Elderly, sick and disabled – the changing face of imprisonment

People aged 60 and over and those aged 50–59 are the first and second fastest growing age groups in the prison population. Between 2002 and 2014 there was an increase of 146% and 122% in the number of prisoners held in those age groups respectively. On 31 March 2014 there were 102 people in prison aged 80 and over. Five people in prison were 90 or older.

Ever-lengthening sentences mean people in prison are growing old and frail with high rates of unmet social care and support needs. Two in five (37%) of those over the age of 50 in prison have a disability.

For the first time, the Care Act 2014 will require local authorities and prison staff to work together to respond to the social care needs of people in prison. The need for a statutory framework and new prison policy is evidenced by the experiences of many elderly and disabled prisoners in contact with the Prison Reform Trust who have been denied essential care and support.

Earlier this year, one prisoner wrote to the Prison Reform Trust:

“I am 65 years old and work full time … Really I am one of the lucky ones. Some of the prisoners are disabled 70, 80 years old, locked behind their doors, no TVs, some have no radio, banged up 5.30 evening until 10, 11 am next day with no hot water, not opening for hot water for a drink. Not opening for them to go for medication, resulting in one man being taken to hospital. Another has self harmed.”

The facts and figures highlight the changing face of the prison population, which has risen by 20% in the past 12 years and now stands at 84,569 in England and Wales.

The report shows that overcrowding and resource pressures have pushed prison managers into mixing people held on remand with sentenced prisoners, even though those awaiting trial are innocent until proven guilty and have a different legal status.

The remand population at the end of June 2014 was 12,197—1,226 more people (11%) than the previous year. In 2013, 32% of self-inflicted deaths were by prisoners held on remand, despite comprising 13% of the prison population.

Prison managers are also increasingly mixing impressionable young people (aged 18-20) with adult sentenced prisoners. This is despite the specific needs and vulnerabilities of this age group and concerns, highlighted in recent independent monitoring board reports, over levels of bullying, intimidation and contraband in some mixed establishments.

Young adults account for 17% of all self-harm incidents although they represent just 7% of the population in custody. A report by the Prison Reform Trust and INQUEST into 200 young deaths in custody between 2002 and 2012 has led the government to commission an independent review, chaired by Lord Harris, into the deaths of young adults (aged 18-24) in prison.

One young man recently told the Prison Reform Trust’s advice and information service that “he is hearing voices and they are scaring him. He says he phones his mum sometimes when the voices are scaring him, but can’t always get to phone when she’s around.”

The mixing of people on remand and young adults with adult sentenced prisoners are symptoms of a prison service forced into crisis management by the impact of drastic staff and budget cuts and the driving pace and scale of change under the current Justice Secretary.

Over the past three years the National Offender Management Service has had to deliver £749m savings and is expected to make a further £149m cuts in 2014/2015. Between 31 March 2010 and 30 June 2014 the number of Full Time Equivalent (FTE) staff employed in the public prison estate fell by 28%, a reduction of 12,530 staff.

A drive to close small community and open prisons, build larger jails and add additional capacity to existing establishments has led to the growth of “Titan prisons by stealth” in order to maximise economies of scale. 29 prisons now hold over 1,000 men each, compared with only 12 prisons a decade ago.

The past year has seen a sharp drop in individual prison performance. The proportion of prisons whose performance, as rated by the National Offender Management Service, is “of concern” or “of serious concern” has risen from 13% in 2012-13, to 23% in 2013-14.

Levels of violence, self-harm and self-inflicted deaths are rising in the adult male estate and people in prison are enduring worsening conditions, less time out of cell, reduced contact with staff and fewer opportunities for rehabilitation.

The Prisons and Probation Ombudsman has reported a 64% increase in self-inflicted deaths in 2013–14. Commenting in his Annual Report he said “this reflects a rising toll of despair among some prisoners.”

Commenting, Juliet Lyon, Director of the Prison Reform Trust, said:

“Despite a Ministry of Justice commitment to transform rehabilitation, in the last few years, prison has been reduced to a punitive holding operation for people growing older and sicker behind bars. Crisis management, drastic budget cuts, shedding and now desperately trying to recruit staff have all distracted prison managers from planning properly for a changing prison population.

“Overall, prisons are less safe and less decent than they were even a year ago when we published our last report. An incoming administration of government in May 2015 must not accept this deterioration in prison standards and conditions as the new normal.”