Earlier work by John Howard led in 1774
to the requirement for all prisons to appoint
a surgeon or apothecary, and prisons can
rightly claim to have the oldest civilian
medical service. Amour propre flowing
from this contributed to prison health care
being omitted from the NHS at its establishment
in 1948, but more recently the
increasing involvement of the NHS in
prison health care has culminated in an
announcement that responsibility will be
transferred to the Department of Health
from April 2003, with primary care trusts
becoming responsible for the commissioning
and provision of health services to
prisoners in their areas. This is welcome
news.
Prison health care has aimed to provide
a service broadly equivalent to that of the
NHS in both scope and quality (Home
Office, 1990), but despite good-quality
care in some prisons – mainly smaller and
long-term institutions – failure to achieve
equivalence has been recorded in relation
to both health care generally