Man who killed dad accuses professor of ‘no remorse’ about decisions over his treatment
A MAN who killed his father after absconding from hospital accused a medical professional at an inquest of speaking like his case was “an every day occurrence”.
Retired doctor Kim Harrison – a renowned chest consultant – was beaten to death by his son Daniel after the 38-year-old absconded from Neath Port Talbot Hospital and went to the family home in the Swansea Valley in March, 2022.
Dr Harrison suffered catastrophic head and neck injuries in the attack and subsequently died in hospital.
Previous stages of the inquest heard details of a review carried out by Swansea Bay University Health Board following complaints by the Harrison family. Among the findings highlighted by the review was official confirmation that, despite being detained under the Mental Health Act, the killer simply walked out of Ward F at the hospital through an open door. The review also highlighted a series of problems with Daniel Harrison’s treatment during his time at the unit.
The inquest had previously heard how Daniel Harrison had a history of mental health difficulties and psychosis dating back to 2007. While there were times when he was stable and medicated and thrived in his chosen career of bespoke furnituremaking, his mental health began to deteriorate from around 2018 and he stopped taking his medication.
Over the following years he began to suffer from bouts of paranoia, delusions, auditory hallucinations, and “thought broadcasting” where he believed other people could hear his thoughts.
Due to their concerns the family made repeated efforts to get a mental health assessment for him, and they eventually made a formal complaint to the Swansea Bay University Health Board about how the case had been handled. A year before he killed his dad, Daniel was seen by a mental health expert who concluded he was not showing signs of psychosis but was leading an “alternative lifestyle”.
On March 2, 2022, police were called to the family home in Clydach due to Daniel’s threatening and aggressive behaviour, and he later agreed to go to Ward F in Neath Port Talbot Hospital. He was subsequently detained at the hospital under the Mental Health Act. It was from this unit that he absconded.
Daniel Harrison subsequently pleaded guilty to manslaughter on the grounds of diminished responsibility and was made the subject of a hospital order.
At Friday’s inquest hearing at Swansea’s Guildhall, consultant psychiatrist with Swansea Bay University Health Board, professor Peter Donnelly, explained how Daniel had been admitted in 2007 with evidence of psychotic symptoms, sometimes saying he appeared to show no symptoms and other times explaining his thinking was altered.
Professor Donnelly said from June, 2020, to February, 2021, face-to-face meetings were limited due to the coronavirus pandemic, and without having seen Daniel, it was clear from medical notes he had a “broad psychotic disorder”, most likely diagnosis was schizophrenia.
The inquest heard that Daniel “categorically” did not want to engage with the service, for details of his appointments to be discussed with his family, and would not take his medication, and that based on what he knew, Mr Donnelly made a decision to discharge him back to his GP, and for the GP to refer him back if there were further issues.
His family, including Dr Harrison, had expressed concern that he was relapsing with his mental health, including an incident of an altercation with his landlord, and they had wanted him to have a mental health assessment, “which should have raised red flags”. There had been a view taken that he had been masking symptoms, the inquest heard.
Professor Donnelly said: “My practice has changed where, if at all possible, I will stress to the patient repeatedly, ‘I need to talk to your relatives, and I won’t share anything, but I need to listen to them’. Patients will still say no, but because of that different approach, some patients have said ‘ok, but do not tell them anything’. That practice has changed because that was a frequent issue with Dan which as a clinical team Daniel was saying ‘Don’t talk, don’t meet’, and that led to the family only having a route in via senior management.”
He added: “It’s extremely difficult to look at how one might change one’s practice at any particular point, without knowing the final outcome. What I have done throughout this process is, based on the evidence in front of me, made a judgement and a clinical decision in regards to Daniel’s mental state, and the risk. I think it is almost impossible to say: ‘I would have done this, this and this’ because of the awful outcome that’s happened.”
Daniel’s brother and Mr Harrison’s son, who was in attendance at the hearing, said: “With all due respect, my dad did [knowing what was going to happen]. And I’m not going to say anything else, but it shows like you have shown no remorse, and this will happen again.” Daniel, observing the inquest remotely, said: “I’m sorry but you’re acting like this is an everyday occurrence. As my brother said, no remorse. It is coming across like there has been no learning. We’re all desperate that this should never happen again. It is coming across to me like the professor is acting like this is an everyday occurrence, and it’s just shocking.”
Coroner Kirsten Heaven said: “Clinical decisions were made, the witness has explained at length why he made such clinical decisions, and my understanding of the evidence is that at no point did this witness ever consider there was a real, immediate or even a possible risk of the outcome actually happening.”
On Thursday, evidence was given by Stephen Jones, Swansea Bay University Health Board nursing representative on the triumvirate within the mental health and learning disabilities service group, together with David Roberts and Richard Maggs at the time. Mr Jones explained his responsibility is for the full oversight of the nursing workforce, patient experience and quality.
He explained that in order for a matter to become subject to a formal investigation, there is an immediate review after any incident, which considers the incident or complaint, followed by an early review of the information and a decision as to whether it needs a full review.
An immediate requirement was to examine the last 12 months, which would be reviewed, and then considerations as to whether they need to look back further in time, based on Welsh Government guidance.
Ms Heaven asked Mr Jones what involvement he had in Daniel’s care before his father’s death. He said he understood at that point that a complaint had been received by Daniel’s family about the treatment he had. He explained that it was being dealt with at a higher level of management.
On February 7, 2022, less than a month before the tragic events, Mr Jones was sent an expert review on Daniel’s case. But it had taken 10 weeks to get to him, something Mr Jones accepted was a “considerable delay”. It took around five weeks afterwards for him to complete requested tasks regarding missing information and return it. The final report was not issued until March 23.
A patient safety investigation was later completed in relation to Daniel’s care, concluding the process of an internal investigation.
Ms Heaven asked: “I’ve heard extensive evidence that the Harrison family was raising concerns about Daniel’s care and treatment over a number of years that he had not been given adequate care, sufficient collateral information had not been taken, there had been missed opportunities, they were questioning whether assessments were correct, amongst a range of other things. So how could the health board get to a position where a serious incident has arisen, and not be looking at, and investigating itself, the treatment Daniel had or had not received in the lead up to going into Ward F?”
Mr Jones responded: “The historical information would have been contained within the summary from the outset of the report. The detail of the history would have been integral to the report.
“The actual focus of the review was around the period of time that was set out in the report for the incident. It wasn’t dismissing the history, the history would have been part and parcel of that, because that was the care was provided. We were looking at the specific incident.”
Ms Heaven responded: “But I want to know why. The question I’m asking is why did the health board fail to investigate the complaints and concerns that Daniel’s family had been raising for a number of years about his care and treatment?”
Mr Jones responded: “I can’t recall the specifics of the discussion as to why we did not go back any further in the scope of review. What I know is the determination to focus on the period of time in that initial review.”
Ms Heaven asked: “Are you satisfied, looking back, that it is an adequate internal investigation? Or do you think now, looking back, that it should have gone into the care and treatment and concerns and complaints that were being raised by the Harrison family?”
Mr Jones said: “We would look at the scope of the report differently today, because now I’m aware of all the information that has been shared.”
The inquest continues on Monday, April 15.