A major shake-up in the way GP services are provided in Scottish prisons is being planned - with private healthcare organisations in the frame as a potential provider.
The Scottish Prisons Service is to scrap the existing arrangement, where locum GPs negotiate contracts with individual prisons, and replace it with a single national contract covering all 18 prisons, starting from October.
Private healthcare companies, will be among those encouraged to tender for the contract, although the NHS could also put forward a bid, said a spokesperson.
'I would not call it privatisation as the NHS can tender for this, she added. 'It's about value for money and standards of service.'
BUPA, which was tipped to bid for the service, has already ruled itself out.
Some prisons have doctors on a contract basis, others have service level agreements and a handful already use private companies.
Scottish prisons are already in the process of contracting out their social work and pharmaceutical services.
Juliet Lion, director of the Prison Reform Trust, was concerned that the care of prisoners might shift from the public to private sectors.
'It may improve services, but you could argue this is a public job to be done and it is difficult to justify privatisation of it.'
She was particularly concerned that the new arrangement should be able to meet the high level of need for mental health services within the prison population.
'The largest problem, is those who have needs such as depression or conduct disorders - things for which prison staff have little training.
'We would be looking for equivalent ifnot better services for prisoners than they would have in the community.'
The move comes in complete contrast to English and Welsh attempts to improve prison healthcare after repeated reports about poor standards.
A taskforce was set up last year to improve links between the NHS and prison service, although according to Ms Lion progress has been very slow.
The NHS already has the healthcare contracts for two private prisons - in Bridgend and Northallerton.