UK prisons as carceral healthcare systems: systemic failures in medicine and justice
Original framing: “[World Report] The medicine of…prisons” — The Lancet
Evidence shows that prison healthcare systems are structurally underfunded, with mortality rates among incarcerated people 2-3 times higher than the general population due to preventable conditions. Studies from the U.S. and UK demonstrate that racialized and low-income groups receive lower-quality care in prisons, reflecting broader healthcare disparities. The Lancet’s focus on 'unusual settings' overlooks how these systems are predictable outcomes of neoliberal austerity and the commodification of health. Scientific literature also highlights the inefficacy of punitive models in reducing recidivism or improving public health.
The Lancet’s framing of prison healthcare as an 'unusual setting' obscures how prisons are the predictable outcome of a punitive justice system that has historically targeted racialized and poor populations, from convict leasing to the modern prison-industrial complex.
This system is not an anomaly but a structural feature of neoliberal capitalism, where medicine is weaponized to manage the surplus populations created by austerity and racialized policing. Indigenous and Global South perspectives reveal how carceral spaces sever the relational fabric of health, replacing communal healing with biomedical control. The solution lies not in 'improving' prison healthcare but in dismantling the system entirely, replacing it with community-based alternatives rooted in restorative justice and indigenous epistemologies. The trickster’s laughter lies in the absurdity of a profession that claims to heal while participating in a system designed to break bodies and spirits—until we choose to see the prison for what it truly is: a tomb for the living, not a hospital.