 1972 from 71 to 108, without any increase in accommodation, and the necessity to place two girls in a number of the rooms, originally designed for one. Under the circumstances it might have been expected that violence would have increased. An examination of the figures contained in Table VIII reveals the contrary to be the case. Assaults have dropped from 14 to 9 and wilful damage from 285 to 152.
TABLE
VIII
Adjudications
at a closed
borstal
for girls 1963
Average daily population Annual no. of offences per head of population Average daily ‘no. of offences punished
Offences** Escape
71 6.1 1.2
1972* 108 7.8 2.3
Attempt to escape Assaults other than gross personal violence Disobedience/idleness Wilful damage to property Unauthorised possession or unauthorised transactions Disrespect/impropriety Other offences
14 0 285 1 23 110
5 4 9 253 152 91 75 253
Total
436
842
offences
* 1972 figures quoted as 1973 ** Classifications are those for either assaults or damage.
not yet available. 1972. 1963 were slightly
3
different,
but not in respect
of
239
It is difficult to put forward adequate reas’ons for this fall, though a change of governor and of a substantial part of the disciplinary staff must have made a difference. Possibly of even greater significance is that in 1963 the establishment had but recently been opened, and had not yet settled down into a pattern of behaviour. In addition it is likely that the attitude of staff to various offences has changed with the years, with a greater ability to tolerate deviant behaviour. It should be noted that the figures given are for 1963 and 1972 as the 1973 figures are not yet available. PERSONAL
EXPERIENCE
OF VIOLENCE
AS A RECIPIENT
Perhaps I may be permitted to turn briefly to personal experience of being on the receiving end of violence. It must be admitted that this has been insignificant, partly due to good fortune and partly due to natural caution or cowardice. As a G.P. my closest escape was from strangulation by a manic depressive patient who I was attempting to admit to hospital. When summoned to a similarly afflicted patient who proved to be 6ft Gins tall and powerful with it, and who was brandishing a large cook’s knife, I must confess to having been unavoidably detained pending the arrival of the police. An incident with its humorous side occurred recently when I was visiting Rampton. Accommodation was found for me in the vacant deputy medical superintendent’s house, which I entered late at night thinking that I was the sole occupant. Unfortunately the recently arrived engineer, new to Special Hospitals was under a similar impression, and it took a few moments for us to identify each other. Happily, no actual violence ensued. As a J.P. I have experienced violence to property by having the tyres of my car let down following a somewhat unpopular decision in court. On another occasion I was on the receiving end of an irate mother’s handbag in the juvenile court. She was a most protective mum, but suffered from the dual disabilities of aggression and deafness. The latter brought her into close proximity with the bench and the former was responsible I suppose for my being assaulted, or at least making ducking more difficult. It is said that as she lashed out she murmured something to the effect that not only must justices be done, but manifestly be seen to be done. THE LEVEL OF VIOLENCE
IN THE LOCALITY
From what I have said it may be inferred that violence is not a particularly worrying problem in the locality with which I am concerned. Contrary to national and international trends the level of violence has decreased during the past decade, and the explanations are not immediately obvious. Admittedly we are not beset by a great number of social problems. The level of employment is fairly high, the schools are reasonably staffed and for
240
the most part well equipped. The court appears to take a fairly non-punitive attitude to offenders, though whether this is partly responsible for the low level of violence, or is a viable possibility because of it, is open to conjecture. It is of particular interest to me that Bullwood Hall Bon&al has experienced a decline in both violence against the person and wilful damage to property, for this being an institution taking highly disturbed girls from all over the country one would expect it to be a reflection of national trends. I have tried to advance some possible reasons, but I still find the situation extremely interesting. The strong suggestion is that if in areas such as this the level of violence has decreased, then assuming that statistics can be relied upon, and that there is a genuine increase nationally, there must have been a truly alarming increase within urban areas. Several studies have tended to confirm this view, but it would be interesting to carry out assessments in a variety of localities to gain a truer idea of the position. SOME FURTHER IMPRESSIOk
