Prison Healthcare Under Strain as Overcrowding Crisis Worsens, Warns BMA

Prison health care services in England and Wales are struggling to cope with the demands of an overcrowded prison system

Recent figures from the Prison Service revealed that the prison population in England and Wales reached a peak of 80,846 at the end of May and that there were fewer than 300 cells available for new inmates. The prison authorities have already begun using police cells to house prisoners in some areas of the country.

Dr Ashok Rayani, a prison doctor and member of the BMA’s Civil and Public Services Committee said:

“Prison healthcare services do not have the staff, infrastructure or budget to cope with the needs of the rising prison population. Unacceptable delays in assessing and treating prisoners are now commonplace, while specialist services designed to deal with mental health and drug addiction problems are badly stretched to the point of becoming ineffective – a disastrous situation considering how endemic these conditions are within the prison population.

The pressure to see large numbers of prisoners also means that maintaining accurate health records is problematic, especially as prisoners are routinely transferred from one institution to another without warning and that there are few efficient mechanisms in place to transfer health information or records.

“In the short term this bleak picture places vulnerable prisoners at risk from serious complications because their conditions are not being assessed immediately and treated adequately. In the long term, the prison system is failing the public by not addressing the serious health conditions that lead prisoners to offend and re-offend, such as mental health and drug addiction problems.”

Dr Clare Jenkins, the Chairman of the BMA’s Civil and Public Services Committee said:

“Prison healthcare services have been neglected for many years by successive Governments. The BMA believes that the prison system is reaching an unprecedented crisis point that requires urgent strategic and financial action from the Government.

Since this has not been forthcoming so far, the BMA strongly advises all concerned prison doctors to write formally to their respective prison governors and prison health provider (PCT or Private Sector Company) in order to highlight that the current situation in their prison is resulting in an increased and serious risk to their patients’ health. The BMA will continue to push hard for extra measures to combat the impact of the overcrowding crisis.”

Prison doctors’ specific concerns about the impact of overcrowding also include:

Prison Healthcare Services

Increasing delays in transferring prisoners to hospital facilities because there are not enough prison officers to act as escorts. There has been no communication from the Government to prison doctors about the overcrowding crisis. This has lead to a widespread feeling of professional isolation and further damaged morale amongst the profession. Increasing pressure on “in-patient” beds for the mentally ill. In some areas prisoners with severe psychiatric conditions have to wait weeks before being transferred to appropriate care units.

Emergency Measures

The introduction of emergency measures that involve keeping prisoners in police cells is inappropriate and potentially harmful to the prisoner, as these facilities often do not have the on-site staff or equipment to perform even basic health assessments.

The BMA remains strongly opposed to the introduction of prison accommodation that does not have access to professional, round the clock medical facilities. The current use of police cells is unacceptable and must be reversed as soon as possible.

Source: BMA
LIN/M