I have been advised by officials in the Irish Prison Service that all people committed to prison undergo a comprehensive medical assessment on committal. People are asked about their history and risk factors for HIV, Hepatitis and sexually transmitted infections and can be offered testing if appropriate. Infectious disease screening is available on request in all prisons and is managed within prison primary care in line with community practices. Conditions which exceed the capacity of any primary care team, including prison primary care, can be referred for secondary and tertiary care via the HSE.
There are weekly consultant-led in-reach Genito-urinary medicine and Infectious Disease clinics at Cloverhill and Wheatfield Prisons. There is also a weekly in-reach nurse-led hepatology clinic at Cloverhill, Wheatfield and Mountjoy Prisons and the Dóchas Centre, dealing largely with Hepatitis diagnosis and management. A nurse led in-reach service for Hepatitis is provided to Cork Prison every three to six weeks, and Limerick Prison on an ‘as required’ basis. There is an in-reach nurse-led HIV clinic every three to six months on an ‘as required’ basis at the Dóchas Centre.
As such, the only closed prisons without an in-reach service at present are Arbour Hill, Castlerea, Midlands and Portlaoise Prisons. The introduction of a permanent GP to Castlerea Prison recently will enhance the provision of care for prisoners with infectious diseases and the need for this service in Arbour Hill Prison is deemed low at the current time. In-reach services are currently unavailable to people in custody in Midlands and Portlaoise Prisons as this service is not available through Portlaoise General Hospital at the current time. Work is ongoing to consider alternative services for these prison locations.
Given the increased prevalence of infectious diseases amongst the prison population and the risks associated with the spread of infectious diseases in a custodial environment, prison primary care teams remain vigilant and diligently diagnose and manage cases of infectious diseases.
The Irish Prison Service is satisfied that there is an adequate level of infectious disease care available to people in custody and that there are appropriate safeguards in place for early detection should the needs of people in custody or the risks posed by infectious diseases increase.