Rebel Justice
What is justice? Who does it serve? Why should you care?
When we think about justice, we think about it as an abstract, something that happens to someone else, somewhere else. But justice and the law regulate every aspect of our interactions with each other, with organisations, and with the government.
We never think about it until it impacts our lives, or that of someone close.
Our guests are women with lived experience of the justice system whether as victims or women who have committed crimes; or people at the forefront of civic action who put their lives on the line to demand a better world..
We ask them to share their insight into how we might repair a broken and harmful system, with humanity and dignity.
We also speak with people who are in the heart of the justice system creating important change; climate activists, judges, barristers, human rights campaigners, mental health advocates, artists and healers.
Rebel Justice
106. Healthcare Is a Human Right — So Why Are Women in Prison Being Failed?
What happens when women in prison need healthcare—and no one listens?
In this episode, we examine the systemic failures in women’s prison healthcare through a powerful conversation with human rights solicitor Rebecca Alonso. We explore how outsourced services, understaffing, and gender-blind medical systems leave women in pain, ignored, and without accountability.
Drawing on lived experiences documented in The View magazine, we look at why the state’s duty of care cannot be outsourced, how international law can strengthen legal challenges, and what real reform could look like—from proper oversight to NHS pathways that actually work.
Healthcare is a human right. It shouldn’t end at the prison gate.
Production: Henry Chukwunyerenwa
Narrator and Host: Sophia Franco
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In this episode, we're focusing on prison health care, not as a policy abstraction, but as a lived reality for the women inside. Issue 16 of The View magazine documents systemic failures in medical care for women in prison, alongside stories of resilience, creativity, and resistance. It turns out these aren't isolated incidents at all, but a part of a wider pattern of delay, disbelief, and neglect that repeatedly fails women in custody. Healthcare in many women's prisons is delivered by private contractors under agreements with the Ministry of Justice. Those contracts are supposed to guarantee a standard of care. To understand what those contracts promise and where accountability breaks down, I spoke with lawyer Rebecca Alonso, who has been scrutinizing these very issues.
Maile:We also speak with judges, lawyers, campaigners, artists, and healers navigating the system every day. Together, we ask how justice might be reimagined with dignity and humanity at its core.
Host:Hello, Rebecca. Thank you so much for taking the time to speak with us.
Rebeca Alonso:Hello, Sofia. Good evening from Spain. Thank you so much for inviting me for this podcast. It's my pleasure.
Host:Of course, it's it's mine as well. Um, if you wouldn't mind please introducing yourself and telling us a bit about your work examining prison healthcare and accountability to start off.
Rebeca Alonso:Yes, uh well, I'm actually working as a solicitor in Spain. I have a long uh career as a legal counsel and as a solicitor. My expertise, or I'm used to deal with international cases in the private sector, particularly in finance, banking, but I used to deal also with cases regarding human rights. Human rights in the sector of private contracts. And well, as healthcare is a human right internationally recognized by the main conventions. I think this is not very different from other human rights in order to deal with, you know. So I've been working as a solicitor, as I told you before, since 2007, when I was admitted at the bar in Madrid dealing with human rights. Particularly, I was uh working with human rights in contracts, in banking contracts, in the cases uh regarding British citizens trying to get properties in Spain, and with all these clauses that were not very clean by mortgage and stuff like that from the banks. Okay. So basically, this is my relation with human rights, but as I told you before, is uh quite similar in the in the context, doesn't matter if it's in the health system or if it's in the prisons or is in a banking or it's in a finance sector. You know, it's it's quite similar the process and and and the situations.
Host:Wow, thank you so much, Rebecca. It seems like you've had a really diverse and exciting career thus far. I'm also really interested that you say that healthcare as a human right is not that different as a lawyer from a legal perspective to handle than other human rights. So I'm gonna move on to my next question, if that's okay. Um, so I know you've been looking closely at the healthcare contract between Sedexo, so the private company running healthcare at Bronsfield and the Ministry of Justice. For those who don't know, what is that contract supposed to guarantee for women's health care in prison?
Rebeca Alonso:Well, I think from the perspective of a contract, there is not a guarantee for a woman. It's more like a commitment from the state to fulfill these human rights obligations that assume internationally when they are part of these international conventions. A part of that, what we can see is the responsibility from the states regarding these people, especially when they are vulnerable, like people in prison, in the sense that they are responsible not only internationally because this fulfillment of these obligations, but also because they have this civil responsibility, indirect responsibility with its citizens. I mean, all states have the duty to safeguard all these human rights. They have this indirect responsibility because I think, like in this case, they did not control how this private company developed the service they compromised with. So what I saw in this case, particularly in the document that I was checking, is there was no references to these international conventions or to this possibility. And I think it's very interesting to introduce, even in the domestic sphere, in the claims, to also introduce the infringement of a human right in the international sphere in order to be able to scale the case to the international court.
