The States agreed a motion to debate the above report, which is normally just added as an appendix to the Billet. My speech on it is below.
Sir, I am pleased that this Assembly agreed to debate this report and that of the IMP. Often these go through without consideration, or worse any negative points are picked up by the media and the public gets a skewed view of reality.
I would just like to build on the health and care aspects raised from this report. Some members may not be aware that under the Prison Ordinance, the Prison Healthcare Manager is required to provide a report to the Governor. Aspects from this report have been included in turn in his report.
However, I thought it was worth adding to what is in this report, bearing in mind comments in the IMP report, in order to give a clearer picture of the extent of work currently being undertaken by a considerable range of healthcare professionals to support prisoners.
Prison healthcare falls under the clinical management of hospital services, medical division.
It is evident from the healthcare report that there is comprehensive level of care being provided. At the end of 2018 the nursing team consisted of one FTE band 7 Healthcare Manager, x 1 FTE band 6 RGN senior staff nurse and x 3 band 5 RGN staff nurses. Bank nurses and overtime were used to fill any nursing shortfalls on the rota.
This is in addition to GP clinics held twice a week, and in-reach support from teams from mental health, community and midwifery.
Daily nurse led clinics are held on a range of matters, New entrants are risk assessed, there is in-reach from key professionals, Bi-weekly dentistry and opticians clinics as well as training on the use of Prenoxad.
The Healthcare Team hold regular meetings throughout the year with
Prison specific policies and, protocols continually developed and introduced.
The Island Prescribing Advisor visits the prison for 2 hours most weeks, to support and offer appropriate training to nursing and medical staff, audit prison prescribing and assist with the development of pharmaceutical policies. 5 drug administration charts were audited each month and the results fed back through the PHOM. Medical and nursing staff were proud to continue to achieve 100% on 95% of the audits throughout the year
The nursing team attend regular and relevant meetings with Prison Pathways and continue to be an integral part of the sentence planning processes.
Prison nurses are actively involved in the weekly Risk Management Meeting which incorporates a part of the ACCT process for all prisoners at risk of suicide and or self harm. Nurses also attend regular reviews on all prisoners commenced on an ACCT document
The Healthcare Manager, or nurse in her absence, attends the Governor’s daily operational meeting along with regular attendances at HSC Medical Division and Adult Hospital Services meetings, Prison Performance Review, Planning and Development, Finance, Safer Custody and MAPPA Meetings.
There were just 10 complaints out of 2,695 appointments in the year, that’s 0.4%.
Now that number of appointments is interesting and I will finish on that point. Taking a rough and ready calculation of 225 per month and around 100 prisoners at any one time, that works out as an average of 2 appointments per prisoner per month. That is more than the average islander. This is not unexpected and is matched in other European jursidictions. There may be a number of reasons for that but it may demonstrate the link that exists between justice and social policies with those in prison generally coming from more disadvantaged backgrounds with poorer physical and mental health than the general population.
Not only that, as the healthcare manager states in her report, more prisoners are presenting with highly complex healthcare needs, with one requiring a lengthy admission in hospital and others having to attend the UK for specialist care not provided on island.
Sir, the sooner we stop blaming the symptoms such as the use of dugs and alcohol and focus on the causes, ie the wider social determinants of health the better and the sooner the justice review is completed the better. It is clearly long overdue and until it is this will just add to the increased costs of health care.