Promoting health in prisons

Requires more than a change in who purchases health services for prisoners

Britain's prison service has been much criticised in the past for providing a health service to prisoners inferior to that available to the general public through the NHS.1 Radical reform of the Prison Medical Service was expected after a Home Office “efficiency scrutiny” in 1990.2 This led to the Prison Medical Service being renamed the Health Care Service for Prisoners, being given a more strategic role in policy formulation and setting standards, and becoming an executive agency with responsibility for purchasing as well as providing health care for prisoners.3 But whether these changes have benefited prisoners is questioned in a discussion document published last week.4

Patient or Prisoner?, produced by Her Majesty's Chief Inspector of Prisons, acknowledges improvements in standards within the Health Care Service for Prisoners, with better qualified staff, better facilities, and some increase in resources. However, it states that the …