When Dr Maria Leitner arrived at HMP Styal to serve a four-and-a-half-year sentence in 2018, she was handed a Hello Kitty T-shirt, a pair of leggings and a “pretty rough pair of trainers”, which she would go on to wear every day for the next 18 months.

“By the time winter came, they were full of holes,” the 56-year-old told openDemocracy. “My feet were regularly wet.”

Leitner’s experience was not unusual. A charity worker told this website of seeing women in prison wearing “flip flops in the snow”, while the official prison inspectorate reported in November 2023 that “many women” in HMP Peterborough could not go outside to exercise “because they did not have a coat, jumper or appropriate footwear”.

The ill-fitting clothing given to inmates is just one of several stark revelations uncovered by openDemocracy’s investigation into the state of England and Wales’ 117 prisons, which house some 87,000 people.

Our analysis of prisoner survey data and reports by the inspectorate reveals widespread and systemic failings in safety, hygiene, healthcare, violence and release planning. We found:

• More than half of inmates feel “unsafe” in 35 prisons
• Nearly one in ten prisoners reported being physically assaulted by staff members
• A quarter of inmates reported threats or intimidation from fellow prisoners, with a further 13% reporting physical attacks
• A quarter of prisoners are held in Victorian facilities, where many do not have access to any in-cell sanitation and are forced to use bins as makeshift toilets
• 7% of prisoners said their time in prison made them more likely to offend
• In 26 prisons, fewer than 80% of prisoners are able to shower every day

Former Conservative prisons minister Rory Stewart said openDemocracy’s findings “really help to make the case for a very important, moral reform that goes to the heart of our culture”.

Stewart added: “[The investigation] confirms that prisons are perhaps the most shameful single aspect of society.”

Labour MP Kate Osamor, who chairs the All-Party Parliamentary Group for Women in Contact with the Justice System, told openDemocracy: "These findings are terrible, but sadly unsurprising, showing that women prisoners are routinely being denied their dignity.

“It is quite clear that the prison system is completely incapable of ensuring serious support to prepare prisoners for release if it is unable to provide such basics as suitable footwear.”

Freezing feet were not Leitner’s only problem. She was also forced to wear underwear so oversized she had to tie it in knots at her hips. When she raised the issue with prison staff, she was told: “You’re in prison, you get what you’re given.”

This attitude of expecting prisoners to wear inadequate clothing extends to dirty clothes, too. openDemocracy’s investigation found that more than 20% of prisoners do not have access to clean clothes every week in 65 English and Welsh prisons.

Writing in his report for HMP Eastwood Park, where only 57% of women reported having enough clean clothes every week, HMP Chief Inspector Charlie Taylor found a “prisoner had to borrow a bra from her cellmate because nothing was available.” In HMP Styal, there was not “a good range of prison-issue clothing or underwear for women.”

Lack of clothing is just one issue of poor hygiene and dignity. In 26 prisons, more than 20% of prisoners are unable to shower every day. In HMP Winchester, this figure rose to 93% of inmates.

A quarter of England and Wales’ prisoners – more than 20,000 people – are held in now-crumbling Victorian facilities, some without access to any in-cell sanitation facilities. This has become a race issue: Black and minority ethnic men in HMP Coldingley were disproportionately housed in wings without in-cell toilets between July 2022 and August 2023, according to an inspection by the Independent Monitoring Board, which produces regular reports on prison conditions.

The HMP Inspectorate issued an urgent notification to HMP Bristol in 2023, where men without in-cell toilets must call an officer to be escorted whenever they need to use the bathroom. Only 16% of prisoners in Bristol said cell bells were answered within five minutes, forcing them to use buckets and bins, which they empty out the window. The waste splashes into the cells below, causing an “overpowering” smell of urine, the inspector reported.

In response, the government committed to install in-cell toilets by 2025.

‘Most shameful single aspect in society’

More than half of inmates in 35 English and Welsh prisons feel “unsafe”, according to openDemocracy’s analysis of surveys conducted by official inspectors. When looking at the number of prisons where a third of prisoners said the same, that number rises to 74.

These safety fears are often linked to violence. More than a quarter of prisoners reported having experienced threats or intimidation from fellow prisoners, a further 13% said they had been physically attacked, and 3% said they had been sexually assaulted. Nearly one in ten also reported being physically assaulted by staff.

The crisis in England and Wales’ prisons has been worsened by years of austerity cuts, with funding falling from £4.4bn when David Cameron became prime minister in 2010 to £3.6bn in 2015/16, his last year in office.

Despite an increase in funding since then, spending levels are still lower than 14 years ago, with £4.1bn spent last year. At the same time, the prison population has ballooned to be the largest in Western Europe. Two-thirds of prisons are now overcrowded, meaning cells are holding a higher number of prisoners than they were designed for.

“The provision of productive sentences in clean and decent conditions, with access to adequate healthcare and support, is simply not possible when the system is being made to cram eye-watering numbers of people well beyond its capacity,” said Andrew Neilson, the director of campaigns at the Howard League for Penal Reform.

The systemic failings in British prisons has caused alarm internationally. In 2023, a German court refused a request to extradite a man accused of drug dealing to the UK, after his lawyer, Jan-Carl Janssen, successfully argued that conditions in English and Welsh prisons are so bad it would infringe his human rights.

Janssen told openDemocracy that he understands that “in the UK – and in England and Wales in particular – prisoners are threatened with inhumane accommodation, a violation of Article 3 of the European Court of Human Rights”.

