Human cost of delivering healthcare in unhealthy prisons

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j1374 (Published 28 March 2017) Cite this as: BMJ 2017;356:j1374
  1. Alison Frater, visiting professor1,
  2. Annie Bartlett, professor of offender healthcare2
  1. 1Centre for Criminology and Sociology, Royal Holloway, University of London, London, UK
  2. 2St George’s, University of London, London, UK
  1. Correspondence to: A Frater A.frater{at}soton.ac.uk

Government must commit to urgent reform or risk more avoidable deaths in custody

Successive UK governments have received strikingly similar recommendations on prison reform from chief inspectors,1 Justice Select Committees,2 and independent parliamentary inquiries,3 yet largely ignored them. Now, an unprecedented increase in rates of deaths in custody4 suggests that deteriorating conditions are compromising the delivery of adequate physical and mental health services. It remains to be seen whether the government’s new Prison and Courts Bill5 will go beyond rhetoric about improving safety and security and tackle current realities.

The public has been briefed about high levels of violence, bullying and intimidation, self inflicted death, self harm, and murder in prisons. Health professionals must now be heard—speaking up for evidence based recommendations at a time when prisoners’ health and humanity are at risk.

Concerns expressed by the House of Commons Justice Select Committee in its 2015 report foreshadowed the current crisis: a 28% reduction in prison staff between 2010 and 2014, poor …

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