Prison health care reform. Ombudsman's demands

The Ombudsman draws attention to problems related to the functioning of the prison health service, which require urgent reforms. On the basis of a visit by the National Torture Prevention Mechanism, a number of areas for improvement have been identified that are crucial to preventing torture and inhuman and degrading treatment.

Key demands of the RPO:

• Mandatory medical examination of all inmates
  Currently, only inmates admitted from freedom are examined, while those transported from other prison units do not undergo such a procedure. The lack of systematic body examinations of newly arrived prisoners creates a gap in the system of prevention against violence they may experience during the convoy.
• Lack of procedures for reporting torture and documenting injuries
  There is still a lack of clearly defined procedures for dealing with cases of reported torture or violence. Injuries are not properly documented - no photos are taken or special medical forms, such as the so-called body map, are used.
• Shortages of medical staff
  The number of doctors and nurses employed in prisons is insufficient. Difficult working conditions and unattractive salaries mean that there are not enough people willing to work in these units, leading to long waits for medical appointments and a lack of adequate supervision of prisoners in isolation cells.
• Lack of 24-hour medical care
  In many prisons, there is no permanent presence of qualified medical personnel. In emergencies, help is summoned from outside, which creates the risk of delays and errors in assessing the health of inmates.
• The role of doctors in the isolation procedure
  Doctors should not give opinions on a prisoner's ability to serve his sentence in an isolation cell, as this raises ethical questions and makes it difficult to build a relationship with the patient. Instead, they should monitor the health of inmates in isolation on a daily basis.
• Long waiting times for specialist consultations
  In some prisons, inmates have to wait up to a year and a half to see a specialist, which is unacceptable by health care standards.
• Caring for inmates with withdrawal syndrome
  Prison health services are often unable to provide adequate care for those with withdrawal syndrome, which can lead to serious health risks, especially in cases of addiction to potent drugs such as fentanyl.

The RPO is calling for systemic changes to ensure decent health care for all inmates, especially those with special needs, such as women, the elderly, the disabled and transgender people.

Source: RPO