Host:Great, thank you so much. It's really interesting how you talk about the potential role that international law can play in these types of situations. So, my next question would be: where do you see the biggest disconnect between what that contract promises on paper and what women experience day to day in prisons like Bronsfield?
Rebeca Alonso:Well, the no compliance with the contract, exactly. I mean, well, I see the lack of staff and prisons, so they don't get these enough people to attend these persons, especially when they have these illnesses like cancer. They are situations with extreme situations, also the lack of the of the staff, also the lack of proper policies on gender perspective, because I think women in prison are a minority, so all the policies inside the prisons are designed for male, so not particularly considering the specific situations of women. So they have reported, for example, when you read this situation of a woman that has a surgery of 13 hours and later on was put on a room in the hospital with this person from the jail. I mean, this is not the right way to proceed. And also they reported the lack of a proper place when they come back to the prison to be recovered. So I think resources, investment, staff, of course, gender policies.
Host:That's really great. I think that's really interesting for our audience to hear. I think for me particularly, I've done a lot of research on how prison as a concept and as an institution has been set up for men. So for me, that's particularly interesting what you mentioned about gender. Um I'm kind of building off of what you have already started mentioning. But when those healthcare standards aren't met, who would you say is legally responsible? The private contractor or the state? That might also connect to what you were talking about with international law, perhaps. Why is it so difficult to hold anyone accountable when things go wrong?
Rebeca Alonso:Well, because you can see different responsibilities in these cases. For one part, you can see the international responsibility of the states for not compliance with human rights obligations that he has to fulfill. They are part of these conventions and they don't fulfill with them, so they have this responsibility in the international sphere. This is one part. But on the other part, you have this civil responsibility, as I stated before, civil responsibility, indirect civil responsibility from the state, because all the states must safeguard and protect civil rights from its citizens. So there is this responsibility always, is an indirect responsibility. And you can also find this other responsibility, but this interparties. I mean, it's a contract. If one party breaks the contract, it has a responsibility, but it's in between both parties. But from the perspective of the woman, the inmates in prisons, I think the indirect responsibility from the state should be improved in these cases. As far as uh, of course, it's a way of pressing or make pressure in states to improve their policies, their laws, stuff like that. If they don't feel they have this responsibility, this indirect responsibility, I think they are not going to move on. So it's quite important to know that point. A part of what I said before, this international possibility to scale the cases to the international courts. And I think they are not very much developed nowadays, and I think it's a very, very good option to open in these cases. Well, it's not easy because you have to elapse to all the procedures, domestic procedures, but you must introduce this legal literacy in the first claims, not only to refer to domestic laws and jurisprudence, in this case in the UK or case law, but also the laws, the international law, the infringement of these conventions. I think is quite interesting this point.
Host:Certainly. Thank you so much. That um I also really like how you talked about indirect responsibility. If you don't mind me asking, would you say that there's a certain moral aspect to it or an ethical standard that directs this responsibility?
Rebeca Alonso:Yes, of course. I mean, I feel this question more as a policy question than responsibility of the state. It's a responsibility of all society that implies media. I think all these cases must be on the in the media and explain a little bit to people how all these human rights works. Because I think many people they are not dealing with it. I think it's important to focus on human rights. You know, healthcare is a human right. We must depart from this point of view, and then all of us will be conscious of the importance of the fulfillment and comply with this, and also to ask our states to improve policies, to improve laws, procedures? This is my point of view.
Host:Great, thank you so much. Um, so kind of going into a different direction with this question. In your view, do these contracts and their incentive structures end up encouraging cost cutting over proper care? Are companies like Sedexo essentially incentivized to save money in ways that might compromise prisoner health care, which, as you said, is an essential human right?
Rebeca Alonso:When I read these documents, I had the sense that the state is delaying to bring it its responsibility to the private sector. You know, I'm not against a private sector providing services, of course. I think there is a balance, but what I don't feel is good is that all the states in these contracts bring all the responsibility to fulfill everything to the private sector. So this is a big problem, and this is the first cause that all these human rights are not compliance with them, you know. So I think the solution would be like a public agency, for example, or a public institution. It can work like an intermediate, mediate in between the private sector and the administration, the public administration, but always from the public way, you know. So this agency can mediate in both and also can control the compliance with the contracts. Um I think this would be very positive for the quality of the service and also to control the costs.
Host:Perfect. Thank you so much for that. Um, so kind of building upon what you started, what other reforms do you think are needed to make sure these contracts deliver on their promises? For example, is there a way that they can be made more transparent or more easily enforceable, for example, so that there are real consequences if they fall short of these standards?
