asked the Minister for Justice if he will outline his policy on the problem of AIDS in prisons; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - AIDS in Prison.
13.
I want first of all to make the point that the problem of AIDS in our prisons is a reflection of the wider problem of AIDS in the community generally. The fact that we have prisoners who are HIV positive arises, unfortunately and inevitably, from the number of people committed to prison who had a history of intravenous drug abuse prior to their committal.
The primary objectives of the prison system in dealing with HIV offenders must be to provide them with the medical and other services appropriate to their condition while, at the same time, ensuring their safe custody.
The House has been informed on a number of occasions of the general approaches being taken by the prison service in dealing with this matter.
Testing for the AIDS virus is available to all prisoners on an entirely voluntary basis and appropriate counselling is available both before and after the taking of the test.
When, in early 1986, a significant number of offenders were tested as HIV positive, it was decided following consultation with prison management and staff to segregate them from the rest of the prison population. This was done to facilitate the provision of appropriate medical services and in the light of operational considerations relating to the maintenance of good order in the institutions.
Segregation remains in operation and at present 43 male offenders who have been identified as HIV positive are accommodated in the separation unit and base of Mountjoy. Four female offenders who have been identified as HIV positive are held in an area of the women's prison at Mountjoy.
Since the initial identification of HIV offenders, two additional medical officers have been appointed to Mountjoy Prison: one to deal exclusively with the male HIV offenders and the other to deal exclusively with female offenders including those identified as HIV positive. The medical officers attend at the prison regularly and are available on call to the prison.
The medical officers make arrangements for the offenders to attend hospital for tests, etc. In-patient hospitalisation is arranged if required. A wide range of other services is made available to this group of offenders. These include psychiatric, psychological, chaplaincy, welfare and educational services. Representatives of a number of community-based agencies involved with the problem of drug addiction visit the prison to counsel offenders. As well as detailing these specialist services it is right that I should refer in particular to the key role played by members of the prison service —who deal with these offenders 24 hours a day, seven days a week — in maintaining an appropriate régime for these offenders.
Dealing with offenders who have been identified as HIV positive is, of course, only part of the approach the prisons must take in dealing with AIDS-related problems. While it would not be practical in the course of a reply to a parliamentary question to deal with every aspect of this problem there are some particular issues I will mention. First, the offenders to whom I have referred so far are those identified as HIV positive. It is reasonable to assume, however, that not all offenders who are HIV positive have, in fact, been so identified. In these circumstances it is of obvious importance that certain hygiene precautions be taken in relation to all offenders. Staff have been given appropriate guidelines in this regard. An important role continues to be played also by the education service in the prisons in providing information to offenders on the subject of AIDS. For example, special material on AIDS designed to help those with literacy problems has been developed by prison teachers.
With regard to custodial accommodation, I can inform the House that this has been the subject of a special examination in my Department in recent months. This examination is taking place in close consultation with local prison management and staff representatives together with medical officers and others involved in the provision of services for HIV offenders.
I hope to be in a position shortly to make a statement about future plans for the accommodation of HIV offenders.
I have dealt with this question at some length in view of the fact that, as I am sure the House will appreciate, the issues involved are, by their very nature, sensitive and problematical. Before taking any supplementaries I would like to take this opportunity to pay tribute to the manner in which prison management and staff and the various support services have responded to the challenge and difficulties presented by this new, complex and distressing problem.
On behalf of my colleague, I should like to thank the Minister for his very full reply. In view of the information which has come to hands recently about the very great increase in the incidence of AIDS in the population in general, may I ask the Minister if he feels it necessary for additional steps to be taken by him to ensure that all facilities are made available to the prison service in order that the spread of this disease among custodial prisoners under his jurisdiction is kept to a minimum and, if possible, reversed?
Obviously, it is my intention to continue to provide as high as possible a level of service for HIV offenders. As I indicated in my reply I hope to be in a position shortly to make an announcement about future plans for the accommodation of HIV offenders. I can assure the Deputy that I will make a comprehensive statement at that time.
Would the Minister not agree that the response of his Department to the problems of HIV prisoners — this is not entirely his fault due to his recent arrival in the Department — is appalling in the extreme and represents a major condemnation of any caring society? Would he confirm, for example, that the 43 male offenders who are HIV positive are housed, firstly, in a separation unit which was specifically designed for isolationist detention of high security prisoners and, secondly, in the B basement which is subterranean and was originally designed as an isolation and punishment unit for prisoners and that both these types of accommodation are totally inadequate for people who require medical attention and who are suffering major trauma as a result of their illness? Would the Minister also agree that the treatment unit at St. James' Hospital for HIV prisoners is anything less than disgraceful?
So far as the accommodation is concerned, as I said in my original answer and in my reply to Deputy Kavanagh, I hope to be in a position shortly to make an announcement about future plans for the accommodation of HIV offenders. I accept fully what the Deputy has said about the total unsuitability of the present accommodation for offenders who are suffering trauma as a result of their illness.
With regard to the adequacy of the unit at St. James' Hospital I would not like to comment on this issue because I am not competent to do so. I suggest that the Deputy should put a question on it to my colleague, the Minister for Health.
I accept that it is not entirely within the Minister's purveyance but it is the unit to which prisoners are brought whenever they need hospital treatment. I can do not more than ask the Minister to permit his Department to give some attention to this matter. Is it intended to improve on the psychological and psychiatric services available to prisoners? The Minister indicated that two additional medical officers had been appointed but I am particularly concerned about the assignment of additional psychological and psychiatric support services. Would the Minister indicate when an overall medical director will be appointed to the prisons, as recommended urgently by the Whitaker commission?
The Deputy is raising a separate matter.
I accept that, but it is particularly relevant to those who need the service.
On the question relating to the unit in St. James's Hospital, I share the Deputy's concern that it would be preferable if the offenders with HIV positive could be treated within a secure unit in Mountjoy. I will deal with this shortly in a further statement.
With regard to the appointment of a director of medical services, it has been explained to the House on a number of occasions that the Civil Service Commission advertised this post on two occasions but were unable to select a suitable candidate from among the applicants. The chief medical officer for the Civil Service has been undertaking this role and is paying particular attention to it and has been consulted regularly on it. It should be borne in mind that it was never the intention that a director of medical services would have clinical responsibility for dealing with the cases of individual offenders. I am more than satisfied with the level of medical care being provided in individual cases. I will examine the situation with regard to the specialised cases which the Deputy has referred to and see what can be done.