THE INTRODUCTION OF A PRISON MEDICAL SERVICE IN BRITAIN WAS A CONSEQUENCE OF THE WORK OF PENAL REFORMER JOHN HOWARD, WHOSE 1977 BOOK CAUSED SOCIETY TO TAKE A SERIOUS LOOK AT CONDITIONS IN ITS PRISONS. THERE IS THE IMPLICATION IN HOWARD'S WORK THAT PHYSICIANS ARE PERSONS WHOSE PRESENCE IN PRISONS WOULD MITIGATE THE RIGORS OF INSTITUTIONAL LIFE. DURING THE 19TH CENTURY, THE ROLE OF THE PRISON PHYSICIAN IN TREATING MENTALLY OR PHYSICALLY ILL INMATES DEVELOPED GRADUALLY. SINCE WORLD WAR II, INCREASING NUMBERS OF FULL-TIME MEDICAL OFFICERS AND PSYCHOTHERAPISTS HAVE BECOME INVOLVED IN PRISON SERVICE. THESE PHYSICIANS SUPPORT THE OVERALL REHABILITATIVE PROGRAMS OF THE PRISONS. ONE OF THEIR MOST IMPORTANT OBLIGATIONS, PARTICULARLY IN THEIR CAPACITY AS FORENSIC PSYCHIATRISTS REPORTING TO THE COURTS ON THE MENTAL CONDITION OF INMATES, IS TO BALANCE THEIR RESPONSIBILITY TO THE INDIVIDUAL PATIENT WITH THEIR RESPONSIBILITY TO THE STATE. THERE IS A TREND TOWARD SPECIALIZATION IN BRITISH PRISON MEDICAL SERVICES. THE AREAS OF SPECIALTY ARE THREE: (1) THE PART-TIME GENERAL PRACTITIONER, WHO HANDLES THE ROUTINE PHYSICAL CARE OF INMATES; (2) THE PSYCHIATRIST, WHO ASSESSES AND TREATS INMATES WITH MENTAL HEALTH PROBLEMS; AND (3) THE FULL-TIME MEDICAL OFFICER, WHO PLANS AND ORGANIZES INMATE HEALTH SERVICES AND MAKES CERTAIN THAT HEALTH MATTERS ARE TAKEN INTO ACCOUNT BY PRISON ADMINISTRATORS. (LKM)