Rebeca Alonso:Well, as I stated before, I'm very much in this figure, this like kind of agent or whatever, but always from the public sector who deal with all of this, with proper resources and staff enough, you know, to deal to mediate so they can know the procedures, they can delay the people, I mean prisoners to the health system, mediate with the national health system with the provider of the services. And uh probably I would state also probably, but I think it's much more difficult to design a proper service inside the National Health Service, particularly specialized in prisons to provide health system in prisons. I don't mean special hospitals, but maybe some hospitals in the systems that whom deliver or bring these patients there from the prisons. It could be an option. I think this has been checking in other countries. I didn't see any country that finally improved this, but I know that they are studying this possibility. You know, consider the healthcare in prison like a specialization inside a national healthcare system or something like that could be a good idea. But I think this agent who can intermediate in between both parties would be a nice option.
Host:Really interesting. So some sort of dedicated sector or discipline within the NHS dedicated to prison health care. That would be that would be a really interesting development if we were to see that. This might actually connect to the next thing I wanted to ask you, which is about what do you think we the public should be demanding right now from policymakers and from companies like Sedexo when it comes to prison health care? Is for example, asking for a specialized section of the NHS, something that we could ask of them. In other words, how can those of us on the outside push for accountability and change specifically?
Rebeca Alonso:I think it's quite different from the private sector. I think everything has to be managed from the public sector. I mean, citizens can press the state and the institutions to comply with human rights. The first step is teaching the society to know their rights. What does it mean a human rights that you must comply with, and you cannot say, I don't want this human right because it's inherent to the person and the importance in society to fulfill all these human rights. Apart from that, then you can press the system to improve all the policies, improve laws, improve investment, all this stuff. But this has to be focused through the public sector, and then the public sector must be more controlling on the private companies the contract to provide these services. I think is the most important part. And I think in the contract I was checking and the cases I was reviewing, the first thing I saw is that it was not controlled because in the paper most of these services are very well written in the sense of compliance with human rights, but in practice, it's obvious like nothing is functioning. So, and these human rights are not being fulfilled by the state, of course. I think improve the control system would be an important thing. Maybe you need more resources, you need more staff. Also to check before this is so important in order to ask, or this is the basis to ask the indirect responsibility to the state is this lack of controlling not only the companies they contract, but also to make the following of the work they are developing for prisons and for the health system. I think this is a big problem, and there is the most important lack on this process.
Host:Your work is really fascinating, and you know, because I'm also really interested in the role of international law and how these policies can be implemented. Um, so for me, it was really interesting to hear your perspective.
Rebeca Alonso:Yes, I think so, and I think I'm checking also from the perspective of Spain, my my country. So I'm I think we must improve the use of this point of view in these cases. It's quite similar in many countries. If we improve this international perspective, we can find solutions that maybe from one country to another country. I think this is something that we have to do also to educate in a manner to the society because it's like Human right is something ethereal that is outside, you know, is something that is not uh close to us.
Host:Yeah, like it's some foreign concept that is like disconnected almost. Yeah. Especially in the modern the modern world, it's I I feel it's people don't think of it as an everyday important theme, but it it really is. It really is.
Rebeca Alonso:Many times when I when I listen to people, they they speak or they consider human rights like something very far, you know, from third countries, you know, in Africa, with no, we have even in our societies, we don't have to to look so far away, of course.
Host:I totally agree, especially in terms of policy implementation. There is that, like you mentioned that too, like this gap, and that's where I think like the theory is seems so distant, and then you go to implement this theoretical understanding of what human rights is, and it's so different when you go to implement these policies because it's not just theoretical, yeah. And that's why you need the expertise um like yourself to help with um policy implementation and finishing it.
Rebeca Alonso:People with interest in many sectors. I mean, with the when you when you are conscious of what's going on. For example, when we talk about prisons, it's like prisons is another world than the rest of the people because you are free, you are not in prison. Well, this is something that is happening outside, and I don't care very much on it. And maybe you can see through through these cases, you can see also the infringement of human rights in other in other sectors. I as I told you, I deal with this contract for some years, particularly with British citizens trying to buy properties here in Spain, and they arranged mortgages with Spanish banks, and they have these clauses, they call it floor clauses, until the European Union said that it was a kind of illegal stuff like that. So suddenly the banks started to call their clients, putting better conditions in their contracts, but they had to sign a clause that they reject future actions in the court. So they make a little better conditions in the mortgage, but they had to reject this in the future. And this is not possible. You know, you have the right to access to justice, it's a human right. So it doesn't matter if the bank gave you money or gave you uh better conditions in your contract, but you can also prosecute this case in the court. And many people didn't know that. Ah no, no, because I signed it, this clause. Yeah, but this clause is nothing because it's it's null, it's not available because it's against the human rights of a person. So it's not something like human rights is only like torture or you know, these kinds of things that we see, crimes, big crimes or drugs or whatever, these kind of things. No, it's also in like in contracts because you are a consumer, you don't know you are a weak part in these relationships, and then you you you have this problem is that your human rights are being infringed. Yeah, as this happened, well, not so not only with British citizens, also with Spanish, but I was dealing with the UK citizenship contracts, and they were even worse because the contracts were in Spanish, they didn't speak Spanish, so they signed it, so maybe they were a little bit even worse, but for Spanish was also the same situation.
