Discussion is needed between prison health service and NHS

Editor—The chief inspector of prisons recently proposed that the NHS should assume responsibility for the delivery of all health care, including that required in prisons.1 2 The prison health service understandably believes that this implies criticism of its previous performance and threatens its future. For example, J M Hall claims that in many ways the prison healthcare service provides a better service for its patients than does the NHS and that the NHS would provide an inferior service for prisons.3 Perhaps this view rests on the assumption that the existing staff would be replaced and the existing service revamped by people with no experience of the special problems encountered in prisons.

Prison health care requires special skill and needs to build on the existing base of caring staff to …