Holyrood Health Committee: Prison healthcare should match wider society within two years

Parity of care with the wider community was a key aim of the transfer, in 2011, of healthcare delivery from the Scottish Prison Service (SPS) to the NHS. A new report published today states that improvements promised by the move have not materialised and the prison population in Scotland has been underserved by the changes.

The report notes that the prison environment presents an opportunity to engage with people who often do not engage with the healthcare system and to tackle health inequalities in wider society. MSPs looked at whether prison healthcare was contributing to efforts to reduce health inequalities, but found that this “unique opportunity” was not being taken up.

The committee also heard that up to 50 per cent of clinical time was being wasted due to missed appointments as a result of difficulties in transferring prisoners to prison health centres. The report states that the committee expects the SPS, contractors and health boards to ensure that patients are able to attend healthcare appointments.

The committee said the SPS were unable to tell them how many prisoners have mental health needs. However, evidence received by the committee, suggests that an estimated 70 per cent of prisoners have mental health problems. MSPs have called for steps to be taken to ensure that the mental health needs of all prisoners are addressed.

The report also draws attention to a change in the age profile of the prison population with more complex health and care needs. Improved life expectancy, longer sentences for serious crimes and more convictions for historic offences are all factors leading to an older prison population. The last five years have seen the number of older people (aged over 50) in the prison population increase by 50 per cent.

Neil Findlay MSP, convener of the Health and Sport Committee, said: “The overriding impression we took from our evidence is of a population very much underserved by the shift to NHS provision of care in Scotland’s prisons. This is a particular concern with our prisons housing growing numbers of older prisoners with more complex health and care needs.

“The point of transferring prison healthcare from the prison service to the NHS was to ensure prisoners receive healthcare equivalent to that of the wider community in Scotland. It also offered a unique opportunity to address health inequalities within the prison environment, so it’s disappointing to discover that that opportunity is not being taken up.

“The fact that missed appointments are accounting for 50 per cent of clinical time represents a waste of resources that needs to be addressed through better joint working between the SPS, health boards and contractors.”