AIDS in Prisons: Policy (Hansard, 21 June 1988)

The Minister of State, Home Office (Earl Ferrers)
My Lords, the prison department's policies for the care of prisoners with AIDS for the prevention of the spread of HIV infection follow in general the Government's policy for the community as a whole.
Continuity of medical care and counselling, where appropriate, is best achieved by the well-established process of liaison between prison medical officers and doctors in the community. We are not aware of any problem suggesting a need for communication at national level within health authorities.

§ Baroness Masham of Ilton
My Lords, I thank the Minister for that reply. Is he aware that in this very good book, AIDS and Drug Misuse, published by the DHSS, chapter 8 is on drugs and AIDS in prisons? Does the Minister agree that it would be wise for those recommendations to be put into practice; that is, to have people from the prison service on health authority committees, regional health authority drug advisory committees, working closely with health districts? Does the noble Earl agree that the prison population is particularly difficult because prisoners go in and out of the community and prisons?

Earl Ferrers
My Lords, I am grateful to the noble Baroness for raising that point. We are considering the recommendations made by that committee.

§ Lord Mishcon
My Lords, will the Minister concede that his reply to the noble Baroness's question was not as considered as his replies usually are? Is he not aware that a grave problem arises, especially in view of the overcrowded conditions in prisons and the lack of a legal pointer to the duties of medical officers towards other prisoners and to the families of a prisoner, as well as in regard even to the enforced examination to see whether AIDS exists?
Does the Minister not think that it is appropriate in these circumstances, before a crisis occurs, to set up a committee on which prison authorities and medical people will be represented?

Earl Ferrers
My Lords, I shall not concede that my reply was not as considered as the noble Lord kindly suggests my replies usually are. It was a considered reply. The problem with regard to AIDS is a national problem. I accept that there are particular difficulties with regard to prisoners, but we have found that the best way of dealing with this is for counselling to be done in the locality.
When prisoners come to a prison, they undergo a health screening on reception by hospital staff and by a medical officer. The noble Lord suggests compulsory testing. I am surprised that he should suggest that because, as he knows, blood tests taken without consent could be an assault. Tests for HIV without the consent of the patient could be unethical.

§ Lord Mishcon
My Lords, will the Minister forgive me if I return to this very important subject? I suggested nothing except the setting up of a committee because of the peculiar difficulties of dealing with prisoners in crowded prisons, where there is a duty to fellow prisoners, a duty to families, quite outside the normal community. Will the Minister at least consider setting up a committee without giving a definite answer now?

Earl Ferrers
My Lords, of course I shall consider what the noble Lord says. However, I am not so sure that the setting up of a committee would provide the answer. There are a number of problems which are fully known by the governors and the medical profession who deal with them. If there are any reasons to think that a committee would help solve that, I shall certainly consider them.

§ Lord Hooson
My Lords, will the Minister explain what is the policy of the Government to prevent the spread of AIDS within Her Majesty's prisons? For example, is there a policy of concentrating known AIDS sufferers in the same prison hospitals; or are they allowed to remain in separate prison hospitals?

Earl Ferrers
My Lords, where prisoners are identified as being HIV antibody positive but have no signs of illness, they are located in single accommodation or accommodated with other antibody positive prisoners. They are not otherwise precluded from associating with prisoners.
601 Various arrangements are made to counsel prisoners. The governors and medical officers have been asked to continue to make leaflets and other suitable printed material available to prisoners. One produced by the DHSS was called, Don't Die of Ignorance, and there was another one by the Health Information Trust. There is also a video educational package which includes a video film tailored to the needs of prisoners, both during custody and afterwards. This is being developed. Meanwhile, a video film made in America is being used until the other one is available.

§ Lord Graham of Edmonton
My Lords, will the Minister accept from me that prison officers acknowledge that the prison department is alert to the dangers inherent in the AIDS problem and that working together is the best solution? Does the Minister also understand that there is a great difference between the outside world and the closed, cloistered community of a prison which houses many dangerous men and women? Will he not think again about looking at the possibility of compulsory blood tests and also isolation units?

Earl Ferrers
My Lords, I am grateful to the noble Lord for saying that the prison officers acknowledge the concern of the Home Department over this. However, I am bound to tell him that we would be in difficulty for the reasons that I gave the noble Lord, Lord Mishcon, about instituting compulsory blood tests. If a person does not want to undergo a compulsory blood test and he is forced to do so, that could constitute an assault.

