Malcolm Ball, a 73-year-old convicted paedophile, died at HMP Stafford on 30 January 2023 after refusing food and drink for more than a month, telling prison staff he wanted to be 'left alone to die in peace'. The Prisons and Probation Ombudsman (PPO) later concluded that staff 'did everything they could' in 'challenging circumstances' and provided compassionate care, though the report noted procedural improvements were needed.
Background and Offences
Ball was jailed for seven years and six months in 2017 for child sex offences. He began refusing meals in December 2022 while serving his sentence at the category C prison in Stafford. At the time, he was struggling with severe digestive problems, including Barrett's Oesophagus and possible coeliac disease, which caused him constant abdominal pain.
According to the inquest, Ball self-harmed on Boxing Day 2022. He then told prison staff that he 'had enough' and was 'waiting to die' due to his unbearable discomfort. He expressed embarrassment after soiling himself and said that eating caused him severe pain.
Hunger Strike and Medical Response
Despite continuous monitoring and encouragement from healthcare staff, Ball remained resolute in his decision to refuse food and fluids. Medical professionals warned him that his body would 'shut down' if he continued, but they assessed that he maintained the mental capacity to make this choice. The PPO report highlighted that staff provided compassionate care throughout, but recommended improvements in food refusal logging and psychiatric consultations.
In early January 2023, Ball briefly resumed eating soup after hospital treatment, but soon returned to refusing all food and medication. He was transferred to the prison's specialist care unit on 19 January 2023, where he remained until his death.
Ombudsman Findings and Aftermath
The PPO investigation found that staff acted appropriately in difficult circumstances, but identified areas for improvement. These included better documentation of food and fluid refusals and ensuring psychiatric input was sought when a prisoner's refusal persisted. The inquest recorded that Ball died 'following food and fluid refusal with an intent to take his life'.
Ball's death has raised questions about how prisons handle hunger strikes among vulnerable inmates, particularly those with serious medical conditions. The PPO report serves as a reminder of the challenges faced by prison healthcare teams in balancing a prisoner's autonomy with their duty of care.
Broader Context
HMP Stafford, a men's prison holding around 700 inmates, has faced scrutiny in recent years over issues such as drug use and violence. However, in this case, the ombudsman found no evidence of neglect, praising staff for their efforts to support Ball during his final weeks.
The case highlights the complexity of managing prisoners who deliberately refuse food, a situation that requires careful medical, ethical, and legal consideration. The PPO's recommendations aim to ensure that similar cases are handled with even greater diligence in the future.
