Robert Stewart: Serving a life sentence for the killing

Robert Stewart battered his cellmate Zahid Mubarek to death in Feltham Young Offenders Institution in March 2000.

Christopher Kinealy told the inquiry into the murder he saw and assessed Stewart in 1999.

He told a colleague that Stewart was a psychopath, but believed he was untreatable and not a threat to others.

The inquiry heard that a manager at Altcourse Jail, Liverpool, asked the nurse to assess Stewart in November 1999, four months before the attack on Zahid Mubarek.

Personality disorder

In his notes on the inmate's prison record, Mr Kinealy concluded: "In my opinion he has a long-standing deep-seated personality disorder. He shows a glaring lack of remorse, feeling, insight, foresight or any other emotion.

I remain of the opinion that Robert Stewart could not be treated in that he could not be given medication as he was not suffering from an actual mental illness Nurse Christopher Kinealy

"He freely admitted he was guilty of armed robbery but stated 'I'm going for not guilty and I'll probably get off'.

"In my opinion he has an untreatable mental condition and I recommend no further action. Only time will have any influence on his personality and behaviour."

In his statement, Mr Kinealy told the inquiry into the 19-year-old's death he had regularly alerted governors to the risks posed by mentally unstable inmates.

He had not done so with Stewart, from Greater Manchester, because he did not believe he was a risk. He did, however, pass his conclusions to a senior prison officer, James Farrell.

"I have a vague recollection of talking to Mr Farrell after the interview and I believe I would have explained to him in layman's terms very briefly what a psychopath was," said Mr Kinealy.

"This would have been a brief meeting on the wing when a lot else would have been going on and therefore I was merely simplifying a complex issue."

Untreatable conditions

Medical opinion remains divided over how to deal with such deep-seated personality disorders.

One theory states doctors can do nothing to help if someone has an untreatable personality disorder because it is a behavioural, not medical problem.

Knife: Stewart made it from cell furniture

But Professor John Gunn, an expert psychiatrist commissioned by the inquiry to write a report on the handling of Stewart, is expected to say Stewart should have been medically treated, even though he was probably not curable.

The government is planning to change the law to make the detention of such people easier, even if doctors have doubts over the merits of intervention.

Defending his decision, Mr Kinealy told the inquiry: "I remain of the opinion that Robert Stewart could not be treated in that he could not be given medication as he was not suffering from an actual mental illness.

"It is my view that a psychiatrist had no role in treating Robert Stewart. A personality disorder is not a mental illness but a mental condition and so cannot be treated by conventional medicine."

Mr Kinealy stressed that it was not an "exact science" dealing with such prisoners and the threats they posed.

"In those circumstances you can only really ascertain whether an individual is a risk to others based on what the individual actually tells you," he said.

"For example, a prisoner recently told me that when he was released he would murder his mother whilst another listed all the people he hated, which included women, ethnic groups and homosexuals."