Having now had some twenty years in general practice and nearly 16 on the bench, I have become more and more impressed with the leading role played by alcohoi in the production of violence. Of the 18 cases referred to in Table VI (encountered in my own practice) alcohol appears to have been an important factor in 14. I have no similar figures for the cases that reach court, but my impression is that the proportion is much the same. The problem seems to be greatest among teenagers and those in their early twenties, and certainly it appears that advertising is being directed mainly at this age group. This is understandable in practical terms as these are the members of the community with the greatest spending power. This was brought home to me in a particularly graphic fashion quite recently, when I was treating a 1’7 year-old youth for a severe muscle injury to his thigh. He sustained the injury when he was lifted bodily and thrown through a glass window in a drunken brawl. He told me that the injury cost him the twelve pounds a day that he would have been earning as a bricklayer’s labourer, It strikes me as anomalous that television advertising of cigarettes is banned, and packets carry a government health warning, when advertising of alcohol is carried on without restriction, and with an obvious slant towards this particularly vulnerable section of the community. As mentioned already, during 1973 I encountered one actual and three potential cases of non-accidental injury to children. In every instance the mother concerned was isolated from older members of her family and not on good terms with her neighbours. Social work intervention seems to have saved the day, but I wonder whether an experienced motherly soul would not have succeeded just as well. To my mind there is an urgent need for ‘community grandmothers’ to lend a friendly hand and emotional support in these sort of instances. This is something I intend to put in hand at the earliest opportunity.
241
In this connection, and in other rather similar circumstances where there is a great deal of emotional tension, I have found a practice nurse to be of tremendous assistance. Having been with me now for a number of years, and having shared in the ante-natal and post-natal care of most of the young mothers in my practice, as well as undertaking immunisation sessions and sharing in the general work, she has built up a great rapport which now stands her in good stead. Many who would feel that it would be unreasonable to take up a great deal of my time (however ill-founded that impression might be) are very willing to share their problems with her. She must save the national health service a great deal in tranquilisers. THE IMPORTANCE
OF RECORDS
It is sometimes said that a general practice is as good as its records, and there is no doubt a great deal of truth in this. As in other branches of medicine the importance of adequate notes cannot be overstressed, and in cases of non-accidental injury these can be absolutely vital. It goes without saying that for acceptance in the event of a case going to court much will depend upon the notes having been taken at the material time. When a G.P. or a casualty officer is called to give evidence, I would like to make a plea for understandable language. I may be fortunate in being able to understand technical terms, but my colleagues on the bench are not always so privileged. It is important for the medical witness to be able to express himself so that lay magistrates (and for that matter stipendiaries and judges) can understand fully. I tend to judge the quality of a G.P. by his ability to express himself in this way. After all, communication is a first essential of our profession. It must be confessed that strange interpretations are placed upon our evidence from time to time. Recently in a talk I attended a judge confessed that he tended to assess the degree of injury in assault cases by the number of stitches inserted! I was able to tell him that not long before I had submitted two reports in accident cases, both including lacerations some 1.25 inches long. One was sutured by a meticulous lady colleague who inserted 16 stitches, and the other by a tired and somewnat disgruntled houseman who used 4. If the penalty was awarded in this type of case according to the number of stitches used, it would not be difficult to imagine a miscarriage of justice. CONCLUSIONS
In conclusion may I thank you for asking me to come to-da;-, and for your courtesy in giving me a fair hearing. I find it a daunting experience to address such a gathering of experts. More usually I am cast in another role, that of interpreting the views of psychiatrists, in the light of my limited knowledge, to my fellow magistrates. I regard rnyself as something of an interpreter. To-day I have tried to carry out the process in reverse - presenting to you the views of a jack of all trades and master of none.
