Older prisoners miss out on health care, says charity

BMJ 2009; 339 doi: (Published 14 August 2009) Cite this as: BMJ 2009;339:b3327
  1. Jo Carlowe
  1. 1London

    Radical changes are needed to improve health and social care for elderly prisoners, says the crime reduction charity Nacro, formerly the National Association for the Care and Resettlement of Offenders. The charity says that of the 7358 prisoners older than 50 in England and Wales, some 80% have chronic illnesses or disabilities but miss out on the most basic provision.

    Sally Wentworth James, senior policy adviser at Nacro, said that a Social Exclusion Unit report published in 2002 (Reducing Re-offending by Ex-prisoners) states that prisoners age up to 10 years faster than their contemporaries and described the level of support as “appalling.”

    Speaking to the BMJ, she described a system that fails because of inadequate resources and training. “We know of prisoners who need breast cancer screening, but there is no prison officer available to take them to outside services, and of prisoners in wheelchairs who miss appointments because officers will not lift them because of health and safety concerns,” she said.

    Ms Wentworth James said that many medical conditions are not identified, with depression and early onset dementia in particular going unnoticed (Age and Ageing 2004;33:396-8, doi:10.1093/ageing/afh113).

    A BMA spokesperson said that although prison doctors do their best, the prison service is underfunded.

    “The BMA does not believe there are enough clinical staff or resources to meet the demands of an overcrowded prison population. In many areas the inadequate levels of staff and services are badly stretched simply because there are so many complicated cases to assess.

    “There are also important organisational issues. Inmates are often moved regularly between prisons, a practice that often disrupts their care, especially as medical records are not always transferred speedily. Getting older patients to specialist services in the NHS is also sometimes problematic as there are not enough prison officers to escort prisoners to hospital.

    “The BMA has lobbied for many years for more joined up thinking, better organisation, and more funding for prison health care. Some improvements have happened at local level, but the United Kingdom’s prison system still falls far short of the role it should be playing in keeping crime down and caring for elderly patients.”

    Ms Wentworth James said that the National Offender Management Agency had “no intention” of establishing a policy for older prisoners.

    A Ministry of Justice spokesperson confirmed that the agency has decided that a national strategy specifically for older prisoners “is not appropriate” but said that it was working with the Department of Health to tackle the challenges presented by the ageing prison population.


    Cite this as: BMJ 2009;339:b3327


    • Working with Older Prisoners, a guide to help prisons improve their services, is available from

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