Prevention of Future Deaths reports · 2019

Carl Sargeant

Regulation 28 report to prevent future deaths, reference 2019-0236, written 11 Jul 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report11 Jul 2019
Reference2019-0236
DeceasedCarl Sargeant
CoronerJohn Gittins
Coroner areaNorth Wales (East and Central)
CategorySuicide (from 2015) · Wales prevention of future deaths reports (2019 onwards)
Sourcejudiciary.uk record · original PDF
Responses published1

The report

Text recovered by OCR from a scanned PDF. OCR is imperfect: check anything you rely on against the source PDF. Reproduced verbatim, including the scan's own layout.

John Adrian Gittins
Senior Coroner for North Wales (East and Central)

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO: The Office of the First Minister to the Welsh
Government, Cathays Park, Cardiff

CORONER

lam John Adrian Gittins, Senior Coroner for North Wales (East and Central)

CORONER’S LEGAL POWERS

| make this report under paragraph 7, Schedule 5, of the Coroners and Justice Act 2009 and
regulations 28 and 29 of the Coroners (Investigations) Regulations 2013.

INVESTIGATION and INQUEST

On the 10! of November 2017 | commenced an investigation into the death of Carl Sargeant
(DOB 27.7.68 DOD 7.11.17) The investigation concluded at the end of the inquest on the 11" of
July 2019 The conclusion of the inquest was one of suicide, the cause of death being 1(a)
Hanging

CIRCUMSTANCES OF THE DEATH

Carl Sargeant was a Welsh Government Minister who was removed from office on the 3% of
November 2017 amid allegations of inappropriate behaviour towards women. At that time he had
some mental health issues and was on anti-depressants. The circumstances of his removal from
office and the considerable media interest which ensued resulted in a significant deterioration in
his mental well-being and he took his own life on the morning of the 7'* of November 2017.

CORONER'S CONCERNS

During the course of the inquest the evidence revealed matters giving rise to concern. In my
opinion there is a risk that future deaths will occur unless action is taken. In the circumstances it
is my statutory duty to report to you.

The MATTERS OF CONCERN are as follows. —
That in the future, persons of a high profile who are removed from a role in Government,
and whose removal from office will attract significant media interest, may not be provided
with appropriate channels of support regardless of whether or not that person has any
mental vulnerabilities or the reason for the loss of their role.

This concern is regardless of the fact that they may continue as Assembly Members.

Coroner's Office, County Hall, Wynnstay Road, Ruthin, LLIS 1¥YN
Tel 01824 708047

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you have the power
to take such action.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report, namely by
the 5" of September 2019. |, the coroner, may extend the period.

Your response must contain details of action taken or proposed to be taken, setting out the
timetable for action. Otherwise you must explain why no action is proposed.

COPIES and PUBLICATION

I have sent a copy of my report to the Chief Coroner and to the legal representatives of following
Interested Persons —

The Widow and Son and extended Family of the Deceased

The Labour Party

| have also provided copies of my report to the media.

| am also under a duty to send the Chief Coroner a copy of your response and | shall also share
your response with the above mentioned parties.

The Chief Coroner may publish either or both in a complete or redacted or summary form. He
may send a copy of this report to any person who he believes may find it useful or of interest.
You may make representations to me, the coroner, at the time of your response, about the
release or the publication of your response by the Chief Coroner.

Dated 11! July 2019

Signature ¢ L ~~ AAS
Senior Coroner fof North Wales (East and Central)

Coroner's Office, County Hall, Wynnstay Road, Ruthin, LL15 1YN
Tel 01824 708047

Responses

1 response published against this report on judiciary.uk. A response is a body's written reply to the coroner's concerns; publication is at the discretion of the Chief Coroner's office, so an absent response does not mean nobody replied.

Response from Welsh Government (PDF)
Response by the First Minister of Wales to the Regulation 28 Report to Prevent 
Future Deaths issued by the Senior Coroner for North Wales (East and 
Central), John Gittins, on 11 July 2019  

As outlined in the written and oral evidence which you received as part of your 

1. 
investigation, and in accordance with Section 48 of the Government of Wales Act 
2006, it has been the practice in successive Welsh Governments when reshuffles 
are conducted, or where Ministers are leaving the Cabinet in other circumstances, to 
follow a similar approach to other governments in the UK. There has been a 
recognition that the First Minister, with the approval of Her Majesty, has sole 
authority as to who serves in their Cabinet and that reshuffles are carried out 
periodically, always at short notice, and are sui generis in nature. The process for 
appointing and dismissing Ministers has been entirely a matter for the First Minister. I 
would not wish you to interpret my response here as being critical of the way in 
which any of my predecessors have conducted their reshuffles, as they were 
following accepted practice and acting within the established framework.  

