Incarcerated Workers & Prison Health Care
Updated: Feb 3
IWOC Ireland has created a series of interviews and texts on what it is like within the prison system and heathcare, this is a recent piece of text sent by a fellow prisoner to help raise awareness of prisons and access to health care.
If you are a prisoner or a relative of a prisoner in the Irish prison system, north or south, and would like to highlight an issue of concern, rights or prisoner struggle then please get in touch with IWOC here.
We should all be able to trust doctors, nurses and other health care professionals absolutely. They are the people we confide our worries and concerns in, with faith that they will treat us with dignity and compassion, and of course in confidence.
These are people who have taken “an oath” to always have their patients best interest at the forefront of everything they do. To protect life, and to be an advocate for those whose care they are charged with.
And let’s not forget primum-non-nocere first do not harm. These ethical standards are inherited from generation to generation in order to protect their patients safety and welfare, and maintenance.
The prison has abdicated from their responsibility to provide a healthcare system for prisoners by outsourcing it to the local health and social care trusts. This measure, while i have no doubt has some financial and logistical reasoning, should act as a protective measure for prisoners. A system that is separate from the oppressive, disciplinarian institution should be free to operate without any caustic influences or coercion. However, this has proved not to be the case, and it has become enmeshed in the destructive and unforgiving framework of the prison system. And with any failings within the NHS, its is the prisoners, rather their patients who ultimately suffer the consequences.
To start with, it is common practice for healthcare professionals to refer to patients as prisoners, identifying them only by surnames, or worse yet by prison numbers. This is the most basic indication of the blurring of the distinction between the independent health care system and the prison administration, In doing so the health care system is wilfully dehumanising us, virtually treating us with the same manner a cattle is tagged in an abattoir.
Furthermore, because of external state-based influences, many people who are suffering from often chronic and debilitating illnesses, both physical and mental, are going untreated or under-treated. Healthcare are reluctant to prescribe painkillers, anti-anxiety medication and anti-psychotic medication for the fear that they maybe misused. Ofter this leaves people in a crisis situation, where their only choices are to endure and suffer their condition, or to seek an alternative by way of del-medicating, which is a lose-lose situation.
There is no negotiation with the healthcare staff, and it is very rare that you can be an active part in the decision making process, having a say in your own treatment plan. This is undeniably a form of collective punishment. Removing peoples autonomy, and indeed the last piece of autonomy that that should be retained while incarcerated, and operating in such a paternalistic fashion goes against all the holistic practices that are common place outside of the prison walls. Leaving people to suffer in pain is inhumane and cruel, and if people do insist upon treatment, they qualify for yet another “helpful” label - ‘displays drug-seeking behaviour’.
in order to keep a tab on prescription medication, prisoners are subject to ‘random’ medication checks whereby any tablets that are in their possession are counted. If there are too many they are accused of stock-piling to hoarding, and if they are short they are accused of drug-dealing or being a drug addict. Either way the healthcare system, choose to inform the Prison Service of this “offence”, knowingly foregoing your right to confidentiality, ad being aware that the prison will punish that person.
This issue could be dealt with discreetly by healthcare staff, and they coal take steps to ensure that medication is taken safely, such as supervised administration, which is their protocol, but they insist upon going this extra step to punish you, much like the prison itself would. They do not take into consideration the reasons behind failing on of these checks, such as being bullied by other prisoners.
The also choose to ignore their own government guidance that promotes self-management of their condition, and using an “as and when required” approach to medication where possible rather than taking them by rote.
Having their patients punished is an unthinkable act, and certainly does not promote a trusting and therapeutic relationship. Along similar lines, if a prisoner challenges substandard care, or indicates that they are not happy with their management, instead of maintaining professional standards and accountability there is a convenient get-out clause - the discipline alarm. One press of a button and their patients are tackled forcibly and violently to the ground by a posse of prison officers, and dragged off with their arms twisted behind their backs. Again, what happened to first do no harm?
Such professions are overseen by governing bodies such as the GMC and the NMC. These organisations are responsible for ensuring appropriate care, ethical standards and public safety, as well as maintaining public trust in their respective professions. But how can we have trust in these professions, or the organisations that represent them, when they are willing to overlook such degrading and substandard care in prisons.
The same governing bodies would revoke a workers licence to practice if that member was arrested at a Civil Rights demonstration, campaign for social justice, but actively choose inaction to prevent the injustices that are happening daily in prisons.
Within the judicial and penal system, it is impossible to provide an appropriate or safe level of healthcare when the system that provides it is intertwined with the prison service, or even subjugated by it. Consequently prisoners are left with physical and mental illnesses that are deteriorating rapidly, and are suffering on a daily basis without a robust protective healthcare system that they can trust or rely upon for help.