Correctional institutions which are characterized by authoritarian organization may control access to health care services through filtering requests through correctional staff, or conversely by using staff to identify and facilitate inmate medical care. The authors investigated the relationship between inmate-assessed prison social climate and satisfaction with health care in over 4,800 male and female inmates in 49 English/Welsh correctional institutions (ranging from high to low security). A single eleven-item dimension of health care satisfaction was identified in the Measuring the Quality of Prison Life (MQPL) instrument. Multiple regression of the dimensions of prison climate as measured by the MQPL on health care satisfaction indicated that the scales 'Relationships with staff', 'Safety', 'Feedback and care', 'Fairness' and 'Care for vulnerable', predicted 30 percent of variance in health care satisfaction. Qualitative data on health care issues from a parallel study of 12 English/Welsh local prisons were used to explicate the quantitative findings. Data suggest that positive prison climates facilitated interactions between correctional and health care staff and prisoners, while in negative climates correctional staff acted as a filter or barrier between inmates and health services. Further, data suggested that health care staff themselves may be influenced by prison climate. These findings implicate health care provision and access as an integral part of prison climate, and suggest that inmates' judgments on access to, and satisfaction with, prison health services are significantly associated with general, non-health related prison climate measures. (Published Abstract)