To ask the Secretary of State for Health
(1) what plans he has to review the health care arrangements for offenders who are (a) diagnosed with hepatitis C while in prison, (b) diagnosed with hepatitis C while in prison and then transferred to a different prison and (c) diagnosed with hepatitis C while in prison and subsequently released;
(2) how many hepatitis C tests were (a) offered and (b) carried out in prisons in England and Wales in each quarter of (i) 2010-11 and (ii) 2011-12 to date;
(3) what consideration he has given to the introduction of a universal offer of a hepatitis C test to all prisoners who are admitted to prisons in England and Wales; and if he will make a statement;
(4) what criteria he uses to determine which prisoners are offered a test for hepatitis C.
Data are available from April 2010 only on the total number of tests carried out in prisons in England for hepatitis C. The number of tests performed per quarter in reporting prisons and the percentage of total new receptions to those prisons this figure represents is shown in the following table:
|Number of hepatitis C tests performed in prisons in England since April 2010: per quarter and as a percentage of total new receptions|
|Source: NHS South Wes|
These data may not reflect the total number of tests performed on people in prison as testing may also be carried out in sexual health services for example, which is not captured in this dataset. Data in respect of prisons in Wales are collected by the Welsh Government.
Professor Martin Lombard is developing a national liver disease strategy for the Department and this has included the establishment of a working group to look at the provision of services for people with hepatitis C in prisons. The group is due to publish its findings shortly.
We recognise that prisons provide an opportunity to educate ‘hard-to-reach’ populations at risk of infection with hepatitis C and to test for hepatitis C infection for those who may be identified as having risk factors for infection. We look forward to Professor Lombard's report on this subject which will assist policy makers in advising commissioners and service providers on issues such as universal offer of testing for hepatitis C.
Prisoners are provided with information and advice on hepatitis C and other blood-borne viruses (BBVs) through a variety of health promotion resources specifically designed for the prison environment by Offender Health in partnership with others like the Health Protection Agency, the British Liver Trust, and the National AIDS Trust. Such resources include posters, leaflets, DVDs and playing cards which carry health promotion messages. These information resources allow prisoners to understand if they have risk factors for infection with hepatitis C and other BBVs and how to get tested if they are concerned.
Health care staff use all contacts with prisoners to discuss their health concerns and this includes discussions about risk factors for hepatitis C. Primary care, drug treatment and sexual health services particularly advise prisoners in their care about risk of infection and testing. The risk factors for infection with hepatitis C are well understood by trained health care professionals in prisons and criteria for testing are exactly the same as they would be for patients seen by health care providers in the community.
The remit of Professor Lombard's group also included making recommendations on managing people diagnosed with hepatitis C while in prisons, those transferred around the prison estate and those discharged back to the community. A survey conducted by Offender Health, the Health Protection Agency and the National Liver Disease Strategy Group in 2011 shows that the vast majority of responding prisons (95 out of 110 responding) do provide follow-up care for prisoners being discharged into the community, but the nature of this varies between prisons.
Continuity of care within the prison estate is supported by the SystmOne national health care database in prisons, which allows receiving prisons to have access to all relevant health information for prisoners transferred in.