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The Debrief: The Doctors fighting for Barton House residents – transcript
Priyanka Raval
Welcome to this episode of the debrief, where cable journalists take us behind the headlines of their latest investigations. I'm Priyanka Raval, and this week, I'm sitting down with Dr Amelia Cussans from health justice charity Medact, to talk through their report into the mass traumatising event that was the Barton House evacuation on 14 November 2023 to read more about our Barton House coverage and to read the full report by Medact, you can get the link in the description.
Hello, Dr. Amelia Cussans, thank you so much for coming into the office today. Thanks for having me here. We were really keen to get you on today, because you are part of Medact, a health justice charity who co authored a report with ACORN about the Barton House evacuation. That report was launched on 26 February, and the council had said that they would respond by the end of March. Obviously, it's fast approaching the end of March, and as of yet, no response.
Amelia Cussans
That's right, any day now, we should be hearing back from them.
Priyanka Raval
Okay, so yeah, we thought it would be a good time just to look back on what that report said, what its findings were, and what kind of response we're expecting from the council. But firstly, so you're a doctor. Where do you work? What's your background?
Amelia Cussans
So I'm a doctor working in mental health services. I'm a psychiatry registrar, and I currently work in central Bristol, and I live around the corner from Barton House.
Priyanka Raval
How long have you been a part of Medact? And could you kind of explain what Medact is,
Amelia Cussans
Sure. So Medact is a charity that brings together health workers to fight for Health Justice. The underpinning principle is that health injustice is driven by political, social and economic conditions, and that's why Medact is mobilising the health community to try to change the system. So I'm part of Bristol Medact, which is a local branch, because it's Medact is a national organisation, and I think there's about 80 of us in Bristol Medact WhatsApp and then a kind of smaller group of active members, and that includes social workers, doctors, nurses, psychologists, occupational therapists.
Priyanka Raval
And I was reporting on Barton House last November, when it had been the one year anniversary, and talking to residents there about the impact it had had on their mental health. And for sure, that came out so strongly that it had such a devastating impact. That's when I first got to know Medact and ACORN and learn about the collaboration between you both, which had started you said at the end of August of last year, right?
Amelia Cussans
Yeah, so it was August last year, ACORN approached Medact, along with several of the residents from Barton House, asking if we would work together to support their campaign. And we met with the residents, and we agreed that we wanted to help. After some discussion, we decided to write the report as the best way to put together our professional opinions on what we were seeing happening in Barton House and how their health had been affected by the evacuation, and also the conditions living there. The report itself was co authored by quite a few medic members and also ACORN members, okay, which includes Barton House residents.
Priyanka Raval
Yeah, I so I met Dr Nazanin rasa. She was interviewed in the article. So she told me a little bit about how that work got going. But when did you get started on that research, and how did you go about it?
Amelia Cussans
So we started, we met with residents in August, and that was when we first started hearing their stories. And from that point, we went to a few community meetings at Barton House, and then we started to formally interview residents in November. So we did interviews on a number of different days, I think, nine households in total. Mostly we interview people in their homes, and then we put together the report, Naz, who you spoke to before, was the lead author. And once we had a draft, we took that back to the residents. So. They had a chance to read it and give their comments, and some people came forward with more testimonies that we then included in our final draft.
Priyanka Raval
And what when you went about doing those home visits, what struck you when you were doing that research?
Amelia Cussans
So collecting the testimonies was a really heart wrenching experience at times. The people we met were really amazing and had been advocating for themselves so powerfully since the evacuation happened, and it was just horrible hearing about how they had been basically ignored.
Priyanka Raval
And I know that one of the main findings of the report was this phrase of it being a mass traumatising event. So you were speaking to people, obviously a year since they had been evacuated from their homes. It seems that one of the symptoms of that trauma, which I think I found when I was doing my reporting as well, is that they're still stuck in that moment of evacuation and the terror and the fear that it created.
Amelia Cussans
Yeah, well, people at Barton House are reliving that experience regularly because they keep getting evacuated again for fire alarms. There's this new fire alarm system that was put in there after the evacuation. And I'm not sure what the issue with it is, but it seems to be happening on a regular occurrence that people are having to go… everyone leave the building, and then fire engines come. People are out in the cold and the rain, and that experience is really distressing for people, because they're there, they've got bags packed by the door, they've got their coats and shoes all ready to go because they're afraid of not being able to return and what might happen next and the safety of the building.
