Doing time: Britain's ageing prison population

"I never realised until I came into prison what the term ‘doing time’ meant… The world I used to know has gone and my only view of the world is what I see on TV or read in papers. All I have are fading memories… I don’t know if any of my relatives are alive and I have no friends to visit me… I increasingly feel I am slowly dying away… ‘dead man walking’, as the saying goes.” *

Inmates aged 60 plus are the fastest-growing group in Britain’s prisons. As of December 2017, more than 13,500 people aged 50 plus were incarcerated, making up 16 per cent of the entire prison population. That number has trebled in the past 20 years. By 2020, it's expected to rise to 15,000. The reason for this ageing population is a combination of tougher sentences and the rise in convictions of historic sex offences. The latter means that many are inside for the first time, and struggling with the physical disadvantages that accompany old age.  What's considered “old age” in prison varies significantly from wider society because any period of incarceration adds around ten years to the physical age of a prisoner. 

The obstacles facing this generation of inmates include: mobility, incontinence, menopause, isolation, dementia, bullying, poverty [state pension is no longer paid upon incarceration] and difficulty adapting upon release. A University of Oxford study found that more than 80 per cent of male prisoners aged 60 plus suffered a chronic illness or disability. Although there are some palliative care suites across Britain, there aren't nearly enough to meet demand.

Many of our prisons were built during the Victorian era, to house young men in the peak of physical fitness. Says Peter Clarke, Her Majesty’s Chief Inspector of Prisons, “In [HMP] Dartmoor—constructed in 1804 to house prisoners of war—the cell doors are simply too narrow to accommodate wheelchairs. I recently encountered a wheelchair user who couldn’t get out of his cell unaided, so he was relying on another prisoner to help him. The impact of this was that this poor gent was basically just lying on his bed for the whole day. Our inspectors found him lying there with a urine bottle under his blanket. The prison state is simply not configured to give long-term residential care to elderly or disabled people.”

There is, at the time of writing, no comprehensive national strategy for the provision of social care in prisons, which means that no long-term plan has been devised for coping with the problems and pressures raised by the growing age of our prison population. The UK has had four justice secretaries in four and a half years, and the distraction of Brexit and lack of permanent attention from a single minister means no meaningful domestic policy has been constructed.

As it stands, older prisoners are often at the mercy of the so-called “postcode lottery” in determining the dignity they’ll be afforded during incarceration. In HMP Littlehey, they might find refuge in one of the prison’s wheelchair-adapted cells but arrive at HMP Foston Hall and they may be unable to attend education or offending behaviour courses as they take place on different floors, and no provision is made to take them there. 

“I've been talking about this for years,” Mr Clarke explains. “The Ministry of Justice said they were going to develop a strategy for older prisoners, so we were all living in hope, but what eventually emerged wasn't a strategy. They published the ‘Model for Operational Delivery’ and it’s no more than a menu of options for governors to choose from.”  

Without this policy in place, prisoners are missing out on vital support. In some facilities investigated by the Inspectorate of Prisons in late 2018, older prisoners who weren’t in specialist heath units were forced to remain in their cells, unable to shower regularly or safely access the toilet. When sleeping on top bunks, incontinent prisoners are often bullied by their cellmates. Speaking to the Prison Reform Trust* an anonymous inmate explained, “I have bladder trouble and I often wet my bedding. I'm very embarrassed and don’t want to be a nuisance. When I mentioned it to my officer he laughed and said we all have problems like that as we get older, but now I’m wetting myself in the daytime… Some of the younger men and officers are teasing me about the smell.”

Though punishment is certainly an objective of incarceration—alongside rehabilitation and public safety—some conditions in which elderly prisoners are currently living border on the inhumane. 

HMP Dartmoor, built in 1804, is not well-suited to older or disabled prisoners

The charity RECOOP (resettlement and care for older ex-offenders and prisoners) aims to promote the care, resettlement and rehabilitation of older prisoners, offenders and ex-offenders. Founded in 2008, the team recognised that some older men were being manipulated and neglected. One of their first solutions was to implement an informal buddy support system, followed by day centres, providing purposeful activities for a cohort that were presenting with needs that weren't catered for within the existing regimes. 

“It’s a contentious but important area of work,” Paul Grainge, RECOOP’s chief officer sighs, “few are interested in prisoners.” He nods to the prevailing lock-them-up-and-throw-away-the-key mentality that pervades much of public opinion. “A lot of people say, ‘Well they’re offenders, why should we be trying to make conditions more comfortable for them?’”

For Peter Clarke, it comes down to human decency. As he told the Prison Service Journal in late 2017, “My role is to see how prisoners are being treated and what conditions they’re being kept in. There’s a particular emphasis on decency at the moment as there's an imbalance between prisoner numbers and the ability to provide a decent custodial environment.”

Says Grainge, “Before the Care Act of 2014 there was little to no social care for this population, so it was tough. One man we worked with wasn't able to wear shoes because he couldn't cut his toenails and they'd become long and painful. The Care Act was great in that it provided the local authorities with the responsibility to provide those services, but there's still a long way to go.”

