Older prisoners are the fastest growing group in the prison population. The number of prisoners aged 60 or over has increased by 82% in the last decade and by 243% since 2002. This rise has primarily been driven by an increase in the number of older adults sentenced for sexual offences. In addition, increases to the length of sentences has meant that more people grow old in prison. It is likely that the older prisoner population will continue to increase. Though the Ministry of Justice’s most recent prison population projections show the over-60 population remaining broadly stable over the next four years, these do not factor in key Government policies, such as increasing police numbers and sentencing reform.
An ageing prison population creates challenges for the prison system as older prisoners often have distinct needs. In particular, older prisoners carry a greater burden of health conditions compared to their younger peers. There is a greater prevalence of chronic diseases, disability, decreased mobility, and sensory impairment among the cohort. As many as 85% of prisoners over 60 may have some form of major illness. Though the needs of individuals vary, collectively, older prisoners therefore have a greater need for health and social care.
Many prisons, particularly those built in the Victorian era, were not designed to accommodate individuals with accessibility requirements. Often, therefore, older prisoners and others with disabilities or reduce mobility need reasonable adjustments to be made for them to receive equitable treatment within a prison. Our inquiry has found that the provision of reasonable adjustments is highly inconsistent across the prison estate and often constrained by limited funding.
Some prisons have developed activities and forums tailored to older prisoners. But at others a lack of age-appropriate activities and the limited physical accessibility of the estate can make it difficult for older prisoners to participate in the regime. Those who no longer or are unable to work in particular can spend extensive amounts of time confined to their cells. This negatively effects both their wellbeing and rehabilitation.
Given the greater health-related needs of the cohort, older prisoners are disproportionately impacted by problems in prison healthcare. A particular issue is the cancellation of external medical appointments due to shortages of staff to escort prisoners to hospital or surgeries. Awareness among prison staff of age-related health conditions, particularly dementia, and the availability of screening for such conditions, is not always sufficient. Holding individuals with severe dementia or other complex health and care needs on the prison estate is particularly challenging and we suggest that in some circumstances an alternative form of custody should be considered for these prisoners.
The rise in the number of older prisoners has primarily been driven by an increase in the number of older adults sentenced for sexual offences. The Committee recognises that a significant element of this cohort are convicted for historic sexual offences. Particular attention must be given to the feelings of victims of such cases, both because of the nature of the offending itself and because of delays often experienced in bringing such perpetrators to justice. We recognise that some of those victims may consider that alternative custody arrangements and potential early release of some individuals risks adding to the suffering that they have already endured.
The ageing prison population has increased demand for social care. Despite improvements following the Care Act 2014 and equivalent Welsh legislation, standards of social care are highly inconsistent across the prison estate. There can be a lack of coordination between prisons, local authorities, and social care providers. A more strategic approach is needed for the provision of social care in prisons.
We welcome improvements in end-of-life and palliative care on the prison estate, though this has not been consistent. The ageing prison population means there is likely to be an increasing need for palliative and end-of-life care and it is important that HMPPS and individual prisons plan accordingly.
At some prisons, resettlement approaches are focused towards younger cohorts and do not consider the specific needs of older prisoners. In particular, older prisoners who have served long sentences and experience institutionalisation can require additional guidance and support before re-joining society. There can be challenges finding suitable post-release accommodation for those with disabilities, reduced mobility, or complex health conditions. Continuity of health and social care is not always well-coordinated among responsible organisations. We also note issues with older prisoners accessing prescription medication following their release and not being registered with a GP.
The greater needs of older prisoners and the challenges many prisons face in meeting these warrants a specific policy for the cohort. Though HM Prison and Probation Service has recently published operational guidance on managing older prisoners for prison governors, there needs to be an overarching, strategic approach. We therefore reaffirm the call of a previous Justice Committee for the Government to produce a national strategy for older prisoners.
Published: 27 July 2020