404.    The Citizens Commission on Human Rights (CCHR) and the Auckland Committee on Racism and Discrimination (ACORD) both played a significant role in bringing the public’s attention to allegations of abuse at the unit. Their work played a key part in the series of events that led to Dr Leeks’ departure and the unit’s eventual closure. In this section, we outline the main sequence of events through to Dr Leeks’ departure. In chapter 2.4 we analyse the Commission of Inquiry into the Case of a Niuean Boy and the Ombudsman’s investigation in more depth.

405.    CCHR describes itself as a non-profit mental health watchdog. It was co-founded by the Church of Scientology and an emeritus professor of psychiatry named Dr Thomas Szasz.^[885] Its tour of Lake Alice on 21 January 1976, generated several media articles raising concerns about the appropriateness of the placement or treatment of children and young people at Lake Alice. For example, an article published in the Wanganui Chronicle referred to allegations that the hospital had become a dumping ground for unwanted children who were being treated with drug therapy and electric shock treatment.^[886] It detailed specific complaints CCHR said it had received, including that injections were given too freely and for punishment and that one boy was locked up for four days for misbehaviour.^[887] Dr Pugmire is quoted in the article saying, although he did not know if those instances had occurred, there were general directives to keep electric shock treatment to a minimum and children should not be detained for more than 20 minutes.^[888] CCHR has remained involved in advocating for survivors of the unit and bringing attention to what went on there.

406.    Dr Oliver Sutherland said ACORD was founded in 1973 to respond to a challenge from Māori and Pacific activists for Pākehā to see it as their job to research and expose institutional racism.^[889] ACORD became aware of the unit on 1 December 1976 when Ms Lyn Fry, a Department of Education psychologist, shared her concerns about Mr Halo’s treatment in the unit.^[890] ACORD’s involvement in the case of Mr Halo, which led to its calling for a full inquiry,^[891] is discussed in more detail later in this chapter.

Te whakatewhatewhatanga a Te Tari o te Kaitiaki Mana Tangata o 1976 - The 1976 Ombudsman’s inquiry

407.    In July 1976, the parents of Mr CD complained to the Ombudsman’s office that various decisions and actions of the Departments of Social Welfare and Health had been unreasonable and unlawful.

Takenga - Background

408.    Mr CD entered the unit in April 1976 after getting into trouble at school and with police.^[892] Mr CD’s parents were concerned about his behaviour and contacted his school principal and social worker.^[893] There is some suggestion that Mr CD required psychological help and his father wished to show the authorities that, although his son had behavioural problems, he was not mentally disordered.^[894] It was on this basis his father requested that Mr CD be received into Lake Alice and assessed.^[895]

409.    The family’s general practitioner assessed Mr CD and formed the opinion he should be placed in the hospital for investigation and treatment.^[896] Dr Leeks then assessed Mr CD, diagnosed him with a “paranoid schizophrenic condition” and said he was “a danger to society”.^[897] On 26 April 1976 a reception order was made, based on these opinions.^[898]

410.    Mr CD’s parents understood their son was being admitted to Lake Alice as a voluntary patient.^[899] On 28 April 1976, they sought to remove him from the unit.^[900] They were informed by staff he was a committed patient and they were unable to do so. The Ombudsman was later satisfied that Mr CD’s father was not fully aware that by applying for his son to be received at Lake Alice he had applied for a formal reception order.^[901] The Ombudsman considered the fact the form applying for a reception order was filled in by someone else but signed by Mr CD’s father supported that view.^[902]

411.    In subsequent interviews with Dr Leeks, the parents expressed their strong desire for their son to be returned home.^[903] From May, Mr CD was granted trial home leave for the weekends.^[904] On one of these weekends his parents called the unit and informed them Mr CD would not be returning.^[905] A staff member, accompanied by a police officer, went to Mr CD’s household and explained the legal implications of the reception order. Mr CD’s father then allowed him to be escorted back to the hospital.^[906]

412.    After this incident, Dr Leeks issued instructions that Mr CD not be granted home leave without permission from himself or the charge nurse.^[907] Mr CD remained in the unit and expressed fears about his home environment and the Lake Alice environment to his social worker.^[908] He said on the one hand he was afraid of his father when he became angry, but on the other hand he preferred home to the institutional life in the unit.^[909]

413.    In July, Mr CD’s parents were upset to learn Mr CD had been convicted and sentenced in the Children and Young Persons Court without the hospital informing them of the charges.^[910] Mr CD’s parents then contacted their solicitor and made a complaint to the Ombudsman about their son’s detention at Lake Alice.