2. 
Nevertheless I recognise that the circumstances surrounding the tragic death 
of Carl Sargeant, and the specific concern which you outlined to me in your Report, 
mean that as First Minister I have had a responsibility to look again at the process for 
Ministers leaving the Cabinet and to consider what changes should be made.  

3. To assist my thinking, I have consulted all current Ministers in my Cabinet as well 
as those former Ministers who are still Assembly Members. I have also consulted the 
family of the late Carl Sargeant and sought to incorporate the views they were able 
to provide at that stage. The Permanent Secretary on my behalf has contacted the 
Assembly Commission since it is the Commission, rather than the Welsh 
Government, which manages the arrangements for making support available to 
Assembly Members, including Ministers. My response here is informed by all of the 
replies that I received.  

4. I think that it is important that I should signal very clearly that as First Minister I 
regard myself as having a responsibility to help promote and safeguard the wellbeing 
of my Cabinet colleagues throughout the period of their time in Government, from 
first joining the Cabinet through to their departure from office. I hope that in practice I 
have acted with this responsibility in mind since I became First Minister. You will 
recall from my earlier evidence to you that when I formed my Cabinet, on becoming 
First Minister, I was careful to ensure that those affected were aware of the support 
services available. I will now take steps formally to acknowledge and codify this 
responsibility. I will do so by adding a new section to the Ministerial Code for the 
Welsh Government. The Ministerial Code sets out the standards of constitutional and 
personal conduct expected of Ministers and the existing Code can be viewed here: 
https://gov.wales/ministerial-code. Other governments in the UK have very similar 
Codes.   

 
 
 
 
 5. The new Section to the Code will be called “Ministers and their Wellbeing” and I 
annex to this letter the text I intend to include in this Section. I believe that making 
this responsibility an obligation upon myself under the Code will provide an explicit 
and public recognition of the pressures that Ministers can face and a commitment to 
support them personally.  

6. Subject to your views, and those of the Chief Coroner, it would be my intention to 
make this change to the Ministerial Code immediately. While the content of the 
Ministerial Code is a matter for the First Minister of the day, I would hope that my 
successors would similarly recognise the importance of ensuring the wellbeing of 
Ministers, and that by adding this section in the light of your findings it should 
become a permanent element in this and any future Code.  

7. There are a number of practical steps which I also intend to implement 
immediately in order to give effect to this new section of the Ministerial Code.  

8. I will develop and adopt a protocol for the appointment and dismissal of Ministers. 
I recognise the need to take into account the effect which there might be upon an 
individual by their being removed from government, to take particular account of the 
circumstances, and to try to ensure that reshuffles are conducted with due sensitivity 
of the impact upon individuals. In any future reshuffle that I might conduct, I will 
ensure that it is framed in a way that recognises the public service rendered by 
departing Ministers. I will ensure that the wellbeing of the Minister or Ministers 
involved is taken into account as part of planning and preparation for reshuffles, 
including a recognition that individuals may react in different ways on being asked to 
leave office.  

9. Particular care will be taken to consider the wellbeing of a departing Minister if the 
circumstances of their departure are difficult and high-profile, such as an alleged 
breach of the Ministerial Code. I see the Chief Whip of my Government as having an 
important role to play in this process, and the Chief Whip will make contact with the 
individual following their departure to see if any further assistance of any kind would 
be appropriate.  

10. As part of the protocol there will be a standardised pack of information for 
Ministers who are departing from Government. This will include a reminder of the 
support services available to them in their capacity as an Assembly Member, and will 
also give them details of a named official in my Cabinet Division who will act as their 
liaison point for any practical queries or issues in relation to their departure, including 
to ensure the orderly completion of any outstanding matters – collection of 
belongings, return of papers, for example – which remain to be transacted. It will also 
remind them of assistance which could be available to them, through their own 
Assembly Member office or trade union, for dealing with any immediate press or 
media issues which may arise as a result of their departure.  

