Special Report to the Storting Document 4:3 (2018–2019) 70 10 The health service’s ­follow-up of inmates in ­solitary confinement In Norway, the prison health service is run by the ­municipal authorities as primary health care provider, even if the services are localised within the prison. Some prisons also have the regional specialist health services present. What is known as ‘the import model’, where the health service is independent of the Correctional Service, supports the medical personnel’s ­independence of the Correctional Service.215 The import model is intended to ensure that medical personnel never partake in administrative decisions on sanctions or in enforcing sanctions. Inmates in prison are entitled to the same access to healthcare services as the general population, but tend to have greater health issues and a greater need for care. In order to provide equal access, the health service must therefore meet needs that can be different in terms of both quantity and quality. As described above in this report, the state has a special responsibility for ensuring proper health care for prison inmates (see section 3.3 Solitary confinement and association with other inmates and Chapter 8 Particularly vulnerable inmates). Those who are deprived of their liberty cannot to the same degree as others procure health care themselves. When inmates are held in solitary confinement, their possibility of contacting the health service themselves is further reduced. The Correctional Service and the health service have a joint responsibility to ensure that inmates get the medical assistance they need and are entitled to. It is important to prevent fragmentation of this responsibility as a result of the division of responsibility between them. Human rights standards on the role and responsibility of medical personnel Inadequate supervision and medical follow-up of inmates in solitary confinement can lead to violation of Article 3 of the European Convention on Human Rights.216 A system must therefore be in place to ensure regular supervision by medical personnel of the physical and mental state of health of inmates held in solitary confinement.217 The Nelson Mandela Rules set out detailed standards on the role of medical personnel in relation to persons deprived of their liberty who are placed in solitary confinement, excluded from company or subject to other similar interventions.218 Medical personnel shall not have any role in the decision to impose restrictive measures.219 Their task is to ensure regular medical checks of the inmate’s physical and mental health for the duration of the isolation. 215 The Directorate of Health (2013). Veileder for helse- og omsorgstjenester til innsatte i fengsel (’Guide to health and care services for prison inmates’), p. 12. 216 ECtHR 3 April 2001 Keenan v. the United Kingdom, paragraphs 109–116. See also 9 July 2007 Khider v. France paragraphs 119–122; 21 July 2005 Rohde v. Denmark, paragraph 99; 25 July 2013 Riviere v. France, paragraph 63; 16 October 2008 Renolde v. France, paragraph 120. 217 ECtHR 10 April 2012 Babar Ahmad v. the United Kingdom, paragraph 212. See also The UN Special Rapporteur on Torture’s report to the UN General Assembly, 5 August 2011, A/66/268, paragraph 100. 218 Council of Europe: Committee for the Prevention of Torture (CPT), Extract from the 21st General Report, Solitary Confinement, 2011, CPT/Inf (2011) 28, paragraphs 62–63. 219 The Nelson Mandela Rules, Rule 46(1). 71 ‹ 10