Nurses are under pressure at Bunbury Regional Prison in WA because doctor services have halved and there has been no increase in health staff numbers to match the rising inmate population, a report has found.
The Office of the Inspector of Custodial Services report, released on Thursday, also revealed a doctor attends the facility three days per fortnight and it takes months to get an appointment.
Acting Inspector Andrew Harvey says it is disappointing satisfaction with health services is declining significantly and most services are under pressure.
But Acting Commissioner of Corrective Services Tony Hassall says a recruitment campaign is underway for nurses and GPs.
Under the prison's drug strategy, inmates who test positive are placed on a management regime, which includes sanctions such as non-contact visits and ineligibility for transfer to another prison.
The report found it was a good initiative but was not well understood and was overly punitive.
By the end of 2019, Bunbury Regional Prison will house an additional 160 prisoners, with a new double-bunked accommodation unit inside the main jail plus the re-opening of an unused minimum security section.
Mr Harvey warned the expansion would need to be carefully managed, noting the main prison was already operating at 50 per cent above its design capacity.
"Most prisoners are sharing cells, some of which do not even meet Red Cross standards of single cells in developing countries," he said.
"The reintegration unit is 70 per cent above design capacity and is struggling to meet its goal of helping prisoners back into the community."
Facilities including kitchens, laundries and video court facilities will be upgraded, but it is not clear whether additional resources will be put into education, employment and health.
"Expansion projects in recent years have been all about beds and not about need and purpose," Mr Harvey said.
"The department needs to better target its resources at specific needs including mental health, substance abuse and older or infirm prisoners."
The department shares concerns about the effect of a rising population on service delivery and accommodation, but Mr Hassell says the $23.7 million upgrades will help.
