Mr. Enda Kelly:

Registered nurses comprise 90% of healthcare staff in prisons. There was a reference to how the culture between the officers and the nurses worked. It is hugely supportive. Over the decade I have been with the Prison Service, we have seen great development in joint training between nurses and prison officers. That is especially the case with mental health. Nearly 1,800 of our staff are now trained in mental health awareness. We see that nurses realise that they cannot function without the daily support of the prison officers. That brings me back to the question of people in isolation. I would like to clarify that it is never done as an easy way to manage somebody with a mental illness. We have a seclusion policy which is akin to a clinical seclusion policy but it is tightly regulated. It has to be prescribed by either a registered nurse or a doctor. The skill mix between the nurses and the prison officers is hugely successful. It has been the basis for many of our projects in the high-support unit where we have been able to enhance the quality of life for people in prison with major mental health problems.

That also touches on the involuntary status of prisoners. We cannot forcibly treat prisoners against their will. Anybody with a healthcare issue of that severity - be it a cardiac or mental health issue - deserves to be in a clinical setting. If a prisoner is that ill, we clearly advocate that he or she should be properly treated and supported by our colleagues in a hospital in the community. We are in the invidious position, as Professor Kennedy said, that we cannot get access. It is important today that we mention the human cost involved. These are people who are suffering and are terribly unwell and as an organisation we are trying to do the best we can to support them. We have professionals and all the experts in but we do not have the right environment.