ABSTRACT
Existing literature tends to examine prison governance and prison healthcare governance discretely. Such separation prevents a comprehensive understanding of how prison healthcare services are subjected to the control of the prison authorities, and how their dynamics impact the delivery of prison healthcare that benefits prisoners. This chapter addresses this gap by first outlining the theoretical definitions of the modes of governance. Then, it unpacks existing research that demonstrates how unclear aims and incoherent policies of imprisonment, a fragile institutional base at all levels of governance, and persistent political intrusion weaken prison rehabilitation.
This chapter further demonstrates how these structures function within a prevailing neoliberal framework that prioritises punishment over rehabilitation and prefers to privatise services that are often underscored by moral legitimacy, service efficiency, and quality fallacies. While checks and balances of power are critical given the closed nature of prisons, extant literature shows how the structure of cross-governmental monitoring, independent prison inspections, and voluntary organisations lack sufficient power and independence to execute reform. These dynamics enabled neoliberal ideologies to infiltrate prisons and prison healthcare governance structures and limit the potential health gains in this setting.