414.    During the course of the Ombudsman’s enquiries to the Department of Health, it was discovered Mr CD’s committal papers were defective.^[911] The Director of Mental Health asked Dr Pugmire for an explanation.^[912] On 29 July, Dr Pugmire responded that the intention had been to admit Mr CD formally, but they had discovered they hadn’t fulfilled the requirements of the Mental Health Act 1969.^[913] He said now they were aware of the issue with his committal papers they had changed Mr CD’s status to that of an informal patient.^[914] They did not inform Mr CD’s parents of the change to his status.^[915]

415.    Mr CD’s parents remained concerned about his detention at Lake Alice and visited their general practitioner on 20 August to discuss their concerns.^[916]  They then visited Mr CD in the unit and expressed their concern about his continued stay in the hospital.^[917] After they left, a senior staff member told Mr CD about his change in status.^[918] On 23 August, Dr Pugmire met with Mr CD’s parents and attempted to persuade them to allow him to remain in the hospital for treatment.^[919] Against  Dr Pugmire’s advice, they decided to take their son home.^[920]

416.    Notes by unit staff indicate Mr CD’s reaction was “I want to go home but am not ready to go yet. What will happen when Dad hits me and I hit him back”.^[921] Mr CD ran back to the villa that same afternoon.^[922] Dr Leeks’ notes said Mr CD had requested to be re-admitted and that he was afraid of his father but also what he might do to his father.^[923] Dr Leeks then contacted NZ Police and the Department of Social Welfare to seek some authority to re-admit Mr CD against his parents’ wishes, given he was not considered “mentally disordered”.^[924]

417.    Mr CD was brought before the Children and Young Persons Court on 27 August, where a direction was made placing him in the custody of the hospital, pending a hearing in September.^[925] In September, the Children and Young Persons Court made an order placing Mr CD under the guardianship of the Department of Social Welfare, which admitted him to the unit as an informal patient.^[926]

418.    During this second admission, Dr Leeks decided to start Mr CD on a course of ECT, because nursing staff found him difficult to control.^[927] On the first two occasions, Dr Leeks gave him unmodified ECT, but in subsequent sessions it was modified.^[928] Dr Leeks neither informed or sought consent from Mr CD’s parents or the Department of Social Welfare before giving ECT.^[929]

Te pūrongo a Te Tari o te Kaitiaki Mana Tangata - Report of the Ombudsman

419.    In April 1977, the Ombudsman, Sir Guy Powles, released his report. He was critical of how the Departments of Health and Social Welfare had treated Mr CD. He upheld the parents’ complaint and said the Departments’ actions had caused Mr CD “a grave injustice”.^[930] In particular, he noted that several aspects of the case fell short of the minimum requirements of the Mental Health Act 1969 and criticised the Department of Health for:

• having “inadequate regard” for the requirements of the Act, as a result of which Mr CD’s detention at Lake Alice was at times “contrary to law”
• keeping Mr CD at Lake Alice against his and his parents’ wishes when Dr Leeks stated that he was not “certifiable” under the Act
• “finding some authority” to hold Mr CD in hospital by becoming involved in a negotiation with social welfare authorities
• failing to keep Mr CD’s parents adequately informed about his detention and treatment
• giving Mr CD ECT without his consent, his parents’ consent or the consent of the Department of Social Welfare
• the way in which ECT was administered to Mr CD.^[931]

420.    The Ombudsman suggested the Department of Health review the administration of ECT in institutions under its responsibility in light of three observations:

(a) The use of unmodified ECT for children and young people detained under the Act should be discontinued.

(b) The use of ECT treatment on children and young people in psychiatric hospitals should be discouraged in all but exceptional circumstances and where the principles of consent have been fully met.