Documents seen by openDemocracy reveal how the Ministry of Justice sent assurances to the German authorities that when overcrowding means prisons “fall short” of European rules on degrading and inhumane treatment, “alleviating factors are found”.

Those factors, the department claimed, include how “prisoners are able to spend a considerable amount of time each day outside their cells.”

But our investigation reveals that nearly three-quarters of prisoners shared cells designed for one and said they spent less than two hours outside of their cells during the week at HMP Wandsworth, which is likely where the man would have been held. At the weekend, the numbers spending less than two hours outside their cells rose to 91% of prisoners.

The data is from autumn 2021 – two years before the extradition request. In 2023, at the time of the extradition request, HMP Wandsworth still had an overcrowding rate of 160%.

‘Health is not a priority’

It was nighttime when Leitner arrived at HMP Styal, and she described the reception as “a deeply disturbing experience”.

“Women were rattling from drugs, screaming, crying in pain, behaving bizarrely. No one could feel safe in such an environment,” she told openDemocracy.

Leitner had enjoyed a 40-year career researching prison conditions before being convicted of asset finance fraud – which she denies and plans to appeal, describing the trial as “a fiasco”.

She never expected to one day find herself inside – and even her decades of research could not have prepared her for the harsh realities of life in prison.

“There were generally one or two showers between two dozen women,” Leitner said. “The showers were metal cubicles, often filthy and freezing when the weather was cold.

“On my first night, I shared a cell with another woman and the toilet had no seat or paper, with only a ‘half door’ – basically a piece of hardboard with hinges – for privacy.”

Leitner has diabetes, and the prison’s conditions led her health to deteriorate. Our investigation found that only 12% of prisoners rated healthcare as “very good”.

“My insulin pens that I need for living with diabetes were taken from me,” she recalled. “I flagged this immediately, and was seen by a nurse who noted my blood pressure and blood glucose was rising. The nurse said that as it was a bank holiday, there was no doctor to give me my medication. On the fourth day without insulin I collapsed and ended up in hospital where I was chained to a prison officer.

“I said to the nurse, if this was happening to a friend, would you say there was no way to see a doctor because it’s a bank holiday? You would do whatever you could.”

Back inside, and her ordeal continued. “I needed vitamin supplements to help manage my diabetes,” she explained. “They would not let me receive them in the prison. Even when my external consultant said he would deliver the supplements straight from the hospital, they were banned.”

Today, Leitner has multiple health issues linked to diabetes – none of which she suffered before prison.

As well as poor physical healthcare, only 13% of people in prison reported mental healthcare as “very good”. In 49 male prisons, more than half of prisoners said their mental health had worsened since being inside.

“There was a woman in Styal who was floridly mentally unwell, she would talk to flowers,” said Leitner. “She was heavily pregnant and in denial about it. Anyone could see she had serious problems. Was prison the best place for her?”

Getting out

Since leaving prison, Leitner has co-founded the Open Justice Initiative, which aims to bring together people who have been involved in the criminal justice system in some way – including prisoners, ex-prisoners, campaigners, academics, judges, magistrates, probation officers and others – to ask how we can reimagine justice.

“There is a feedback loop between politicians and the public to be tough on crime, which is an easy slogan to sell,” she said. “But it does not solve the problems and the causes of crime, so we have people who keep on returning to prison and the cycle continues.”

Our investigation found that 7% of prisoners said their time in prison made them more likely to offend, while a third said prison would make no difference to their reoffending.

Government figures show the overall reoffending rate for people who have been in prison is 25.8%, rising to 56.1% for adults who served custodial sentences of less than 12 months. This reoffending not only has hugely negative impacts on the mental and physical health of the individuals and their families, it also costs the taxpayer £18bn.

“Governments neglect their prisons and prisoners at their own peril,” UN special rapporteur on torture, Alice Jill Edwards told openDemocacy. “This short-term approach leads to repeat reoffending, it does not keep communities safe and it results in inhuman and degrading conditions. These worrying trends in England and Wales must be reversed.”

“Eighty percent of all crimes are committed by people who’ve been to jail or been through the criminal justice system before,” said Chris Atkins, who was held in HMP Wandsworth after being sentenced to five years for tax fraud in 2016, and has since written Time After Time, an investigation into reoffending in the criminal justice system,

“That shows you what a core problem this is,” he added. “It's not new people coming into the system, it's the same people stuck in it. We’re not letting people get out.”

This was echoed by Sonya Ruparel, the CEO of Women in Prison, a charity that supports women affected by the criminal justice system. She believes reform is needed to prevent people being imprisoned.

“Rather than locking women up and removing access to the very basic things that retain dignity, like clothing and hygiene products, we need to invest in community-based services – like domestic abuse, welfare, mental health and housing – to address the root causes that draw women into the criminal justice system,” Ruparel said.

A HM Prison Service spokesperson said: “All prisons have arrangements in place to ensure offenders can stay clean and decent and we are improving conditions by building new, modern prisons at the fastest rate since the Victorian era.

“We are also improving safety and have invested £100m into tough security measures to clamp down on the contraband that fuels violence behind bars.”

openDemocracy analysed survey results carried out by HMP Inspectorate across 93 adult prisons from autumn 2021 onwards, looking at responses to 47 questions from a range of categories. We excluded any prisons that had not been inspected since before 2021, as the survey questions were different.