2.9. Penitentiary health care
Somatic (physical) health
In 2019, the number152 and qualifications153 of medical staff, production of medical documentation,154
protection of medical confidentiality, periodic screening for non-communicable diseases, timely
implementation of medical referrals and preventive health were still problematic in the penitentiary
facilities.
For timely medical care, it is important to ensure access to the primary health care at the facilities. It is
less difficult for convicts in semi-open institutions to see a primary care doctor, because they go to the
doctor themselves, although they often have to stand in line. As for the closed facilities, the problem is
both the high demand and the fact that prisoners are taken to the doctor by prison staff.155 The problem
of access to a family doctor was pointed out by both prisoners and doctors.156
Considering the work schedule of the medical staff,157 it can be said that doctors and nurses on duty
have heavy workload,158 which in turn creates problems in terms of providing timely medical services.
In addition, in some cases, the medical staff have to perform several functions.159 Working under such
152
The report of the European Committee for the Prevention of Torture (CPT) on its 2007 visit to Greece reads
that there should be no more than 300 prisoners per doctor and 50 prisoners per nurse. For example,
Establishment No. 15 has a high ratio of day doctors to convicts (about 475 convicts per family doctor). The ratio
of nurses to prisoners is high in all facilities. See the report on the visit paid to Establishments Nos. 2, 8, 14 and
15, p. 51.
153 Problems in the direction of continuous medical education can still be observed. Trainings provided for
medical staff focus mainly on prisoners’ mental health and rights, which is welcome, but it is also important to
raise the professional level and qualifications of medical staff, by conducting relevant trainings immediately in
their specialty.
154 No. chronology is observed, no dynamics of treatment or the results of the prescribed treatment are reflected.
There are also shortcomings in the production of prescriptions; in some cases, the medication is changed or
withdrawn so that there is no record of this in the outpatient medical card.
155 The problem of access to a primary medical service is particularly acute in Establishment No. 8.
156 According to doctors, they are very busy, as they have to produce medical documentation in addition to
examining prisoners, which takes a lot of time. They also point out that prisoners are brought to them by prison
staff, who also have to have to find time for the above.
157
Establishments Nos. 2, 14 and 15 are provided with 4 primary health care services during the day, while
Establishment No. 8 is provided with 10 primary health care services. Establishment No. 3 did not have a primary
care doctor or a nurse during the visit of the Special Preventive Group. In all penitentiary facilities, family doctors
and nurses serve patients from 10 a.m. to 6 p.m, on working days.
158 Doctors and nurses are on duty once every 4 days. For example, Establishment No. 2 is served by 1 doctor on
duty and 2 nurses on duty on weekends and non-working hours, Establishment No. 3 - 1 doctor on duty and 1
nurse on duty, Establishment No. 8 - 2 doctors on duty and 8 nurses on duty, Establishment No. 14 - 1 doctor on
duty and 1 nurse on duty, Establishment No. 15 - 1 doctor on duty and 2 nurses on duty.
159 For example, in Establishment No. 2, some nurses have to perform several tasks, inlcuding the function of a
sanitation worker, for which they do not receive additional remuneration. The chief doctor of Establishment No.
3 was performing the functions of a primary care doctor, doctor on duty and person responsible for sterilization.
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