Offender Management Bill

moved Amendment No. 112: 112: Clause 22, page 17, line 5, leave out subsection (1) and insert— ““(1) Section 7 of the Prison Act 1952 (c. 52) is amended as follows. (2) In subsection (1) for ““medical officer”” substitute ““health care manager””. (3) In subsection (4) the words ““and the medical officer shall be a registered medical practitioner”” are omitted.”” The noble Lord said: I tabled the amendment amid some concern after reading in the Bill: "““It is no longer a requirement for there to be a medical officer appointed under section 7(1) of the Prison Act 1952…for each prison””." I raised that because there certainly is every requirement to have someone in each prison who is responsible for the medical arrangements there. The medical arrangements are increasingly complex. They now consist of three separate contracts, for primary care, secondary care and mental health care. They consist of the oversight of the assessment arrangements when people arrive, which include not just physical but mental checks, checks to see whether drug treatment has been arranged and checks to make certain that people are not at risk. One hopes that there is increasing involvement with diversionary schemes for those with mental health disorders. There is also a need for someone in the prison to be responsible for ensuring that regular treatment of the right kind is available for the people who are there. I agree entirely that the old description of ““a doctor”” goes back to the original Prison Act, when the three people who always lived inside the compound of a prison were the governor, the doctor and the chaplain. Things have now changed. Those people do not live in the prison and the doctor is now technically provided as a GP by the primary care trust with whom the contract is held. However, I remember from my time as Chief Inspector of Prisons that the healthcare arrangements depended on a prison having a manager who was responsible for those arrangements and was part of the prison’s management team, reporting directly to the governor. When I published a report on healthcare in 1996, I called it Patient or Prisoner? because there was considerable confusion over whether a prisoner in medical care was to be treated as a patient or a prisoner and a question over whose writ ran. There is a proper healthcare manager post in the National Health Service and the holder is trained to be the manager of healthcare arrangements. My amendment is designed to suggest that in future, although it is no longer appropriate to use the term ““a doctor”” because the doctor is on call from trusts, there should be a requirement in the Bill for a properly trained healthcare manager in every prison to have responsibility for the healthcare arrangements in that prison, to make certain that they happen and to be responsible and accountable for them. Bearing in mind the number of times that we hear concerns expressed in your Lordships’ House about, for example, the inadequacy of mental health treatment, it seems to me that if we really care about improving the management of offenders we should not let this very important aspect of what goes on in every prison go by default merely because the term ““a doctor”” has gone out of use due to a change in circumstances. That is why I tabled the amendment. I beg to move.