Lack of alignment between health regions and prison service – meeting

Challenges posed by lack of alignment between the six health regions and the prison service have been discussed by the Irish Prison Service (IPS) and the HSE.

The matter was raised at a meeting of the health needs assessment steering committee in June. The committee oversees the implementation of recommendations from the IPS health needs assessment, which was published in 2023.

According to minutes, Dr David Joyce, IPS Executive Clinical Lead, noted that a “key issue” for prisons is that the new HSE regional system “does not align” with current IPS structures. Mr Jim Walsh, Principal Officer, Drugs Policy, Refugee and Inclusion Health Unit at the Department of Health, advised the meeting that the new National Drugs Strategy required the health regions “to be more aligned with local drug services” which would provide enhanced care for those leaving prison.

When contacted for comment, an IPS spokesperson noted that primary healthcare for people in custody is provided by multidisciplinary healthcare teams within individual prisons.

Prison healthcare is under the governance of the IPS, but it relies on the HSE for access to a range of secondary and tertiary healthcare services and for continuity of healthcare and addiction services following release.

“The geographical configuration of the prison estate and prison catchment areas will not necessarily correspond with HSE health region boundaries,” the IPS spokesperson told the Medical Independent.

“The important consideration, therefore, is ensuring that these different structures do not create barriers to accessing healthcare or to continuity of care when people move between custody and the community.”

The IPS has a “very positive and well-established engagement” with the HSE and works collaboratively with HSE colleagues to address specific healthcare needs and resolve issues as they arise, they added.

“This ongoing engagement provides an important mechanism for identifying practical solutions where the respective organisational structures do not directly align.”

The spokesperson said the IPS would continue this “collaborative approach”, with a particular focus on “effective pathways into specialist services” and continuity of care following release.