Lord Morris
My Lords, since when has the overcrowding as such, as seems to be suggested by the noble Lord, Lord Mishcon, had any effect on the incidence of AIDS?

Earl Ferrers
My Lords, AIDS is a recent, highly regrettable and very frightening phenomenon. The fact that it can appear in circumstances where a lot of males are gathered together is a matter for concern.

§ Baroness Ewart-Biggs
My Lords, can the Minister say whether there is any evidence that homosexuality within our prisons is a reason for the spread of AIDS? If so, can he say whether the use of condoms is legal in prison?

Earl Ferrers
My Lords, there is no doubt that homosexuality is a cause of spreading AIDS. The fact that a lot of males are gathered together in a confined space can presumably add to that difficulty. Condoms are not among the items which prisoners are allowed to have in their possession and the Government have no intention at the moment of supplying condoms. To do that would be to condone behaviour which may amount to a criminal offence in so far as homosexual acts are legal only in private. In prison they are not likely to be private. It could also encourage behaviour which in itself might encourage AIDS.

§ Lord Ennals
My Lords, has the Minister had his attention drawn to the exchanges in the House which 602 occurred on 16th June on the recommendations of the Advisory Committee on the Misuse of Drugs as regards AIDS and drug misuse? Is he aware that I asked the Minister responding, the noble Earl, Lord Arran, about the recommendation that within the prison system the prison department should be asked to identify drug misusers? When I put that question the noble Earl replied that he would refer the matter to his right honourable friend the Secretary of State. Is the noble Earl now able to answer that question which I think is of some importance in view of the very close link between drug misuse and AIDS?

Earl Ferrers
My Lords, if I understood the noble Lord correctly, he asked about the misuse of drugs. That is slightly different to the matter of AIDS. We have no evidence at the moment to show that needle sharing or any such practice is being encouraged.

§ Lord Ennals
My Lords, with deep respect, drug abuse is an important cause of AIDS. Very many cases have been identified as being the result of shared needles. The Minister will know that that applies out in the community and within prisons. Had it not been so the Advisory Committee on the Misuse of Drugs, which considered specifically the question of AIDS and drug misuse, would not have thought it appropriate to make the recommendation.

Earl Ferrers
My Lords, I quite see the noble Lord's point and I apologise if I did not take it fully the first time. There is no evidence in the prisons at the moment of needle sharing, nor is there any evidence of intravenous drug use. Obviously this is a matter which is being kept closely under review and should there he that evidence we shall have to take such steps as are necessary.

§ Lord Stallard
My Lords, is the Minister aware that later this year we expect to receive the first reports due under the AIDS (Control) Act 1987? Can he tell us whether his department has made any contribution or will he making any contribution to those reports?

Earl Ferrers
My Lords, I cannot tell the noble Lord that but I shall find out about it and let him know.

§ Baroness Masham of Ilton
My Lords, is the Minister aware that drug users are unfortunately the fastest spreading group with AIDS, and that they may come into prison HIV positive; therefore it is important to identify them?

Earl Ferrers
My Lords, I quite agree with the noble Baroness that it is important. Everything is done that can be done to find out whether prisoners have AIDS, but short of compulsory screening of everyone we cannot always find this out. Where a potential AIDS sufferer invites a test, we will know the results, but they can only be a reflection of those who have been tested. There are 59 HIV positive prisoners at the moment. In all, since we started monitoring this problem in March 1985, 186 HIV positives have been identified.

§ Lord Mishcon
My Lords, I promise that this is the last time that I appear at the Dispatch Box on this matter, but it is a very urgent problem. Will the Minister reflect upon the worth of what a committee investigating this matter might recommend in regard to compulsory powers in prisons? Will he take into account the fact that many in this House might not regard it as an invasion of privacy if people's health, and possibly lives, are at stake if this is not done?

Earl Ferrers
My Lords, of course I shall take into account the views of the noble Lord and the representations that he has made. However, I am bound to tell him that if we were to go down the path which he suggests, it might mean an alteration in the law because it is the law that states that compulsory testing would be an assault despite what your Lordships may feel.

§ Lord Nugent of Guildford
My Lords, is my noble friend aware that we have already spent 19 minutes on two Questions and that in the interests of the ensuing business we should proceed to the next Question?

Earl Ferrers
My Lords, I am particularly grateful for that supplementary question. I only hope that I was not the cause of the Questions continuing for 19 minutes but merely for about 18 minutes.