HSE and Department of Health must take responsibility for prison health services

Money must not be an "excuse" to stop the Irish Prison Service from giving responsibility to HSE and Department

Midlands Prison PortlaisePicture:  Finbarr O'Rourke

A new report on health services at prisons in Portlaoise and other Irish jails has recommended that the HSE and Department of Health take over prison healthcare from the Irish Prison Services.

The recommendation is contained in the new report of the late Inspector of Prisons Judge Michael O'Reilly. Judge O'Reilly who died in recent months said the need for change is urgent. He said finances should not be used as an excuse.

"There may well be resource issues in transferring responsibility for prisoner healthcare from the IPS to the HSE and the Department of Health. However, this cannot be used as an excuse for delaying such transfer of responsibility.

"In this regard it must be borne in mind that the State accepts a heavy responsibility when it detains a person to ensure the well-being of that person. It is internationally acknowledged that lack of financial means cannot reduce this responsibility. This has been made clear by the Council of Europe in numbers of its instruments," the judge found.

Entitled Healthcare in Prisons it contains a number of key recommendations as follows:

  • Responsibility for the provision of healthcare should be transferred from the IPS to the HSE.
  • A health needs assessment of prisoners in all prisons should be undertaken immediately.
  • The lead in the assessment referred to in paragraph 5.2 must be a clinician.
  • A healthcare staffing needs analysis for each prison should be undertaken on the completion of the health needs assessment. This analysis should be clinically led.
  • The healthcare staffing needs analysis must reflect the health needs assessment of prisoners in each particular prison. 
  • It is important that such an analysis should be clinically led and should not be influenced by operational or other non-healthcare considerations other than the obvious interdependence of healthcare staff and custody staff working together e.g. in ensuring prisoners are escorted to the nurse/doctor appointment or to outside hospitals etc.
  • The health needs assessment of prisoners and the staffing needs analysis must be published for each prison. 
  • The health needs of prisoners and by extension the staffing needs of each prison must be kept under constant review as prison populations change as do the cohort of prisoners in all prisons.

"As this is an urgent issue and as this report must be published pursuant to Part 5 of the Prisons Act 2007 it is not unreasonable that a public response be  forthcoming either accepting the thrust of this report and giving time lines for implementing or rejecting this report. If the recommendations in this report are rejected it would be reasonable to expect that reasons for such rejection would be given," concluded the judge.

Minster for Justice Frances Fitzgerald welcomed the report but gave no commitment on its implementation.

“I welcome the publication of the Inspector of Prison’s Report on Healthcare in Irish Prisons. The report makes a number of timely recommendations regarding the provision of healthcare in prisons. I have recently been in discussions with my colleague the Minister for Health about a Review of Prison Healthcare.

"Such a Review will address many of the issues raised by Judge Reilly. Terms of Reference are being finalised. Once
these are agreed and the Review is undertaken, I will be better placed to decide on how to proceed in terms of the recommendations of this report,” she said.

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