Committee publication · Correspondence · 14 January 2026 · HC 702
Letter to and from Healthcare Inspectorate Wales, following the 12 November evidence session on Prisons, Probation and Rehabilitation in Wales, dated 8 & 19 December 2025
From: Welsh Affairs Committee
Summary
Correspondence between Ruth Jones MP (Welsh Affairs Committee Chair) and Alun Jones (Healthcare Inspectorate Wales Chief Executive) following a 12 November 2025 evidence session on prisons, probation and rehabilitation in Wales. The Chair requests comparative analysis of healthcare provision across Welsh prisons and recommendations for health board accountability excluding structural changes. HIW responds with detailed analysis of variation in primary care, mental health, substance misuse, and specialist services across six Welsh prisons, and proposes governance, health needs assessment, and accountability measures.
Key findings
- Healthcare Inspectorate Wales conducts clinical reviews in death in custody investigations, participates in Her Majesty's Inspectorate of Prisons inspections, and undertook a governance review at Swansea Bay University Health Board following repeated unaddressed findings at HMP Swansea.
- All Welsh prisons provide core healthcare services (primary care, mental health, substance misuse treatment, dental and optical services) but effectiveness and timeliness vary significantly: HMP Cardiff and HMP Berwyn demonstrate stronger provision than HMP Parc, which faces persistent mental health capacity challenges and drug-related issues.
- Chronic disease management remains inconsistent across prisons, particularly in busy local prisons like Cardiff and Swansea; incomplete initial health assessments and weak follow-up systems for conditions like asthma and diabetes are recurring issues identified in death in custody reviews.
- Mental health provision varies widely: HMP Cardiff delivers seven-day secondary services with 70% prisoner satisfaction, while HMP Parc's 2025 inspection identified mental health as priority concern with delays in care; neurodiversity support (ADHD, autism) remains inconsistent across the estate.
- HIW recommends robust quality governance with prison healthcare as standing board item, comprehensive health needs assessments informing service planning, consistent national standards, and formal accountability for implementing improvements from HIW, HMIP and Prisons and Probation Ombudsman—without requiring structural reorganisation.
Tone
FactualTopics
Key actors
Ruth Jones MP, Alun Jones, Healthcare Inspectorate Wales, Cardiff and Vale University Health Board, Swansea Bay University Health Board, Her Majesty's Inspectorate of Prisons, Prisons and Probation Ombudsman, Betsi Cadwaladr University Health Board
Notable line
“… which local health boards deliver prison healthcare – can provide excellent care. Conversely, without strong governance arrangements, any model will risk failing prisoners.”
Key Quotes
“During the session, you said that you did not believe that structural changes 'necessarily create better services in and of themselves'.”
“HIW's position is that with the right loca l governance, the current model – in which local health boards deliver prison healthcare – can provide excellent care.”
“In our Swansea Bay review, HIW found that prison health services had a ' low profile' at Board level – for example, significant risks and recurring problems in HMP Swansea were not being escalated to the Health Board's Quality and Safety Committee.”
“HMP Cardiff stands out as a positive example: Cardiff & Vale UHB delivers both primary and secondary mental health services seven days a week, including counselling, psychology, and visiting psychiatry.”
“In contrast, HMP Parc has faced persistent chall enges in meeting demand. HMIP's 2025 inspection identified mental health as a priority concern, citing delays in care and cases where prisoners with serious conditions "did not receive the care they needed." At the time …”
“Every health board must treat prison healthcare as a core part of its business and integrate it into its governance structures.”
Source · parliament.uk record ↗