Hospice UK report highlights inequality in end of life care for imprisoned people

A significant rise in deaths, together with an increasingly sick and older prison population, has led to a corresponding rise in need for end of life care – a need that Hospice UK’s new report – Dying Behind Bars – says is not being adequately met.

It is well evidenced that end of life care in the UK is highly unequal, with those marginalised by society – including racialised communities, LGBTQ+ and incarcerated people – being left by the wayside.

For those facing their last days in prison, society continues to fail them, with adequate palliative and end of life care needs remaining unmet.

End of life care in the prison service

Today, the prison system is the UK’s largest provider of residential care for frail, older men – with significantly more people dying behind bars as a consequence of the number of incarcerated people aged over 60 tripling in the past two decades.

In the 12 months to June 2020, there were 218 deaths in prison due to natural causes, which is an increase of 77% compared to a decade prior.

This trend is the consequence of harsher, longer sentences, the rise in the number of convictions for sexual offences (including historical cases), and the absence of timely and transparent processes when it comes to compassionate release when a person in prison has a terminal illness and is approaching death.

Despite people in prisons being legally entitled to the same healthcare and treatment as those on the outside, older incarcerated people’s experiences are much worse in comparison to those of the same age in the general population.

Accounts from inside prisons include:

People with dementia who didn’t know they were in prison being locked in cells alone;
frail, elderly people cuffed to hospital beds;
and terminally ill people dying in their cells while awaiting their application outcomes for compassionate release (with the pandemic halting the process for many).

These examples, sadly, are all too common.

While the health inequalities within the prison population are stark and present major challenges, we should expect uniformly high standards in the services available across society – including within prisons.

Why this new report is so important

Hospice UK’s new report, Dying Behind Bars, explores how the system is failing to provide sufficient palliative and end of life care, and argues that the need for better end of life care for imprisoned people is not being met.

Given prison population projections, this must be addressed as a matter of urgency. The lack of good care at the end of life is exacerbated by a general lack of understanding of what hospice care is, combined with entrenched cultures within the prison estate.

Rini Jones, Hospice UK’s Policy and Advocacy Officer, and author of the report says:

“Incarceration is the punishment for crimes committed and the deprivation of an individual’s liberties, it is not a sentence to poorer health and social care services.

“Hospice UK is calling for action to improve the end of life care received by imprisoned people.”

The report’s asks have been backed by a poll of 2,000 UK adults, which concluded that 3 in 5 would support better end of life care for terminally ill prisoners to reduce suffering, and over half feel terminally ill prisoners should have the same right to high quality end of life care.

As an organisation supporting and championing high quality palliative and end of life care for all, Hospice UK firmly believes that action must be taken to improve the care received by imprisoned people.

This report is the first step, and we look forward to working with our members, partners, and Government to move the sector in the right direction.

Download the full report at www.hospiceuk.org/dying-behind-bars-report.