The Irish Prison Service seeks to ensure that prisoners receive the same standard of healthcare as members of the public who hold a medical card. Prisoners receive care through the primary care system (involving doctors, nurses and other in-reach healthcare professionals) delivered in each prison. Where a doctor or other healthcare professional operating in a prison determines that a prisoner requires treatment in an external setting (emergency department, out patients department, surgical procedure etc), following a comprehensive clinical assessment, a referral is made to the public health system. Where prisoners attend for hospital appointments, decisions regarding their clinical care are determined on the same basis as persons in the community accessing public health services.
Research and practice has identified three main care domains in the prison context:
Primary care is the model of care through which healthcare is delivered. The primary care service is provided using a multi-disciplinary model and intra-disciplinary working processes and strives to provide proactive healthcare with a focus on health awareness and preventative medicine. Each prison has a complement of Nurses, Medical Orderlies and attendance by a prison doctor commensurate with the healthcare needs and prison population of the institution.
Given the large number of prisoners requiring drug treatment services, the Irish Prison Service endeavours to provide a comprehensive range of such services in closed prisons. Drug rehabilitation programmes for prisoners involve a significant multidimensional input by a diverse range of general and specialist services provided both by the Irish Prison Service and visiting statutory and non-statutory organisations.
The prevalence of severe mental illness is significantly worse among prisoners compared to the general population. The Central Mental Hospital, National Forensic Mental Health Service provides consultant led in-reach sessions weekly by arrangement at all Dublin prisons and also at Portlaoise and the Midlands Prisons. Specialist in-reach services are in place for consultant led mental health sessions in the remaining closed prisons.
In addition, professional in-reach healthcare services are provided as required in relation to, inter alia, pharmacy, dental services, chiropody, physiotherapy and optical.