The Priory fined £300,000 after death of girl, 14, in its care

Amy El-Keria, 14, was being treated at the private mental healthcare group’s Ticehurst House psychiatric hospital in East Sussex when she died in November 2012.

A jury inquest in 2016 heard neglect contributed to her death and found she died accidentally of unintended consequences of a deliberate act.

The Health and Safety Executive (HSE) pursued a criminal investigation and the company admitted to a charge of being an employer failing to discharge its duty to ensure people were not exposed to health and safety risks.

Judge Mr Justice James Dingemans sentenced the London-based company at Lewes Crown Court on Wednesday.

He said: “It is obvious that any penalty I impose can never reflect the loss suffered by Amy’s family in this case.

“Amy’s mother, when giving her victim impact statement, said that she hoped that lessons would be learned from this tragedy.

“It is apparent from the investigations that have been carried out in Amy’s death, and the works carried out by Priory Healthcare and the CQC, that there is now a much better understanding of young person suicide, and that vital lessons have been learned.”

The judge said he was “unable to be sure... that the offence was a cause of Amy’s death”.

He concluded that there was a “low likelihood” of harm in the case but culpability should be assessed as “high” as patients including Amy were exposed to risks to their health and safety.

“This is because Priory Healthcare permitted these breaches to persist over a long period of time, from the opening of the HDU in 2008 until Amy’s death in 2012,” he said.

“They only took action after her death. Further, Priory Healthcare failed to make appropriate changes when required to do so by the CQC.

“There was, in my judgment, insufficient urgency demonstrated in dealing with these problems.”

Mr Justice Dingemans said Priory Healthcare had a turnover of £133 million in 2017, with an operating profit of £2 million that year.

He said he was unable to find any aggravating factors and he took into account the company’s guilty plea, lack of previous convictions, “good” health and safety record and its steps to close and refurbish the unit where Amy lived.

The private mental healthcare provider was also ordered to pay the Health and Safety Executive’s costs of £65,801.38 and a victim surcharge of £120.

Speaking outside court, Amy’s mother Tania El-Keria said: “The public’s eye has been firmly opened to what the Priory stand for, profit over safety.

“Today is a historic day in our fight for justice for Amy.

“Our Amy died in what we know to be a criminally unsafe hospital being run by the Priory.”

Amy’s mother added: “This whole painful process has been marked by the Priory’s long and bitter failure to show any level of remorse... or responsibility.

“To us, the Priory are a morally-bankrupt company. They continue to take large sums of public money allowing our children to suffer by placing profit over safety.

“This cannot be allowed to continue and I will not stop fighting until this stops.”

Asked about the size of the penalty handed out to The Priory Group, Ms El-Keria said: “It’s not about the fine, it’s not about the money.”

She said the Priory’s contract with the NHS should not carry on.

“I don’t believe there’s any lessons learned”, she added.

In a statement, Priory Group CEO Trevor Torrington said: “We would like to repeat our sincere and profound apologies to Amy’s family.”

Mr Torrington added: “There was common ground between the experts that the care planning was of good quality, that the suicide of 14-year-olds is extremely rare and prediction is likely to be extremely difficult.

“Priory Healthcare accepts there were certain risk management procedures in 2012 in relation to environmental audits and BLS training which were not robust enough.

“However, the court found such shortcomings were not causative of Amy’s tragic death.”

The company has since taken steps to improve training and support for staff to manage patients at risk of self harm, Mr Torrington said.

The latest CQC report rated Ticehurst hospital as “good” and staff were focused on patient safety and learning lessons from incidents.

A strategic review of in-patient CAMHS services will be undertaken.

In a statement, the charity Inquest, which has supported Amy’s family, said: “This is understood to be the first prosecution of its kind and is a historic moment in terms of accountability following deaths of children in private mental health settings.”

It added: “There is a lack of transparency surrounding deaths of children in both NHS and privately-run mental health settings, in addition to the lack of pre-inquest independent investigations into these deaths despite higher standards in other detention settings.”

Victoria McNally, a senior caseworker at Inquest, said: “The lack of any independent system of investigation, allowing the Priory to investigate their own actions, has meant it took six-and-a-half years for their criminally unsafe practises to be exposed.

“If we are serious about child safety and welfare, such a blatant lack of oversight and scrutiny cannot continue.

“The grave concerns for safety raised by Amy’s and other children’s deaths must lead to an immediate intervention by the government and an urgent review of the Priory’s fitness to deliver national CAMHS hospital services.”

Amy’s mother Tania El-Keria is due to meet with mental health minister Jackie Doyle-Price in May.

At an earlier hearing, the court heard that Amy had arrived at the hospital’s high dependency unit on August 23 2012.

On November 12, at 8.15pm, she was found in her bedroom with a ligature tied around her neck and taken to Conquest Hospital in Hastings, where she died the following day after life support was withdrawn.

Prosecutor Sarah Le Fevre told the court that information relating to Amy’s care had not been properly handled.

A ligature audit of her room, carried out by an untrained member of staff, identified medium risks which were not followed up.

The hospital was also slow to tackle concerns over risks identified in a Care Quality Commission (CQC) inspection in November 2011.

Details of a conversation on suicide Amy had with a nurse in the early hours of November 12 were not passed on to her doctor.

Amy’s mother Tania El-Keria told the court that the “nightmare” of losing her “spirited” daughter left her feeling like her “heart and soul is ripped out every morning”.

She admitted to having “low points where I have not wanted to be alive any more just so that I could be with Amy”.

Ms El-Keria added: “I hope that the knowledge gained from this case goes on to change what I see as a failing system and prevents future avoidable deaths.”

At the earlier court hearing, the Priory offered its “sincere apologies” to Amy’s family for “serious failings”.

The 2016 inquest jury’s findings were highly critical of the Priory, ruling staff failed to dial 999 quickly enough, failed to call a doctor promptly and were not trained in CPR.

Staffing levels were inadequate, Amy was not resuscitated properly by staff, and had to be removed from the hospital on a body board because the ambulance stretcher could not fit in the lift, it found.

The response of staff was so inadequate the jury agreed there was a possibility that Amy may have lived if she had received proper care.