Sir David Ramsbotham said pay inequality meant that prison inmates got a worse standard of health care in custody than they would in the community.

Young offenders were particularly hard hit because they needed good health if they were to develop properly and play a useful role in society on their release, he said.

Without pay levels on a par with those in the NHS, it is difficult for the prison service to attract staff with the same abilities, Sir David warned.

However, the Home Office has denied that there is a significant pay gap between the health service and the prison service.

Value to society

Sir David said: "Virtually all these young prisoners will return to the community at the end of their sentence.

Sir David Ramsbotham criticised prison health care

"Good health is an important ingredient in their future development as citizens, let alone the likelihood of their being able to hold down a job, one of the keys to preventing re-offending."

His comments followed an inspection of Aylesbury Young Offenders Institution where he criticised a rapid turnover of five senior medical officers in two years.

He called for an official to be appointed to ensure the health care of young offenders was kept up to a high standard.

The British Medical Association agreed that pay for prison doctors was low, but hoped that this could be improved through greater integration with mainstream health services.

Closer integration

"What we are hoping is that prison doctors will actually be integrated with NHS doctors - at the moment they are totally separate," a spokeswoman for the association said.

Young offenders suffer most

"We hope that by doing that it will bring pay levels and standards in line with other doctors."

At the moment the role of the prison service is to provide primary care services, while the NHS provides more specialist care.

At 1997 rates, the starting salary for a prison doctor is £37,952, compared to a GP's £46,450. This can rise over time to as high as £62,856.

However, some GPs raise their income as high as £70,000 a year by adding to their core workload.

A Home Office spokesman said the reason for the difference was due to the different ways in which doctors were employed.

GPs in the NHS are employed as independent contractors, while doctors in the prison service are employed as civil servants.