A GENERAL
PRACTITIONER
229
LOOKS AT VIOLENCE*
DOUGLAS I. ACRES Rochford,
Essex (Gt. Britain)
INTRODUCTION
Let me first confess to a certain degree of anxiety at the task that has been set for me. In the face of such a highly informed audience I am wide open to the charge of being a grand-matriarchal oval aspiration instructor, and I am reminded of the story of Hiram B. Goodchild who survived the Johnstown floods in Pennsylvania in 1889, in which some 2300 people were drowned as the result of a reservoir bursting. Hiram never tired of retelling his experiences, and became one of the best known bores in the state. This reputation did not pass unnoticed by St. Peter, for when he in due course arrived at the pearly gates and was asked if he had any special requests, the saint’s face fell when Hiram said that he would like to address a combined meeting of the archangels, cherubim and seraphim. After a moment the saint’s countenance cleared as he recalled that this sort of thing was the concern of the Archangel Gabriel, coming under the heading of “Communication”. Gabriel, too, was a little depressed at the request, but in the end agreed, and in due season the archangels, cherubim and seraphim were assembled in the Great Hall, with Gabriel occupying the chair. Just as Hiram B. Goodchild was about to address the congregation, Gabriel said, “I think it only fair to tell you that Mr and Mrs Noah and their family are seated in the front row”. Obviously I am no expert, and the view that I shall present is that of a generalist. I do not altogether apologise for this, for expertise can in itself present problems, as is well illustrated by what I am assured is the true story of a certain stipendiary magistrate, who regarded himself as something of an expert upon drugs. Before him was a defendant charged with illegally possessing cannabis resin, and the prosecution, being uncertain as to whether this was the genuine article or a mixture of sawdust, treacle, curry powder and glue, were seeking an adjournment to obtain an analyst’s report. The stipendiary would have none of this. “Pass it up here”, he said, “I know cannabis * Paper presented at an inter-disciplinary Inaugural Symposium on Violence arranged by the Midland Institute of Forensic Medicine and held at the Haworth Lecture Theatre, University of Birmingham, on 28th and 29th March, 1974.
230
when I see it”. His request was met, and he proceeded to subject it to a number of examinations, first sniffing it, then scratching it with a fingernail, and subsequently examining it with a magnifying glass before going on to touch it with his tongue and finally somewhat ostentatiously paring off a minute portion with a penknife and chewing it. “That’s cannabis”, he declared. “Carry on with the case”. The first witness was the arresting officer, who said, “We arrested the defendant, and searched both his clothing and his person. It was not until we had summoned medical assistance that we were able to discover the whereabouts of the drug”. So if I find a certain satisfaction in not regarding myself as an expert, I trust that you will understand. What I have to say to you can better be described as a “generalist” looking at violence, rather than a “general practitioner” doing the same thing. I trust, Mr Chairman, that you will pardon this slight deviation from my brief, because I am not at all sure whether the view that I have obtained of the problem of violence, seen entirely from the G.P.‘s point of view, would be of sufficient interest to this distinguished audience. The fact is that I do not seem to see a great deal of it in my particular practice, so I propose to extend the scope by adding the views of a J.P., a member of a Board of Visitors of a girl’s borstal, and the chairman of governors of a large comprehensive school. I have been able to do this without stirring from my seat, as I happen to wear these three additional hats. You will observe that I have the bulk to combine these four functions, and badly need the protection of the additional headgear. THE DISTRICT
The district involved in what I have to say is the Petty Sessional Division of Rochford, which encompasses the Urban Districts of Benfleet, Canvey, and Rayleigh, and the Rural District of Rochford. As you will see from Table I, the population has risen from approximately 109 to about 148 thousand between 1963 and 1973. The area is largely a residential one, with little local industry and many workers travelling to London and to Ford’s plants at Dagenham and neighbouring Basildon. The division separates the denser connurbations of Southend-on-Sea and Basildon. Canvey Island has a large num-
