ABSTRACT
This chapter discusses the problems associated with providing adequate healthcare to people in prison. The physical and mental healthcare needs of prisoners have been an important consideration since the early days of the development of the penal system in England. In 1774, the Parliamentary Act for Preserving the Health of Prisoners in Gaol was passed, obliging local justices to appoint a resident medical officer to each gaol (Sim 1990). However, for as long as legislation to protect the health and well-being of prisoners has existed, those standards have also been subject to widespread criticism. One of the earliest critiques of the prison environment and its effect on health was published in 1777 when social reformer, John Howard, highlighted neglect and disinterest by gaolers, and a sense of moral decay and idleness pervading prison institutions in his work, The State of the Prisons in England and Wales. Howard blamed an unsuitable population mix within the prisons as contributing to the unhealthy atmosphere whereby the most experienced offenders were housed with children, petty thieves and the mentally disordered, the latter often unintentionally providing a source of amusement for other prisoners.