A particular victory for RECOOP has been the development of their four-day resettlement courses and formalised buddy support training, which aim to reduce the anxiety that surrounds release and give inmates the tools to live independently. Both schemes are sorely needed across British jails. “We spoke to a gentleman less than two weeks ago,” Grainge explains, “who'd been given four hours’ notice that he was being released, having served over 50 years. The plan was to give him a phased support package, but it didn't happen. He’s not even seen decimalisation, never mind hybrid silent cards, chip and pin, Google pay, all the technology we take for granted.”

Her Majesty's Chief Inspector of Prisons, Peter Clarke

Former inmate Carl Cattermole, who spent time in five different prisons for a non-violent offence and is now the author of Prison: A Survival Guide, explains, “The prison system is good for no one but in particular for older prisoners. In prison, you’ll wait six months just to see a dentist, let alone the complex health needs that older inmates might face. I’m diabetic so I saw first-hand the inadequacies. If you have a complaint, more often than not it’s ignored. The prison system is so over-stretched, they have no time for the medical complexities of the older generation. I pushed one guy up and down to education in his wheelchair, because there were no staff available. Because there’s no capacity, younger prisoners fulfill those caring roles.”

Carl’s experience is far from unique. As one inmate told the Prison Reform Trust, “I can’t get my wheelchair through the door of my room. When it’s mealtime someone has to collect my food and bring it to me. I’ve been told that officers aren't allowed to push me. I would be lost without the support of my friends.”

“Institutionalisation is something you never get over,” Carl reflects. “It's like building a concrete structure in a forest. The ivy can grow back, it can get hidden, but there are still lumps of concrete beneath the surface.
I think it’s much harder to adjust into the community as an older person than it is if you’re coming out in your twenties or thirties.”

Dr Amanda Brown has worked in prisons for 15 years

In women’s prisons there are some even more complex issues at play. Many incarcerated women have found themselves in prison as part of a chain of domestic violence that can span their entire lives. 

A GP at Europe’s largest women-only facility, HMP Bronzefield, Dr Amanda Brown has worked in prisons for 15 years. Now the author of The Prison Doctor, a no-holds-barred account of her eventful career, she recalls female prisoners who have told her that their first night in prison was their first experience of sleeping with a sense of safety. 

“Some of these poor women have had pretty horrible lives, being controlled by men for many years. One woman in her fifties and new in prison said she felt freer than she had for the past 12 years, so actually, she was quite happy to be inside. There’s a lady in Bronzefield who's been inside for 40 years and it’s her home. Her parole's coming up and she’s trying to avoid getting out. Once she pretended she was going to strangle an officer with a shoestring, just so that it would look like she wasn’t safe to be taken out.” 

Author and prison activist Carl Cattermole 

As overwhelming as the problems facing this demographic undoubtedly are, there are some signs of hope. 

“There’s some good work being done in [HMP] Northumberland,” says Peter Clarke. “There’s an entire block there that’s given up for older men. Last time I was there, one man was having a problem standing in the lunch queue, and his colleagues got him a wheelchair, and it was all very supportive. The men I spoke to said they really liked being away from the drugs, violence and loud music from young prisoners on the other wings. So, there are some examples of good practice, but then I go around jails and ask, ‘Do you know what’s happening in Northumberland?’ and they look at me blankly and say no.”

“At [HMP] Stafford, rather than trying to rehabilitate prisoners by getting them ready for work, which is rather pointless [as they’re post-retirement age], they have a facility that works like a drop-in centre. The older men meet their peers and have a cup of tea and that’s realistic rehabilitation in terms of what the future might hold for them. So, there are good examples, but it feels patchy.”

MP Robert Buckland, the current Minister for Prisons, didn't respond to our request for comment. A Prison Service spokesperson said: "The ageing prison population poses challenges but inspectors noted last year there is already good work going on with the NHS and local authority partners to adapt prisons for their needs." 

“They should be thinking about a different type of custody entirely," says Clarke. "To put it crudely, an old peoples’ home with a wall around it. Older or disabled prisoners don’t need the levels of security in which many of them are held. We’re missing opportunities to think imaginatively about a different type of custody.”

Paul Grainge says that groups of prisoners he’s consulted on the idea have been split almost 50/50. “I don’t know why HMPPS or the Ministry of Justice don’t start looking at secure care home models.”

 “The narratives of our prisons are constructed by three main groups: journalists who haven’t been to prison, scriptwriters who haven’t been to prison and politicians who haven’t been to prison,” Carl Cattermole explains. “Factors like homelessness, poverty, prison, PTSD, poor health—they all feed into one another. If you don’t get into one of them, then you’re unlikely to get into any of them and you surf above it all without knowing anything about it. And people don’t want to know about prisons. They don’t want to know anything about it.” 

You can donate to RECOOP by visiting recoop.org.uk

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*Quote from “Doing Time” a briefing from the Prison Reform Trust