TRC Final Report

Volume 5

Chapter 8

Subsection 24

Health care services in prisons

84 The Commission recommends that:

THE ROLE, RESPONSIBILITIES AND OBLIGATIONS OF INDIVIDUALS RESPONSIBLE FOR THE HEALTH CARE OF PRISONERS AND DETAINEES, BOTH IN PRISONS AND POLICE CELLS, BE CLEARLY DEFINED AND ACCEPTED BY ALL POLICE AND PRISON STAFF.

AN AUDIT OF DISTRICT SURGEONS CURRENTLY EMPLOYED BY THE DEPARTMENT OF HEALTH BE CARRIED OUT, TO ENSURE THAT THOSE WHO PARTICIPATED IN OR COLLUDED WITH HUMAN RIGHTS VIOLATIONS IN THE PAST ARE NO LONGER IN A POSITION TO OFFER TREATMENT TO DETAINEES AND PRISONERS. (NOTE: THIS IS NOT A RECOMMENDATION THAT SUCH PEOPLE SHOULD NO LONGER BE ALLOWED TO PRACTISE, ONLY THAT THEY BE REMOVED FROM SITUATIONS IN WHICH THEY MIGHT BE VULNERABLE TO COLLUSION.)

THE MEDICAL RECORDS OF PRISONERS AND DETAINEES BE INACCESSIBLE TO NON-MEDICAL PRISON STAFF AND/OR POLICE, UNLESS THE HEALTH PROFESSIONAL IN CHARGE DEEMS SUCH ACCESS TO BE IN THE INTERESTS OF THE PATIENT.

MEDICAL EXAMINATIONS OF PRISONERS AND DETAINEES TAKE PLACE IN PRIVATE, UNLESS THE PATIENT OR THE HEALTH PROFESSIONAL PERFORMING THE EXAMINATION REQUESTS OTHERWISE.

REGULAR INDEPENDENT REVIEWS OF HEALTH CARE IN PRISONS AND OTHER PLACES OF INCARCERATION, MILITARY INSTALLATIONS AND MENTAL INSTITUTIONS BE CONDUCTED.

AN INDEPENDENT LINE OF AUTHORITY BE ESTABLISHED TO ADVISE, GUIDE AND SUPPORT DISTRICT SURGEONS AND OTHER PRISON HEALTH CARE PERSONNEL FACING CONTROVERSIAL ETHICAL DECISIONS.

COMPULSORY REFRESHER COURSES FOR PRISON HEALTH CARE WORKERS FOCUS ON ETHICS, MENTAL HEALTH ISSUES, HUMAN RIGHTS AND THE SPECIFIC HEALTH NEEDS OF PRISONERS.

THE FORMAT OF DOCUMENTATION COMPLETED BY HEALTH PROFESSIONALS PROVIDING HEALTH CARE FOR PRISONERS AND DETAINEES SPECIFICALLY INCLUDE SECTIONS ON ALLEGATIONS OF TORTURE OR ABUSE, EVIDENCE OF SUCH ABUSE AND HOW THE ALLEGATIONS ARE BEING INVESTIGATED. ALL ALLEGATIONS OF ABUSE MUST BE REPORTED TO AN INDEPENDENT MONITORING BODY. FAILURE TO REPORT ABUSE SHOULD BE A DISCIPLINARY OFFENCE.

Medico-legal services

85 The Commission recommends that:

THERE BE UNIFORM STANDARDS OF TRAINING FOR ALL STAFF REQUIRED TO PERFORM POSTMORTEMS OR OTHER FORENSIC EXAMINATIONS.

CUSTODIAL CARE AND FORENSIC SERVICES BE SEPARATED. TO PREVENT A CONFLICT OF INTERESTS, PROFESSIONALS WHO PROVIDE HEALTH CARE TO PRISONERS AND TO OTHERS INCARCERATED OR DETAINED SHOULD NOT HAVE FORENSIC RESPONSIBILITY.

THE LEGISLATION GOVERNING FORENSIC PSYCHIATRY BE REVISED, THE SECRECY CLAUSE RELATED TO FORENSIC PSYCHIATRY BE LIFTED, AND FORENSIC PSYCHIATRY SERVICES BE REVIEWED.

THE STATE FUND AN INDEPENDENT FORENSIC SERVICE FOR THE USE OF THE FAMILY OF

ANYONE WHO DIES IN CUSTODY. THE FAMILIES BE INFORMED OF THEIR RIGHT TO HAVE AN INDEPENDENT FORENSIC PATHOLOGIST PRESENT AT A POST MORTEM.

THERE BE REGULAR INDEPENDENT AUDITS OF THE POLICE MORTUARIES AND FORENSIC PATHOLOGY LABORATORIES.

POLICE MORTUARIES AND FORENSIC LABORATORIES BE ADEQUATELY EQUIPPED. THE ABSENCE OF X-RAY FACILITIES, FOR INSTANCE, IN THE MAJORITY OF MORTUARIES IS NOTED WITH CONCERN.