Frail or ill prisoners are being prevented from dying with dignity by the inappropriate use of restraint by prison staff, despite repeated warnings about the practice from the prisons watchdog.
There were "too many examples where prisons restrain elderly or frail prisoners" when they need hospital treatment outside of prison, despite their poor health meaning they posed little risk to the public, the Prisons and Probations Ombudsman (PPO) said in his annual report. This included cases where prisoners were dying.
This is the fourth consecutive annual PPO report in which successive ombudsmen have raised the issue of inappropriate restraint of inmates being taken to or receiving treatment in hospitals. In last year's report, the PPO called for a review of policy on restraint for these prisoners, but this has not been carried out by the National Offender Management Service.
Where inmates need to leave prison to receive hospital treatment, prison staff carry out an escort risk assessment of the potential for the prisoner to escape or cause harm to the public. In this year's report, the PPO said risk assessments were often based on the person's original offence, despite the fact that their health may have deteriorated significantly since entering prison, lowering significantly the potential for them to cause harm or escape.
The PPO, which is responsible for investigating prison deaths, said it had investigated cases where medical staff had not contributed to risk assessments, and also where prisoners with limited mobility were restrained with handcuffs and chains even where they were assessed as low risk.
"An escort risk assessment must strike the appropriate balance between protecting the public and ensuring the humane treatment of the individual prisoner," said the annual report. "We continue to see too many examples where prisons restrain frail and elderly prisoners even when their physical condition renders it implausible that they could present any risk."
The PPO, Nigel Newcomen, said he would continue to raise this concern and would be producing a "lessons learned bulletin" on the topic for prisons and other services under the PPO's remit in due course.
The concern comes amid a sharp rise in deaths in custody, with the PPO starting 229 investigations into fatalities in prison, immigration detention and probation approved premises in 2011-12, a 15% rise on the previous year. The majority of these - 142 - were deaths from natural causes, up 20 on the previous year, and reflecting the ageing of the prison population and the increasing number of inmates with long-term conditions.
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