Prison care 'puts public at risk'

Prison medical services are 'sub-standard'

The public is being put at risk because of the appalling state of the prison health care service, according to the former UK Chief Inspector of Prisons.

Sir David Ramsbotham has warned that the physical and mental health of prisoners is often worse when they return to society.

Nothing is worse for these people than to be locked up alone in a cell all day with nothing to do

Sir David Ramsbotham

He argued that as all except 23 of the 67,500 prisoners currently in England and Wales are going to return to society, their health is a matter of public safety.

Writing in the student edition of the British Medical Journal, Sir David said that figures show that 70% of prisoners may be suffering from some form of personality disorder and at least 60% are using class A drugs.

Yet as recently as 1995, prison service health care in the UK was not part of the NHS.

As such, only 10% of prison senior medical officers were qualified to act as GPs in the NHS, and health care centres were woefully understaffed, he said.

Progress made

Sir David Ramsbotham fears for public safety

Sir David said progress was being made, but there is still a long way to go, particularly in the treatment of those with personality disorders and other mental health problems.

He said: "Nothing is worse for these people than to be locked up alone in a cell all day with nothing to do.

"I was distressed every time a nurse or practitioner told me that all they could do was watch people's condition deteriorate, meaning that they would be worse when they went out than when they came in.

"It is irresponsible and far removed from the aim of the criminal justice system, namely to protect the public by preventing crime."

Sir David said there was a general ignorance about prisons, but the public needed to know what goes on in them, because prisoners will return to their communities.

"Their physical and mental health when they return does matter, and is something that the public should both know and protest about if their future safety is affected."

Richard Garside, spokesman for crime reduction charity Nacro, said Sir David was ideally qualified to speak about the problems with the prison system.

He told BBC News Online: "It is common knowledge that prison doesn't work. It is less well known that prison can be seriously bad for your health.

"It is the job of prison to protect the public by tackling reoffending.

"So it goes without saying that promoting the health and well-being of prisoners is fundamental."

Government reaction

A Home Office spokeswoman said the government fully acknowledged the need to improve health services for prisoners.

Formal partnership had been launched between the Prison Service and the NHS in April 2000 to modernise health services for prisoners.

She said: "Prison is an opportunity to identify and address health needs among prisoners, many of whom will have had little or no previous contact with health services.

"All prisons and local NHS partners have undertaken joint health needs assessments for prison populations, and are using these to plan and implement service improvements."

She added that £58m had been invested in health care over three years by the Prison Service.

More money had also been made available to improve mental health services.

In addition, the Prison Service had decided only to recruit qualified GPs to provide prison primary care services.