The underlying facts

2. D1275 arrived at Brook House on 1 May 2017. He was immediately referred to a Registered Mental Health Nurse (RMN) following an initial assessment, as he:

“Claims mental health issues. States he hears voices. Repeated ‘they will find me’ on admission. Would not elaborate on who he was referring to or what would happen if ‘they’ found him. Preoccupied and inappropriate in manner. Vague and misleading with answers to questions on admission.”¹

In his medical notes, D1275 was recorded as “Intruding on other detainees’ admissions whilst in the waiting area”. The assessor noted that it was “unclear” whether D1275 had been a victim of torture. D1275 did not attend his arrivals clinic appointment with the Brook House GP on 2 May 2017, or his appointments with an RMN on 9 and 17 May 2017. He was discharged from the RMN service as a result.²

3. On 14 June 2017, Detention Custody Officer (DCO) Callum Tulley covertly recorded D1275 being attended to in the courtyard after he had taken the new psychoactive substance known as ‘spice’.³ D1275 lay face down and motionless on the ground, grimacing and groaning in apparent pain and violently retching. He was being attended to by a DCO identified to the Inquiry only as ‘Mark’. Detention Custody Manager (DCM) Stephen Loughton, DCM Nick London, DCM Steven Dix and DCO Aaron Stokes were also present, and a crowd of detained people had gathered, who Mr Tulley attempted to disperse. After approximately four minutes a nurse arrived and Mr Tulley was asked to find an evacuation chair.

Figure 25: D1275 on the ground of the courtyard being attended to by ‘Mark’

4. Mr Tulley returned to the courtyard approximately four and a half minutes later, having been unable to find an evacuation chair. The courtyard was still full of detained people crowding around D1275, who appeared to be conscious and distressed, crying out, “mama”.
5. D1275 got to his feet unsteadily and was taken to E Wing by several officers. Mr Stokes and another officer supported him as he walked.
6. D1275 was met at the door to E Wing by DCO Derek Murphy. The footage shows that Mr Murphy held the door open for D1275 and said:

“I’ve no fucking sym[pathy], look at the state of that. Look, imagine bringing that home to your Mother. Alright, how are you doing? There you go young man.”

7. After a quick search, D1275 was taken into a cell where Mr Murphy put him into the recovery position on the bed. Over the course of at least 15 minutes, D1275 fluctuated between appearing intoxicated and incoherent, and appearing to understand what was being said to him. Healthcare staff took medical observations as various officers came and went from D1275’s cell. One officer (it is not clear who) suggested that the officers ought to film detained people who had taken spice and show them the footage later so that they could see “how stupid they’ve been”. DCM Nathan Ring shouted to D1275, “Does your face taste nice mate, because you’re chewing it off.”
8. While the officers were making these comments, Healthcare staff were monitoring D1275’s blood pressure. One of the nurses said that D1275 was tachycardic (ie his heart was beating too fast), and attempts were made to put a pulse oximeter onto D1275’s finger to measure the oxygen levels in his blood.
9. Mr Tulley briefly left D1275’s cell. When he returned, Mr Murphy, who was then also in the cell, said in a loud voice, “I have absolutely no sympathy for them, absolutely no sympathy for them at all. If he dies, he dies.” He then appeared to leave the cell.
10. Mr Tulley sat across from D1275 and talked to a nurse about D1275’s heart rate. The nurse explained that D1275’s heart rate was currently 128 beats per minute, but that it had reached 178 beats per minute when D1275 was in the courtyard. She explained that the worst thing that can happen when someone takes spice is that their heart rate drops too low and the person stops breathing. Mr Tulley asked the nurse whether she thought that someone in Brook House was likely to die soon, and she replied “yeah”.
11. The nurse then noticed that D1275 appeared to be sleeping, woke him up and placed an oximeter on his finger. D1275 appeared drowsy and the nurse gently encouraged him to stay awake.
12. As she did so, she, Mr Tulley and Mr Stokes continued to talk about the prevalence and seriousness of spice in Brook House, and the ability of Healthcare staff to respond. This issue is discussed further in Chapter D.8 in Volume II.
13. After approximately six and a half minutes, Mr Tulley turned his covert camera back to D1275, who was smiling. D1275 then started to sing loudly in a foreign language and play with the oximeter. He was singing intermittently for approximately 15 minutes.
14. One of the nurses asked D1275’s name and Mr Ring appeared to be unable to pronounce it, saying, “How do you pronounce that?”. His tone was mocking and he answered his own question, saying, “Knob” and “We’ll stick with div”. The nurse appeared to respond “no” to this, and D1275 then briefly stopped singing.
15. The nurse checked D1275’s heart rate again, and expressed concern that he was still tachycardic. Mr Ring shouted over D1275, “stay still you div” and called him a “scrotum”. In relation to D1275’s elevated heart rate, Mr Ring said, “I’ll get him cold water. That will sort his heart out. That will do it the world of good.” Mr Tulley then left the wing.
16. When Mr Tulley returned, approximately seven minutes later, D1275 could still be heard singing. Shortly afterwards, Mr Tulley asked Mr Ring what D1275 was doing. Mr Ring commented, “Probably gurning. Checking out the inside of his skull. Eyes are rolling around.”
17. In line with what he told G4S investigating officers in the course of his disciplinary interview on 7 September 2017, Mr Murphy told the Inquiry that he did not dispute that he said the words attributed to him.⁴ However, he told the Inquiry that he believed the secretly recorded footage had been edited to mislead the viewer about the context and timing of his comments, which he said was indicated by a change to the light.⁵
18. Mr Murphy told the Inquiry that he recognised that his comments were inappropriate.⁶ He also said that they were born of frustration at the fact that D1275 had taken spice after they had previously discussed the dangers of doing so.⁷
19. Mr Ring also accepted that he had made the statements heard on the footage during his G4S disciplinary interview on 7 September 2017.⁸ In his oral evidence to the Inquiry, Mr Ring said that the intention behind his comments had been misinterpreted, stating:

“I’d had a previous conversation talking about how cold water can stop you passing out and that and how it affects your heart rate. That was just another joke, silly comment really.”⁹

20. Mr Ring told the Inquiry in his witness statement that his actions were a result of feeling frustrated with D1275 for taking spice.¹⁰ He likened the incident to being out with a friend who drinks too much alcohol.¹¹ Mr Ring accepted in his oral evidence that he and Mr Murphy were not setting a good example to other staff during the incident. He maintained that the comments needed to be seen in the context of the “rapport” he had with D1275 and that they were a result of his frustration with the situation.

1. CJS001120[↩]
2. CJS001121_065-067[↩]
3. Day 8 PM 2 December 2021 00:33:00-00:49:02 (KENCOV1035 – V2017061400015) and 00:49:20-00:53:53 (V2017061400016)[↩]
4. CJS005928_004-005; INQ000121_006 paras 18a-18b; Derek Murphy 2 March 2022 77/1-77/24[↩]
5. Derek Murphy 2 March 2022 79/1-82/6[↩]
6. Derek Murphy 2 March 2022 77/22-24, 78/13-14[↩]
7. INQ000121_005-006 para 18[↩]
8. HOM001503[↩]
9. Nathan Ring 25 February 2022 123/11-18[↩]
10. Nathan Ring 25 February 2022 118/24 120/24-7[↩]
11. Nathan Ring 25 February 2022 120/19-121/7[↩]