George Donald McLellan

It could, and probably should, be the vehicle for a root and branch re-examination of the current practices and planned changes within the eight police forces, with a view to creating a system that meets the needs of a changing prisoner population.

They are as follows: (a) A procedure for confirming and countersigning the vulnerability assessment of a prisoner at each handover should be introduced, for the reasons to which I have already referred.

This would involve very little change in present procedures, but it should ensure that the outgoing and incoming officers focus clearly on the issue of vulnerability, particularly in circumstances where the frequency of the monitoring regime is to be altered.

(b) Priority must be given to the timeous monitoring of vulnerable prisoners, particularly those who are on quarter-hourly or half-hourly observations.

Duty officers and custody officers should be made aware that processing other prisoners must not take precedence over visiting a vulnerable prisoner in his cell, unless there are exceptional circumstances.

(c) Staffing levels should be sufficiently adequate to ensure that effective monitoring can take place without undue delay in the processing of other prisoners, or undue pressure being placed on custody staff.

I suspect that Tayside Police may already have reviewed their staffing levels in the light of the present case, but if they have not, I recommend that they do so now.

Dr Morrison’s suggestion that lay persons - including custody care staff - might be trained to administer a potentially life-saving drug such as Naloxone in an emergency should undoubtedly be followed up.

So should her suggestion that resuscitation equipment should be available, with training on how to use it.

That is a task which should perhaps be undertaken by someone with professional editorial skills who understands the requirement for plain English in official documents.

If that is done, I suggest that a copy of it could be issued to police officers and custody care assistants at the end of their training.

For that reason, I suggest that I could be accompanied by a simple aide-memoire - perhaps in the form of a leaflet - containing the basic rules about the assessment and monitoring of vulnerable prisoners - such as the rousing procedure - which they could keep with them at all times, and which could also be freely available within each police station.