As early as 1922, the English recognized that inmate medical care was inadequate, primarily because (1) gifted medical officers were not attracted to prison service, and (2) the medical staff was not large enough to permit individualized service. U.S. prison authorities have also recognized the need for improvement in prison medical care, and the reorganization of the service system has already been undertaken. The Health Law Project, which produced a report on the types and quality of health care in Pennsylvania, made numerous recommendations for correcting abuses in the system: (1) all personnel must work the hours for which they are paid, (2) adequate malpractice coverage must be provided, and (3) medical staffing should be available at all times. Other recommendations relate to the services that should be provided, including surgery, laboratory services, inpatient nursing services, psychiatry, radiology, and dentistry. Two possible solutions to prison medical care problems are discussed: the development of prisoner medical care grievance programs and the use of community-based services. Forty-two references are included.