TABLE I Population and total cases dealt with Year
Estimated population
Adult cases
Juvenile cases
Total cases
1963 1973
109,060 148,720
7,036 18,022
431 540
7,467 18,562
231
ber of visitors during the summer months, many of them day trippers or staying in a very extensive caravan park. I work in a group practice, each of the five principals having an above average list, and my own is 3,500. Employment does not present great problems, and the age distribution of my patients is around the national average. IMPRESSIONS
OF VIOLENCE
A discussion with the local headmaster, the borstal governor, other members of my practice, and experienced members of the bench revealed an unanimous opinion as to how the pattern of violence had changed over the past decade. Without exception all agreed that violence against the person and damage to property had both increased to an alarming extent. I decided to make an attempt to quantify this, and sent a questionnaire to all the other 35 members of the Rochford bench. The first, as you will see from Table II, asked for an evaluation of the seriousness of a series of 10 offences against the person, damage to property, and four non-violent offences. Another sought an opinion as to the most appropriate penalty for each of the violent offences, and yet another an estimate of the increase or decrease in their incidence. They were not asked to allow for population changes. All of the magistrates responded to the enquiry, though only 24 were prepared to give an estimate of the changed incidence of violence. As you will see from Table III the average age of the magistrates is 50.1 years (taking their ages at 1.1.74), there are 12 women and 24 men. With
TABLE
II
Concensus of opinion as to the relative seriousness of 10 offences against the person, damage to property, and four non-violent offences. The lower figure indicates greater seriousness 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Homicide (including murder, attempted murder, infanticide Rape and attempted rape. Assault occasioning grievous bodily harm. Causing death by dangerous driving. Robbery. Wounding. Assau.lting a police officer in the execution of his duty. Assault occasioning actual bodily harm. Indecent assault. Common assault. Theft of $50 from employer. Damage to property. Careless driving Indecent exposure. No television licence.
and manslaughter).
232 TABLE III Composition
of the Rochford
Bench
A. Years of appointment Year
Number appointed
1954 1955 1956 1957 1958 1961 1963 1965 1966 1968 1969 1970 1972 1974
1 1 2 1 1 2 3 1 7 1 5 3 4 4 Total = 36
B. Average age (as at 1.1.1974) 50.1 years C. Sex distribution 12 women; 24 men D. Political allegiance Conservative 22 Labour 10 Independent 4 E. Votes cast at 1970 General Election Conservative 41,589 23,684 Labour 6,811 Liberal
regard to politics - 22 are Conservative, 10 Labour, and 4 owe no political allegiance. Eleven (including myself) were appointed in 1963 or earlier, and were asked to give their impressions of the cases dealt with by the bench, the remaining 25 were asked to record the change in violence in the district as it appeared to them. Finally they were divided into two groups of 18, half being given the national statistics for violence over the past 10 years and the remainder being told that, “Most people agree that there has been a substantial increase over the past 10 years”. They were paired for age, sex, political persuasion and experience.
233 TABLE
IV
Criminal
Statistics
for Rochford
P.S.D.
1963
and 1973
A. Crude figures 1973
1963 Adult
Juv.
Total
Assault (A.B.H.) Assault (C.B.H.) Assault police Causing death by D.D. Common assault Damage to property Indecent assault Homicide Rape and att. rape Robbery Wounding
23 5 7 1 5 12 20 3 0 0 4
5 0 0 0 0 14 9 0 0 0 0
28 5 7 1 5 26 29 3 0 0 4
Totals
80
28
12 68 80
Total Total
damage to property violence to the person
B. Percentage
change (with figures adjusted Adult
Adult
Juv.
Total
21 6 7 1 1 36 12 3 0 0 3
11 0 0 0 0 14 0 0 0 14 0
32 6 7 1 1 50 12 3 0 14 3
108
90
39
129
14 14
26 82
36 54
14 25
50 79
28
108
90
39
129
for population
%
Juvenile
Assault (A.B.H.) Assault (G.B.H.) Assault police Causing death by D.D. Common assault Damage to property Indecent assault Homicide Rape and att. rape Robbery Wounding
8.7 20.0 0 0 -800.0 +300.0 - 40.0 0
Total Total
+300.0 (+ 119.5) - 20.6 (43.6)
damage to property violence to the person
+
-
0 0 25
increase
(33.5) (14.0) (27.1) (27.1) (-854.0) (+119.5) (56.0) (21.6) ( ( (-
0) 0) 43.7)
+120
Total
(+61) 0 0 0 0 0
( 0) ( 0) ( 0) ( 0) (-27.1) (-Inf.)
