A female inmate was left handcuffed to a male prison guard while she had a mammogram. An example of prisoners being denied their dignity while receiving care from the NHS, a watchdog has revealed.
The incident is highlighted in a report by the Health Services Safety Investigation Body (HSSIB) into the difficulties prisoners can face when leaving prison to see a GP or visit a hospital.
Some prisoners are put on a long chain while the prison guard guards them and stays just outside the room, while others have to wait in cupboards for their appointments, it emerged.
A government spokesperson said the report’s findings, based on interviews with more than 120 prisoners, were “very worrying”, especially regarding the problems experienced by female prisoners.
The prospect that prisoners will not have the same dignity and privacy as other patients during NHS appointments is a key reason why more than half do not attend appointments outside prison.
HSSIB found that the ‘no attendance’ (DNA) rates for outpatient appointments in 2024 for those in prison ‘were high, at 52% and 57% for men and women respectively. This compares with a DNA rate in the general population of 26% for both sexes,” the report said.
Female prisoners being escorted to an outside appointment by male or mixed teams of prison staff “may influence patients’ decisions about whether to go, especially at appointments for sensitive female clinics such as obstetrics and gynaecology,” it added.
HSSIB has identified a number of situations in which prisoners can be deprived of their dignity when receiving NHS care outside:
male and female prisoners are seen in public handcuffed and wearing prison clothing
prison guards who remain present during the clinical appointment
companions to outpatient appointments of the opposite sex
HSSIB was told by an unnamed national organization that fear among patients about waiting for a doctor or nurse with a prisoner in the same room had led to “patients (prisoners) having to wait in broom closets to interact with, or see to be avoided. by other patients”.
One female prison inspectors visited “made efforts to reduce privacy and dignity concerns by using side entrances in one of the hospitals and only taking the patient to the hospital when the appointment was about to begin,” to minimize interaction with other people waiting.
Dr. Miranda Davies, a senior fellow at the Nuffield Trust health think tank and an expert on prison healthcare, said: “It is understandable that women in prison may not want to attend a hospital appointment with a male prison officer for an intimate healthcare procedure.
“Women in prison, just like women outside prison, want to be treated with respect and feel heard when they have concerns, and if this doesn’t happen, women’s health is ultimately at risk.”
Research that Davies led, published in 2022Research found that women in prison are almost twice as likely as the general population to miss an appointment for obstetric care – 31% compared to 17%.
A government spokesperson said: “This is a deeply worrying report.
“We are committed to improving care for every patient, including better addressing the specific needs of female prisoners, and will work with NHS England to respond in due course.”