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Opportunities for doctors in the prison serviceThe director of health care in prisons, Mike Longfield, explains the range and scope of the service for those who serve at Her Majesty's pleasureWorking in prison

BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7178.2 (Published 23 January 1999) Cite this as: BMJ 1999;318:S2-7178

The director of health care in prisons, Mike Longfield, explains the range and scope of the service for those who serve at Her Majesty's pleasure

  1. Dr Mike Longfield, director of health care
  1. HM Prison Service,London SW1P 4LN
  2. Churchfields Medical Practice, Old Basford, Nottingham NG6 0HD

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    Medical practice in prison is, perhaps by its nature, little known and poorly understood outside the confines of the prison service. Only 225 doctors work in prisons in England and Wales (of whom 133 are full time and 92 part time), but their potential to influence the health of some of the most disadvantaged people in society is considerable. Last year around 65,500 prisoners were in custody at any one time, a number that has been rising steadily for about five years. That number is deceptive: in the latest year for which statistics are available, around 200,000 people spent some time in prisons in England and Wales because the vast majority of prisoners spend comparatively short periods in custody. All of these people will come into contact with a prison doctor during their time in custody, and this contact offers prisoners the opportunity for consistent health care, which may well have been absent from their lives outside prison.

    The doctor's role

    Opposite, Patrick Keavney argues that prison medical officers are general practitioners who need even more vision, tenacity, and common sense than their non-prison counterparts, in work with a group of patients who are more likely to need some form of mental care.

    I would like to add to that by first putting the role of the prison medical officer within the judicial context of the Prison Act (1952). This is the basic legal constitution for the work of the prison service and requires, among other things, that “every prison shall have a governor, a chaplain and a medical officer and such other officers as may be necessary.” This legal context underscores the fact that prison medical officers are required not only to “have the care of the health, mental and physical, of the prisoners in that prison,” as stated in the prison …

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