113.The 2013 Justice Committee inquiry into older prisoners called on the Government to produce a national strategy for the cohort. The Committee considered that the ageing prison population and the severity of the needs of some older prisoners warranted a specific approach, to provide for minimum standards and effective and equitable care. The Government rejected the recommendation, stating that it was inappropriate to generalise about older prisoners and that their needs should be managed on an individual basis, not according to their age. Though they accepted that older prisoners are likely to have greater health and social care needs, the Government argued that those were best catered for within overall policy for prisoners with care requirements.
114.In its submission to this inquiry, the Government reaffirmed its response to our predecessor’s call for a national strategy:
MOJ and HMPPS are not yet persuaded that categorisation of prisoners by age is necessarily helpful given the wide range of needs, abilities and requirements that will be included in the older prisoner cohort.
As set out in our response to the Justice Select Committee report of 2013, our view remains that prisoners should be managed based on individual needs not solely based on their age.
115.In the years since our predecessor’s inquiry, there have been indications that the Government was considering producing a national strategy. Peter Clarke, HM Chief Inspector of Prisons, told us that he attended an MOJ-led steering group working on a national strategy for older prisoners in late 2017, but that it had only met once and he had heard nothing since. In written evidence to the previous Justice Committee’s inquiry, Prison Population 2022, the Prisons and Probation Ombudsman also mentioned that he had been a member of this steering group. The output of this work appears to have been HMPPS’s Model for Operational Delivery (MOD) for older prisoners, published in April 2018.
116.By the MoJ’s admission, the MOD is not a strategy, but is designed to inform prison governors and directors and give a framework for managing older prisoners, setting out the services and activities they need, good practice examples, and other considerations for effectively supporting the cohort. At nearly 50 pages, the MOD includes guidance on:
the regime and activity considerations for older prisoners;
Supporting older prisoners’ needs, including around health and social care, and release and resettlement;
Providing palliative and end of life care and other arrangements for prisoners nearing the end of their lives.
117.As the MOD states, it was developed “in recognition of the sizeable and growing proportion of older prisoners in the prison estate and the need to think differently about how we manage them to ensure we can better meet their needs.” The MOD: Older Prisoners is one of several models for operational delivery designed support the reconfiguration of the prison estate into reception, training and resettlement prisons, as part of the Prison Estate Transformation Programme (PETP).
118.Though the development of the MOD was welcomed in evidence we received, it was pointed out that it falls short of a strategy. The MOD’s provisions are optional, with prison governors under no obligation to implement the guidance it contains. The Prison Reform Trust and the joint submission from Clinks and RECOOP and questioned the extent to which governors across the prison estate had implemented the model since its publication. The MOD is also focused on operations within prisons; as Peter Clarke highlighted, a strategy would set out overarching objectives and resourcing towards meeting the current and projected demands created by an ageing prison population:
I would want some timelines. I would want to see some accountabilities. I would like to see some resourcing and some clear objectives about what the strategy is intended to achieve. You can hang all sorts of activity from that. As it stands at the moment, the model for operational delivery is a menu of options. It is no more than that. They are exactly that: options. I would like to see something that aligns population projections, about the type, capabilities and needs of the future population, with the future residential estate in prisons. When you line the two up together, you can start resourcing it properly and decide what you actually want to deliver in operational terms.
119.Dame Anne Owers, National Chair of IMBs, echoed this:
I think your strategy should drive your operational model, rather than your operational model being the only show in town. I would want something that pulled everything together; that pulled together health and social care, where you place people and what your projections are for the future, and not just what you might do now if you can but what you ought to be planning for, given the way we know the prison population is going.
120.In oral evidence, Prisons Minister Lucy Frazer indicated that the MoJ’s position on a national strategy for older prisoner had shifted:
[It] is something we need to seriously think about. I am in favour of having an overarching strategy, particularly on things like accommodation. We have an opportunity now to build 10,000 additional places, which is going to include a number of new prisons. This is a good opportunity to think about how we configure that accommodation, particularly having in mind the fact that we have an older cohort.
121.We disagree with the argument that older prisoners’ needs are too wide-ranging to generalise. Though it is important to treat each prisoner as an individual, there is a commonality among older prisoners which warrants a specific approach to their management. The MOD: Older Prisoners shows that the MoJ recognises this; indeed, it is inconsistent for them to have developed the MOD and yet not recognise the similarity of need among many older prisoners.
122.An ageing prison population creates specific pressures on the prison system. Currently, the response to these and the treatment of older prisoners is highly inconsistent across the prison estate. Though the Model for Operational Delivery: Older Prisoners contains useful operational guidance, it is not enough to address this inconsistency and ensure the prison system can properly respond to the needs of the older cohorts. With the older prison population likely to rise further in the coming years, the MoJ should produce a national strategy for older prisoners. This strategy should encompass the provision of suitable accommodation for older prisoners, health and social care on the prison estate, and the release of older prisoners, including continuity of medical treatment or care in the community. It must also ensure that the resourcing and expansion of the prison estate is aligned to projections of the older prisoner population.
283 Justice Committee, Fifth Report of Session 2013–14, Older Prisoners, , 12 September 2013, para 136
284 Ministry of Justice, Government response to the Justice Committee’s Fifth Report of Session 2013–14: Older Prisoners, , November 2013, page 17
285 Ministry of Justice, Government response to the Justice Committee’s Fifth Report of Session 2013–14: Older Prisoners, , November 2013, page 17
286 Ministry of Justice, Department of Health and Social Care, Public Health England, NHS England and Improvement ()
288 Prisons and Probation Ombudsman ()
289 Ministry of Justice, Department of Health and Social Care, Public Health England, NHS England and Improvement ()
290 Ministry of Justice, Department of Health and Social Care, Public Health England, NHS England and Improvement ()
291 Ministry of Justice, Department of Health and Social Care, Public Health England, NHS England and Improvement ()
292 Ministry of Justice, Department of Health and Social Care, Public Health England, NHS England and Improvement ()
293 Clinks and RECOOP (); Age UK (); Prison Reform Trust ()
294 Clinks and RECOOP (); Prison Reform Trust ()
296 [Dame Anne Owers]
Published: 27 July 2020