Despite the introduction of the role of Personal Officers and the availability of suitable training for them, it was disappointing to find that in many prisons the full roll-out of Personal Officers had not yet been achieved. The potential benefit of engaging constructively through these processes is substantial.
Time in cell
We were concerned to find that in many prisons, some prisoners were being confined to their cells for long periods of time each day. This was particularly true for prisoners who were held on restricted regimes, often for their own protection. We observed that prisoners on remand, too, are frequently held on restricted regimes. It is a legal requirement for all prisoners to be able to have at least one hour in the open air each day. They should not be restricted unnecessarily in their cells as a result of any form of informal isolation.
We regularly found that places on treatment programmes to address offending behaviour were limited. This meant that prisoners who had been identified as needing to complete a programme were unable to progress due to the lengthy waiting lists.
"Successful healthcare depends on a shared responsibility between the healthcare staff and the operational management and staff in a prison."
Healthcare concerns were raised consistently in both inspection reports and in the findings of IPMs. The inquiry into healthcare in prison conducted by the Scottish Parliament’s Health and Sport Committee was welcome. HMIPS provided both written and oral evidence to assist the Committee in its deliberations. I hope that the Committee’s report will lead to improvements in the provision of healthcare in prisons, as the SPS and Scottish Government respond to the Committee’s report.
It is apparent that barriers to good healthcare can come from a number of sources. Staffing levels in health centres are sometimes inadequate, compounded by high levels of staff turnover. The operational prison regime can make it difficult for prisoners to be brought for clinical appointments. The arrangements for the dispensing of medications can often have an adverse impact on the wider operation of the prison. Successful healthcare depends on a shared responsibility between the healthcare staff and the operational management and staff in a prison. Clear governance is required to ensure clarity of responsibilities. Similarly, there needs to be greater clarity about responsibility for delivering the growing need for social care in prisons.
Access to opiate replacement therapy can be inconsistent between prisons and often does not reflect the practice in the community. Variations in prescribing practices between different prisons and between the community and prison provide further causes of dissatisfaction and are unsatisfactory. There is a need for a national IT prescribing system.
There continues to be a rise in instances of the use of novel psychoactive substances, commonly known as legal highs. These substances are illegal in prison and often lead to unpredictable behaviour, linked to high levels of violence.