Satisfactory progress was also made on the separate schemes. for officers' quarters at Wakefield and Parkhurst, and work on the provision of ten more quarters for the nurses at Holloway was well in hand at the close of the year.

The position, therefore, with regard to housing for officers is improving, but much remains to be done before the difficulty is

overcome.

Quarters for two superior officers were built at Manchester during the year, and one each at Wandsworth and Feltham.

Within the prisons a considerable amount of building work was done in providing workshops and stores at Swansea, Manchester, Preston, Portland, Birmingham, Cardiff, Durham and Leeds.

At Manchester and Gloucester the comprehensive schemes for general improvements to the prison buildings were satisfactorily advanced. At the former prison the new large boilers for the supply of steam for cooking, laundry, heating, and all other purposes, were taken into use; and the rebuilding of the kitchen, bakery, and other central offices was pushed forward.

Electric light was installed in the hospitals at Wandsworth and Holloway, but the general substitution of electric light for gas cannot yet be taken up owing to lack of funds. Electric light is therefore only installed in those buildings where large expenditure in renewing the gas installation would otherwise be incurred.

XV. STAFF.

The annual conference of the Commissioners with the Prison Governors was held in the autumn of 1925. The discussions were chiefly on points of administration, but there was also an interesting comparison of experience on the effect of unemployment as reflected in the prison population. The Governors did not find much reason to think that a prolonged period of unemployment sapped the character of adults to such an extent as to lead them to commit offences; but those from the large centres of population were agreed as to the bad effect on the young, and some told us that the calendars of prisoners for trial at Assizes and Sessions in their areas were unusually full of young men.

Our meetings with the two Representative Boards took place as usual. The same friendly and helpful spirit which it has given us pleasure to record in previous years, has characterised our relations with our officers of all ranks. All alike have shown a willing spirit in the public service, and have worked together for the advancement of objects of public interest.

We regret to record the retirement, early in the year under review, of our friend and colleague Mr. J. R. Farewell. He entered the Prison Service in 1897, and after serving as Governor of several prisons in succession became an Inspector in the year 1909. After a long period of good service as an Inspector, he took up the duties of a Commissioner in the autumn of 1921.

Mr. Farewell throughout his long service set a fine example of devotion to a high ideal of public duty, and was held in genuine esteem by the staffs of the prisons, as well as by his colleagues on the Commission.

Lt.-Col. J. S. Knox, O.B.E., one of H.M. Inspectors of Prisons, was appointed his successor.

We regret also to record the retirement of Mr. A. J. Wall, C.B.E., Secretary of the Commission since 1919. Mr. Wall entered the Prison Service in the year 1880, and rose through successive grades of clerical work to become Assistant Secretary in 1910, and Secretary in 1919. On his retirement he had completed the exceptional period of 45 years of efficient public service. His ability and resource in coping with difficulties of every kind, and his thorough knowledge of the history of many prison problems, derived from his long experience, made him a valuable Secretary. His last piece of work was the organisation of the arrangements for the holding of the International Penitentiary Congress in London in August, 1925, and for the subsequent tour made by no less than 80 members of that Congress to a number of Prisons and Institutions in England and Scotland. These arrangements were planned and carried out with a success which won him high praise from the foreign and Dominion visitors. Mr. L. W. Fox, M.C., of the Home Office, was appointed Secretary and Inspector in succession to Mr. Wall.

XVI. NOTES ON APPENDICES.

The Appendices contain the Medical Commissioner's report, the administrative Inspectors' report, and extracts from the Governors', Chaplains', and Medical Officers' annual reports. These extracts are the individual opinions of the officers concerned, which their experience has led them to form on certain aspects of their work. They do not necessarily represent the views of the Commissioners. Next to these will be found the questions put to the International Congress, and the resolutions. passed by that body in reply. Then come the list of Educational Advisers, the list of closed prisons, and the usual statistical tables.

