Source: http://www.nationalhealthexecutive.com/Health-Care-News/bma-calls-for-more-prison-health-powers-to-halt-rise-in-inmate-deaths

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Prisons should use new powers to address poor health outcomes for inmates, the BMA argued in its submission to the Justice Select Committee report into prison reforms.

The average life expectancy of a prisoner is only 56, and Ministry of Justice figures show that natural deaths in custody have increased by 26% in the past year, while suicides increased by 28%.

The BMA warned that prisoners suffer from particular issues which make them more likely to have health problems. The prison population is ageing, with the number of prisoners over 50 growing by 161% since 2002. Drug and alcohol addiction are high, and prisoners are more likely to be illiterate or speak English as a second language, which makes it harder for them to understand medical information.

In particular, BMA members warned that care was being delayed because of a “security first” approach, with prisoners having to cancel hospital appointments because of a lack of guards to escort them. Female prisoners also had difficulty accessing a doctor of the same gender.

The union said it welcomed the government’s plans to introduce ‘reform prisons’, with more responsibilities devolved to prison governors.

It recommended using these powers to improve health outcomes by allowing governors to abolish cases of prison health facilities being closed during lockdown; providing services such as radiotherapy, physiotherapy and dialysis within prisons; and encouraging prisons to sign up to the Royal College of Psychiatrists’ quality assurance framework for prison mental health.

The Prison Reform Trust estimates that 90% of inmates have one or more of the five main psychiatric disorders (psychosis, anxiety disorder, personality disorder, alcohol dependence and substance misuse).

Other recommendations from the BMA included encouraging healthy eating, exercise and stopping smoking in prisons; establishing health plans so that the different agencies contracted to provide healthcare work more closely with each other and with prison staff; modernising facilities to reduce the risk of suicide and self-harm; and providing suicide training to staff.

Prison Officers Association members held a walkout and protested outside prisons last week to highlight the issue of staffing cuts, which they say are making it impossible to guarantee prison safety.

The government sought a High Court order to end the protest. Chancellor Philip Hammond then promised funding for an additional 2,500 officers in the Autumn Statement.

A recent Public Health England report said that there have been “significant improvements” in prison healthcare since NHS England and the Department of Health took over the contract in 2006. However, it recommended ongoing improvements, including integrating prison healthcare with local communities.