0
(
-1nf.
+Infl) 0
+
%
0)
[+Inof!) (
in brackets)
0)
0 (-27.1) 78.6 (+30)
%
+ -
12.5 14.0 0 0 -800.0 + 92.3 - 58.6 0
(16.6) (14.0) (27.1) (27.1) (-854.0) (+ 40.3) (69.6) (26.6)
0 +Inf. - 25.0
( 0) (+Inf.) (45.0)
f -
92.3 (+ 3.6 (-
40.3) 31.1)
234 AN ENQUIRY INTO THE ACTUAL ROCHFORD P.S.D.
CASES INVOLVING
VIOLENCE
IN THE
Having sent out the questionnaires I made a detailed study of the cases of violence against the person and damage to property as recorded in the court register of the Rochford Petty Sessional Division, abstracting the figures for both adult offenders and juveniles in the various categories for both 1963 and 1973. The rather surprising results you will find in Table VI. After allowing for the increase in population, all offences against the person, with the exception of robbery, showed a downward trend, in total in the region of 30% whereas damage to property increased by over 40%. A few of these figures warrant some comment. You will see that the total offences of robbery amounted to 14, all committed by juveniles in 1973. At first sign this appears quite alarming, but a study of the individual cases showed that all of these were concerned with intimidation in schools, and in no instance was the sum involved more than 2p! The court hearing revealed a high degree of social disturbance, and in these cases 4 supervision and 10 care orders were made. It is interesting that the figures for damage to property revealed no change in the actual numbers involving juveniles, and after allowing for population changes an actual decrease of just over 27% whereas there was an increase of over 90% in the adult cases. In part this is probably accounted for by the change in philosophy of the Children and Young Persons Act of 1969, with proportionately fewer cases being dealt with in the courts, and a rather similar effect from the introduction of a police Juvenile Liaison Scheme. Support for this theory is given by the total figures for cases dealt with, which show a far greater increase for adults as compared with juveniles. PENALTIES
An examination of the penalties shows a remarkable similarity for the two years. There was an understandable tendency towards somewhat higher fines in 1973. The tendency to award a custodial sentence for adults was similar, though 14 care orders for juveniles were made in 1973, with no fit person orders or approved school orders in 1963. With sentencing exercises it is usually noted that penalties tend to be higher than those actually imposed in court when there is the opportunity of seeing the defendant and studying reports. The present study confirmed this trend, with several opting for imprisonment for assaulting a police officer in the execution of his duty and for actual bodily harm. In the event no prison sentences were imposed for either of these offences in the two years in question, although 3 were committed to the Crown Court or to Quarter Sessions (1963) for sentence. It was of interest to find that magistrates appointed after 1963 were nearly 4 times as likely to suggest a custodial sentence as were their more experienced colleagues appointed before 1963.
X963.
ass.
Totals
Wounding
Robbery
Rape
Homicide
ass
Damage
Ind.
D.D.
ass.
by
1
7
5
2
13
2
6
I
4
J
J
1
A
CD.
11
7
3
A
A.D.
A
1
1
1
J
J
A
C.D.
A.D.
Penalties
D.D.
ass.
P.O.
Comm.
Death
Ass.
G.B.H.
A.B.H.
B. 1973.
Totals
wounding
Robbery
Rape
Homicide
Ind.
Damage
V.
by
P.O.
Comm.
Death
Ass.
G.B.H.
A.B.H.
A.
TABLE
2
2
J
85-
Fine
5
A
8
1
7
2
3
A
of
of
J
15-
Fine
16
1
24
6
3
5
A
1
2
2
J
11
10
4
9
1
16
A
1
A
6100
A
J
sup. A
4
1DC
J
3
1
1
1
J
A
10
4
2
4
J
5
4
1
3
D.C.
or SUP.
Prison
1
or
A
9
Prob.
4
3
1P
2P
A
4
1
1
J
C.C.
to
26
3
3
3
10
1
5
A
commit
22
4
3
7
1
2
1
A
1
J
Q.S.
4
1P
A
Commit to
1
3
J
D.C.
