Half of prisoners said it was difficult or very difficult to obtain a GP appointment, with many facing long waits for care, a report published on Thursday by the House of Commons health select committee warns.
At one prison highlighted in the report, patients faced waits of eight to 12 weeks for an appointment, while at another more than a quarter of appointments were missed because patients were unable to be escorted to the GP.
Meanwhile, prisoners are often discharged from prison without being registered with a GP, and those requiring medication are often not supplied with it or given the wrong items.
Equivalence of care
The report warns: 'No one is sentenced to worsened health but that, largely as a result of overstretched staff, overcrowding and poor facilities, is too often the outcome. Prison health and care services should be delivering standards of care, and health outcomes, for prisoners that are at least equivalent to that of the general population.'
The UK government is signed up to a commitment to 'give prisoners access to the same quality and range of healthcare services as the general public receives from the NHS'. But prisons in England are understaffed and overcrowded, with many prisoners living in 'unsafe, unsanitary and outdated' facilties, the report warns.
Violence and self-harm in prisons are 'at record highs', it says. One in four prisoners are in overcrowded cells, while staff shortages are 'severely limiting' opportunities both for physical activity and access to healthcare.
'So-called natural cause deaths, the highest cause of mortality in prison, too often reflect serious lapses in care,' the report adds, warning that prisoners at risk of suicide 'face unacceptable delays awaiting transfer to more appropriate settings'.
Drug use
The government and prison service are also 'some way' from controlling 'increasingly widespread use of novel psychoactive substances, which are a serious risk to the health and safety of users, fellow prisoners and staff alike', the committee's report says.
RCGP chair professor Helen Stokes-Lampard said: 'With more than 80,000 people currently in prison in England and Wales and even more in other secure environments, it’s vital to recognise that prison health is also a part of public health.
'There are obviously obstacles to delivering the same care to people living in secure environments to people in the wider community, and the college is advocating that prisoners should be afforded provision of, or access to, appropriate care services or treatment that are at least consistent in range and quality to patients in the wider community, with the aim of improving health outcomes for society as a whole.'
BMA forensic and secure environments chair, Dr Bethan Roberts, said: 'Prisoners are often some of the most vulnerable people in society presenting complex mental and physical health needs; many of whom are at greater risk of suicide and self-harm.
Workforce
'There needs to be a clear focus on improving the current provision and accessibility of mental and physical healthcare in prisons. This will require adequate funding with an emphasis on boosting the healthcare workforce such as the promotion of the prison GP role.
'The BMA is calling for a statutory requirement for prisons to support the health and wellbeing of offenders, which should be reinforced by expanding the scope of the prison population data set to monitor and record health indicators of the prison population, including those with mental health issues, chronic conditions and the ageing population.'
She also called for invesment in mental health and community services, particularly in more disadvantaged areas, outside of prison.
A government spokesperson said: 'We take our duty of care to prisoners and staff extremely seriously and have introduced a package of measures designed to make our prisons safe, decent and better able to manage the often complex health needs of offenders.
'This includes an extra £70m to enhance the fabric of the estate and tackle the drugs which we know are fuelling violence, while up to 10,000 new prison places will provide conditions where healthcare can be delivered safely and efficiently.'
