Cases like Valdo Calocane, who killed three people in the Nottingham attacks, could become ‘much more frequent’, a doctor who treated him has told a public inquiry.
Calocane, who was diagnosed with paranoid schizophrenia, fatally stabbed Barnaby Webber, Grace O’Malley-Kumar and Ian Coates, before running over and injuring three others with Mr Coates’ van in the early hours of June 13, 2023.
On Tuesday, May 12, a public inquiry into the tragedy heard from a doctor who treated the killer at Highbury Hospital – his fourth and final sectioning – in early 2022.
Dr Jonathan Gibson, who remains a consultant psychiatrist at Nottinghamshire Healthcare Foundation Trust (NHFT), told the hearing he had concerns that Calocane’s case “was not extraordinary in any way”.
“I see multiple patients like this all the time with this level of risk, this pattern of disengagement and this could become much more frequent than it is. These outcomes,” he said.
The doctor said mental health services have “much fewer beds to deal with a much larger and sicker population”, which has ‘dramatically’ increased over the last 40 years.
He said there are “multiple patients in the community at any one time that are dangerous” and that there was a “constant pressure to discharge patients back into the community”.
When asked whether he adequately assessed the risks of Calocane before his final discharge from hospital on February 24, Dr Gibson said he “believed all the factors were taken into account” but the “wrong decision was made”.
Ian Coates, Barnaby Webber and Grace O’Malley-Kumar
The doctor said there was and still is “a culture and climate that emphasises the least restrictive approach” to patients with mental disorders, which aims to “enhance their autonomy wherever possible”.
He said when he attends conferences he is told by people from the Care Quality Commission, the Royal College of Psychiatrists and government that psychiatry is “being overly coercive”, in particular with “young ethnic minority males”.
The inquiry has been told several times that Calocane was not given depot medication – a long-acting injectable method – due to his fear of needles.
Dr Gibson said he thought the depot was the best treatment option but was unable to persuade Calocane to take it.
Dr Jonathan Gibson giving evidence to the Nottingham Inquiry(Image: Nottingham Inquiry)
“He declined the depot, therefore the only means would be coercion,” he said, explaining this would “most likely be full face down restraint by six to eight nurses” while he was forcibly injected.
“Calocane himself didn’t want it. He was denying symptoms and he was concordant with medication on the ward.”
Hearings for the Nottingham Inquiry have been running in London since late February, examining failings both in the run-up to and in response to Calocane’s rampage.
Tuesday’s sitting also heard from Dr Tim Baker, a senior partner at Calocane’s former GP practice, Cripps Health Centre, which is situated on the University of Nottingham campus.
Calocane, who was sectioned four times in two years for violent behaviour, was discharged by mental health services to his GP in September 2022.
Dr Tim Baker giving evidence to the Nottingham Inquiry(Image: Nottingham Inquiry)
The hearings were previously told the decision – nine months before the killings – was made after NHFT’s community services essentially ‘lost’ Calocane.
Dr Baker told the inquiry it was the incorrect decision, adding: “I would expect a discussion, I would expect a very clear plan and agreement for ongoing monitoring, especially regarding non-compliance and non-engagement.
“These are very difficult patients to look after… are associated with lack of insight which makes them very difficult to engage for medication to continue.”
Sophie Cartwright KC, questioning the doctor on behalf of the surviving victims, asked why the practice was not “immediately escalating” Calocane’s discharge as a serious incident when they received the letter.
Dr Baker replied: “When that letter came in with as little information on it as was there, all the dots would not have been put together to form a picture.
“Purely on the basis of the letter. It didn’t flick the switch to enable that to happen.
“The assumption is that secondary care makes serious decisions like this with responsibility that they are given to do so.”
When reminded Calocane was in the care of his GP at the time of the killings, and asked if the practice could have done more, Dr Baker said: “We have a duty of care, yes. [But] he could be anywhere at this point. He’s not engaging. There’s not really a lot of action we can take other than contacting him to engage him.”
The inquiry continues.