2P
Over
J
8100
1
$50~8100
A
Over
2 2
3
8100
1 DC
2
7
A
so-
3
620-650
J
820-$50
or
6
J
85-820
6
4
4
2 4
A
J
d5-$20
PriSOIl or
Prob.
14
10
CJJ
4 CD
J
Other
J
Other
2
2 B/O
A
4
1 s.60
1
2 B/O
A
236 PREDICTION
OF TRENDS
IN VIOLENCE
It might have been expected that magistrates appointed before 1963 would be in a better position to assess trends than those appointed later, and that those who were given the national figures for the increase in offences of violence would make a higher prediction than those who were not. In point of fact neither of these expectations proved true, the less experienced magistrates being equally good (or bad) as the ‘old hands’ and those who were given the figures gave no different reply to those who were not. There was a general tendency to assess the increase of offences against the person too highly and of damage to property too low. THE VIEW OF THE SERIOUSNESS
OF OFFENCES
There was some variation in the assessment of degrees of seriousness of the various offences. The average opinion is to be found in Table II. It will be noted that those offences involving violence against the person were placed at the top of the list, followed by theft from an employer, damage to property, and the other three non-violent offences. No difference in attitude to the offence of ‘theft of $50 from an employer was demonstrated as between those of different political allegiances, and there was an almost identical opinion with regard to both indecent assault and indecent exposure as regards male and female magistrates. It has proved difficult to relate each individual magistrate’s view of the relative seriousness of the offence with his or her concept of the most appropriate penalty, but the general impression has been that there has been a reasonable degree of consistency. SOME OBSERVATIONS
IN GENERAL
PRACTICE
Table VI gives details of cases of non-accidental violence against the person that I have encountered personally in the two years under review. It will be seen that the figures are roughly comparable, and the size of the list remained constant for the two years. Only one actual case of non-accidental injury to a child was encountered in the two years, but in three other cases in 1973 I was concerned for the possibility of such an injury. In each case the assistance of the Social Services was invoked, and no injury ensued. The change may have been partly due to my increased awareness of the problem, and partly to the greater readiness with which mothers now seem to be prepared to share their fears. Violence between spouses heads the list, though there was no change in the figures for the two years, I have no statistics to back my view, but I feel that appearance in court for an assault on a spouse is highly undesirable, and does much to deepen the rift. However, on two occasions I have been a party to making a probation order for this type of assault, and in both instances
237
TABLE Violence
VI encountered
in practice
of 3,500 1963
1973
Non-accidental injury to children Husband assaulting wife Wife assaulting husband Other assaults
0 4 2 3
1* 3 2 3
Totals
9
9
* Plus three tion.
cases in which violence
appears
to have been averted
the result was good, there being no apparent repetition orders were terminated on account of good progress. VIOLENCE
by social work interven-
of violence
and both
IN SCHOOL
Unfortunately I have not been able to obtain figures for corporal punishment for violence for the year 1963, since the school in which I have an interest changed from secondary modem to comprehensive in 1967. However, figures for 1967 and 1973 are given at Table VII. It will be seen that there has been a slight drop in the number of violent offences, and a somewhat greater drop in the actual use of the cane. The school population has remained constant at about 1250, but with the change from a selective to a non-selective intake there has been a consequent change in the nature of the pupils. Violence is not a substantial problem, and it may be felt that this, though largely due to the locality, is in part due to an emphasis on pastoral care. There is a vertical system of tutoring, with the school divided into 6 houses,
TABLE Corporal
VII punishment
in a comprehensive
school
of approx.
