The information requested is as follows:
(a) Commissioning responsibility for health services provided in the publicly run young offender institutions (YOIs) rests with NHS primary care trusts (PCTs). These services are subject to the same standards, regulation and governance as are applied in the wider NHS. Each PCT should decide which health care treatments and services to provide for its local population based on a full needs assessment, and commission these from NHS or independent sector providers. PCTs also decide on spending levels for specific health care treatments and services provided in all primary care settings, including staffing levels. The Department of Health (DH) does not ring-fence PCT money, and is not prescriptive about how individual PCTs spend their budgets.
In both the publicly run YOIs and in private YOIs, all young people are screened within 24 hours of arrival for any immediate needs including health care needs. Health services in all YOIs must comply with Prison Service Orders/Prison Service Instructions and any relevant DH and NHS guidelines.
24-hour health care is provided at private YOIs. Health services must also be of an equivalent standard to those available in the community. There are full-time medical staff on site to provide regular assessment and health care and in addition there are visiting doctors, dentists and specialists. Any young person involved in an incident or a restraint will be seen immediately by a nurse.
Young people will also be taken outside to local NHS services where required for emergency or specialist treatment.
(b) Medical and nursing care is available every day on a 24-hour basis within Secure Training Centres (STCs). Contractual provisions require that a qualified nurse must be on site at each STC during the day and early evening and on call at all other times; and that a young person who requests to see a health care worker will be seen by a qualified nurse or medical practitioner within 30 minutes of making his/her request. Any young person involved in an accident or emergency will receive immediate medical attention. Young people are also entitled to a basic monthly medical examination and/or health assessment by health care staff at the STC and have access to NHS facilities and specialists when clinically required.
(c) Secure Children's Homes (SCH) are regulated by The Children's Homes Regulations 2001 which are made under the Care Standards Act 2000. Under Regulation 20, each child must be registered with a GP, have access to health services that s/he may require and be provided with the necessary support for their health needs. Additionally, at least one person on duty in the SCH must have a suitable first aid qualification and any appointed nurse must be registered. The National Minimum Standards (NMS) for Children's Homes are issued under section 23 of the Care Standards Act 2000. These standards are to enable individual providers to develop their own particular ethos and approach to practice. For example, standard 6 of the NMS state that all children's homes (which include SCHs) must promote good health and wellbeing of young people.
It has been agreed by the Department of Health and Ministry of Justice that commissioning responsibility for health services in STCs and SCHs with youth justice commissioned beds, will transfer to the NHS. The Ministry of Justice is also working closely with the Department of Health to ensure that the changes to the NHS proposed in the Health and Social Care Bill (regarding the responsibilities of the National Commissioning Board for those in prison and in custody) will further enhance commissioning of health services in the youth secure estate.