A new palliative care centre is set to be built on the Midlands Prison campus, where prisoners who are very elderly or terminally ill will be cared for in the final days of their lives. The decision to create the new facility comes as the number of very elderly prisoners continues to increase, especially in the Midlands which has large numbers of lifers and elderly sex offenders.
It also follows concerns expressed by the then inspector of prisons over the handling of the case of a 47-year-old prisoner who died from cancer in a cell in the Midlands Prison in 2018. A hospice setting had been recommended by medical staff but no beds were available for him and so on his discharge from hospital he was taken back to the Midlands where he died six days later.
The Midlands Prison, which is adjacent to the maximum-security Portlaoise Prison in Portlaoise, is the biggest prison in the State and also has a larger number of sex offenders than any other jail. Many of the sex offenders have been jailed for historical crimes and are often in their 70s starting their sentence.
In an interview with The Irish Times, the governor of the Midlands Prison, David Conroy, said planning for the palliative care facility on the jail campus was well advanced. He said the area of the campus where the centre was to be constructed had been identified and that business cases had been accepted.
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“It’s just a matter of getting the job started,” he said. “A prison landing isn’t really conducive as a place to die. It’s noisy and it’s robust and we have recognised that. A centre would be quieter [and would] allow family to come in and be with a person as they’re dying, as they would be in hospital or in another care setting.”
He said during the pandemic period, when special extras including cocooning had to be extended to elderly prisoners, managing the end of life period in the prisoner population had come into focus. And while some prisoners could still be granted compassionate release – meaning they could die at home – or could be treated as patients in hospitals, it was inevitable others would die behind prison walls.
“This is a thing that we never really had to manage before; end of life during a custodial sentence. Sometimes a lengthy sentence [imposed] when they’re very old... the intention of the court, which has to be considered, is that they would finish their life in prison.”
The Irish Prison Service said the centre would initially be a one-bed unit, adding its priority was “to make the person as comfortable as possible by providing all the necessary palliative care supports for the individual and their families”.
When the centre was being built next year other new facilities would be built to better manage the “elderly and infirm prisoners” in the jail, with approximately 90 of the 875 inmates aged 60 years or over. This would include “hoisting in showering areas” in the G wing, where many elderly sex offenders were housed.
In 2018, a prisoner who was dying from cancer was discharged from Portlaoise general hospital when medics there concluded he no longer required an acute hospital bed. His transfer to a hospice was signed off on by the Department of Justice, but no community hospice bed was available. He was taken back to the Midlands Prison and died in his cell six days later.
Two years ago the then inspector of prisons, Patricia Gilheaney, commended the efforts taken by prison management and staff to put special medical care arrangements in place for the man, including by medical staff with palliative care expertise. However, she was critical of some aspects of his care, about six months before his condition became grave, and said the case highlighted the need for palliative care options for prisoners.
