A working group has recommended that substantial change and improvement be accomplished in the provision of inmate health care through a formal partnership between the Prison Service and the NHS. A Prison Health Policy Unit will replace the current Directorate of Health Care. Health authorities and prison governors are to work together to identify the health needs of inmates and to develop prison health improvement programs. The ability of the NHS to fund and provide quality health care to inmates is discussed, with special emphasis on the needs of mentally ill inmates. The proposal of the partnership between the Prison Service and the NHS is considered in the context of providing appropriate psychiatric services. Relevant issues in this context are the cost of care, the quality of services, and the availability of medical staff. The article emphasizes the importance of treating the severely mentally ill in custody in the most effective manner possible, recognizing that men and women convicted of criminal offenses should receive the same quality of treatment as any other member of the population. 12 references