Prison health service blasted

Prison health care has been criticised

The health services offered to prisoners are in "crisis", says a report by the British Medical Association (BMA).

Underfunding has left too few doctors trying to help too many inmates, it says, with many doctors leaving the Prison Health Service in frustration.

These problems are not the fault of prison doctors, who are as much victims of the underfunding and poor managerial support as are the prisoners themselves

Dr Patrick Keavney, BMA

Ministers have responded by promising a cash injection of £14m to improve staff training, and more than £10 million to provide an extra 400 drug detoxification programmes a year.

Prisons Minister Paul Boateng admitted: "Historically, health care provision in prison has fallen short of the service provided by the NHS and on too many occasions has fallen short of basic decency."

In addition, prisoners are to be offered vaccination against hepatitis B when they enter Britain.

Prison doctors have a responsibility to ensure that prison conditions do not impact on the health of prisoners, and to care for those who fall ill.

The BMA's report says that experienced prison doctors are leaving the service, and new doctors are deterred from entering it due to poor working conditions.

It adds that public health could be put at risk by the failings of the service - many prisoners contract HIV or other communicable diseases while in prison.

Other recommendations put forward by the BMA include:

• Guaranteed study and training time for prison doctors, so that they can keep skills up to date
• A comprehensive review of the "health needs" of the prison service
• Prison doctors to have the right to set health priorities and protocols within the prison service

'Active opposition'

Dr Patrick Keavney, chairman of the BMA's Civil Service Committee, said: "These problems are not the fault of prison doctors, who are as much victims of the underfunding and poor managerial support as are the prisoners themselves.

"Much of the difficult working environment for prison healthcare staff stems from the lack of cooperation, and in some cases active opposition, of prison administrators."

The doctors who provide health care in jails are a mixture of ordinary local GP's who work part-time behind bars and full-time prison service doctors.

The BMA says there are too few of them, leading to stress and isolation.

Since 2000, medical care in jails has been the joint responsibility of the prison service and the Department of Health.

The government argues that this is a more "joined-up" approach. Its critics, though, say there is still too sharp a divide between prison and the community.

Health Minister Lord Hunt also announced details of new NHS teams to support specialist mental health services in prisons.

He said: "At any one time there are around 5,000 seriously mentally ill people in prison for whom we need to provide better services.

"Reoffending may in many cases be linked to an untreated mental health problem.

"If we can break that cycle we benefit those individuals and society."

Dr Michael Wilks, a forensic physician in London who chairs the BMA's Medical Ethics Committee, said: "Prisoners have a basic human right to health care. They may not be the most popular candidates for public spending but prison doctors are sometimes the only advocates their patients have."