Priyanka Raval
What was the kind of medical perspective that you could bring to understand what people were going through.
Amelia Cussans
Well, the way people talked about the evacuation was quite varied. So some people would be very emotional, very tearful. Other people would become quite withdrawn, almost seem quite confused. Some people were experiencing dissociation. These are all signs that people have been through a really distressing, traumatic event, and that can be expressed in lots of different ways.
Priyanka Raval
And what about the children? Because I understand that there were some developmental knock on effects from what happened.
Amelia Cussans
Yeah, again, the way that children have been affected has, there's a big range. So there have been some children who have had delays to their development that appeared to kind of correlate with the time that they were evacuated. Some of them became quite ill. In the Holiday Inn, there were repeated outbreaks of norovirus and chicken pox. I spoke to one family where their children were taken to a&e because they'd had norovirus. They were very dehydrated, they were just vomiting and diarrhoea to the point where they did need hospital treatment. One of their two children following that hospital admission, stopped talking, so she had been, I think, 18 months old, and saying a few words. And then after this happened, she became non verbal, and even though it's a year on, she's still non verbal, and a lot of her other behaviours also changed, and essentially, her needs are much higher now than they were before. So it's had a huge impact on her family. Really, really tough for her parents, who obviously just want their child to develop like other children.
Priyanka Raval
And is that? Is that a symptom of trauma, then stunting in some way your development.
Amelia Cussans
I think it's a bit hard to say for individual cases, but it's quite plausible that this infection was a triggering event for this child. Obviously, we don't know, but we saw quite a few children where similar things had happened. There was a similar story.
Priyanka Raval
I guess you know, saying it's a mass traumatising event, we should remember that it was not just the way the evacuation was done, which was chaotic and without warning. As you say, it was then the months spent in the Holiday Inn, in really poor conditions, with terrible food, in a state of prolonged limbo, and then moving back into the house and feeling unsafe. And you know, now, as you say, the fire alarms as well. It just feels like one thing after another.
Amelia Cussans
I think, yeah, the Holiday Inn, the experience that people had there was absolutely horrendous. I mean, I already mentioned, the disease outbreaks. There were also bed bugs. People moved into unclean rooms, and they weren't given any, you know, there was no Hoovers or anything they could use to actually improve their environment. They also couldn't access any kitchen, so they weren't able to cook for themselves. And that was a real problem, because the food was often not suitable for children, and then left parents in this dilemma, like, how are they going to feed their family? And some people were actually re entering Barton House, kind of just to quickly cook and then bring all the food back. And then there was issues with the hotel, and that food would get confiscated. There were some people that had medications that needed to store it in a fridge. They weren't able to access the fridge all the time. So then when they needed their medication outside of nine to five, they were in trouble.
Priyanka Raval
What I found when I was doing my reporting is that a lot of people are not happy about the fact that they've moved back in one of the central demands that ACORN are making, along with residents, is for them to be put on priority re housing. Why do you think residents aren't able to feel safe in that block?
Amelia Cussans
So I think a big part of the problem is that there's been a real breakdown in communication with the council. So when people were moved back in, it was really not clear to them why suddenly the building was safe. I mean, they were told that it was there was at risk of collapse, like serious structural issues when they were first evacuated, and to them, it just looked the same. So there was that. And then, you know, there were still things like cracks in the walls, really sad stories about kids that are basically quite afraid of any kind of visible sign of structural problem in the building. So in some of the flats that we visited, families like parents had put scarves up over the walls to try and cover the cracks. And they did this because their kids wouldn't sleep like they would be crying about the cracks in the ceiling. I think it's going back to Barton House. People are just reliving the evacuation again, and even though the council have now tried to reassure residents that the building's safe, there's still been a lot of miscommunication. Like, for example, people come around from the council to do bits of works and repairs, but they don't, kind of communicate with the residents what they're doing, and that's just left this real sense of distrust.
Priyanka Raval
It's not the case, though, that residents haven't been telling the council about the effect it's had on them. I mean, residents have been trying to tell the Council this for years. ACORN have been supporting them. Medact has joined in with the calls as well. Why aren't the council listening to that?
