Responsibility for the management of prison health services should be transferred from the Department of Justice, Equality and Law Reform to the Department of Health and Children or to local health boards, the Labour Party's spokeswoman on health has said.
Launching a discussion document, Healthcare in Irish Prisons, Ms Liz McManus called for a dedicated budget for prison medical services, which she said amounts to only 1 per cent of the annual prison budget at the moment. This contrasted with 6 per cent in England and Wales and 9 per cent in Scotland.
"Healthcare should be delivered by dedicated healthcare professionals who should not be in day-to-day prison duties or disciplinary matters," she said.
According to the document,
successive reports have highlighted the fact that prison medical care is inadequate. "Prison-specific problems include the transmission of infectious diseases due to overcrowding, illicit drug use and physical violence.
"Most prisoners come from lower socio-economic groups, and are therefore likely to have more medical problems than the general population. In addition, mental health problems are common."
The situation in Mountjoy Prison, the State's largest, was particularly bad, the report said; "70 per cent of the inmates have a history of serious drug misuse".
Urging the establishment of a primary care centre in Mountjoy men's prison, the document said this would allow the development of a multi-disciplinary approach, liaising with probation, welfare and education services. This would also cater for out-of-hours medical cover and the development of health promotion services.
Drug services should be "much expanded", said the document, and efforts to reduce the supply of drugs in prison should be supported.
Ms McManus called for the creation of drug-free wings in all prisons. Inmates with drug problems should be given access to methadone and to needle exchange facilities, she said. Addiction counselling services should be expanded.
Mental health services in prison have failed, said Ms McManus. Padded cells were used on 500 occasions in Mountjoy in 1997. "At present, existing psychiatric services in the wider community will not cater for prisoners and this policy needs review." This was "urgently required". The case for an expansion of the prison psychological service was "extremely strong".
On the treatment of women prisoners, Ms McManus said appropriate facilities for mothers and babies should be provided. Women prisoners should have access to the same range and quality of services, particularly in the area of drug treatment, she said.
The treatment of sex offenders "needs to be tackled", said Ms McManus. While 280 men were in prison for sex-related crimes, there were only 10 treatment places each year on a special programme at Arbour Hill. The Curragh Prison holds almost 100 sex offenders in a treatment-less environment, she said.
The document is to be discussed by the Labour Parliamentary Party with a view to becoming party policy.
