A shortened version of this article is to be published in the July-August edition of Around Europe.
At the end of June, I attended the second CONNECTIONS Conference focusing on drugs and alcohol in the criminal justice system.The Conference drew delegates and speakers from across the European Union and beyond, and a great diversity of experience, both the successes and the failures, was shared over the course of two jam-packed days in London.Despite differences between jurisdictions, two constant themes proved pervasive: that drug and (particularly) alcohol rehabilitation and harm reduction services can and should be delivered more effectively (both in and out of prison), helping more people turn around their lives; and that impending budget cuts offer both an opportunity to think again, but also pose a great risk.
The right to health care for everyone, including prisoners, is well established in international law.The provision in Article 12 of the 1966 United Nations International Covenant on Economic, Social and Cultural Rights firmly stated ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’.The UN (1990) Basic Principles for the Treatment of Prisoners outlines how the aforementioned right to health shall be delivered: ‘Prisoners shall have access to the health services available in the country without discrimination on the grounds of their legal situation’.The principle of equivalence may be firmly established, but considering the high health risks associated with prison – overcrowding, lack of sterile needles and poorly cleaned living space all dramatically increase the risk of contracting infectious diseases such as HIV/AIDS, hepatitis and tuberculosis – it can be argued that states have a heightened responsibility to those they take into their custody which is not limited to provision of health care, but extends to enabling and promoting healthy living.
Dame Anne Owers, who has just stepped down as head of the prison inspectorate in England & Wales, warned the Prison Reform Trust on Tuesday that it will be ‘challenging to maintain progress [in the prison system], never mind continue it’ in the years ahead.The examples I heard at the CONNECTIONS Conference – from Moldova, Portugal, Hungary, France, Hungary, Lithuania and others – showed some of the real progress being made in promoting health and harm reduction services in prisons across the continent, but also revealed the staggering health inequalities that remain and the significant risks faced people in prison.In Lithuania, for example, 76 per cent of HIV patients had been injecting drug users, and 71 per cent of all drug-dependent people have spent time in prison at some point in their lives.The nature of imprisonment seems to further increase this risk, as studies from across Europe suggest that between seven and 24 per cent of the prisoners who do inject, started doing so once they were committed to prison.Needle exchange programmes, although available in the community, are often not available in prison – security concerns are cited as trumping the right to equivalence of health provision.Moldova’s experience highlights the danger of not addressing the health implications of this approach.A local NGO – Innovative Projects in Prisons – found one-in-five inmates had been or were injecting, using needles (sometimes little more than ball point pens) that were being shared by up to ten or 12 prisoners.As a consequence of their research, the Moldovan government agreed to allow the organisation to pilot needle exchange and condom distribution in prison on a peer-to-peer basis, significantly cutting rates of HIV transmission.In the ten years since, similar projects have sprung up in 24 prisons across Moldova.
Prison presents an opportunity to reach some of the most vulnerable and disadvantaged members of the community, and even to readdress some of the health inequalities in society.A high proportion of people with multiple health problems are incarcerated in prisons: for example, in England & Wales, 72 per cent of male and 70 per cent of female sentenced prisoners suffer from two or more mental health problems.Problems that the reality of prison life, more often than not, simply exacerbates.In the case of communicable diseases, diagnosis and treatment alongside the implementation of effective harm reduction schemes has benefits not just for the individuals concerned, but the communities to which prisoners will return upon release.Moldova, for example, is one of the few Eastern European countries that has managed to halt the spread of HIV throughout the entire population.Furthermore, good health and physical well being are crucial to the successful resettlement and social reintegration of ex-offenders after release from prison.
Good prison health is good public health.It is important that people do not come out of the prison system in a worse state of health than when they entered, more dependent on the public health and social services, less able to rebuild their lives.Ultimately though, it is only through a reduction in our overreliance on the use of imprisonment – over half of Council of Europe member states have larger prison populations than they did five years ago – that will limit the damage to individuals, families and communities that prison creates and perpetuates.The current budgetary constraints being experienced in many European countries is no excuse to demure from our responsibilities, or the broader social aims of criminal justice systems: the rehabilitation and social (re)integration of former offenders.
Ken Clarke said in a speech last week to the Centre for Crime and Justice Studies that, ‘for as long as I can remember, political debate on law and order between rival parties has been reduced to a numbers game’.Since then the press has been just full of ‘numbers’, including comparisons between England & Wales and our European neighbours.What can these statistics tell us, if anything?And is a European perspective meaningful at all on a continent with such diverse approaches to criminal justice?
Since the Coalition’s Justice Secretary, Ken Clarke stated last week that England & Wales prison population of more than 85,000 is, ‘quite an astonishing number which I would have dismissed as an impossible and ridiculous prediction if it had been put to me as a forecast in 1992’, all we have heard about is numbers.
The prison population has ‘doubled’ since 1992, the Secretary noted.‘It costs more to put someone in prison for a year than it does to send a boy to Eton – on average £38,000’ he quipped (by the way, the Prison Reform Trustputs it at £45,000). Clarke told us reoffending has been rising in recent years, up 8 per cent for adults between 2006 and 2008.The shadow (and former) Justice Secretary, Jack Straw’s pre-emptive strike in the Daily Mail used a different rubric: adult reoffending down by 20 per cent since 2000; juvenile reoffending down by nearly 24 per cent over the same time period (Incidentally, at the beginning of Straw’s tenure at the Ministry of Justice he sounded far more like Clarke).Both agree that reoffending rates are ‘significantly higher’ – about 60 per cent within two years – for the 60,000 prisoners serving short sentences each year: Straw argues this is because ‘they are the hardest nuts to crack’, and community sentences have failed; Clarke, that ‘it is virtually impossible to do anything productive with offenders on short sentences’.Following?