1,250 1967*
Punishments Punishments Punishments
for offences for offences for offences
against the person involving damage to property against discipline other than above
Totals * Figures
for 1963
not available
due to change
of type of school
1973
4 5 14
2 4 7
23
13
238
each with a housemaster in charge and 7 or 8 multi-year tutor groups. This has resulted in many children having the same tutor throughout their school lives, with the opportunity for a deep personal knowledge and an ability to develop an early warning system for signs of emotional disturbance. I attach great importance to this care. VIOLENCE
AT BULLWOOD
HALL
Bullwood Hall is the only closed borstal for girls in England and Wales. The impression of both the Board of Visitors and the staff is that the trainees that have been received into the borstal have tended to be younger and more disturbed, but I have no figures to support this impression, and it may be that they are as erroneous as magistrates’ impressions of the incidence of violence. What is certain is that the average daily occupancy has increased between 1963 and 1972 from 71 to 108, without any increase in accommodation, and the necessity to place two girls in a number of the rooms, originally designed for one. Under the circumstances it might have been expected that violence would have increased. An examination of the figures contained in Table VIII reveals the contrary to be the case. Assaults have dropped from 14 to 9 and wilful damage from 285 to 152.
TABLE
VIII
Adjudications
at a closed
borstal
for girls 1963
Average daily population Annual no. of offences per head of population Average daily ‘no. of offences punished
Offences** Escape
71 6.1 1.2
1972* 108 7.8 2.3
Attempt to escape Assaults other than gross personal violence Disobedience/idleness Wilful damage to property Unauthorised possession or unauthorised transactions Disrespect/impropriety Other offences
14 0 285 1 23 110
5 4 9 253 152 91 75 253
Total
436
842
offences
* 1972 figures quoted as 1973 ** Classifications are those for either assaults or damage.
not yet available. 1972. 1963 were slightly
3
different,
but not in respect
of
239
It is difficult to put forward adequate reas’ons for this fall, though a change of governor and of a substantial part of the disciplinary staff must have made a difference. Possibly of even greater significance is that in 1963 the establishment had but recently been opened, and had not yet settled down into a pattern of behaviour. In addition it is likely that the attitude of staff to various offences has changed with the years, with a greater ability to tolerate deviant behaviour. It should be noted that the figures given are for 1963 and 1972 as the 1973 figures are not yet available. PERSONAL
EXPERIENCE
OF VIOLENCE
AS A RECIPIENT
Perhaps I may be permitted to turn briefly to personal experience of being on the receiving end of violence. It must be admitted that this has been insignificant, partly due to good fortune and partly due to natural caution or cowardice. As a G.P. my closest escape was from strangulation by a manic depressive patient who I was attempting to admit to hospital. When summoned to a similarly afflicted patient who proved to be 6ft Gins tall and powerful with it, and who was brandishing a large cook’s knife, I must confess to having been unavoidably detained pending the arrival of the police. An incident with its humorous side occurred recently when I was visiting Rampton. Accommodation was found for me in the vacant deputy medical superintendent’s house, which I entered late at night thinking that I was the sole occupant. Unfortunately the recently arrived engineer, new to Special Hospitals was under a similar impression, and it took a few moments for us to identify each other. Happily, no actual violence ensued. As a J.P. I have experienced violence to property by having the tyres of my car let down following a somewhat unpopular decision in court. On another occasion I was on the receiving end of an irate mother’s handbag in the juvenile court. She was a most protective mum, but suffered from the dual disabilities of aggression and deafness. The latter brought her into close proximity with the bench and the former was responsible I suppose for my being assaulted, or at least making ducking more difficult. It is said that as she lashed out she murmured something to the effect that not only must justices be done, but manifestly be seen to be done. THE LEVEL OF VIOLENCE
IN THE LOCALITY
From what I have said it may be inferred that violence is not a particularly worrying problem in the locality with which I am concerned. Contrary to national and international trends the level of violence has decreased during the past decade, and the explanations are not immediately obvious. Admittedly we are not beset by a great number of social problems. The level of employment is fairly high, the schools are reasonably staffed and for
240
