Published: 27/03/2003, Volume II3, No. 5848 Page 10 11

Primary care trusts will not take full responsibility for prison healthcare for another three years, the Department of Health has announced.

Although funding for primary care for prisoners will officially transfer to the NHS next month, the DoH says it will be immediately transferred back to the prison service, which will continue with 'business as usual' in the short term.

The question of who takes responsibility for prisoners' healthcare has sparked controversy. In 1999, the government rejected calls from chief inspector of prisons Sir David Ramsbotham for full integration of prison healthcare within the NHS, and instead introduced joint accountability between the DoH and Home Office. But last September it was announced that budgetary responsibility for all prison health services would transfer to the NHS in April 2003.

That now looks to be a shortterm paper exercise, while PCTs prepare to take full responsibility between 2004 and 2006.

A spokesperson for the prison health section of the DoH and Home Office said that although operationally it would be 'business as usual' for the running of prison healthcare this year, funding would be increased by£19m, on top of the£117.7m identified by prisons as the cost of healthcare.

This financial year, the money will immediately transfer back to the prison service and will then be allocated to prisons in consultation with the DoH. Prison governors will remain responsible for health budgets in their prison. No prison healthcare staff will transfer to the NHS next month.

But the spokesperson said nearly 30 PCTs had expressed an interest in joining a prison development network from 2004 onwards.

Prisons and PCTs will be selected in the next couple of months to take part in pilot schemes to model the transfer of funds.

British Medical Association civil service committee chair Dr Paddy Keavney said many PCTs 'who are already very cashstrapped' feared discrepancies between the amount of funding they would receive and the costs of meeting their needs analysis of prisoners' healthcare.

One prison healthcare manager said she suspected PCTs were not keen to take on the responsibility:

'PCTs have 196 priorities to deal with and this will be number 197'.

Howard League for Penal Reform assistant director Anita Dockley said the charity was 'very disappointed that it is going to take longer because we have always advocated giving the same quality of care to people in prisons as in the community'.

Prison Reform Trust policy officer Enver Solomon said: 'If the delays mean changes in service delivery will be delayed, that doesn't bode well. But the fact that they are providing more money is certainly a good thing.'