Amelia Cussans
Yes, it's a really good point. The residents and ACORN have been lobbying for some time, even before the evacuation, because the conditions in Barton House have been unacceptable for many, many years, we're talking about, like, serious mould and damp issues, not being able to heat their homes. So the council haven't really given a decent response yet. We're obviously awaiting that response soon. I can't really speak for the council, so I don't know why they haven't, but I imagine part of the problem is that there is a housing crisis, like throughout Bristol, with lots of homes that are really substandard.
Priyanka Raval
Yeah totally. I mean, over, overstretched, overburdened waiting lists for social housing is the predominant reason the council give for not being able to immediately house these residents. I mean, I know the comeback is then that because the council are responsible in a huge way, that they have a an added duty of care to compensate the families. But I remember hearing that residents had got medical evidence from their doctors or mental health teams, and that they were showing that to HomeChoice, the council service that allocates people for rehousing. Was the point that that medical evidence wasn't being taken seriously?
Amelia Cussans
Yeah, that's absolutely true. I've actually read a number of those letters so they've come from GPs, they've come from occupational therapists. These are people that have gone into their homes and said these conditions are making these people ill. Some of the letters that we read were really quite shocking, like I remember reading one there was a child with autism who lived on one of the upper levels of the building. It's a 14 storey building, and this boy would kind of often run out of the flat. And as he was getting taller, it was getting more risky, because the balcony was right there. He doesn't have any understanding of risk. And the letter really spelled out, you know, what could possibly happen here. It could be an absolute tragedy. And despite this kind of, like huge issue, none of these people were have been rehoused. As far as we know, only one have been rehoused, and this was a family who actually got a private diagnosis of PTSD. That whole thing in itself is quite problematic. Because they had to take out a loan to get that diagnosis. And so it creates this kind of issue of inequity, like, why does this private diagnosis suddenly count more than all of these other letters that have been written?
Priyanka Raval
So finally, having amassed all this evidence when that report was launched, and you and your colleagues from Medact could give that presentation to the press, to residents, to ACORN members on 26 February, what was the main message that you were trying to get across? I mean, I know you were presenting your findings, but was the purpose to kind of show that there is this wealth of medical evidence, and just really bring that hope?
Amelia Cussans
Yeah, exactly that. I mean, we wanted to challenge the council by presenting to them what we had observed and really trying to amplify the voices of the residents. I think one of the big things that we wanted them to hear is how dehumanising the experience had been and still is.
Priyanka Raval
What was your experience of that day? I mean, I was there for several of my cable colleagues. I have my own feelings about the way that went down, but how was it for you?
Amelia Cussans
I was quite nervous presenting the report. I think we all just really wanted to do our best to support the residents and make sure that we were kind of echoing their calls for justice, and we wanted you know we wanted the council to hear us and for it to be received and for a proper response to take place as well.
Priyanka Raval
So after you guys did your presentation, which was really moving, really excellent, spelled out the problem very clearly, an assembled panel of council officials working across housing, including Barry Parsons the Cabinet lead, what did you think of their response?
Amelia Cussans
So overall, I thought that we need to hear more from the council. They didn't really respond to everything that we had said. Barry Parsons did apologise. He apologised directly to the residents, and that was really good to hear, because I don't think there's been much apologising thus far.
Priyanka Raval
That's one of the ACORN demands, is to receive an official apology and an official inquiry, and the fact that that's what they've been calling for for a while. And Barry Parsons kind of just tripped out a bit, but I guess it's something right, yeah,
Amelia Cussans
I mean, it was the right thing to say, and I do think that he was speaking in a much more kind of human and connected way than perhaps some of the other panel members who were maybe being more political in their responses, the stories that people were telling about their lives. And, you know, there was a woman there talking about one of her babies. She had her twins there with her, and I've met those babies before and and her little girl has really bad breathing difficulties because of the mould, and she's gone to hospital multiple times. It's terrifying for her. She lives every day thinking something bad is going to happen to her. And she kind of said directly to the council, like, if something happens to my daughter, it's on you. Yeah, it was really moving. And she basically received no meaningful response from them, which was pretty hard to see…
Priyanka Raval
Yeah, it's what you said about the way this process has been handled, and focusing on the dehumanisation, I felt that the response from the council has lacked humanity, yeah, and it was a lot of political pre barricading, dodging questions, not giving a straight answer. And I could just see that compounding everything that the residents and yourselves have been talking about, the way this whole process had been handled anyway.
