Former GP Dr Richard Matthews worked in the Australian prison health system for 20 years, eventually becoming chief executive of Justice Health in NSW. Here, he talks about the complex health problems experienced by inmates and the importance of doctors not becoming complicit in a regime focused on punishment rather than care.

AD: What difficulties face GPs working within the prison system?

Dr Matthews: You need to be very aware of the boundaries in a custodial setting. Health privacy is important but needs to be considered within the context of what the custodial authorities need to know.

A good example is if you’re going to put a diabetic in a truck for six hours from one jail to another; they need to know he is a diabetic so he can have his jelly beans.