Re: Access to specialist services is missing
Professor Sugarman in his letter misses two important factors. The first is an NHS response to increasing costs from the independant mental health sector (private and charitable) providing beds at a reduced cost to help control local NHS expenditure. The second is an increased investment by the NHS into all prison healthcare including mental health services, leading to an improvement in care within the prisons and referral of a smaller number of people to specialised mental health services because treatment can be intitiated and maintained within the prisons at significantly lower costs.
Competing interests: I receive a pension from St. Andrew's Healthcare and am executive director of the largest NHS provider of forensic (secure) psychiatric services