I am not sure that I can answer that. We tend to visit mainly hospitals, as well as community facilities. The commission met representatives of the SPS about 10 years ago, before I started to work at the commission—I could get the details—and we achieved an agreement that we would visit prisons, given the level of identified needs and issues coming out of them.
We have debated our role in prisons for a while. We are not an inspection agency. We tend to ask prisoners about the care that they receive, and we can react, follow through and make recommendations. We were visiting prisons prior to the transfer from the SPS to local health boards.
We did a report on the mental health of prisoners nearly six years ago—in 2011—that considered the issues at that time. We pass on to health boards our reports, which raise issues that we pick up, but we also share information with HM inspectorate of prisons for Scotland and Healthcare Improvement Scotland. When prisons are inspected, those bodies primarily consider standards for healthcare and mental health care. We liaise quite closely, and we can pick up on issues from our visits and those organisations’ visits. That is effective in highlighting issues that we pick up. We do make recommendations.
We find that the situation is quite variable—there are good points and less good points, often in the same prison. The picture varies, and we pick up on that and make recommendations—for instance, on inadequate healthcare and health centre facilities and on time being wasted when psychiatrists cannot get a room because they have to wait behind the general practitioner.
As has been mentioned, a good relationship is needed between health staff and prison officers. There is no point in having a psychologist visiting if nobody brings the prisoner across. There is a whole dynamic whereby people need to work together.
We have been going into prisons for a while, and we have seen the situation with the SPS and then the health boards providing a service. We have not seen huge changes. There has been a chipping away, and nurses who work in the healthcare teams in prisons now have the opportunity to be much more connected with health boards and with training. We would like much more transferring back and forth between nurses who work in the community and those who work in prisons, so that we can build bridges and find out what is happening in the community and in prisons. That does not happen a lot, although it is beginning to happen more.
One big thing about the change from the SPS to the NHS is maintaining the links and relationships. Our experience is that staff turnover has not been massive, and healthcare staff who work in prisons have often been there for a while. They have good relationships with the prison officers, and much is built on trust and on who they know. Maintaining the dynamic is important.
With the service having moved to the NHS, the danger is that there could be more of a gap between the two services. Both services need each other to do their jobs properly, and we want to ensure that that continues to happen.
I am sorry—I have probably gone away from the question.