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MSPs to investigate healthcare in prison

3 February 2017

Access to and the effectiveness of healthcare in prisons is to be investigated by MSPs on Holyrood's Health & Sport Committee.

The committee has issued a call for evidence as it begins a short inquiry which will look at how healthcare is delivered in prisons and the cost of the service, as well as current and future pressures on the delivery of prison healthcare.

In 2011 responsibility for the provision of healthcare in prisons transferred from the prison service to the NHS. It is now the responsibility of the local integration authority. The Committee will be writing to each authority to establish facts around budgets and costs of the service, staffing and facilities, demand, performance and service development.

Views from others interested are invited on questions including current pressures and how they have been responded to; the extent to which health inequalities can be addressed in the prison healthcare system; current barriers to using the system to improve the health of the prison population; potential improvements to current services; and expected pressures in the next 15 years.

Committee convener Neil Findlay MSP commented: “The whole purpose of transferring prison healthcare from the prison service to the NHS was to reduce health inequalities, encourage better access to treatment and improve the continuity of care. Five years on, this committee feels it is an appropriate time to investigate how successful this has been.

“Prisons offer a unique opportunity to reduce health inequalities by engaging with people who are not on the radar of the healthcare system due to their often chaotic lifestyles. As with care in the wider population, there is also an aging prison population which will require care for multiple long term conditions.”

Click here to view the call for evidence. The deadline for responses is 28 February 2017.


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Judy Buchan

Saturday February 4, 2017, 23:08

Dear Sir/Madam

I would like to express my concerns about the changes in medical healthcare provision to the prison population in Scotland.

I am a GP working in Lothian for Lothian Unscheduled Care Service (as well as working full time as a principal in a deprived area of Edinburgh).

While I can appreciate there were several issues with the previous set up of healthcare for the inmates, I feel the current service is inadequate. My understanding is that within "working day time hours" the inmates receive a good service with trained nurses and doctors available to them. During out of hours the system appears to be that a trained nurse assesses the inmate if unwell and contacts the out of hours GP to discuss the patient if concerned. I work as a triage GP and have frequently dealt with these calls. The GP can then either give advice (and sometimes recommend basis management of these patients to the nurses), OR if the GP feels the patient needs any investigation/examination or further assessment they must attend A+E.

I feel the basic rights of these individuals are being breached. The nurses are often somewhat reluctant to pursue a Doctor assessment as I can imagine this must be time consuming and expensive for prison staff. An A+E assessment often means a lengthy delay for the patient and also puts pressure on A+E staff when a simple GP assessment would be more appropriate.

Would it not be possible to negotiate GP appointments at a local treatment centre and even a return to home visits where appropriate?

The prison population often includes patients with complex physical and mental health issues and I am not convinced their needs are being met by the current set up.

Yours sincerely

Judy Buchan