1.1 Levels of health‑care services in prison
It is obvious that the prison itself cannot cater for all the possible
health‑care needs of prisoners. This is particularly true of specialist services.
Health‑care services that cannot be provided in prison should be arranged
in co‑ordination with nearby community hospitals. The substantive section
of the 3rd General Report of the European Committee for the Prevention of
Torture and Inhumane or Degrading Treatment or Punishment (CPT) outlines
the organisation of health‑care services in a prison setting.5 Health‑care services
in prison should, as a minimum, be able to provide:
X regular general practitioner and specialist consultations,
X supervised outpatient treatment,
X dental care,
X an infrmary,
X direct
support of a fully‑equipped service from either civil or prison
hospital,
X interventions for emergency situations.
There is a growing trend of integrating prison health care into community
health‑care services. This development has been seen as a step in the right
direction by the Council of Europe. When the prison health‑care service
relies on specialist care from providers outside the prison, the availability
of these services may become an issue. The prison service needs to make
sure that the working times and qualifcations of attending physicians meet
the prison’s needs. The presence of nursing staf should make it possible to
provide all necessary nursing care. For example, medication should preferably
always be distributed by nursing staf. If that is not possible, the authorities
should at least draw up a list of medication that must always be distributed
only under the supervision of the medical staf, such as psychotropic and
antiviral medication as a minimum. In cases when there is no medical staf
available on the premises, at night‑time and weekends, the staf should be
trained in providing frst aid. As a rule, a doctor should be on call for emer‑
gency situations.
5. CPT/Inf (2012)21.
Prison health care and medical ethics Page 10