the most part well equipped. The court appears to take a fairly non-punitive attitude to offenders, though whether this is partly responsible for the low level of violence, or is a viable possibility because of it, is open to conjecture. It is of particular interest to me that Bullwood Hall Bon&al has experienced a decline in both violence against the person and wilful damage to property, for this being an institution taking highly disturbed girls from all over the country one would expect it to be a reflection of national trends. I have tried to advance some possible reasons, but I still find the situation extremely interesting. The strong suggestion is that if in areas such as this the level of violence has decreased, then assuming that statistics can be relied upon, and that there is a genuine increase nationally, there must have been a truly alarming increase within urban areas. Several studies have tended to confirm this view, but it would be interesting to carry out assessments in a variety of localities to gain a truer idea of the position. SOME FURTHER IMPRESSIOk
Having now had some twenty years in general practice and nearly 16 on the bench, I have become more and more impressed with the leading role played by alcohoi in the production of violence. Of the 18 cases referred to in Table VI (encountered in my own practice) alcohol appears to have been an important factor in 14. I have no similar figures for the cases that reach court, but my impression is that the proportion is much the same. The problem seems to be greatest among teenagers and those in their early twenties, and certainly it appears that advertising is being directed mainly at this age group. This is understandable in practical terms as these are the members of the community with the greatest spending power. This was brought home to me in a particularly graphic fashion quite recently, when I was treating a 1’7 year-old youth for a severe muscle injury to his thigh. He sustained the injury when he was lifted bodily and thrown through a glass window in a drunken brawl. He told me that the injury cost him the twelve pounds a day that he would have been earning as a bricklayer’s labourer, It strikes me as anomalous that television advertising of cigarettes is banned, and packets carry a government health warning, when advertising of alcohol is carried on without restriction, and with an obvious slant towards this particularly vulnerable section of the community. As mentioned already, during 1973 I encountered one actual and three potential cases of non-accidental injury to children. In every instance the mother concerned was isolated from older members of her family and not on good terms with her neighbours. Social work intervention seems to have saved the day, but I wonder whether an experienced motherly soul would not have succeeded just as well. To my mind there is an urgent need for ‘community grandmothers’ to lend a friendly hand and emotional support in these sort of instances. This is something I intend to put in hand at the earliest opportunity.
241
In this connection, and in other rather similar circumstances where there is a great deal of emotional tension, I have found a practice nurse to be of tremendous assistance. Having been with me now for a number of years, and having shared in the ante-natal and post-natal care of most of the young mothers in my practice, as well as undertaking immunisation sessions and sharing in the general work, she has built up a great rapport which now stands her in good stead. Many who would feel that it would be unreasonable to take up a great deal of my time (however ill-founded that impression might be) are very willing to share their problems with her. She must save the national health service a great deal in tranquilisers. THE IMPORTANCE
OF RECORDS
It is sometimes said that a general practice is as good as its records, and there is no doubt a great deal of truth in this. As in other branches of medicine the importance of adequate notes cannot be overstressed, and in cases of non-accidental injury these can be absolutely vital. It goes without saying that for acceptance in the event of a case going to court much will depend upon the notes having been taken at the material time. When a G.P. or a casualty officer is called to give evidence, I would like to make a plea for understandable language. I may be fortunate in being able to understand technical terms, but my colleagues on the bench are not always so privileged. It is important for the medical witness to be able to express himself so that lay magistrates (and for that matter stipendiaries and judges) can understand fully. I tend to judge the quality of a G.P. by his ability to express himself in this way. After all, communication is a first essential of our profession. It must be confessed that strange interpretations are placed upon our evidence from time to time. Recently in a talk I attended a judge confessed that he tended to assess the degree of injury in assault cases by the number of stitches inserted! I was able to tell him that not long before I had submitted two reports in accident cases, both including lacerations some 1.25 inches long. One was sutured by a meticulous lady colleague who inserted 16 stitches, and the other by a tired and somewnat disgruntled houseman who used 4. If the penalty was awarded in this type of case according to the number of stitches used, it would not be difficult to imagine a miscarriage of justice. CONCLUSIONS
In conclusion may I thank you for asking me to come to-da;-, and for your courtesy in giving me a fair hearing. I find it a daunting experience to address such a gathering of experts. More usually I am cast in another role, that of interpreting the views of psychiatrists, in the light of my limited knowledge, to my fellow magistrates. I regard rnyself as something of an interpreter. To-day I have tried to carry out the process in reverse - presenting to you the views of a jack of all trades and master of none.
