Prison inspector warns of growing health challenges

Fresh concerns have been raised over healthcare provided to some of Scotland’s most physically ill prisoners following latest inspections.  
 
Her Majesty’s Inspectorate of Prisons for Scotland (HMIPS) today warned that healthcare provision for prisoners at HMP Perth with chronic or long-term conditions is “not adequate”.
 
The report is the first of two inspection reports to be published that will underline the challenges facing the Scottish Prison Service (SPS) amid an ageing population within custody.

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While HMICS found no undue delays in prisoners accessing healthcare services at Perth prison, today’s report notes that those with chronic health problems are “seen only through ad hoc arrangements”.
 
“The Healthcare Management Team acknowledge that the skills and capacity to provide care to those with chronic/long-term conditions such as diabetes, asthma and cardiac complaints is inadequate at times,” reads the report.
 
“This is largely attributed to the overarching demands placed on healthcare staff.”
 
A register to identify prisoners who have chronic healthcare needs is not used and there is no data collected in terms of this population, though inspectors have been advised of plans to put in place a clinic for prisoners with “enduring needs”.
 
In March, an independent evaluation of high care needs commissioned by the SPS called for a specific prison to be identified and equipped as a “first cluster facility specifically adapted to meet the needs of prisoners with high care needs”.   
 
Another imminent inspectorate report on HMP Gleonchil, which holds convicted sex offenders as well as mainstream prisoners sentenced to over four years, is unlikely to contain recommendations on a specific model for the care of offenders with severe ill health or disability going forward, Holyrood understands.
 
However, it is expected to underline the need for SPS and the NHS – which has held responsibility for healthcare in prisons since 2011 – to reach a decision on the way in which an ageing population with greater health and social care demands will be housed going forward.
 
“I think they need a better plan for it,” Chief Inspector of Prisons David Strang told Holyrood. “At the moment it’s just very ad-hoc and I don’t think they’ve quite grasped the enormity [of the situation].
 
“I’m not saying it’s a crisis, but I am saying it’s a growing problem and I don’t think they’ve readjusted their thinking.”
 
NHS Tayside’s service manager for prisoner healthcare Jillian Galloway said: “We welcome the findings in this inspection report.
 
“Our staff work hard every day to ensure person-centred, safe and effective care for all our patients and it is encouraging that the inspectors observed this during the inspection.
 
“Some of the observations noted by the inspectors require improvement and therefore we have worked alongside staff to respond to the recommendations.”
 
Inspectors found that relationships between prisoners and staff at HMP Perth, which holds over 600 prisoners, were positive, in particular in terms of supporting those preparing for release.
 
Prisoners have good access to a range of opportunities spanning work, education and recreation, albeit spaces on work programmes were deemed insufficient, leading some prisoners to spend longer time in their cells.
 
SPS head of corporate affairs, Tom Fox, said: “By and large it’s a positive report. Obviously, there are a number of recommendations that we’ll require to consider and develop an action plan to respond to.
 
“But it is gratifying that the inspector recognises the hard work and dedication of the staff and governor there and that he sees so many positives in what is going on at Perth.”