Amelia Cussans
Absolutely. I think my feeling was that the panel were just wanting to confer with each other before they any of them committed to saying anything, which just led to this quite painful experience of them not really connecting with the residents, and it became quite adversarial. It was hard to watch.
Priyanka Raval
And was it, personally, a bit disappointing, considering the amount of work that you and your colleagues, in collaboration with ACORN, in collaboration with residents, but you know how much work you'd put into this report, and that being the response. Were you expecting that?
Amelia Cussans
Yeah, I think I'm still holding out hope that a better response will come. But yeah, I mean, it did feel like we had put a lot of work in. And obviously every all of the residents sharing their stories for it to be met with without much response was, yeah, it was disappointing.
Priyanka Raval
What struck me about that meeting as well is that inevitably, the conversation started to zoom out to the bigger picture. And there were stories about, you know, the issue of institutional racism, the fact that the majority of people in Barton House are from global majority backgrounds, many of them not native English speakers, and that that seems to correlate to poor housing conditions in the city, in general, worse health outcomes, and I mean second class citizens, was a phrase that so many of the Barton House residents that we've interviewed have said, is that something that you consider in terms of health justice in general, issues like structural racism and how that impacts on people's health outcomes.
Amelia Cussans
Yeah, structural racism is a huge part of health injustice, and it definitely intersects with housing injustice. And again, that was something that did come up at the launch, and the council members were challenged on it, and they were kind of unwilling to commit to saying whether or not there was racism involved in the Barton House evacuation and the inequity that we see in the housing in Bristol, but we know it's there.
Priyanka Raval
Well, I mean, what are the other kind of… what is the bigger picture here for you? Is it about social housing in general, social inequality. Is it about racism, or is it all a mishmash of things that have come together to produce a disaster like Barton House?
Amelia Cussans
All of those things intersect. I think Barton House is somewhat exceptional in that the evacuation was so poorly handled. Unfortunately these towers blocks that exist throughout England are like they do get evacuated from time to time for similar reasons of structural issues that are an emergency, but there have been many other evacuations nationally that have been handled so much better. We really felt that the way that this took place was a case of quite significant mishandling, and then obviously all of the subsequent events with the terrible conditions on the Holiday Inn, the really prolonged time living in limbo before this very chaotic return, does make Barton House quite unusual. It's it's obviously also true that there are terrible housing conditions all over Bristol, all over the country, and we see this a lot in our work, when I visit people at home, and people come in with mental health difficulties, often housing as a factor, and there's only so much you can do for someone with the resources that we have in mental health services, when what's actually making them ill is their home. If you're living in a home that you feel is unsafe, that you feel is making you ill because there's mould, damp, it's causing you problems with your lungs, problems with your skin, problems your mental health. Yeah.
Priyanka Raval
So the demands put forward in this report echo the ACORN demands for band one, urgent prioritisation for re housing for the residents, for compensation for the distress and the costs incurred, and an independent investigation into exactly what happened, along with that an apology, but answers, answers about why this was handled so badly, the councillors have made vague assurances that they will say something by the end of the month. The end of the month is coming. What are you hoping for? You said earlier that you were hopeful.
Amelia Cussans
Yeah, so we're definitely expecting a response soon, and what should be following as an independent investigation into how the council has handled the crisis. And one of the things that we're hoping will also come from that is publication of findings relevant to other similar blocks in Bristol. So part of it is about making sure that this kind of mishandling is not repeated. We want the public apology to be kind of formalised. It was good to hear Barry Parsons kind of spontaneously apologise, but I think it needs to be official. And then, you know, the other thing is that these people, the residents, they should be entitled to compensation for the distress and also the actual, like financial costs they incurred, which for some people, was a lot.
Priyanka Raval
It was significant. I mean, time off work, taxis to and from what's next for you at Medact? What's next for Medact Bristol in trying to keep this campaign alive so we're
Amelia Cussans
still in touch with the residents. We're still meeting. We're still hearing about things that are happening at Barton House. There was another fire alarm just a couple of nights ago, we will be waiting to see what the council say by hopefully the end of the month, and take things from there with ACORN and with the residents.
Priyanka Raval
Okay, that's great. Thank you so much for joining us today. Thank you. This was the Debrief: the doctors fighting for Barton House residents, presented by me Priyanka Raval and produced by George Colwey for the Bristol cable. Head to the Bristol cable.org. Forward slash join to become a member of the cable and subscribe to the Bristol cable wherever you get your podcasts. Thank you.