GP went “above and beyond” to help son who later stabbed mother

Thursday 25 April 2024

A family has paid tribute to the efforts of their GP in seeking to manage a long-running dispute that culminated in a 40-year-old man stabbing and killing his mother in the kitchen of her home in St Peter.

Pamela Nisbet, a 68-year-old former honorary police officer, died after being attacked on 5 August 2019 at the property near Wheatlands Golf Course by her son Andrew.

Nisbet faced the Royal Court a year after his mother’s death, when he admitted manslaughter on the basis of diminished responsibility and was sentenced to remain in a secure psychiatric hospital.

An inquest into the death of Mrs Nisbet resumed yesterday.

The inquest heard that Dr David Bailey had held numerous meetings in a bid to manage the worsening mental state of Nisbet and his relationship with his parents.

Dr Bailey told the hearing that he had been heavily involved in Nisbet’s care between January 2018 and August 2019, starting with treatment for injuries sustained by Nisbet when he deliberately jumped from a second floor window following a disagreement with his parents.

The inquest heard that Nisbet had wanted to live in an annex to the family home near Wheatlands Golf Course with his partner and their young child, but that his parents did not consider this suitable and resisted his moves to develop the property. This included a request for the installation of a heat pump, which was turned down and prompted the window jump.

Dr Bailey said that Nisbet had become fixated on the matter, rejecting an offer from his parents that they buy a three-bedroom house for him to live in at a low rent, and that his mental state had worsened.

Pictured: Andrew Nisbet admitted manslaughter on the basis of diminished responsibility and was sentenced to remain in a secure psychiatric hospital.

The inquest heard that both Dr Bailey and Jane Pointon, a private psychotherapist engaged by Nisbet in December, had expressed concern on multiple occasions that Nisbet’s case was too complicated to be dealt with by a GP or other private practitioner.

Dr Bailey said that there had been periods when he was working in partnership with clinicians from the Adult Mental Health team, including July 2019, amid mounting concern for Nisbet’s mental state and the risk that he may indulge in self-harm or attempt suicide.

The inquest heard that Mrs Nisbet and her husband Pat had initiated eviction proceedings as a last resort, triggering a series of angry exchanges that on three occasions in late July caused police to be summoned to the property.

Dr Bailey described a mental health assessment that took place on 1 August, five days before the death of Mrs Nisbet.

The GP said he had agreed with consultant psychiatrist Matthew Marshall of the Adult Mental Health team that Nisbet needed to be detained due to a high risk of impulsive dangerous behaviour, but that this move was not signed off by social worker Lisa Chapman.

Miss Chapman's explanation for her decision was described as "bizarre" by Dr Bailey, after she told him that people with Aspergers should not be detained against their will, and that it was "normal" to hear voices, as Nisbet had reported.

"It was so bizarre that when I left the house, I only drove 50 metres before pulling over and writing down what she'd said so I had a contemporaneous note of it," Dr Bailey said.

The inquest heard that on the evening of Tuesday 6 August, a further argument had taken place, culminating in Nisbet stabbing his mother in the neck.

Nisbet's father heard screaming from a next-door room and wrestled his son aside before seeking to help his wife, who was pronounced dead shortly afterwards on arrival at Jersey General Hospital.

Pictured: The St Peter property where Mrs Nisbet was killed in August 2019.

The hearing was told that Dr Bailey’s contribution had included remaining in touch with the family while on leave and holding meeting lasting up to three hours.

As he finished giving evidence at the inquest, he was thanked by lawyer Dexter Flynn, representing the family, for his contribution.

Mr Flynn said the family were very grateful that Dr Bailey had gone “above and beyond” in his role as GP.

Viscount Mark Harris, presiding over the inquest as coroner, said the purpose of the hearing was to consider Nisbet's contact with mental health services in the build-up to his mother's death, including the steps taken to manage his worsening mental state and the risks arising from this.

The inquest continues today, with a provisional indication from Advocate Harris that it would conclude next Thursday.

A recommendation to introduce a register of known domestic abusers was made in 2021 by an independent Domestic Homicide Review following Mrs Nisbet’s case, with the review finding warning signs had been missed.