Exclusive: Prison crisis affecting health services for inmates, says GP

Rising tension and staff shortages in prisons are affecting decisions about how to manage urgent medical care for inmates, a senior prison GP has warned.

Dr Mark Sanford-Wood: prison health warning (Photo: Wilde Fry)
Dr Mark Sanford-Wood: prison health warning (Photo: Wilde Fry)

GPC member and prison GP Dr Mark Sanford-Wood said that doctors were having to make decisions about when to send patients to hospital for emergency care based partly on prison officer numbers, amid rising tension and violence in jails.

The GPC lead on prison medical services said the ‘severe’ shortage of officers was making doctors’ jobs ‘very difficult’.

The government has agreed to fund an extra 2,500 prison officers to ease staff shortages in England and Wales. The Prison Officers Association has warned of ‘bloodbaths’ because of declining staff levels and rising prisoner numbers, as official Ministry of Justice figures showed suicides in prison hit record levels in 2016 and assaults on both staff and inmates soared.

Increased tension in prisons has meant medical staff are having to work more cautiously for their own safety, said Dr Sanford-Wood, who works in HMP Exeter in Devon. Doctors, he added, now had to ‘consider very carefully’ about ‘sending people out, for example to casualty’.

GP referrals

The doctors’ leader was speaking on the eve of a BMA conference last week set up to offer prison GPs a chance to exchange ideas and experience of the fragmented service.

Dr Sanford-Wood warned that pressure and staff shortages were forcing doctors to make more careful decisions about when to send patients to hospital. Prisoners are required to be escorted by two prison officers when they are sent for care outside the jail, making existing staffing pressures ‘more acute’.

‘For emergency care ... it isn’t simply a case of saying this person needs an x-ray, so they have got to go to casualty now. Sometimes you do have to judge, it is usually around timing. Do they have to go right this minute, or could they go later today or even possibly tomorrow?’ said Dr Sanford-Wood.

Doctors, he said, were aware that when officer numbers inside the jail drop to a certain level, prisoners are locked into their cells. ‘That then creates further tensions because they don't have their free association time, they don't have exercise time, and that causes knock-on pressures in the system.’

‘But if someone needs to go out, they need to go out,' he added. ‘It is a simple as that. It's not that people don't get the treatment they need. But you just have to think more carefully about how you organise it.'

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