News Roundup [abridged Versions Appear In The Paper Journal]

NHS ignoring prisoners' health needs, says report

BMJ 2001; 322 doi: (Published 28 April 2001) Cite this as: BMJ 2001;322:1014
  1. Zosia Kmietowicz
  1. London

    The health needs of prisoners are being ignored, says a report criticising the NHS for missing an important opportunity to tackle problems of addiction among prisoners and prevent reoffending.

    Working conditions in prison medicine are so poor that experienced doctors and nurses are leaving the service in droves, said the BMA's report Prison Medicine: a Crisis Waiting to Break. Of those who are left, many feel powerless to help prisoners because their clinical judgment is undermined, often by prison governors who do not recognise the need for intervention. When they do try to access NHS hospitals and secondary services, prison doctors are often met with opposition because of a reluctance to admit prisoners.

    A 1996 study showed that more than 60% of unconvicted male prisoners had mental health problems, but doctors found it extremely difficult to access psychiatric nurses, occupational health workers, substance misuse counsellors, and clinical psychologists (BMJ 1996;313:1524-7).

    The BMA report called for a comprehensive review of the prison health service, greater financial support, and more clinical independence for prison doctors. Prison doctors should also be given guaranteed study and training time to keep their skill up to date. To prevent professional isolation their work should also be more integrated with the wider NHS.

    Commenting on the report, Sir David Ramsbotham, chief inspector of prisons for England, said: “Concerted and determined action is required to bring prison health care up to accepted standards. Prisoners often have multiple health problems, including addiction to drugs and alcohol. Prison health care is an important public health issue. By failing to tackle prisoners' healthcare needs, we fall short of the duty of care we owe to them, and we miss the opportunity to contribute to the prevention of reoffending.”

    Prison Medicine: A Crisis Waiting to Break can be seen on the BMA's website at

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