The briefing – drawing on research and insights from academics at The University of Manchester– finds that healthcare in prisons is fragmented across the health and justice departments, with responsibility split between multiple agencies and service providers and no single body in charge. Poor coordination between the Department of Health and Social Care, the Ministry of Justice and healthcare providers continues to undermine the quality and continuity of care available to prisoners.
This lack of joined-up working is compounded by severe pressures in the prison system itself. Overcrowding, staff shortages and an ageing, crumbling prison estate are making it harder to deliver basic healthcare and are contributing to poor health outcomes among prisoners. On average, people in prison have a life expectancy more than 20 years lower than the general population. While around 70% of prisoners are estimated to need mental health support, only around 10% are recorded as receiving treatment.[1]
Supporting people’s underlying health needs has been identified as a critical component of reducing reoffending. Chief Medical Officer for England, Professor Chris Whitty, highlighted offending and reoffending are strongly linked to health, with the greatest risks occur at moments of transition: entry into prison, transfers between facilities, and after release.[2]
The pressures within the system are only set to get worse, due to an ageing prison population. Nearly 1 in 4 prisoners is now aged 50 or over, a group with complex and chronic health needs that prisons were never designed to meet.[3] Deaths from natural causes among older prisoners have increased over the past decades, yet access to appropriate care, including palliative and end-of-life support, remains inconsistent.
The SMF warns that without reform, the prison health system will continue to miss the chance to break cycles of ill health, disadvantage and crime.
To address these challenges, the Social Market Foundation sets out four key priorities for government, including:
- establishing a sustainable, long-term funding settlement for prison healthcare;
- improving coordination and integration between health services, justice agencies and service providers;
- prioritising prevention and early intervention; and
- strengthening cross-government oversight of prisoner health.
“The University of Manchester is a public research university in Manchester, England. The main campus is south of Manchester City Centre on Oxford Road.”
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