The paper is based on survey work undertaken in the Cynon valley, south Wales, an area of high social deprivation. We interviewed local solicitors to establish their understanding and usage of the Human Rights Act (HRA). Outside of south Wales there is evidence of growing awareness and involvement of specialist practitioners in human rights actions. This we call a top‐down process. Our work starts at the other end: a bottom‐up account of high‐street, small‐practice solicitors.

We consider the reasons for and detail current changes to the prison medical service in England and Wales. We note that whilst civil society increasingly seeks redress through law, prisoners are ill equipped and relatively ineffective in using the courts. Instead, a medical paradigm might be an empowering process for prisoners to improve their quality of life. Delivery of an efficient health care service is a prisoner's right. This is of particular importance to HIV positive and AIDS prisoners for whom the standard of health care is literally a matter of life or death.

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