Strong arm of the law

September 26, 2002

Susan Machin, former Ashworth social worker, is now a barrister and fights for the human rights of psychiatric patients. By Adam James

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Susan Machin is back - not so much with a vengeance as with a set of more powerful tools.

Nine years ago, she was a senior social worker at Ashworth special hospital on Merseyside. With five colleagues, she publicly exposed abuse of patients at the high-security unit.
Shortly after, Machin left social work altogether.

But now, at 58, she has re-emerged as a barrister specialising in mental health law. Working from opulent chambers in Manchester, she has returned with characteristic zeal to the territory she feels at home in: advocating for the rights of psychiatric patients.

As one of the whistle-blowing "Ashworth Five", Machin gave damning evidence of patient abuse to the Blom-Cooper inquiry in 1992. She still recalls with horror witnessing a nurse sitting on a chair on top of a straitjacketed brain-damaged patient, reading a newspaper.

The inquiry report precipitated a shift towards liberalisation of management culture at Ashworth and the other English high-security hospitals, Rampton and Broadmoor.

But Machin, with a career in trade unionism and civil rights activism, paid a price for, as she describes it, "putting my money where my mouth was" and exposing malpractice.

One year after the inquiry, she was sacked from Ashworth on the grounds that she broke security guidelines by "supplying to a patient a catalogue of listening devices". She denied this and was vindicated by winning her case for unfair dismissal at a tribunal which concluded that the decision to dismiss her was "perverse".

However, the saga left Machin clinically depressed and experienc ing flashbacks. It also contributed to the break-up of her marriage.

Traumatised, disillusioned at social work's ineffectiveness in bringing about change, and feeling that her reputation would be stained as a "trouble-maker", she turned her back on her profession. Largely to aid her own recovery, she enrolled for a law degree at Lancaster University.

Four years later, her energies restored, Machin beat some 700 other applicants to win one of eight pupillages at Doughty Street chambers in London, working alongside some of the most distinguished barristers in the land, such as Geoffrey Robertson and Helena Kennedy.

Once at the bar, Machin hoped to avoid mental health work. But, with her experience and knowledge, this was always going to be difficult.

Perhaps no barrister in Britain is more intimately familiar with the culture of psychiatric hospitals and the skills necessary to sit alongside confused and distressed patients, trying to gain their confidence, to hear their story.

So, when a solicitor working on a mental health tribunal approached Doughty Street for a suitable barrister, Machin had no choice but to accept. Days later, she was in a hospital, cross-examining a psychiatrist. "It felt wonderful," she says. "I was right back at home."

Since then, working for the St John's chambers in Manchester, she has revelled in her position of powerful influence. "If a patient's rights are broken, I can use the law," she says. "This was something I was not able to do as a social worker."

It is an urge to see justice done that drives Machin. She describes herself as someone unable to hold back from interfering in a street argument if she feels someone is being wronged.

Her "hatred of the abuse of power" is enshrined in her commitment that the rights of patients must be protected against psychiatric institutions, with their powers of detention and compulsory treatment. And she is getting results.

The day before this interview, Machin had helped a 28-year-old mother on her first steps to winning her appeal against three years of detention at Annersley Park, a medium-secure hospital in Nottingham.

Three months before that, Machin won a tribunal to free a man she believes was wrongly diagnosed and detained for five years in a psychiatric hospital near York.

In an intriguing twist of fate, Machin also visits Ashworth to represent patients. There could be no one better qualified to keep the public reliably informed of what is happening inside Ashworth, now re covering from the catalogue of security lapses and mismanagement exposed by the Fallon inquiry of 1999.

Machin, careful with her words, says: "Yes, patients still have complaints, but some of the brutal things that happened do not happen now. And I have old friends there who are interested in what I am doing now."

Machin describes herself as a "radical". But she does believe that some people should, for the purposes of public safety, be compulsorily detained. She also agrees that psychiatrists should be given the right to treat their patients under compulsion. "I do not think this means sticking a needle into someone willy-nilly," she says. "But the mentally ill have a right to be well and to receive treatment.

"However, a lot of people are compulsorily detained because community services have failed them. It is down to lack of resources. But the patient's liberty should not be the price for this."

Two years away from her 60th birthday, Machin buzzes with professional fulfilment. "I wish I had done what I am doing now years ago," she says. "As a social worker, I was seen as disruptive, always arguing for the right to present a patient's case in a court. But now I have authority and the right of attendance.

"I can go to court and be a stroppy bitch if I want. But I will be heard - and I get results."

(C) Copyright Adam James

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