Until recently the provision of health care within prisons was the sole responsibility of the prison service. The Prison Health Service (formerly known as the Prison Medical Service) is the oldest civilian medical service in Britain. In addition to being much older than the NHS the Prison Health Service is much smaller, less well developed and less well resourced. Prison health care was coordinated by the Directorate of Health Care at the Home Office; the Department of Health and the NHS had no direct input. As a result, prisoners were afforded a standard of health care well below that provided by the NHS, and without radical reform there was little prospect of improvement. However, in recent years things have begun to change and last year collaboration between the prison service and the NHS resulted in the creation of a partnership between these two organisations (Joint Prison Service and NHS Executive Working Group, 1999). Although the intention is to improve health care standards for prisoners, the formal nature of this partnership also has the effect of making the NHS more directly responsible for health care in prisons.
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