Episode 8 - Healthcare

When Julie S discovered a lump in her breast she did exactly what a lot of women do and tried to pretend everything was fine for a while. As soon as Julie J. found out what she was so worried about she made her visit the Senior Medical Officer Dr. Nicholson and from then on the whole process of hospital appointments, tests and surgery started. Like most women in that situation Julie S. felt as though it was all beyond her control. For any prisoner suffering a serious illness the anxiety is made worse by the fact that they don't have the choices people outside are able to have.

The first thing Julie S. did was go and look on the Internet to find out more about breast cancer. That is where most of us get our information these days, and the fact that you are reading this factsheet means it is probably one place you would look! Prisoners do not generally have access to the Internet, and would certainly be unable to look things up freely in a prison like Larkhall.

The dreadful Dr. Nicholson's arrival back at Larkhall was the worst possible news for Julie as it is hard to imagine anyone taking being more insensitive. If a GP outside prison acted like that there would probably be a lot of complaints about him and his patients would transfer to other practices. Of course prisoners don't have that kind of choice.

Prison primary health care has, in the past, been fairly separate from the National Health Service. The Prison Service had its own medical service which employed its own staff, and the quality, as well as the way in which it was organised and delivered, and its links with NHS provision, varied a great deal around the country. Because of concerns about the fact that prisoners, a group of people with fairly major health needs, were not getting the same level of service as people in the community, a working group was set up to look at improving links between prison medical care and the NHS. It is a gradual process, but responsibility is gradually moving across to the NHS, and the Prison Service and NHS are working very closely together. As part of this there is a much more thorough system for monitoring the quality of healthcare in prison, referred to as the 'traffic light' system. Dr. Nicholson would certainly find himself stuck on red!

Secondary health care, in Julie's case her tests, surgery and treatment, are all carried out at the local hospital. This would certainly be the case in prisons around the country where prisoners are escorted to appointments. Sadly their closest prisoner friends would not be able to accompany them as Julie J. was able to just before Julie S.'s surgery.

Prisoners are usually escorted by two officers, and bed watches (officers guarding prisoners while they are actually in a hospital bed) usually involve at least two officers at a time as well, so the prisoner is never left unguarded. The only exception is when a prisoner poses no risk to the community and can be trusted not to escape, and then s/he might be given temporary release while they are in hospital or to attend an appointment.