The Irish Prison Service (IPS) annual report for 20041 was released in December 2005. The mission of the IPS is to provide safe, secure and humane custody for people who are sent to prison. The IPS aims to provide a range of care and rehabilitation services for prisoners. These services are important in sustaining prisoners’ physical and mental health and ensuring equivalence of care with the health services available in the community. The services included are medical, dental, psychiatric, psychological and counselling.  

The provision of drug treatment services, in particular methadone services, continues to use a significant proportion of health care resources. A number of prisons provide methadone treatment and, in 2004, 1,309 prisoners were treated with methadone. Of these, 96 commenced methadone treatment for the first time, indicating the important role of prison services in introducing prisoners to drug treatment (Table 1).

The IPS recognises that people who take drugs require assistance in order to tackle their addiction successfully. Meeting the needs of drug users requires a variety of interventions tailored to each individual. According to the authors, the dramatic increase in methadone treatment over the past five years and the consequent demand for a range of drug treatment services in prisons highlight the need for a review of the structures and staff required to deliver these services. The authors state that there are some pilot initiatives in place that could be useful if provided throughout the prison service. For example, two nurses have been allocated to the delivery of drug treatment services in Wheatfield Prison, which has considerably improved the continuity of care for drug users within the prison and, more importantly, between the prison and the community.

 Table 1   Number of cases receiving methadone treatment in Irish prisons in 2004 

The Prison Health Working Group (PHWG) is responsible for implementing the recommendations of a review group on the structure and organisation of prison services published in 2001.2  The re-organisation of the health service management structures resulted in delayed implementation of some of these recommendations. However, the PHWG has completed a large body of work which has been submitted for consideration and includes:

·         a health-needs assessment of the Irish prison population

·         a report on meeting the mental health needs of prisoners

·         a protocol in relation to the management of prisoners attending acute hospitals.

The first recommendation in the report of the review group is that the same care and treatment should be available in both the prison and community health services. In order to implement this recommendation, considerable groundwork was undertaken during 2004 to develop formal service agreements in a number of areas. For example, formal agreements will be developed between Cloverhill and Wheatfield prison services and the health sector in order to provide consultant-led infectious disease and drug treatment services at these prisons from 2005 onwards. Of course, the effective development of these services within the prisons will require adequate and appropriate internal administrative and clinical support. The experience gained from the introduction of these services in Cloverhill and Wheatfield prisons will facilitate similar developments across the prison estate.

The Irish Prison Service Health Care Standards manual was published in June 2004.

This will provide governors and other managers with clear guidance regarding the health services to be provided and the facilities required to provide these services. From 2004 onwards, prison entrants are provided with an outline of the level of services they may expect to receive.

The feasibility of formally incorporating the prison population within General Medical Service (GMS) structures so as to facilitate treatment structures in custody, and in the period immediately following release, is under consideration. Progress in this matter will require a formal acceptance that prisoners should be covered within the same administrative structures as other citizens.

The resolution of the prison doctors' strike resulted in a new contract which benefits both the doctors and the prison services. As part of the contract, doctors are required to implement a range of clinical and administrative tasks. These tasks are in line with the specifications in the IPS health care standards and are necessary for the effective and co-ordinated provision of health care within a custodial environment and between the prisons and the community.

A nursing service was introduced in Irish prisons in 1999. There are 79.5 whole-time-equivalent nursing officers providing health care in 11 of the 16 prisons. 

1. Irish Prison Service (2005) Annual Report 2004. Dublin: Irish Prison Service.

2. Report of the group to review the structure and organisation of prison health care services (2001) Dublin: Stationery Office.