I have a Director of Prison Medical Services who is a qualified medical practitioner with higher qualifications in psychiatry. He advises me on these issues on a continuing basis. He also liaises, in tandem with other prison and Department officials, with outside hospitals in respect of outpatient care arrangements of the type referred to by the Deputy.
The provision of a comprehensive accident and emergency treatment service within prisons to meet all possible medical emergencies is not feasible on practical grounds. To do so would require enormous expenditure to ensure the presence of a fully qualified accident and emergency treatment team at all times in the prisons. The physical plant and facilities associated with accident and emergency treatment is very extensive.
There is in place a system of medical cover for all prisons and 24 hour medical orderly cover at all closed prisons. However, medical orderlies who come on an injured prisoner, say, in the middle of the night, are only in a position to administer basic first aid and the doctor on call to the prison would, when contacted, tend to advise that appropriate further steps to manage an injured prisoner should be taken in a proper local accident and emergency unit.
