Doctors warn on police cell care: Ethics committee says poor surgeons put prisoners' lives at risk. Jason Bennetto reports

MEDICAL treatment for prisoners in police cells is often 'appalling' or 'non-existent', a doctors' ethics committee reported yesterday.

The committee warned that badly trained police surgeons were putting detainees' lives at risk and criticised the sharp increase in the number of mentally ill people ending up in cells.

But the most severe criticism was for the treatment given to remand prisoners, some of whom, the report said, were held for long periods with no medical facilities in conditions that breach basic human rights.

Growing alarm at the treatment in police cells has prompted the British Medical Association's ethics committee and the Association of Police Surgeons to draw up new guidelines. There are about 1,800 police surgeons, most of whom are general practitioners working part-time for the police; about half are BMA members. In their report, Health Care of Detainees in Police Stations, published yesterday, the BMA and APS said standards of care in some areas were well below those in the NHS.

The report said: 'The procedure for administering medication to detainees falls below the very lowest standards. In police cells, doctors are required to leave the medicine with the custody officer for the detainee to take later. This results in people being given either the wrong medicine or dose. The medicine can also be lost.'

Facilities for treating remand prisoners were attacked. In some cases, doctors have to examine detainees in the presence of other inmates. Dr Michael Wilks, a member of the committee and a forensic medical examiner, said: 'The use of police and magistrates' cells for the long-term detention for remand (prisoners) are a serious abuse of their human rights.'

The number of people on remand has fluctuated in the past few years from 1,367 in July 1992 to 81 last week.

Dr Michael Knight, honorary secretary of the APS, called for a purge of poorly trained police surgeons, who ignored medical ethics. He said: 'There are a large number of surgeons working without adequate training.'

Authors of the report highlighted concern that confidential medical notes, including possible details about HIV infection, were read without the patients' consent. They also emphasised the importance of obtaining consent, whenever possible, from the detainee before treatment.

Dr Wilks said they were very concerned about the rise in the number of mentally ill people in police custody. He said: 'There's an increasing problem with having to care for people who seem to have fallen through the safety net . . . It reflects badly on the current community care system.'

The report concluded: 'In spite of the fact that detainees in police stations have lost their liberty, they have not lost their fundamental right to the doctor's duty of care, even though there may be limitations, to some

degree, of the patient's usual rights, particularly those of consent and

confidentiality.'