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Prison healthcare is failing, claim MPs

50% higher mortality rate for people in prison

Adrian O'Dowd

Thursday, 01 November 2018

Healthcare services for people in England’s prisons are failing due to staff shortages, overcrowding and too little focus on health, according to MPs.

In a critical report* on prison health published today by the parliamentary health and social care committee, its MPs said the government was failing its duty of care towards prisoners.

“A prison sentence… is a deprivation of someone’s liberty: it is not a sentence to poorer health or poorer health and care services,” says the report, but warns that standards inside England’s prisons have deteriorated in recent years, following budget reductions and fewer prison officers.

Many prisons were unsafe, with incidences of violence and self-harm at a record high, and institutions were limiting prisoners’ access to healthcare and their ability to lead healthy lives due to staff shortages and overcrowding.

During their inquiry, MPs were told that more than 50% of prisoners reported problems accessing a GP.

The mortality rate of people in prisons was 50% higher than the general population, they said, reflecting the poor health of prisoners and people in contact with the criminal justice system.

This was often the result of, or was made worse by:

  • early childhood experiences (abuse, neglect, trauma)
  • social circumstances (housing and employment problems)
  • higher rates of smoking, alcohol and substance misuse.
Efforts to reduce the health inequities faced by people in prison were vital, said MPs, who recommended the government’s programme of prison reform place greater emphasis on health, wellbeing, care and recovery.

As well as improving outcomes for prisoners, such an approach could also improve the safety of prisons and reduce reoffending.

Prisons should take a whole prison approach to health and care, but this required a sufficient, stable, well-trained workforce, both of prison staff and health and care professionals, whose own safety and health was valued, argued MPs.

The prison service often failed to learn lessons, even from serious incidents and inspection reports, said the report authors.

This was not acceptable, said MPs, adding that every suicide should be regarded as preventable. A whole prison approach should be supported by a rigorous inspection regime providing a robust picture of the state of health and care in prisons, they recommended.

Committee chair Dr Sarah Wollaston said: “Too many prisons remain unsafe and unsanitary. Violence and self-harm are at a record high, with illegal drugs adding to the problems for both prisoners and staff.

“Poor living conditions, diet and restricted access to healthcare and activity are compounding a cycle of deprivation and health inequality. We need assurances from government that it will urgently address the very serious situation in prisons with a whole systems approach underpinned by sufficient funding and attention to the prison and healthcare workforce.”

Professor Helen Stokes-Lampard, RCGP chair, said: “It is not the college’s role to pass judgement on those who are in prison and the reasons why they are there, but many of our GPs work with patients in secure environments, and maintaining and improving health in prisons is crucial, especially in view of the fact that the vast majority of people will, at some point, be reintroduced to society.”

Think tank the Nuffield Trust’s senior research analyst Dr Miranda Davies said: “This sobering report sets out clearly why the health and wellbeing of our prison population is everyone’s business.

“As well as the moral case for ensuring prisoners receive the same access to high quality care as the rest of the population, the committee highlights that improved healthcare could improve the safety of prisons, tackle health inequalities and reduce reoffending.”

*Prison Health. Health and Social Care Committee (November 2018).

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