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Paul Hayton, MA, Dip HEd and John Boyington

Paul Hayton is with the Healthy Prisons Programme, Healthy Settings Development Unit, University of Central Lancashire, England, and with Prison Health, Department of Health, London, England. John Boyington is with Health and Offender Partnerships, National Offender Management System, Department of Health, London.

Correspondence: Requests for reprints should be sent to Paul Hayton, MA, Dip HEd, Prison Health, Department of Health, Wellington House, 133 Waterloo Road, London, SE1 8UG, England (e-mail: paul.hayton{at}dh.gsi.gov.uk).

Prison health in England and Wales has seen rapid reform and modernization. Previously it was characterized by over-medicalization, difficulties in staff recruitment, and a lack of professional development for staff. The Department of Health assumed responsibility from Her Majesty’s Prison Service for health policymaking in 2000, and full budgetary and health care administration control were transferred by April 2006. As a result of this reorganization, funding has improved and services now relate more to assessed health need.

There is early but limited evidence that some standards of care and patient outcomes have improved. The reforms address a human rights issue: that prisoners have a right to expect their health needs to be met by services that are broadly equivalent to services available to the community at large. We consider learning points for other countries which may be contemplating prison health reform, particularly those with a universal health care system.