(c) Consideration should be given to instituting legislative change to give effect to points (a) and (b).^[932]

421.    He also criticised the Department of Social Welfare for not paying sufficient attention to Mr CD’s status during his detention at Lake Alice.^[933] He said the Department was careless in its appreciation and understanding of the legal authority by which Mr CD’s placement was made.^[934] The Ombudsman’s opinion was that the law did not allow the Department to consent to the admission of children and young people under its guardianship to psychiatric hospitals as informal patients, and that the correct route was to formally commit such children and young people.^[935] He further considered that the Department failed to pay sufficient attention to Mr CD’s welfare while at Lake Alice.^[936]

422.    The Ombudsman recommended:

• the Director-General of Social Welfare should discharge the guardianship order made in respect of Mr CD
• the Department of Health should adopt and apply specified standards in relation to consent in psychiatric hospitals, regardless of the patient’s age
• steps be taken to alert the appropriate personnel of the Departments of Health and Social Welfare to the absolute necessity to strictly follow statutory requirements for safeguarding patients’ liberty
• the practice of the Department of Social Welfare in placing children and young people subject to its guardianship in hospitals without recourse to the formal committal procedures should be stopped
• the Department of Health should ensure the medical superintendent of Lake Alice has closer control over and final responsibility for the administration and operation of the unit^[937]. 

Te whakatewhatewhatanga o te take a Mr Hake Halo - Commission of Inquiry into Mr Hake Halo’s case

423.    The Commission of Inquiry into the Case of a Niuean Boy was established in response to media coverage of the way the Department of Social Welfare had handled the case of Mr Hake Halo. As described in more detail below, the commission of inquiry led by Magistrate William (Bill) Mitchell was set up quickly, the terms of reference were narrow in scope and the inquiry was given only four weeks to investigate and report.

424.    The inquiry came about as follows. In December 1974, Ms Fry, an educational psychologist, recommended Mr Halo, then aged 14, be sent to Hokio Beach School.^[938] Ms Fry later learned the Department of Social Welfare sent Mr Halo instead to the Lake Alice unit on the advice of a local medical officer of health. Ms Fry was appalled because she did not consider he had a psychiatric problem and “never would have supported such a referral”.^[939]

425.    In August 1976, Ms Fry learned the Department planned to send him back to Niue. She contacted advocate Dr Sutherland from ACORD and gave him Mr Halo’s file to copy. Ms Fry said, “I knew what I was doing was not legally acceptable, but I felt a strong moral obligation to act on what I knew”.^[940] ACORD subsequently helped Mr Halo conduct an interview with a reporter from the New Zealand Herald, which published a story on 15 December 1976 about his experiences at Lake Alice.^[941] The story described how Mr Halo was given electric shocks without his parents’ knowledge or consent. The story sparked public interest in the treatment of children and young people at the unit, and the inquiry officially began a month later.

426.    The Minister of Social Welfare, Mr Bert Walker, made it clear when he announced the inquiry that it “in no way” was a response to ACORD’s calls for an investigation and it had been established at the request of the Department of Social Welfare.^[942] What he did not say was that the Department had told him its social workers considered an inquiry was necessary to restore public confidence in the Department.^[943] The Department also said it couldn’t respond to ACORD’s criticisms in the media without revealing confidential details of Mr Halo’s medical and personal history.^[944]

427.    Mr Walker seemed confident the inquiry would find no departmental wrongdoing. When he announced the inquiry, he said the Department had his full confidence.^[945] In December 1976, Dr Werry, professor of psychiatry at the University of Auckland medical school, wrote to Mr Walker expressing support for Dr Leeks and offering his assistance at the inquiry.^[946] A similar letter of support was also sent to Mr Walker from Dr John Dobson, chair of the Australian and New Zealand College of Psychiatrists.^[947] Mr Walker said Dr Dobson had offered the assistance of the college, which was “concerned that skilfully used psychiatric treatment may be brought into disrepute by the ACORD criticisms”.^[948] He replied to Dr Werry saying “it was very heartening” to receive this letter and he was “satisfied that the Social Workers involved acted properly at all times in the interests of the boy”.^[949] Dr Werry told this inquiry that he now regretted writing the letter: “had I known then what I know now, I would never have offered my support to Dr Leeks”.^[950]

Ngā hui tōmua me te whakawātanga a te whakatewhatewhatanga  -
Commission of inquiry preliminaries and hearing

