Hayton Paul, Boyington John
Healthy Prisons Programme, Healthy Settings Development Unit, University of Central Lancashire, England.
Am J Public Health. 2006 Oct;96(10):1730-3. doi: 10.2105/AJPH.2004.056127.
Prison health in England and Wales has seen rapid reform and modernization. Previously it was characterized by over-medicalization, difficulties in staff recruitment, and a lack of professional development for staff. The Department of Health assumed responsibility from Her Majesty's Prison Service for health policymaking in 2000, and full budgetary and health care administration control were transferred by April 2006. As a result of this reorganization, funding has improved and services now relate more to assessed health need. There is early but limited evidence that some standards of care and patient outcomes have improved. The reforms address a human rights issue: that prisoners have a right to expect their health needs to be met by services that are broadly equivalent to services available to the community at large. We consider learning points for other countries which may be contemplating prison health reform, particularly those with a universal health care system.
英格兰和威尔士的监狱医疗体系经历了快速的改革与现代化进程。以前，该体系存在过度医疗化、员工招聘困难以及员工缺乏专业发展机会等问题。2000年，卫生部从女王陛下监狱管理局手中接过了卫生政策制定的职责，并于2006年4月实现了全面的预算和医疗管理控制。此次重组带来了资金改善，服务现在也更多地与评估出的健康需求相关。有早期但有限的证据表明，一些护理标准和患者治疗效果有所改善。这些改革解决了一个人权问题：囚犯有权期望其健康需求能由与广大社区所享服务大致相当的服务来满足。我们思考了一些可供其他可能正在考虑监狱医疗改革的国家借鉴的经验，尤其是那些拥有全民医疗保健体系的国家。
