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Prisons lack on-call health care service

Deputy-Ombudsman Jääskeläinen concerned about prisoners' safety

 11.3.2009

Deputy-Ombudsman Petri Jääskeläinen finds it unacceptable that in nearly all prisons no health care personnel are on call at weekends and in the evenings. He is concerned about prisoners' safety. In his view, a comprehensive and adequately resourced on-call system must immediately be put in place in every prison in order to guarantee the safety of prisoners.

The absence of an on-call service was revealed when the Deputy-Ombudsman investigated a complaint made by an inmate in Kerava Prison. The prisoner had been placed in so-called isolation for observation one Sunday, because it was suspected that he could have contraband substances, such as drugs, within his body. It was only around midday on Monday, 21 hours later, that the prison nurse became aware that the prisoner had been placed in isolation.

A doctor or nurse must be informed immediately when a person is placed in isolation for observation

The Prison Act permits a prisoner to be placed in isolation for observation if there is a reasoned ground for the assumption that contraband substances or objects are concealed within his or her body. When this is done, the prisoner is placed in a room or cell where, using technical aids or by other means, he or she is monitored round the clock and any removal of contraband substances or objects from within the body is observed. However, the Act requires that the health care personnel must be informed without delay when a prisoner is placed in isolation for observation so that a doctor or nurse can examine the prisoner’s state of health as soon as possible. If, for example, there are drugs concealed within the prisoner's body, there is a grave danger of acute toxic effects on or blockage of internal organs. Both can lead to death.

The Deputy-Ombudsman notes that what "without delay" means is not defined more precisely in the Act. In his view, the objective should be that notification of a prisoner having been placed in isolation for observation is made almost immediately. In the present situation, however, this is problematic, because an on-call system has not been organised in prisons. Thus notification without delay is impossible in practice outside normal working hours and at weekends. Yet it is often just when the health care personnel are nor present nor on duty that the need to place a prisoner in isolation for observation arises.

The Deputy-Ombudsman points out that making notification without delay that a prisoner has been placed in isolation for observation is not an end in itself, but a means of safeguarding the prisoner's constitutional right to safety. The authorities have a duty to ensure that the conditions in which prisoners are isolated for observation are safe. Thus making a notification without delay is not enough in itself; a member of the health care staff must also examine the prisoner sufficiently soon.

A comprehensive on-call system must be put in place in every prison

Deputy-Ombudsman Jääskeläinen stresses that a comprehensive and adequately resourced on-call system must be put in place without delay in every prison in order to guarantee the safety of prisoners. The inadequacy of the resources available to the Prison Service's health care units came up for discussion already earlier, when the Deputy-Ombudsman took a stance on understaffing at the Prison Hospital. He considers the inadequacy of the resources available to the health care units very worrying from the perspective of prisoners' safety.

The European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) has likewise drawn attention to the inadequacy of prison health care resources in general and also in separate inspection situations. In its report on an inspection visit to Finland in spring 2008 the CPT recommends that a person capable of rendering first aid and preferably with certified competence as a nurse should always, also at night, be on duty in prisons.  Prisoners who are suspected of having contraband substances concealed within their bodies should be given an appropriate examination by a doctor and monitored to eliminate serious risks. The CPT has asked the Finnish authorities to undertake the necessary measures. In 2008 the Committee inspected prisons in Helsinki, Riihimäki and Vantaa.

Deputy-Ombudsman Jääskeläinen has sent his decision to both Kerava Prison and the Criminal Sanctions Agency. He has asked the latter to inform him, by 11.9.2009, of what measures have been deemed necessary in the matter.

Additional information will be provided by Legal Adviser Pasi Pölönen, tel. +358 (0)9 432 3345.