The Biggs effect: Caring for older prisoners

Older prisoners are growing in number yet there are few services to help them manage chronic illnesses or end of life, writes Sally Wentworth-Jones

The case of Ronnie Biggs, who was last week granted compassionate release on medical grounds, raises issues of how equipped the system is to cope and what problems older prisoners pose.

Older prisoners, deemed to be aged over 50, are the fastest growing population currently on remand or serving a prison sentence in England and Wales.

Prisoners age up to 10 years faster than their contemporaries in the community with 80% having a chronic illness or disability. Many will have cardiovascular, mobility, respiratory or mental health problems; more than half are reported to have the latter.

Immobility and disability

Historically, prisons were built for the young and even now prisoners experience a “survival of the fittest” regime where he who shouts loudest gets the most attention. This is certainly true of the services provided for older prisoners. Cases of prisoners not being able to access showers or missing hospital appointments through immobility or disability, or a lack of availability of prison staff is not uncommon.

The green paper, Shaping the Future of Care Together, states that “wherever you are in England, you will have the right to have your care and support needs assessed in the same way. And you will have the same proportion of your care and support costs paid for wherever you live”.

Prisoners should expect the same level of service as their community contemporaries, yet provision of nursing home care, care homes, aids to support mobility, access to occupational therapists, chiropodists, preventive healthcare and social workers is very weak.

Training provision

In partnership with the Ministry of Justice, Department of Health and third sector colleagues, Nacro has taken action to encourage better support and training provision to improve the lives of older people behind bars. This includes production of a Working with Older Prisoners pack, a practical information, support and advice guide for prison staff and prisoners to use.

Nacro also believes there should be a review of the availability of appropriate community care homes, hospice care and nursing homes for prisoners where prison no longer is appropriate to their needs or where they have reached the end of their sentence.

Due to a lack of appropriate end of life environments, many prisoners will die in prison. There are only a handful of facilities suitable for this provision of care. There should be small secure units set up to offer a smoother, more comfortable passing without the presence of security prison staff and where friends and family can pay their last respects.

Sally Wentworth-James is senior policy adviser at Nacro, the crime reduction charity

This article is published in the 13 August 2009 edition of Community Care under the headline “Getting old behind bars”