A prisoner who claims that the refusal of the prison service to introduce a needle exchange policy represents a real and immediate risk to his life has started legal proceedings against the home secretary.
Lawyers acting for John Shelley, a long-term prisoner currently in Long Lartin jail, near Evesham, are seeking a judicial review of current policy. Under this policy, as revealed by The Guardian in March, prisoners are being issued with disinfecting tablets, which the Department of Health, doctors and drug-user support groups say are inadequate in protecting addicts from blood-borne infections such as HIV and hepatitis.
A gay former prisoner who was wrongly diagnosed as HIV positive claims that Home Office figures on the number of prisoners with HIV are the "tip of a hidden iceberg". He said this was due to prisoners failing to report their condition to jail staff from fear of discrimination. During one sentence, he said, he was moved 38 times because no prison would accept him.
The last survey of prisoners with blood-borne viruses was carried out in 1997/98. The Public Health Laboratory Service concluded that 0.36% of inmates were HIV positive and 7.8% had Hepatitis B. A further 7.5% tested positive for Hepatitis C, regarded as the most serious of these viruses, directly responsible of around 100 deaths a year in the UK and a major contributor to a further 5,000 deaths annually.
A recent Home Office report suggested that 2% of prisoners inject drugs in prison and it acknowledged that there may be significant under-reporting of the problem because of the stigma, and illegality, of drug use in prison. A previous study suggested that 6.7% of inmates injected drugs and that there was a high level of needle sharing by prisoners who used drugs intravenously.
When the introduction of disinfecting tablets was reported a spokesman for the Department of Health said it would not recommend it as a suitable method of sterilising needles. It later denied saying this. However, a department report, commissioned in 1999, states that, "although cleaning equipment is a safer practise than not cleaning at all, the practise - of disinfecting needles - has only been shown to reduce the risk of HIV and may offer little or no protection against more enduring or prevalent hepatitis C".
At least 99% of health authorities operate needle exchange programmes, which have proved to reduce the spread of blood-borne viruses among drug addicts who inject.
Shelley's solicitor, Sean Humber, said that the failure of the prison service to consider needle exchanges, "exposes prisoners and prison officers alike to unnecessary risks and is a breach of their human rights".
Glen Fielding was released from prison in October. In 1993, after being told he was HIV positive, he received his first jail sentence. During that five-year term he said he was in 38 different prisons as a result of staff refusing to have contact with him.
"Every time I was moved prison officers would refuse to be handcuffed to me."
He was advised to go on protection on the vulnerable prisoner wings and received daily abuse from staff and prisoners because of his supposed condition. "Staff were frightened of me," he said.
He went back to prison in 1997, serving seven years. Although he had by then been told that the earlier diagnosis was wrong, he was still treated with suspicion by staff and inmates. This was largely due to him not hiding his sexuality, he said.
Mr Fielding took a successful legal action to force the prison service to supply condoms to inmates.
Although Mr Fielding, 43, is not a drug addict, he said he began to notice the problems associated with needle sharing. In one prison, Littlehey, near Huntingdon, 32 prisoners were sharing one needle, fashioned from a biro and a needle that had been secreted by a diabetic prisoner, he said.
"Of the 32," he said, "four were HIV positive. By the time I left that nick, all 32, the whole shooting match, had contracted the virus."
Mr Fielding said that, in 12 months, in two jails in the south of England, he met at least two dozen HIV positive prisoners who had not declared their condition to prison staff.
"It may sound awful," he said, "but I could not blame them, after the dreadful experiences I suffered as a result of my wrong diagnosis."
He said the prison service had to face up to the reality of the drug situation and work to stop the spread of blood-borne viruses.
"Drugs are coming into prison, everybody knows that they are," he said. "Therefore the prison service has an obligation to prevent the spread of ill health."
Tim Newell is a former prison governor, widely respected for his innovative therapeutic work with prisoners at Grendon jail. Now a consultant for the Butler Trust, he said the issue of drug abuse was huge and needed a multi-faceted approach to address it. His basic view is that that the problem should be seen and treated as a health issue, rather than a prison one.
"I agree that what they are doing - in relation to disinfecting tablets - may be a dangerous practice," he said. "The ideal way of dealing with this serious problem would be for the prison service to implement a needle exchange policy."
© The Guardian