428.    In January 1977, the Government appointed Magistrate Bill Mitchell to look into how the Director-General of the Department of Social Welfare and other departmental staff discharged their powers, duties and responsibilities towards Mr Halo, his parents and his maternal grandmother.^[951]

429.    Mr Mitchell convened the inquiry in mid-February 1977 and heard evidence over seven days. Witnesses included representatives from the Departments of Social Welfare and Health, ACORD, the New Zealand Psychological Society and CCHR. He interviewed Mr Halo and members of his family, visited Lake Alice and met Dr Pugmire. He submitted his report on 18 March 1977.^[952]

Tā te whakatewhatewhatanga i ngā tūhura ai, me ngā tūtohu - Commission of inquiry findings and recommendations

430.    In relation to CCHR’s concerns, Mr Mitchell did not accept that ECT was given as punishment, he considered children and young people who were suffering from psychotic depression were likely to behave in unruly ways, so ECT may have followed this behaviour but was not a consequence of it.^[953] He queried the reports of children and young people having an intense fear of ECT, as he did not consider this squared with Mr Halo saying he disliked the injections more and that he reportedly went back to the hospital cheerfully after the Christmas holiday.^[954]

431.    Mr Mitchell considered that authority for Mr Halo’s treatment during his two admissions could be implied from the conduct of his family and the Department of Social Welfare, based on their trust in Dr Becroft (the school medical officer).^[955] He found neither the hospital nor Dr Becroft discussed the specifics of Mr Halo’s treatment, including ECT, with his family or the Department before or during his first admission.^[956] However, he was firmly of the view that by the time Mr Halo went back to Lake Alice in February, his family and the Department must have known about the treatment he had received, including ECT, and they did not seem worried about this treatment continuing.^[957]

432.    Mr Mitchell recommended that the Children and Young Persons’ Court be given the power to obtain a psychiatric report before it disposed of a complaint.^[958] He considered this should include permitting treatment of a patient held in the hospital for that purpose, provided the patient or their parent or guardian consented.^[959]

433.    Mr Mitchell considered that by the time Mr Halo returned to the hospital in February, clippings from media coverage of CCHR’s visit had been hung on the hospital notice board and everyone was talking about it.^[960] He was satisfied Mr Halo’s letter to his mother about receiving shocks was sparked by this talk around the hospital.^[961]

434.    However, Mr Mitchell considered the system needed to be examined as dialogue was lacking between medical practitioners and social workers, which could let down other children and young people.^[962] He recommended processes to ensure that when a child under the Department’s guardianship needed medical treatment, their medical practitioner spoke to someone about the treatment, preferably their family.^[963] He also considered that the laws should be passed to define the positions of parents and the Department for the purposes of consent to treatment.^[964]

435.    Mr Mitchell found that ECT for Mr Halo was warranted and accepted medical practice in psychiatric hospitals in New Zealand, including in unmodified form without anaesthetic or relaxant.^[965] He accepted the evidence medical practitioners presented that loss of consciousness was instant and patients could not remember receiving the treatment.^[966] He was certain ECT was not used at Lake Alice as a punishment.^[967]

436.    Mr Mitchell did not accept ACORD’s allegations that social welfare officers had acted negligently.^[968] We discuss those allegations further in chapter 2.3.

Ngā amuamu ōrite i whārikihia mō te manga - Similar complaints had been laid about the unit

437.    The Department of Social Welfare received complaints about the unit from as early as 1973. One complaint in 1976 that reached head office came from head office-based child psychiatrist Dr Frazer. In a letter to the manager of Epuni Boys’ Home, he offered advice about a 15-year-old boy who had been admitted to the unit twice for a period of 10 months. Dr Frazer said the boy had “some very disturbing information” about the unit that was similar to “other reports” the Department held about the unit. Dr Frazer said these reports related to the misuse of drugs, the use of ECT and sexual deviation. Dr Frazer noted the boy’s difficult background and personal shortcomings, but said he was “not inclined to believe that [the boy] has distorted the facts too much”.^[969] To our knowledge, the Department did not investigate these matters.