Host:Yeah, and especially, you know, when I'm with my bank and they ask me to read a contract, I'm not reading the contract in detail. Personally, I'm reading it as much as I can and as much as I understand.
Rebeca Alonso:Yes, exactly. And then suddenly appear things, well, I was really shocked because I was working for many years in banking, you know, as a lawyer in an important bank here in Spain. And then I decided to be uh an independent solicitor, so I started to work on the other side, you know, had so many clients with this kind of problems. And the first time I saw these clauses, these questions in the contract, I was really shocked. It was like unbelievable. How can a bank can present this contract to a customer, to a client? It was for me quite unbelievable. So I started to be more conscious on these questions of human rights and say, well, this is something that happened here. You don't have to go to places where they have these wars or bigger problems. We have this here, and we are not fighting. We are not, you know, saying to the state, okay, you are responsible because you suit this indirect responsibility. They have to control and to be in charge of safeguarding all the rights of its citizens.
Host:Certainly. Were there any other cases that you came across similar to that one that you found in the banking contract?
Rebeca Alonso:Well, in banking contracts, most of them were in regarding mortgage when buying properties, because this was this resolution from the European Union saying that this is illicit and stuff like that. And just before this resolution was firm, the banks knew that it was going to be this problem for them, that they had to change, delay these clauses, and they were going to have so many money lost. So then decided before, just like one month, month or two months before this resolution was in firm, decided to contact directly to the clients. Saying, Well, we were reviewing your contract and we can make it better for you. Of course, they make some changes in benefits of the client, but not all the benefices that they had to have, considering this resolution from the European Union. So they wanted to make them just to accept these benefices, but rejecting to go in later to the court to ask for the rights in the basis of this resolution. And then, of course, this clause was absolutely impossible. You know, it doesn't matter if they sign it the contract or not. It's not possible to reject your right. This is a human right. The right to access to justice is not possible. But many people thought it was possible because they signed the contract. So many people didn't want to a lawyer to, you know, and they lost some of their money or to get better conditions on their contracts. It was an interesting work during these years.
Host:Yeah, I can imagine. I can really imagine. Thank you so much. Is there anything else that you would like to add, building upon any points that you've made or anything that I asked in the interview that you would like to follow up on?
Rebeca Alonso:These specific references to conventions, and and this is very important in order to scale. We have the last word, for example, in the context of Europe, we have the European Human Rights Court. This is the last step, you know, if you if you proceed everything in the in your country and you don't have your rights properly safe and guarded, you can scale this case to this court. So this is very important to start to use it in the claims and introduce all this concept from the international perspective.
Host:Thank you. I, for one, really appreciated the points you brought about international law, indirect, and civic responsibility. And I think you really summarized a lot of the themes that we've discussed in this issue quite well. Oh, thank you so much. After speaking with Rebecca, I am struck by a stark reality. Women inside describe pain and illness being ignored. Advocates see the same neglect happening repeatedly, and lawyers find that even contracts meant to guarantee care often lack any real enforcement. What connects all these stories isn't just a failure, it's also silence. The system's failures are so often met with official silence or dismissal, and it's incredibly difficult for women's lived experiences to be translated into real consequences or change. Just because someone is incarcerated doesn't mean they don't deserve health care. Prison healthcare is not a privilege, it's a basic right, a legal duty, and a moral obligation. Issue 16 of The View magazine shows what happens when that obligation is repeatedly breached, when women are left managing illness, trauma, and fear inside a system that denies responsibility. If these conversations matter to you, you can support this work. Read issue 16 of The View, share these stories, and demand accountability from those who design, oversee, and profit from the prison system. Because justice shouldn't just end at sentencing, and healthcare should never depend on whether someone is incarcerated. I'm Sophia, and this has been Rebel Justice. Thank you so much for listening.
Maile:You've been listening to Rebel Justice, a podcast from The View magazine. If you'd like to support our work, you can subscribe to The View for just £20 a year and receive four digital editions and one print issue. Follow us on social media. You can find us on Instagram at the underscore view underscore magazine and on LinkedIn, X, and TikTok. For press or general inquiries, email press at theview magazine.org. And if this episode mattered to you, please share it.