Abstract

SummaryPrisons have high levels of psychiatric morbidity and function as mental illness recognition centres. Their healthcare wings are not hospitals and timely transfers to hospital are often unavailable. The United Nations' right to the highest attainable standard of health is assessed according to whether healthcare services are available, accessible, acceptable and of good quality (AAAQ). It is proposed that the AAAQ framework goes beyond the principle of equivalence of care and provides a more sophisticated measure for exploring prison healthcare.

Highlights

  • The United Nations (UN) model, which contains the concept of equivalence, resonates with Her Majesty’s Inspectorate of Prisons’ four tests of a healthy prison11 - safety, respect, purposeful activity, resettlement - and could be measured and publicly reported

  • We suggest that this would offer a more sophisticated measure for exploring prison healthcare, by more honestly describing the limitations and more accurately producing focused change within custodial settings

  • It is unlikely to offer an appropriate clinical environment, as many prisons were built in the 19th century, with limited adaptation possible for modern health and safety requirements

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Summary

Introduction

The 1966 United Nations (UN) International Covenant on Economic, Social and Cultural Rights has detailed a right to the highest attainable standard of health for every person[9] and has suggested the AAAQ framework - that healthcare should be available, accessible, acceptable, and of good quality10 - as a paradigm to assessing the progressive realisation of that right. Availability: is the provision of healthcare services sufficiently available through the prison estate, and operated by properly trained health professionals, to protect prisoners’ health?

Results
Conclusion

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