We have the honour to be,

Sir,

Your obedient Servants,

M. L. WALLER,

A. PATERSON,

G. B. GRIFFITHS,

J. S. KNOX.

To the Right Honourable

The Secretary of State.

for the Home Department.

APPENDIX No. 1.

REPORT OF THE MEDICAL COMMISSIONER.

I have the honour to submit the usual medical statistics for the year ended 31st March, 1926.

I.-Local Prisons.

The daily average number of sick prisoners treated out of hospital was 709-550 men and 159 women. The daily average hospital population was 398-303 men and 95 women. This gives a proportion of sick in hospital to the general prison population of 4.2 per cent. in the case of men, and 12.8 per cent, in the case of women.

Seventeen men and 10 women (including 9 cases of advanced pregnancy) were released on medical grounds.

In addition to these, 56 men and 5 women were removed to civil hospitals under the provisions of Section 17 (6) of the Criminal Justice Administration Act, 1914, for operation or special treatment; of these 7 men died during the currency of their sentences.

Including the 7 men who died in civil hospitals during the currency of their sentences the total number of deaths was 5049 men and 1 woman. Of the men 24 were executed and 3 committed suicide, and 1 man sentenced to death died from the effects of an attempted suicide before reception.

This leaves 21 deaths amongst the men, and 1 among the women, due to natural causes, giving an annual death rate of 2.8 per 1,000, as compared with 3.8 last year.

The number of prisoners certified as insane in local prisons was 98-84 men and 14 women, as compared with 97 (84 men and 13 women) last year. In addition to these, 192 men and 38 women remand prisoners were found by Medical Officers to be insane and were dealt with by the Courts; 14 men and 5 women were found by juries to be insane on arraignment and 27 men and 9 women guilty but insane.

In addition to the mental cases referred to above, 1,595 men and 690 women were remanded to prison for observation and reports to the Court as to their mental condition.

The number of mental defectives reported to Courts and dealt with under Section 8, Mental Deficiency Act, 1913, was 198, of whom 167 were men and 31 women.

Forty-four men and 6 women were certified as mentally defective under the Mental Deficiency Act, 1913, whilst undergoing sentences of imprisonment in local prisons, and of these 34 men and 4 women were removed to institutions by order of the Secretary of State under Section 9 of the Act. Those not removed to institutions were sent to the care of the Local Poor Law Authority or the local branch of the Central Association of Mental Welfare on discharge.

II.-Borstal Institutions.

The daily average number of inmates in hospital was 16 in the case of lads, and 5 in the case of the girls. There were also daily averages of 79 boys and 24 girls under treatment, out of hospital. Thirty-four boys were removed to hospital under Section 17 (6) of the Criminal Justice Administration Act, 1914. Of these 2 boys died. In addition one boy died as the result of an accident in Feltham Institution. Four boys were certified as mental defectives under Section 1 of the Mental Deficiency Act, 1913, and were removed to institutions for mental defectives under Section 9 of the Act.

III.-Convict and Preventive Detention Prisons.

The daily average number of patients under treatment in hospital was 159 (of whom 147 were men and 12 women), and under treatment out of hospital 193 (of whom 175 were men and 18 women). Ten men died, giving a death rate of 64 per 1,000 of the population: eight men were certified insane and removed to asylums; two men were certified under the Mental Deficiency Act, one of whom was removed to an institution by order of the Secretary of State under Section 9 of the Act. One convict was released on medical grounds. IV.-General.

The Medical Officers of certain prisons in their reports draw attention to the practice of some Justices of convicting prisoners about whose mentality they have doubts, and drawing the attention. of the prison authorities to them, instead of taking the better course of remanding them, and asking for a medical report before dealing with them. In a few cases the Justices have convicted and asked for a medical report at the same time.

In one such case a man was sent to prison for two months for assault. It was remarked that "the Magistrates have great doubt as to the prisoner's state of mind, but as there are no proofs they have no alternative but to send him to gaol for two months." It was further asked that he should be kept under observation and a report sent to them on his release. The man was certified as insane at the prison; having delusions of persecution and auditory hallucinations.

