Sick prisoners forced to wait in hospital cupboards before getting treatment, report finds

Exclusive: Inmates also required to undergo intimate medical examinations in presence of prison guards, says study

May Bulman
Social Affairs Correspondent
Monday 22 June 2020 10:26
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Sick prisoners forced to wait in cupboards before getting treatment when they go to hospital

Sick prisoners are being forced to wait in hospital cupboards before getting treatment, according to a new report.

The study also reveals that inmates are required to undergo intimate medical examinations in the presence of prison guards, which is said to have a damaging affect on their wellbeing, with one describing feeling suicidal afterwards.

The findings, collated by academics at University College London (UCL) and based on accounts of around 40 prisoners, suggest that fear, stigma, reduced autonomy and security requirements have resulted in prisoners in England receiving lower standards of healthcare than the general population.

Inmates reported having no prior knowledge or control over appointments, and experiencing significant delays in treatment due to cancellations and prison-to-prison transfers – potentially exacerbating their illness.

They spoke of “dehumanising” treatment once in hospital, including being chained to officers throughout the visit and forced to wait in inappropriate spaces, such as cupboards.

The study also suggests prison officers exert control during appointments, including staying present during intimate examinations and refusing to leave the room when asked by doctors.

In closed prisons, patients have no choice but to be accompanied by prison officers, which the report said creates a “difficult three-way dynamic between the patient, security staff and clinicians”, as inmates described being accompanied by officers not known to them and of different genders.

One male inmate interviewed by the researchers said: “You’re chained to the officers and you want to discuss your illness or your medication and they don’t, like, put a longer chain on and let you have a private conversation with the consultant.”

In another case, a female prisoner spoke of having to have an intimate examination with two officers present: “I have FGM damage to me and they wanted to do reversal and reconstruction surgery. As the doctor was talking to me and […] showing me the computer, these two members of staff were there, and they could see everything.

“I came back, I was devastated. I was so depressed. I nearly, nearly took my life.”

The report, which was funded by the Wellcome Trust and Surrey Heartlands Health and Care Partnership, found that many prisoners felt clinicians often direct their questions and attention at prison officers instead of the patient, making the inmate feel “frustrated, upset and patronised, feeling little more than an observer in relation to their own healthcare”.

The study includes examples of prison officers trying to exercise authority over patients’ clinical care to reduce the time spent at hospital in order to return in time to finish their shift, such as actively trying to encourage proceeding without the need for sedation.

It found that wearing handcuffs and being accompanied by uniformed officers was “highly stigmatising” for inmates, as it identified them as a prisoner to other patients and staff, and producing negative emotions and fears around hospital attendance.

Participants who spoke to researchers frequently used comparisons to animals, describing their experiences with phrases like “with that long chain like a dog”.

One respondent said: “I think what are they thinking? Am I a rapist? A sex offender? But then I’m none of those things. But I think peoples’ persona when they see a prisoner is oh, he must be a murderer or sex offender or rapist.”

The researchers concluded that while security issues were often unavoidable, some prison officers may be “reluctant to make proportionate accommodations to help lower-risk prisoners conduct medical appointments with dignity, comfort and safety”.

The report also raises concern that due to cancellations, prison-to-prison transfers, and other causes of delay, inmates often wait considerably longer than the NHS target of 18 weeks from referral to treatment, which can exacerbate their illness.

“This represents a complex and challenging area for healthcare. Delayed access to hospital appointments is a harmful consequence of the resource implications associated with transport and security, which could lead to significant adverse health outcomes and legal challenges,” researchers said.

It comes after a report by the Nuffield Trust in February revealed that as many as four in 10 hospital appointments made for a prisoner were cancelled or missed in 2017-18, with missed appointments costing the NHS £2m.

The think tank said its findings raised concerns about how prisoners were able to access hospital care after a cut in the number of frontline prison staff and a rising prison population, which it said was likely to have reduced the number of prison escorts available.

Frances Crook, chief executive of the Howard League for Penal Reform, said the study revealed how the “injustice and unfairness of daily life for prisoners extends beyond prison walls”.

She added: “Healthcare practitioners have told the Howard League how they set up appointments inside prisons for people who are known to be sick, but due to a range of problems from incompetence to plain bloody-mindedness, they are not escorted through the prison to see the doctor.”

A prison service spokesperson said: “Decisions not to leave a room during an examination or not to wait in public areas are taken carefully after a thorough risk assessment – and it’s right that prison officers balance treating prisoners respectfully with protecting the public from harm.”

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