Nicholas Duvall

This project examines the place of prison doctors within the medical profession as a whole in England in the 1970s and 1980s. It looks at how they and their work was perceived by health service colleagues, the quality of the working relationship between these two groups, and how doctors belonging to the Prison Medical Service, constructed their professional identity. The existing historiography has tended to focus on power interrelations between inmates and their doctors, as well as the responses of prison medical officers to politically inspired hunger strikes. Building on this work, this study examines the intra-professional discourses on prison medical care, which shaped the treatment prisoners received. Many of the complex healthcare needs of inmates could not be met within the Prison Medical Service and were instead treated by National Health Service doctors. Appropriate treatment depended on effective working relationships between the prison doctors initiating referrals and their external counterparts. Nevertheless, tensions emerged, for example over the difficulty of finding hospital places for severely mentally ill prisoners.

This project draws upon sources which reflect varied perspectives on prison medicine. Medical journals and magazines, from formal publications such as the Lancet and the British Medical Journal, to the more journalistic World Medicine, acted as forums for debate about prison healthcare. The correspondence pages, and longer articles, demonstrate the ways in which health-service doctors criticized their prison counterparts, and how prison medical officers responded. The discourse within medicine was heavily informed by voices beyond the profession, including those of campaign groups, such as the Prison Reform Trust and Radical Alternatives to Prison, and politicians. Prison doctors’ participation in these exchanges was an important means by which they came to define their own professional identity allowing them to articulate their approaches to the practical and ethical problems posed by working in the prison environment.

Image: MSS 16A/7/23/1, Howard League Papers. Photograph courtesy of Modern Record Centre, University of Warwick