438.    The last complaint to reach the Department’s head office before the inquiry got under way arrived on 24 January 1977 and also involved the use of electric shocks as punishment. Mr Nicol’s mother complained to a social worker that her son had been admitted to the unit from Holdsworth without her knowledge. She asked whether her son had received ECT and, if so, how often and why. She also wanted to know whether the Department knew her son had a history of concussion before his admission to the unit. She said her son had told her he had been given ECT as punishment.^[970]

439.    Mr Nicol’s nursing notes record that ECT could be given for aversion therapy reasons such as passing wind, being “anti-social”, being picky about his food, “being in a world of his own”, “showing off in front of the girls in class”, “annoying others during work periods” and being “argumentative”.^[971] He was even given “ECT introductory to Unit”, as though electric shocks were part of the induction process at the unit.

Ngā āhuatanga i whai ake i te whakatewhatewhatanga - The aftermath of the commission of inquiry

440.    Following the inquiry, Dr Mirams told media it had shown there had been no impropriety on the part of Department of Health staff.^[972] Dr Leeks was not employed by the Department. A New Zealand Herald story the next day pointed out that the inquiry’s finding that ECT caused an instant loss of consciousness was “not entirely consistent with the statements made by children” it had interviewed, “especially when it was given without anaesthetic”, which it said one child had likened to being “hit on the head with a sledgehammer”.^[973]

441.    Mr Jackson went to opposition health spokesman Jonathon Hunt about the unethical use of ECT, and, in May 1977, Mr Hunt issued a press release alleging the unit was using ECT to punish children.^[974] Dr Leeks dismissed the claim as “arrant rubbish”,^[975] and Acting Minister of Health, Bob Templeton, said it was certainly not Department of Health policy that ECT should be used as punishment.^[976] He denied any attempted cover-up by the Department or Mr Walker,^[977] although it is unlikely he knew what evidence the departments had withheld.

Te wehenga o Dr Leeks i te manga - Dr Leeks’ departure from the unit

442.    Shortly after the reports from the commission of inquiry and the Ombudsman were released, Dr Leeks wrote to another doctor saying the running of the unit was “changing hands”.^[978] According to Dr Leeks, he had been told he had to give up his post.^[979]

443.    In an interview with The Dominion in July 1977, Dr Leeks made it clear his superiors removed him from his position in charge of the unit. The newspaper reported, “Dr Leeks has been told he must give up his post as psychiatrist in charge of the adolescent unit at Lake Alice by the end of [August 1977]. He has been allowed to carry on there till his patients are either discharged or under other care.”^[980] By this point, Dr Leeks was under investigation by NZ Police, and he told The Dominion he felt he had been made a “scapegoat”.^[981]

444.    Only days before this interview, Dr Mirams learned from NZ Police that Dr Leeks was aware that nursing staff at the unit had been carrying out aversion therapy despite Dr Leeks denying this in a letter he wrote to Dr Mirams on 16 May 1977.^[982] We consider it likely that this influenced Dr Mirams’ decision to remove Dr Leeks. In an interview with the Wanganui Herald, Dr Pugmire said Dr Leeks’ removal was ‘sensible’ and designed to ensure “similar allegations on ECT could not be made again”.^[983]

445.    In late July 1977, Dr Leeks informed the Department of Social Welfare that ECT was no longer being carried out at the unit.^[984] The last known time Dr Leeks used ECT in New Zealand was in September 1977 at the  Manawaroa health clinic. He gave modified ECT to a boy from Lake Alice, but only after having obtained approval from Dr Siriwardena.^[985]

446.    Following the allegations of abuse and the 1977 inquiries, which he described as “a witch hunt”,^[986] Dr Leeks left New Zealand for Australia at the end of 1977.^[987] In 1978, he started practice as a consultant child psychiatrist in Melbourne, where he continued practising until 2006, apart from two years he spent working in Canada.^[988] 

447.    In the 2000s, several of the Lake Alice survivors complained to the Medical Practitioners Board of Victoria about Dr Leeks.^[989] The board investigated Dr Leeks’ conduct and scheduled a hearing for 19 July 2006.^[990] However, Dr Leeks surrendered his practising certificate before that date, which meant the hearing was cancelled.^[991] At the time of the inquiry public hearing in June 2021, he was in his 90s and still living in Melbourne. He was unable to give evidence because his cognitive impairment meant he did not have the capacity to do so.^[992]

448.    On 6 January 2022, Dr Leeks died in Australia.

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