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Prison Healthcare Departments

January 7, 2012

Prison Healthcare departments are brilliant, let me explain;

In the community, any doctor will tell you, they have a core group of drug related patients who attend and try to extort medication. These people are drug dependent and look to their local GP for top-up meds such as pain relief or anti depressants. The same patients will also often be on methadone and some will be using street drugs. This lifestyle makes the patient vulnerable to a spell in prison.

On arriving in prison the first stop is healthcare. Much is made of the bad back or depression and the prisoner will often have a list of medication he currently gets from his doctor on the outside. The prison doctor will generally declare the patient fit and not in need of further meds.

All hell breaks loose.

Alarm bells are pushed and the prisoner struggles with up to three prison officers like a professional wrestler. He then starts a losing battle with the system. A drug user in a normal GP practice who turns up demanding additional medication is probably one in a couple of hundred patients. The doctor tries hard but with time constraints will often give in to some if not all of the demands. In prison this type of patient is one in three and the system is in place to deal with the drama. The lengths prisoners will go to are amazing, rooftop protests, food refusal, assault and seg are most common but eventually they get on the methadone programme, reduction not maintenance, they do their rattle and take one of two routes.

They get off the gear or they use the heroin available in prison with all the appalling consequences that brings.

Working solidly within this chaos are the brilliant doctors and nurses of the prison healthcare department. They say no on a daily basis, they are threatened and sometimes assaulted. They stand in front of people who have made some bad life choices and tell them the bad news, the consequences. On top of this healthcare are pulled in to every prison operation to observe, cell extractions, rooftop protests, self harm incidents, removals to segregation are all attended by healthcare.

The mental health side of their workload is large and growing. From clear mental illness to subtle personality disorders healthcare are in attendance. They talk to and support people who have almost no perception of reality as I know it then feedback to me in a way I understand.

Lastly gallows humour. You want a guaranteed good night out on the piss with great company?Healthcare……………..Want to know where to be told the best jokes? Healthcare………….Want to know who’s gossiping about you and what they’re saying? Healthcare………….. What’s the diagnosis Nurse? “There’s not a pill big enough.”…………The most committed chainsmoking cigarette addicts, Healthcare

If you know someone who works in a prison healthcare department buy them a drink, smile at them and make sure they are OK. You know one of the hardest working people in the country.


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  1. Ahhh! Healthcare. Six of the best years of my working life! Getting stabbed in the head, washing psychotic murderers in catatonic states, the pretend madness to avoid justice! All with no coverage by the Mental Health Act.

  2. Elaine permalink

    Very good article but disappointing only Drs & nurses get nhs mentioned how about us admin who get threatened for not bowing down to appointment demands or not giving the what want in general , always the same , it’s only clinicians that get recognised, without admin the first cog would not turn !!

  3. Bernadette permalink

    Spent 10yrs of my nursing days in PHC. Have to say i had some of the most horrendous and great days. Each day was a different day. From pracrice nurse to emergency nurse we coped with everything.
    Hard but rewarding.

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