The news that living conditions at Liverpool prison are the worst that jail inspectors have ever seen will come as no surprise to anyone who has spent time there. The gaunt Victorian pile on Hornby Road, in the Walton area of the city, was always known as the dirtiest jail in the system.
Most of the old jails have a cockroach problem, but Liverpool took the infestation to a new low, with cell floors carpeted with them, as they came out at night to feed off the crumbs. I experienced those conditions some 20 years ago. With prison budgets still reeling from the cuts imposed by former justice secretary Chris Grayling, it can hardly be imagined that conditions have improved since my time there. According to a leaked report on Liverpool, some areas of the jail were so filthy and hazardous they were beyond cleaning.
The chief inspector of prisons, Peter Clarke, spoke of a prisoner with complex mental health needs, caged in a cell that had no furniture other than a bed. The cell windows were broken, as was the light fitting. The toilet was filthy and blocked and electrical wires were exposed in his “dark and damp” living space. He had been held in these conditions for weeks.
Conditions such as these would challenge the wellbeing of prisoners in good health. To impose them on prisoners suffering mental health problems is taking punishment to a shameful and degrading level.
For some years now, I have been saying that mental health is the biggest single problem facing a prison service beset with difficulties. I saw it coming back in the 1980s, when the Thatcher government closed many of the old asylums and, supposedly, replaced them with care in the community. We know what happened there. Mental health became – and still is – the poor relation of the NHS, and many of those suffering end up on the streets and in our prisons.
Prisoners miss an average of 15% of medical appointments because there are not enough staff to escort them
And our political masters cannot say they are unaware of the problem. The Commons public accounts committee this month published a report saying that the record levels of self-harm and deaths are a “damning indictment” of the state of mental health provision in jails across England and Wales. The committee found that long-standing understaffing and increased prevalence of drugs in jails have led to deep-rooted failures in the management of mental health.
Shockingly, MPs concluded that, while the prison service and NHS England have a duty of care to prisoners, they “do not know where they are starting from, how well they are doing or whether their current plans will be enough to succeed”.
Incredibly, the most commonly used data, used to estimate the scale of the problem within our prisons, is 20 years old, when the prison population was about half of what it is today. Yet the committee found that governments efforts to improve the mental health of prisoners so far have been poorly coordinated, with information not shared, not even between community and prison GP services. Prisoners miss an average of 15% of medical appointments because there are not enough staff to escort them. Yet the loss of staff continues to outstrip recruitment in many jails.
The chair of the committee, Meg Hillier, said the appalling toll of self-inflicted deaths and self-harm in prisons can be laid at the deep-rooted failures in the management of prisoners’ mental health.
When The NHS replaced the prison medical service and took responsibility for healthcare in prisons in 2000, it seemed a change for the better. Prisoners come from the community and are released back there. It never made sense for them to be treated by a different health service while locked up. But it is no coincidence that a struggling NHS, particularly the mental health sector, is failing to cope with the demands of thousands of prisoners in need of therapeutic care. There are no votes to be won behind bars.
Deborah Coles is the director of the charity Inquest and sees, more than most, the results caused by the neglect of some of the most vulnerable people in our society. She says that alternatives to prison must be found for those suffering mental health problems and a more therapeutic response for those for whom prison is the last resort.
Can we hope her words will be heeded? On Monday, the justice secretary, David Lidington, gave a speech to the thinktank Reform. He said the “overriding trigger” for the levels of violence, self-harm and disorder inside prisons in England and Wales was “the availability of drugs, including new psychoactive substances and other contraband”.
On mental health, the minister had nothing to say.
He should be taken to that filthy cell in Liverpool and made to explain his failure to master his brief to that prisoner with complex mental health needs; to whom, I remind him, he owes a duty of care.
• Eric Allison is the Guardian’s prison correspondent