Gay Mitchell
Question:80 Mr. G. Mitchell asked the Minister for Justice, Equality and Law Reform his views on the levels of medical services, including psychiatric services, in prisons. [28780/00]
Written Answers. - Prison Medical Services.
I share the concern that has been expressed by commentators over many years about deficiencies in the health care service available to prisoners. One of the worst aspects of prisoner health care which I inherited on taking office was vast overcrowding in unsanitary conditions throughout our prisons. I have acted decisively to address this issue creating over 1,200 new prison spaces.
As a general principle, I hold that prisoners' health care arrangements should fully match public health care provision in the general community. In November 1999, I established a group to review the structure and organisation of prisons health care services. The terms of reference of this group are to consider and make recommendations regarding the structure and organisation of primary medical and nursing services within the prison environment in light of the development of health care services generally and the needs of the prison population, to consider and make recommendations regarding the provision of psychiatric services to prisoners taking into account changes in service provision generally and the potential ramification of possible new mental health legislation, to consider the appropriate need and level of in-house provision of specialist medical services and make recommendations accordingly, to consider structures for the legal and professionally appropriate control of pharmaceutical products within the prison system, to consider the present organisation of prison dental services and make any appropriate recommendations and to consult with all relevant professional and representative bodies in this connection.
The review body is under the chairmanship of Mr. John Olden, a member of the Council of Europe Committee for the Prevention of Torture, Inhuman and Degrading Treatment of Persons in Custody, and former Secretary of Roinn na Gaeltachta. The membership of the review group consists of representatives of: Department of Justice, Equality and Law Reform; Department of Health and Children; Department of Finance; Director of Prison Medical Services; a senior prison governor; a nominee of the Irish College of General Practitioners; a nominee of the Royal College of Psychiatry; a nominee of An Bord Altranais; A nominee of the Pharmaceutical Society; a nomi nee of the Irish Dental Council. As the review is still ongoing, it would not be appropriate for me to make any comment on the group's work at this time. I expect to have a report from the group by mid-2001. It is my intention that this report will be published as soon as possible. Any recommendations made by this group in relation to improving prison health care services will be treated as a matter of priority by me.
Because of often chaotic lifestyles on the outside, many prisoners present as requiring special medical attention in custody. The period of imprisonment often represents a real opportunity to address long-standing and damaging lifestyle patterns such as drug or alcohol addiction which undermine personal health and social competence. Prisoners can be a demanding group as patients but their demands are often quite reasonable and their period in custody represents a positive opportunity from a public health perspective.
I have also recently obtained Government approval to proceed with a strategy to address the drug problem in partnership with the health authorities. This strategy emerged from a prison drugs policy review group which I established in late 1999 under the chairmanship of the Prisons Director General, Mr. Alyward. The new policy will entail the appointment of various professional staff as well as the training of prison officers. Already 49 nurses have been appointed to the Prison Service, including 16 in the remand prison at Cloverhill.
Under my predecessors in office as Minister, methadone maintenance was not provided for prisoners who were compliant participants in such programmes prior to entering custody. I have reversed that policy and almost 200 prisoners in the Dublin prisons are on such programmes today. The psychiatric service is provided to the prisons and places of detention by visiting psychiatrists. Offenders who, in the opinion of the psychiatrist and the prison medical officer are in need of in-patient psychiatric treatment, may be transferred by ministerial order to either the CMH or a district mental hospital. In practice all such transfers occur to the CMH.
My officials in the Department and in the Prisons Service are working with the Eastern Regional Health Authority to improve the organisation and level of psychiatric input in prisons in the Dublin area. It is envisaged that the improvements in psychiatric care being developed through this dialogue will be extended, where feasible, to prisons within other health board areas.
I have appointed a full-time doctor to the new prison at Cloverhill in Clondalkin, and propose to do so in the Midlands Prison in the near future. Both appointments represent a change in employment arrangements for prison doctors who hitherto were all recruited on a part time attendance basis. Over the past 15 months, the number of psychologists employed by the Prison Service has increased from five to ten. The recruitment of further psychologists for the prison service is under way.