The term 'offender' refers to people who
come into contact with the criminal justice system because they
have committed or are suspected of committing a criminal offence.
They may have been given a custodial (prison sentence) or non
custodial penalty e.g. a fine, community based order etc.
The principle of equivalence.
Offenders often experience significant problems gaining access to
health care services which can add to problems of social exclusion,
and puts offenders at risk of continued offending. Responsibility
for offender health care lies within the NHS and the North East
offender health commissioning unit which aims to give
offenders access to the same quality and range of health care
services as the general public receives in the community.
Losing your freedom shouldn't mean losing your health or the
opportunity to regain it. We operate a philosophy of providing
non-judgemental and equivalent care to all of our patients.
Prisoners have an opportunity to consider health needs and concerns
that they may not have been able to deal with and get help with on
the outside. Prisons and custodial settings can provide a unique
opportunity to reduce health inequalities through health promotion,
health education, and disease prevention measures, and engaging
offenders in primary care, mental health, and drug services.
HMP Durham was built in the early 19th century and has been
undergoing a major refurbishment programme during the last ten
years. This is the oldest prison in the cluster and its role is a
Category B local prison serving the courts in the area, holding
approximately 981 remand and sentenced prisoners. The prison has
six residential units and a busy reception/first night
The prison regime includes both full time and part time education,
workshops (both production and training such as bricklaying, data
input, woodwork and contract work), works and gardens. There are
other features e.g. integrated resettlement strategy which provides
advice and guidance on a wide range of resettlement issues such as
accommodation, finance, benefits, training development through job
clubs and community involvement. Post release support is also
provided through the Continue to Work programme as well as a
coordinated approach to involving families.
Healthcare is provided 24 hours a day, consisting of a 20 bed
in-patients unit, a primary care facility which has a GP surgery,
dentistry, optician, physiotherapy and podiatry services. There are
also chronic disease clinics, smoking cessation clinics and general
health promotion. There is a mental health facility providing
primary mental health support, which includes links with colleagues
at the Hutton Centre in Middleborough and St Nicholas Hospital in
Newcastle. HMP Durham also benefits from a pharmacy which supplies
a service to Low Newton Prison.
The prison has 734 male prisoners serving sentences more than four
years, some Cat A remand prisoners are held at HMP Frankland.
Frankland is a High Security Dispersal Prison.
Each of the wings - A to D holds 108 men. Wings F and G, opened in
1998 holds 206 prisoners. During 2009 an additional wing was built,
to hold 150 prisoners.
The Westgate unit holds approximately 80 prisoners who are
categorised as DSPD (Dangerous and Severe Personality Disorder).
This unit has a separate regime to the main prison and is self
contained. The unit is ten minutes walk from the main prison. The
Westgate unit assesses prisoners who have committed serious violent
or sexual offences in relation to their risk and potential
personality disorders. It then goes on to develop and provide
treatment or management aimed at reducing the short and long term
impact of these factors. The unit has a separate healthcare
facility to that of HMP Frankland, with its own team of nursing
staff (comprising registered general, mental health and learning
disability nurses), its own psychiatrists and regular visits from
other health professionals such as general practitioners and a
dentist. It should be noted that after 19:30 hours on weekdays, and
17:00 hours at weekends, there are no Westgate nursing staff on
duty, and any urgent care will be provided by the main healthcare
team. In terms of care that may be required out of hours, the
Westgate unit should be thought of in the same way as any other
residential wing within HMP Frankland.
HMP YOI LOW NEWTON
There are 310 female sentenced and remand prisoners. The prison
also holds young offenders (females only). HMP YOI Low Newton is
situated approximately four miles south west of Durham, and was
purpose-built as a remand centre in 1965 with accommodation for 65
males and 11 females. Additional accommodation was provided in 1975
with a CNA (Certified Normal Accommodation) of 215. Low Newton
serves the courts in the catchment area from the Scottish Borders
to North Yorkshire across to North Cumbria.
HM YOI DEERBOLT
Deerbolt is a purpose built young offenders institution, which
opened in 1973 built on a former army camp. It is situated on the
outskirts of Barnard Castle in County Durham. Deerbolt accommodates
prisoners from the North East and North West of England, Yorkshire
and Humberside. Deerbolt is a male Category C training prison and
caters for approximately 500 prisoners between the ages of 18-21,
generally serving sentences up to four years in length.
Deerbolt has nine residential wings, including an induction wing, a
large gym, healthcare centre, chapel and various educational areas
spread over a 23 acre site. The prison offers a variety of
purposeful activities including educational courses/qualifications
and vocational courses e.g. bricklaying, painting and car
mechanics. Deerbolt also participates in the Duke of Edinburgh
Healthcare cover is provided on a 24 hour basis. The healthcare
centre consists of a small inpatient facility (5 beds) which
provides crisis care/intervention and limited post operative care.
The outpatient area provides access to the primary care services.
These consist of GP, surgery and dentistry, as well as specialist
clinics for triage, sexual health, vaccinations, asthma, and
smoking cessation. There are also optician, podiatry and
physiotherapy services on a needs basis. Healthcare also has a
small mental health team which provides a range of primary care
services as well as crisis intervention.
PHOTOGRAPHING AND INTERVIEWING WOMEN IN THE CRIMINAL
The photographer and researcher, Adrian Clarke, has been
commissioned to photograph and interview between 40 and 50 women
who have had contact with the criminal justice system. The project
will include women in custody and those who have spent time in
custody but who have now been released. The interviews will deal
with the following issues:
as well as any other matters raised by the subjects which
concern their health, offending behaviour and imprisonment.
It has not yet been decided whether the project will involve
photographs and interviews of women whilst in custody or whether it
will be restricted to those who have already been released.
Adrian Clarke is a qualified solicitor. For the last seven years he
has worked as a photographer and researcher. His particular method
has been to use photographic portraits to accompany interviews with
his subjects, in effect engaging in an unusual form of user
consultation. Examples of his work can be seen at www.adrianclarke.net.
He was commissioned by the County Durham DAAT in 2004 to photograph
and interview a group of drug and alcohol abusers and their carers,
which is why he was chosen for this work. The previous project
resulted in the series "Gary's Friends", which formed a book of the
same title. The work has been used by the DAAT and the Home Office
to illustrate the particular issues faced by families in which
there is one or more member who abuses drugs or alcohol. The
project has proved to be a useful tool in informing policy and in
engaging with those afflicted by similar difficulties.
We hope that the project will provide, in an unusually graphic
form, a body of evidence concerning the particular difficulties
faced by women in prison. It will help those charged with framing
policy in this area to identify the particular circumstances that
create the risk of self-harm and suicide and it will be used as a
tool to help other women facing a similar situation to feel less
isolated. We hope it will be used both inside and outside prison to
help women examine their offending behaviour, their past lives,
their drug use and what steps they can take to help themselves in
the future. It will assist recovery groups, counselling services
and others to focus on matters that should be addressed in order to
improve women's health, reduce drug and alcohol use and reduce the
risk of re-offending.
It is important to note that the focus of this project will not be
on criticising the current prison regime but on what women say
about their own lives. Thus far, where women have raised issues
concerning the regime at HMP Low Newton they have tended to be
complimentary of recent changes that have taken place, particularly
in relation to the induction processes and the policies surrounding
'The treatment I have received from all the staff has been
excellent and could you extend my thanks to them all. A very
thankful and relieved patient'.
Patient, Dermatology Outpatients Department, University Hospital
of North Durham