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Prisons

My Lords, I thank my noble friend for this debate. If a standing royal commission takes place, it should not sit on a shelf. It would need to look also at aftercare and resettlement, because reoffending rates remain high, with two-thirds of prisoners reoffending within two years of release. That figure goes up to 76 per cent within one year of release for young people under 18. Many of them come from care or are homeless. Children under 16 should not be in a prison situation, especially a Titan prison, but in a secure school, having full-time education, plenty of exercise and support in changing their habits. There should be zero tolerance of bullying. Many of those young people have truanted from school, been involved with drugs and alcohol, and have a chaotic lifestyle. They should be given the chance of challenges such as those provided in the camps in America, where activities like those offered in the Duke of Edinburgh schemes are undertaken. Prison health is now the responsibility of the NHS, which I welcome. However, there is no national information on the amount of resource being spent by PCTs on commissioning prison mental health care, either from specialist mental health trusts or as part of the day-to-day work of primary care teams. Nor is there any way of comparing what is spent on prison primary care with what is spent outside. With so many health problems existing in prisons—whether physical, mental or dual-diagnosis, which is a combination of mental illness and addiction—and elderly long-term prisoners, there is no way of judging whether this level of provision meets the health needs of prisoners. Many of these mental health patients should be out of prison and treated in secure mental health units where their conditions are understood. An article in the March/April edition of Diabetes UK’s magazine says that prisoners with diabetes often pay a high price in health terms, struggling to square self-management with the prison regime, which is not helpful to prisoners. A prison officer called Andy Cross at HMP Woodhill, a category A remand prison, is a diabetic himself. He helps prisoners with their diabetic problems and advises prison staff on how to manage diabetic prisoners when things go wrong. This include hypos due to low blood sugar or glucose. Prison staff often mistake hypos for behaviour problems. Andy has become a diabetic liaison officer for the Prison Service. There are many public health needs in prisons. Recent developments include a specialist TB nurse at Pentonville and a hepatitis programme across London, while the Health Protection Agency is setting up a prison network across the country. One could have a royal commission for the prison health service alone.