Healthcare provision in prisons: an ongoing challenge (3 June 2026)

Summary

This BMJ Editorial by Emma Plugge and Caroline Watson argues that, despite major improvements in prison healthcare since responsibility transferred from the Prison Service to the NHS, true 'equivalence of care' with the community has still not been achieved.

Drawing on a new study by McFadzean et al, the authors highlight evidence that people in prison experience dramatically higher rates of avoidable healthcare-related harm than the general population, with prisoners estimated to be 41 to 67 times more likely to suffer probably avoidable significant harm.

They attribute this not to individual clinical failures but to systemic challenges, including an ageing and increasingly complex prison population, poor continuity of care during prison transfers, limited escort capacity for external appointments, fragmented health records and operational pressures within prisons that disrupt access to timely assessment, treatment and specialist care.