Neha Raju

From Maria Caulfield MP 
Parliamentary Under Secretary of State  
Department of Health and Social Care 

39 Victoria Street 
London 
SW1H 0EU 

Ms Anna Loxton  
HM Assistant Coroner for Surrey   
HM Coroner's Court  
Station Approach  
Woking  
GU22 7AP                                                                                                   

 19th January 2023  

Dear Ms Loxton,   

Thank you for your letter of 14 October 2022 regarding the death of Neha Susan Raju.  I am 
replying  as  Minister  with  responsibility  for  Mental  Health  at  the  Department  of  Health  and 
Social Care.  

Firstly, I  would like to say  how  deeply  saddened  I  was to read  of the  circumstances  of  Ms 
Raju’s death. I can only begin to imagine the effect that this will have had on her loved ones 
and, whilst I know that it will come as little comfort to them, I nevertheless hope they will accept 
my heartfelt condolences.    

The  circumstances  your  report  describes  are  very  concerning  and  I  am  grateful  to  you  for 
bringing these matters to my attention.  It is important that we limit the spread of information 
about emerging methods of suicide.  As such, my reply does not make direct reference to the 
chemical  used  in  this  case,  nor  link  to  information  about  it,  and  I  hope  that,  when  making 
Regulation  28 reports  and  responses  to them  publicly  available,  the  Chief  Coroner  and  his 
office will practice similar caution.  

In  preparing  this  response,  Departmental  officials  have made  enquiries with  the  Medicines 
and Healthcare products Regulatory Agency (MHRA).  The MHRA have advised that they are 
responsible  for  regulating  the  substance  used  in  this  case,  when  it  is  used  as  a  licensed 
medicine, in the form of a solution for injection.  It is a prescription only medicine and has an 
indication for cyanide poisoning. This substance in other forms is used in other sectors, such 
as food manufacturing.  However, when the purchase of this substance over the internet is 
not a licensed medicine, or counterfeit medicine, it is not within the remit of the MHRA.   

Turning to your concerns that information on suicide methods is so readily available online 
and about the availability of the substance used in this case.  I share your concerns and would 
like to assure you, and Ms Raju’s family, that we are aware of these matters and are working 
across Government with the Home Office and the Department for Digital, Culture, Media and 
Sport  (DCMS),  and  with  suicide  and  self-harm  academics,  and  voluntary,  community  and 
social enterprise (VCSE), to address such concerns.  

As an important first step, and with regard to information online about suicide methods, you 
may be aware DCMS introduced the Government’s Online Safety Bill in March 2022.  The Bill 

 
 
 
 
 
 
  
  
  
 
  
  
  
  
  
  
 is a major milestone in the government’s mission to make the UK the safest place in the world 
to be online.  

All  companies  in  scope  of  the  Bill  will  need  to  do  far  more  to  protect  children  from  being 
exposed to  illegal  and  harmful  content  or  activity,  including  the  promotion  of  self-harm  and 
suicide.  This could include ensuring that systems for targeting content to children, such as 
the use of algorithms, protect them from harmful material, or signposting children to sources 
of support if they search for harmful content.  If children do encounter harmful content, they or 
their parents will be able to report it and should expect to see platforms responding quickly 
and effectively.  

Regarding online safety for adults, all services in scope of the Bill, regardless of size, will have 
duties to take proactive, preventative measures to limit adult users’ exposure to priority illegal 
content, which includes the promotion of suicide.  Beyond the priority offences, all companies 
will also need to remove and limit the spread of any other illegal content in scope of the Bill 
when it is flagged to them or they become aware of it.  They will be required to have effective 
and accessible mechanisms for users and affected persons to easily report concerns and seek 
redress.    

If a service fails in its duties, it could face enforcement action from Ofcom.  It could be liable 
for fines of up to 10 per cent of global annual qualifying turnover or £18 million, whichever is 
higher.   The  enforcement  powers,  which  include business  disruption  measures,  have  been 
designed to be effective against companies with and without a physical or legal presence in 
the UK.  

