Making prison health care more efficient: The cost may be higher than the price

doi:10.1136/bmj.331.7516.575-a

BMJ 2005;331:575-576 (10 September), doi:10.1136/bmj.331.7516.575-a

Letter

Making prison health care more efficient

The cost may be higher than the price

The first 150 words of the full text of this article appear below.

EDITOR—By focusing on the price of prison health carein the editorial by Awofeso,¹ the BMJ has done a major disserviceto communities that pay for poor (in both meanings of the word)prison health care in non-fiscal ways.

Cost and price are not interchangeable concepts. The prisonis a particular environment that gives access to health carefor those who are often excluded in other settings: the priceof the care should be set against the cost of its absence.

Degradation of the wider public health—for example, throughculturing bloodborne diseases in prisons with inadequate servicesto prevent needle sharing—and degradation of public orderby the reoffending that follows inadequately addressed forensicmental health problems are costs borne by populations but hardlynoticed by criminal justice ministers.

While locking fewer people up may keep us safer from disease,it carries political risks that are difficult to take . . . [Full text of this article]

Andrew J Ashworth, general practitioner principal

Davidson's Mains Medical Centre, Edinburgh EH4 5BP andrew.ashworth@lothian.scot.nhs.uk