In another case a woman was committed to prison for 14 days for sleeping out so that there can be opportunity for medical examination, with a view to a report upon her state of mind as she seems to be mentally deficient if not exactly lunatic."

A third case was that of a woman who was sentenced to 21 days' hard labour for stealing a pair of shoes. A note was received from the Justices asking that she should be kept under observation with a view to deciding whether she was sane enough to be at large. She was not certifiable as insane.

In a fourth case a woman was sentenced to 14 days' imprisonment for wilful damage, and was found to be insane. The Justice committing her desired her to be examined as to her mental condition.

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A fifth case was that of a man sentenced to 21 days' hard labour for exposing his person. A request was sent to the prison for medical examination as he behaved in such a manner during the hearing of the case as to make the Justices wonder whether he was altogether responsible for his actions."

The Governor and Medical Officer of a women's prison cites a case in which a woman was sentenced to 14 days' imprisonment, and a report was asked for in 7 days. The prisoner was found to be certifiable as insane.

It is a simple matter for the Court to obtain a medical report as to a prisoner's state of mind. Such reports will prevent some insane or mentally deficient persons from being detained in such an unsuitable environment as a prison.

This practice of conviction first and mental examination afterwards is not very common, and would probably disappear altogether if the Justices had the matter brought to their notice.

The majority of Courts adopt the safe practice of mental examination in prima facie cases, as is shown by the very large number remanded to prison for observation and report, not only to prisons staffed by whole-time, but also to those served by part-time Medical Officers.

At the International Prison Congress in August, 1925, the necessity for the mental examination of prisoners before conviction was strongly urged.

Mental examination of all prisoners before adjudication is impossible, as large numbers are not remanded to prison at all, but it can safely be said that all prisoners remanded or committed for trial, whether a report is asked for or no, have their mental state investigated. It is the practice in prisons that prisoners charged with certain offences, which experience has shown may be associated with diseased mentality, are placed under observation for mental investigation.

The centres which were instituted for the collection of uncertifiable mental cases have been in operation during the year, and favourable reports have been received as to the beneficial effect of work taught by the Brabazon Society.

As I reported last year, the intelligent application of the Mental Deficiency Act (1913) by Prison Medical Officers has resulted in the permanent diminution of the prison population by a large but unknown number-possibly 200 daily.

A logical extension of a similar measure to those persons who are to some degree feeble-minded, though not so much so as to be certifiable under the Lunacy or Mental Deficiency Acts, either by some form of indeterminate sentence or permanent segregation in some form of special institution or farm colony would undoubtedly in my opinion lead to the elimination from the unsuitable environment of a prison of a further large contingent of weak-minded habitual petty offenders.

With the practical elimination of such, a prison would then be what it ought to be, a place for hard work, discipline and education, with a view to rehabilitation on completion of the sentence.

The competence of Prison Medical Officers is brought out by an extract from an address delivered by the late Dr. R. H. Cole, an authority on mental diseases, before the Royal Society of Medicine.

"The detection of insanity in prisoners under remand, or when first sentenced, is often a matter of difficulty. A tribute is due to the prison medical officers for the advance they have made in the diagnosis of mental disorder or defect among the prisoners under their charge."

I would draw attention to the original work which is being done by the Medical Officers in the Prison Service and read before Scientific Societies or published in the Medical Journals. The papers contain valuable information from direct observation unobtainable from text books.

These investigations deal largely with facts and do not, as a general rule, start out to prove a theory-Freudian or otherwise. The following is a list of such recent papers:Dr. W. Norwood East, Medical Inspector:-

1. Observations on Exhibitionism.-" Lancet."

2. The Interpretation of certain sexual offences.-" Journal Mental Science."

3. Some Forensic aspects of Epilepsy. Read at the annual meeting of the Royal Medico-Psychological Association. (Dr. East has also published a book "Forensic Psychiatry "; publishers-J. & A. Churchill.)