Rolling back the prison estate: The pervasive impact of macroeconomic austerity on prisoner health in England

Prisons offer policymakers an opportunity to address the pre-existing high prevalence of physical and mental health issues among prisoners. This notion has been widely integrated into international and national prison health policies, including the Healthy Prisons Agenda, which calls for governments to address the health needs of prisoners and safeguard their health entitlement during imprisonment, and the Sustainable Development Goals 2030 concerning reducing inequality among disadvantaged populations.However, the implementation of the austerity policy in the United Kingdom since the re-emergence of the global financial crisis in 2008 has impeded this aspiration. This interdisciplinary paper critically evaluates the impact of austerity on prison health. The aforementioned policy has obstructed prisoners’ access to healthcare, exacerbated the degradation of their living conditions, impeded their purposeful activities and subjected them to an increasing level of violence.This paper calls for alternatives to imprisonment, initiating a more informed economic recovery policy, and relying on transnational and national organizations to scrutinize prisoners’ entitlement to health. These systemic solutions could act as a springboard for political and policy discussions at national and international forums with regard to improving prisoners’ health and simultaneously meeting the aspirations of the Healthy Prisons Agenda and the Sustainable Development Goals

NHS commissioning in probation in England – still on a wing and a prayer

Policy reforms in England and Wales mean that all individuals released from prison will have some contact with probation services, either serving a community sentence, or being on licence postrelease. Despite often having complex health needs, including a higher prevalence of mental illness, substance misuse problems and physical health problems than the general population, this socially excluded group of people often do not access healthcare until crisis point. This is partly due to servicelevel barriers such as a lack of appropriate and accessible healthcare provision. We conducted a national survey of all Clinical Commissioning Groups (CCGs, n=210) and Mental Health Trusts (MHTs, n=56) in England to systematically map healthcare provision for this group. We compared findings with similar surveys conducted in 2013 and 2014. We had excellent response rates, with the data analysed here representing responses from 75% of CCGs and 52% of MHTs in England. We found that just 4.5% (n=7) of CCG responses described commissioning a service specifically for probation service clients, and 7.6% (n=12) described probation-specific elements within their mainstream service provision. Responses from 19.7% of CCGs providing data (n=31) incorrectly suggested that NHS England are responsible for commissioning healthcare for probation clients rather than CCGs. Responses from 69% (n=20) of MHTs described providing services specifically for probation service clients, and 17.2% (n=5) described probation-specific elements within their mainstream service provision. This points to a need for an overarching health and justice strategy that emphasises organisational responsibilities in relation to commissioning healthcare for people in contact with probation services to ensure that there is appropriate healthcare provision for this group

Drug testing and court review hearings: uses and limitations

The ability of the UK criminal justice system to divert drug-dependent offenders into treatment has been enhanced during recent years. Despite the rapid expansion of such coercive measures, research findings to date are equivocal about their impact. This article draws on qualitative data from in-depth interviews with professionals and those mandated to treatment by the courts to assess the uses and limitations of two defining features of court-ordered drug treatment in Britain and elsewhere – drug testing and court review hearings – as a means of promoting and monitoring compliance with the conditions of these disposals

The Relationship Between Residential Quality of Life and Socioeconomic Status in England

This article explores the quintessential “person–environment” relationship that forms the core of the subdiscipline of social geography within the context of a national accountability shift from state to society in England. Two Audit Commission datasets are mined to establish homogeneous clusters of residential socioeconomic status and quality of life status before being cross-tabulated to detect genuine issues that affect each characteristic locality. In three of the four cross-tabulations, significant differences on economic well-being, life-long learning, and health distinguish correspondences, whereas in the other, less tangible, case, such factors as the use of cultural facilities, community cohesion, and people’s access to work seem to matter. The implications for research, policy, and practice are duly considered