 
 
 
 
 
 11.  You will be aware from the proceedings of the Inquest of the support services 
available to all Members, including Ministers, from the Assembly Commission   This 
includes access to an Occupational Health Nurse and an Employee Assistance 
Programme which provides a confidential 24-hour helpline providing emotional and 
practical support for issues at home or work.  As well as reminding departing 
Ministers of the availability of this service, I will ensure that Ministers remain aware of 
it throughout their tenure.   The Welsh Government also has its own Employee 
Assistance Programme, which has been made available to serving Ministers, and in 
relation to which enhancements to the support available are currently being 
procured.  Specifically these arrangements will offer access to Occupational Health 
(OH) support and Cognitive Behavioural Therapy. 

12.  The Assembly Commission has told me that it is currently renewing contracts for 
occupational health services which provides a timely opportunity to enhance 
provision for counselling, and I have asked that the new contracts should include 
provision for a more proactive role to be played by a professional counsellor where 
that would be appropriate and necessary.    I have also asked that staff who support 
Ministers can work with Commission staff to ensure that the particular circumstances 
of Members who have left the Government are taken fully into account. 

13. An induction programme for new Ministers is being developed, and as part of 
that I will ensure that the programme includes advice on managing a challenging 
workload and dealing with the pressures of ministerial responsibilities, alongside 
wider constituency duties and personal circumstances. It will also include giving new 
Ministers the opportunity to be linked to an experienced Minister who will be able to 
offer informal support and guidance at the outset.  

14. The Permanent Secretary will ensure that Private Secretaries who work with 
Ministers on a daily basis are given training in how they can best support their 
Ministers in dealing with the pressures of the job, how they may be able to identify 
early signs of excessive stress developing, and actions they should take as a result.  

15. While I certainly would not wish to intrude upon the privacy of any of my 
Ministerial colleagues, the point has also been made to me in my consultations that it 
might be helpful for new Ministers to have an opportunity to indicate, in a very 
confidential setting, any particular pressures upon them, or conditions which might 
have the potential to impact upon their wellbeing while they are Ministers. Under the 
current arrangements Ministers are expected to declare to the Permanent Secretary, 
soon after taking office, their relevant financial and other interests. I will introduce 
arrangements for them to have the opportunity at the same time to draw attention on 
a confidential basis to any circumstances or conditions of which they may wish to 
make the Permanent Secretary and myself aware.  

 
 
 
 
 16. You might also wish to be aware that your Report has prompted us to review 
more widely the access to support services which we provide at the moment. While 
Ministers and civil servants of the Welsh Government do have such access, it has 
not been our practice in the past to offer this to our public appointees. But we cannot 
rule out the circumstances which you outline in your Report being replicated with an 
individual appointed by the Welsh Government. We are expanding access to the 
support services available to cover our public appointees as well.  

Rt Hon Mark Drakeford AM, First Minister of Wales, 5 September 2019  

 
 
 
 
 New Section to be added to the Welsh Government Ministerial Code  
Ministers and their Wellbeing  

The statutory powers of a First Minister to appoint and remove Ministers from office 
are derived from Section 48 of the Government of Wales Act 2006. These powers 
are wide and unfettered.  

The First Minister recognises that at times the personal pressures upon Ministers 
can be considerable. Most of the time these pressures, which are not unique to 
Ministerial responsibilities, will be accommodated by Ministers as part of the 
resilience required to undertake the role. But the First Minister will have regard to the 
wellbeing of Ministers and will ensure that there are adequate arrangements in place 
to provide Ministers with support where necessary if they wish to avail themselves of 
it; and that these arrangements are drawn to the attention of Ministers on a regular 
basis.  

In particular, the First Minister will ensure that the wellbeing of the Minister or 
Ministers involved is fully taken into account as part of planning and preparation for 
reshuffles or other circumstances in which Ministers may depart from Government. 
This will include ensuring that the Ministers at the time are aware of the support 
services which are available to them to access. This will be the case particularly 
where departure is taking place in circumstances which may attract significant media 
interest. The First Minister will endeavour to ensure that outgoing Ministers are 
provided with appropriate channels of support. 

The First Minister will ensure that information surrounding any reshuffle is kept to as 
tight a cohort of individuals as the First Minister thinks possible.

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