Key Elements
Healthcare at least equivalent to that in the community should be available free of charge to all detainees. The health service should address prevention of disease, health promotion, as well as the treatment of mental and physical illness. The first contact with the health service should be an initial medical screening that takes place within the first 48 hours of admission to the prison. The medical screening should document existing illness so that there is continuity of treatment, identify other illnesses that may need addressing, and provide information to all new detainees on the function of, and access to the health care services.
Since prisons are closed settings, the health care facilities and health care staff must be situated within the prison perimeter so that they are readily accessible at all times of the day and night. The health care service should be integrated into the national health service so that national health policies, programs and protocols are applied equally in the prisons. In particular programs for the prevention, treatment and care of HIV, TB and mental health issues must be integrated into the prisons. The health staff should report to the Ministry of Health in order to maintain clinical and ethical independence.
Detainees must have ready access to the health service for acute illness and accidents, as well as the follow-up of cases and chronic disease. The detainees must be able to approach the health staff directly to request an appointment so as to avoid that prison staff or other detainees interfere with the access. All health consultations must be held confidentially without the presence of guards, and noted in an individual medical file that is held securely in the health clinic. A stock of essential medicines must be held within the prison, and be maintained by a central pharmacy stock.