Rise in prison deaths raises questions about access to health care

A “small but sharp” rise in deaths in prisons should prompt serious questions about the impact of pandemic restrictions on those in jail, according to campaigners. 

Since January 2021 there have been 25 deaths in prison already, compared with the previous five-year average of 35, according to statistics from the Scottish Prison Service.

The number of deaths this year is an almost 50 per cent increase, based on a five year average at this date – calculated by the Ferret – of 17 deaths. Last year there had been 20 deaths by the end of June.

Of the 25 who have died so far this year, eight people took their own lives and there was one homicide. In January, Dean Ramsey, 30, died from injuries sustained during an attack at his Glenochil prison cell.

Two of the deaths in 2021 were Covid-19 related.

But though 16 were due to “natural causes”, academic Sarah Armstrong said her research revealed there had been concerns about the impact of restricted access to health care and mental health support as a result of the pandemic.

Earlier this year she received allegations from a prisoner with cancer that he had struggled to access healthcare. She later found his name on the register of deaths in Barlinnie Prison.

The letter was written by the prisoner in Barlinnie in December 2020 and received by Armstrong in February 2021. He claimed he had been in pain for six months but couldn’t get healthcare because it wasn’t judged to be an emergency.

He also alleged that after a cystoscopy in June 2020 to look at the inside of his bladder he suffered a chronic infection and had to “beg” for antibiotics.

Others interviewed by Armstrong and her team also said they had difficulty in both mental and physical healthcare services due to restrictions, which have largely seen prisoners locked in their cells for all but a couple of hours a day.

Armstrong acknowledged that death rates were often particularly high in prison in January, meaning slightly more deaths were logged within the first six months of the year. But she claimed both a gradual increase in deaths and the smaller but sharper recent rise showed the need for questions to be raised.

“The number of deaths has been trending upwards for the  last few years but the increase during the pandemic is concerning,” she added.

“There are quite a few deaths that are due to chronic conditions like heart conditions and so on. So one could say that these are people who would have died anyway. But what is clear in the pandemic is that there have been serious issues with access to healthcare.

“That has been the experience for all of society but is even more apparent in prisons. That’s not just emergency healthcare but ongoing preventative care.”

She also has concerns that 11 of the 25 who have died have done so within a year of being jailed, as well as about the circumstances of the eight who have taken their own lives.

As previously reported by The Ferret, researchers are concerned about the mental health impact for those on remand – now one in four of the prison population.

“Those who are in remand are also more likely to take their lives statistically and we have a very high population on remand at the moment,” added Armstrong.

“We also know that even as prisons begin to unlock, life for those on remand is still very restricted.  People are still spending up to 22 hours a day in their cells.

“The fact remains that despite attempts to improve things, deaths are still rising.”

Matthew McGovern, defence solicitor and partner at law firm McGovern Reid, said he was “taken aback” by the number of deaths already logged in this year.

He added: “From my point of view the impact of lockdown on prisoners has really been extraordinary, even those who know the score and have been to prison before.”

He raised concerns about a “distressed” client who missed surgery in May to remove metal plates inserted after a car accident because he was remanded the week before the operation was due. The man is still on remand and waiting for the plates to be removed.

I understand that prisoners are not the public’s biggest concern but it doesn’t  mean they should be thrown to the wolves and forgotten about.

Matthew McGovern, [NEED TITLE IN HERE]

Another of his clients claims to have spent over 23 hours isolated in his cell in Polmont on his 18th birthday. “To be frank it’s heart-breaking what’s happening in prisons due to Covid-19,” added McGovern.

“I understand that prisoners are not the public’s biggest concern but it doesn’t mean they should be thrown to the wolves and forgotten about.”

Emma Jardine, policy and public affairs manager at the Howard League Scotland, said it was “entirely valid” to raise the possibility of a link between the recent number of deaths in custody and access to appropriate healthcare.

“Those in prison are entitled to exactly the same provision of NHS services as anyone else,” she added.

“If that isn’t being provided and it’s contributing to a higher than expected number of deaths, then that needs to be looked at very closely”.

“The conditions and length of time under which people are currently being held on remand are very likely to be contributing to poor mental health and instances of self-harm.

“The uncertainty of a release or trial date, the continuing regime restrictions and the potential inconsistencies with existing treatment plans mean that – unsurprisingly – some people feel utterly lost.”

Tom Fox, head of corporate affairs for the Scottish Prison Service (SPS), said that the rise in deaths – which were often disproportionate in the first six months of the year – was a small one. The increase in prisoner deaths in recent years was a reflection of the prison’s older population, he added.

“But we very much appreciate the pressures on mental health and have been doing all we can to alleviate that,” he added.

“We’ve put in place in-cell activity and changed the working patterns of staff to allow people more time out of their cell. But ultimately we need to ensure people are safe – the potential for outbreaks are far greater in prison.

“We have a duty of care and provide access to healthcare. But the health care itself is a matter for the NHS. People in prison should always have equal access to medical care as the rest of society.”

Cover image thanks to iStock/C_FOR

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