Prisoners excluded from new health care law. Ombudsman intervenes

- Is it planned to introduce a mechanism to establish for persons deprived of liberty an analogous level of health care protection as for other citizens, taking into account the specifics of providing services in penitentiary conditions? - asks the Ombudsman to Deputy Health Minister Waldemar Kraska and Deputy Director General of the Prison Service Colonel Krzysztof Stefanowski.

The Law on Quality in Health Care and Patient Safety passed by the Parliament introduces, among other things, mechanisms for assessing quality in health care and defines the concept of an adverse event. The ROP's doubts are raised by one of the law's articles, which excludes from the law health care providers who provide health care services to persons deprived of liberty. Moreover, the draft was not submitted to the RPO for an opinion. Nor was it consulted with the Ombudsman for Patients' Rights.

Meanwhile, the solutions adopted may, in the Ombudsman's opinion, raise fundamental doubts about their compliance with the constitutional principles of equal treatment by public authorities and the right to health care and the obligation of public authorities to ensure that citizens, regardless of their material situation, have equal access to publicly funded health care services.

The close connection and integration of prison and general health services and policies is also recommended by the European Prison Rules. According to the ROP, the position of the European Court of Human Rights, which has consistently indicated that prisoners should be provided with medical care at a level comparable to the standard for the general public, is also extremely important.

In this regard, the ROP in January sent a letter to the Ministry of Health, asking it to address the reasons for such a regulation . The response, among other things, discussed organizational aspects of the prison health service and included a compendium of the legal status.

However, it is not clear from the response why it was thought that the consequence of the organizational distinctiveness of providing health services to people in prisons and detention centers should be the distinctiveness of the standard of health care quality and patient safety.

It also fails to explain why at least some of the solutions of this law are not envisaged to apply appropriately to people deprived of their liberty (e.g., in terms of recording adverse events).

Deputy Ombudsman Wojciech Brzozowski again asks the MZ to indicate the reasons for the introduction of this regulation and to address concerns. He asks whether it is planned to establish in other legal acts, concerning medical care provided by medical entities to persons deprived of liberty, an analogous or similar level of patient protection to that provided by the general health service, taking into account the specificity of providing services in penitentiary conditions.

In turn, the Deputy Director General of the Prison Service is asking the Ombudsman to inform whether he has presented an opinion on the exclusion of prison medical entities from this law. If, on the other hand, he did not participate in the legislative process, the Ombudsman asks for his position on the problem presented in terms of the implementation of the principle of equal treatment for persons deprived of liberty, including equal access to medical services.