Impact of austerity on prison health in England: a qualitative study involving national policymakers

Abstract

Prisons offer states access to a population that is at high risk of morbidity. The UK austerity policy adopted in 2010 led to a 22% reduction (-£2.71bn) in prison spending by 2017. Whilst the number of prison officers dropped by 30%, the long-term impact of austerity on prison health in England has not been systematically contextualised. This research seeks to articulate the impact of austerity on prison health in England from the perspective of national policymakers.Semi-structured interviews (X: 66 min) were conducted with 30 key prison policymakers. Constructivist grounded theory was used to assess the impact of austerity on prisoner health in England. Transcripts of 195,680 narrative texts were analysed using NVivo 11 until data saturation was achieved.As a stealthy political ideology, austerity has caused societal disruption, which disproportionately affects prisons. The lack of access to services offered by the welfare state, including health-related provisions, precipitates societal unrest, increases prisoner numbers, and encourages harsher and longer sentences.The prolonged constrained funding and the burgeoning population widen health inequalities in prisons. Healthcare provisions become increasingly limited, which unduly affects older and female prisoners who require more complex support. The degrading living conditions and lack of purposeful activities contribute to the increasing violence, self-harm and suicides in prisons, and reorient the healthcare provision from planned services to health emergencies. The excessive focus on Brexit and the perpetual changing political direction imposed on prisons reinforce the system’s instability.Despite having the fifth largest economy in the world, England’s poorest population continues to bear the brunt of austerity. Initiating a more informed economic recovery policy and considering alternatives to imprisonment would help to ensure that England lives up to its view of itself as a progressive society.