On Sunday it all got a little bit more confusing.We had been told that the Ministry of Justice needs to cut £2bn from its current £8.7bn budget[1], with the prison system accounting for £4bn of the total spend.However, the Mirror reported the Government intends to plough ahead with the building of nine new jails, providing 14,000 further prison places by 2012.The following day Serco announced it had won the £415 million contract to build and manage a new prison at Belmarsh West in London.
I think we may have to wait and see what course the Government is going to take with regards to prison, probation and its ‘rehabilitation revolution’.As Straw noted in his Mail article, David Cameron did explicitly back short sentences in the television debates before the election (when attacking the Nick Clegg’s position).David Davis was forthright in his opposition to Clarke’s proposals, arguing his slogan as shadow Home Secretary had been to ‘Make Prison Work’.And it is fair to say that the Conservative back benchers are not overly chuffed with Clarke about this one.Moreover, Clarke did not make clear how exactly paying ‘independent organisations by results in reducing reoffending’ would work.Would organisations have to wait two years for payment?Would a reduction in the severity of the crimes committed be a factor, or would any parole violation, however petty, lead to non-payment?How do you avoid the ‘best’ offenders (i.e. those most likely not to reoffend again anyway) being cherry picked by organisations, who then receive their payment, whilst the individuals posing the most risk to society fall through the net, increasing the danger to us all?
‘The failure of the past’, argued Clarke last Wednesday, ‘has been to use tough rhetoric and to avoid taking tough decisions that might be unpopular.’These tough decisions are still to come, although there is some room for cautious optimism.What I am interested in for the moment is how we, as an informed public, help shape those ‘tough decisions’.
I recently attended the European CONNECTIONS conference on drug and alcohol interventions in prisons, which concluded that you learn so much by simply comparing different experiences.If we look at the experience of England & Wales (Scotland and Northern Ireland both have separate prison administrations) over the previous 15 years or so, and compare it to the other five largest European Union Member States, England & Wales increasing dependency on prison is clear:[2]
If you compare the prison population rate per 100,000 inhabitants of a country, the differing approaches of England & Wales and Spain, as compared to Germany, France and Italy becomes clearer still:
The mean and the median results in the second graph show the respective average for the number of prisoners per 100,000 of population for all 47 member states of the Council of Europe.The difference between the two numbers reflects the greater reliance on prison of some of the much larger Eastern European member states, notably the Russian Federation, which currently imprisons 609 people per 100,000 inhabitants.If you include England & Wales’s (generally smaller) western European neighbours in the graph the smaller median begins to be explained:
It all gets a bit messy, but in terms of western European experience, England & Wales, Scotland and Spain are clearly the exceptions, with the Netherlands and Portugal having successfully reduced the proportion of their population in prison in recent years, and the Scandinavian countries averaging well under half the incarceration rate of England & Wales over the series.
Why do I mention any of this?Well, because it is an easy and quick example of how people interested in criminal justice reform can demonstrate how England & Wales’s use of prison isn’t the norm in western Europe, even if we are far below Russia at 609 per 100,000 (or the USA at an eye-watering incarceration rate of 748 per 100,000).But be warned, this approach is fraught with danger, as this recent article from the Spectator demonstrates:
‘Britain is a “crime hotspot”.The latest European Union figures, collected three years ago, show England & Wales to have the third highest crime rate in Europe.
‘Yes, Britain locks up more people than most European countries.But this is because we suffer more crime.The way to determine if judges are issuing too many prison sentences is to look at the number of inmates, as a proportion of the crimes committed.Here, it is 16 – well below the European average of 21.Far from being vindictive, our prison system seems to let go of most of the persistent offenders.’
The figures were not referenced in the article, but I have no reason to doubt their validity.Anyhow, even if the source was provided, in all likelihood I probably would not have the time (nor the expertise) to look further into the figures.But that’s the point.All this talk about numbers misses the argument we should be having.Why are crime rates so much higher in England & Wales?Why do we feel we have to lock away so many more people?There are very different approaches to prison and post-prison rehabilitation, which are far more successful than our own approach.As a recent Time article showed, Norway is a shining example of this, with only 20 per cent of offenders being returned to prison within two years of release.However, the debate should be far wider than how we improve our prison and probation rehabilitation systems.Dame Anne Owers has often noted that the system ‘is a mirror for problems in prisoners’ communities’. Now, more than ever, is the time to talk about how we can build a more equitable society, one which is better for everyone in society.
The above tables are constructed using Council of EuropeSpace I Penal Statistics, King’s College London’s International Centre for Prison Studies’ World Prison Brief, and returns from ministries of justice for previous and upcoming research.
[1] To access the article, Google: http://www.ft.com/cms/s/0/8e6b5fcc-83b6-11df-b6d5-00144feabdc0.html
[2]The above tables are constructed using Council of EuropeSpace I Penal Statistics, King’s College London’s International Centre for Prison Studies’ World Prison Brief, and returns from ministries of justice for previous and upcoming research.The full tables for prison population and prison population rate are available here.