With regard to the sale of the chemical used in this case, Department officials work closely 
with the Home Office on this matter, and I understand from them that this chemical is available 
to  the  public  for  legitimate  uses.   It  is,  however,  included  in  The  Poisons  Act  1972  as  a 
reportable  substance,  meaning  that  while  it  is  generally  available  without  the  need  for  a 
licence, sellers (including online sellers) are obligated to make suspicious transaction reports, 
whether they process the transaction or not, where they have grounds to believe that the sale 
is for an illicit use.   

Officials inform me that the Home Office regularly engages with suppliers to help them meet 
their requirements under the Poisons Act, and to provide detailed guidance in relation to any 
additional  safeguarding steps  they may wish  to  take.   It  achieves this  in a number  of  ways 
including by regulating, raising awareness and asking businesses to be more vigilant.   

Generally, online marketplaces maintain their own policies on prohibited items, many of which 
will include a prohibition on the sale of poisons.  It is the seller’s obligation to check that items 
they  are  listing  are  permitted  by  their  own  policies  and  to  take  any  action  where  it  is 
appropriate.  Online marketplaces will remove listings that contravene their prohibited items 
list when notified.   

More broadly, we are working with VCSE partners to ensure that intelligence on emerging and 
known methods of suicide (including the use of the chemical in this case) is shared so that 
appropriate action can be taken.  This includes the Samaritans, who continue to monitor online 
forums for self-harm and suicide content that may include future emerging methods.   

In addition to this, the Samaritans continues to work with the media and online platforms to try 
and reduce the availability of information about emerging methods of suicide.  The Samaritans’ 
media monitoring shows that there have been 62 stories in the press about the chemical used 
in this and similar cases.  Of those cases, three named the chemical but, of them, two removed 
the detail after Samaritans contacted them and the other removed the whole story.  

  
  
  
  
  
  
  
  
  
 From Maria Caulfield MP 
Parliamentary Under Secretary of State  
Department of Health and Social Care 

39 Victoria Street 
London 
SW1H 0EU 

Turning  to  protecting  people  who  are  trying  to  purchase  items  that  might  be  used  for  the 
purposes  of  taking  their  life,  and,  more  broadly,  supporting  people  online  who  may  be 
experiencing suicidal ideation and at crisis point, the Samaritans and SHOUT have worked 
with search engines, like Google and Bing, to develop algorithms that mean if people search 
for harmful, suicide-related content online, information on where to get help is the first result 
on the page.   

More generally, the Office for Health Improvement and Disparities (OHID) is working to set up 
a national near-Real Time Suspected Suicide Surveillance System (nRTSSS), which is likely 
to be operational by the end of Spring 2023.  This will allow us to detect changes in suicide 
rates  quicker  than  through  provisional  quarterly  and  final  annual  data  on  suicide  death 
registrations published by the Office for National Statistics.  

Finally, it is vital that we take action nationally and in local areas to prevent suicides.  We are 
investing  an  additional  £57 million  in suicide  prevention  by  2023/24  through the NHS  Long 
Term  Plan.   Through  this,  all  areas  of  the  country  are  seeing  investment  to  support  local 
suicide prevention plans and the development of suicide bereavement services.   

We know that as many as two thirds of people who take their own life are not known to mental 
health  services  or  have  not  had  contact  with  those  services  for  at  least  a  year  prior  to 
death.  This is why it is important that local communities have suicide prevention plans that 
take into consideration their local populations.  Every local authority has a multi-agency suicide 
prevention plan in place and, in 2021/22, we provided over £550,000 to the Local Government 
Association for a support programme to help local authorities strengthen their plans.  

In addition to this, when there are particular concerns about suicides, such as clusters or new 
and  emerging  methods,  OHID  regional  mental  health  leads  work  with  the  relevant  local 
authorities to provide support on how to respond based on national guidance.  

I  know  this  reply  will  come  as  little  consolation to  Ms  Raju’s  family.   I  nevertheless  hope  it 
assures them that we are taking steps across Government and with the suicide prevention 
sector to prevent future tragic loss of life from occurring.  

Thank you for bringing these concerns to my attention.  

Kind regards, 

 MARIA CAULFIELD