‘You tried your best, but we suffered enormously’: A decentred analysis of the contested narratives surrounding COVID-19 policy implementation in the British prison system

Abstract

Prison health is intricately connected to public health given the significant burden of poor health which the majority of people in prison experience. Prison healthcare suffers from chronic understaffing, mostly due to macroeconomic austerity. The COVID-19 pandemic inflicted extensive damage on this already fragile milieu. We employ decentred theory as a sensitising concept to articulate competing narratives about prison healthcare decision-making during the pandemic. We predominantly draw upon 44 interviews conducted in 2021. We found that non-urgent healthcare provision almost collapsed with exhausted healthcare staff trying to deliver a reduced service to patients who felt abandoned. Consequently, our analysis portrayed narratives of suffering, trauma and injustice that were experienced in markedly different ways. Many participants compared a muddled and un(der)funded prison healthcare COVID-19 strategy against that of well financed community healthcare. Decision makers implicitly competed with each other over lines of accountability and responsibility. The research process itself was distorted and resisted by various actors in both overt and covert ways. We argue that prison healthcare is emblematic of a devalued and underfunded public healthcare agenda where actors have been physically and emotionally harmed by habiting space within a struggling institution during the largest public health crisis of the past century