The Impact of Macroeconomic Austerity on Prisoner Health and Wellbeing in England

Prisoner health has not significantly improved over the last two centuries. English prisons are currently facing a sustainability crisis that dovetails with the government's austerity measures, represented by a £900 million (24%) prison spending reduction at the end of the last Parliament (National Offender Management Service 2015). This research will investigate the variegated, deepening impact of austerity on prisoner health and wellbeing. Specifically, it will focus on the Healthy Prisons Agenda (World Health Organization (WHO), 2007), which promotes reduction of prison health risks; preservation of human rights while maintaining a security regime; equivalence of prison health provisions compared to community health services; and promotion of the whole-system approach in prisons. This research aligns with the ESRC Delivery Plan 2016-2020, which calls for greater understanding of the macroeconomic impact on governmental policies.
The research proposes four interdisciplinary work programmes that will collectively explore the current disconnect between policy and practice.
Programme 1 (International Level) will situate the current austerity measures towards prisoner health and wellbeing against the international obligations on prison health, focusing on the following research questions:
1) How has the UK Government articulated a compelling state interest in consolidating fiscal measures that impact the delivery of the Healthy Prisons Agenda?
2) How has the state balanced austerity with its international obligations that seek to protect prisoners' health entitlement?
3) How has the state demonstrated that it has exhausted alternative measures regarding prisoners' enjoyment of health?
Findings will bridge the gap between international policy and the political constructs that legitimise the notion of austerity, which potentially impact prisoner health.
Programme 2 will explore how austerity measures align with recent developments in prison health, including the prison reform agenda and prison diversion scheme at the macro-level, and focus on the following research questions:
1) How do decision-makers maintain prison standards under an austerity mandate?
2) How does austerity fit with the Prison Safety and Reform Agenda 2016 and the calls for justice reinvestments in diverting people from prisons for rehabilitation purposes?
Potential contributions include advancement of knowledge in policy formation, policy initiation, and institutional interactions at the macro-level during times of uncertainty.
In response to the gap in contextualising the austerity phenomenon at the operational level of prisons, Programme 3 will investigate the influence of austerity on prison governors and staff, and voluntary organisations, examining the following research questions:
1) In what ways has austerity impacted the delivery of services by prison governors and staff?
2) How do voluntary organisations adapt to the service demands and funding changes that create gaps in state provision in this time of austerity?
3) How do voluntary organisations deal with the confluence of forces such as market efficiency, competition, and altruism that can result from austerity?
This programme will develop empirical knowledge about how prison governors, prison staff, and voluntary organisations negotiate the impact of austerity upon prisoners, whilst simultaneously advancing improvements in working practices in English prisons.
Programme 4 will explore how austerity, at the micro-level, suppresses prisoner health:
1) What are the expectations of prisoners regarding support for their health?
2) How do prisoners make sense of austerity?
3) How do the politics of austerity impact prisoners regarding the availability, accessibility, acceptability, and quality of health services?
This programme will seek to build knowledge on the impact of macro-level policy on austerity upon prisoners at the micro-level.