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Welcome to the EuroPris Knowledge Management System. The table below shows questions and responses from European National Agencies. Select a question for more information or use the filters on the left to narrow down questions based on Agency or Category.
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Introduction: The Prison Service of the Czech Republic operates two prison hospitals, both located on prison premises and managed by prison governors of respective prisons. The Czech Prison Service is currently considering creating a new organizational unit within the prison service that would entirely focus on prisoners’ health care. The new unit would be created by a merger of the two prison hospitals. To help us facilitate the transformation, we would be grateful to learn how the prisoner health-care system works in other countries and therefore would like to ask you to answer the following questions. Most of them require just yes/no or very short replies
yes
If so, are prisoners insured (health insurance) in the same way as the regular citizens are?yes
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?NO
Who pays for the health insurance of prisoners?Both the public health system and the prison service.
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?No.
Doctors and medical staff providing health care to prisoners in your country are:They are staff-members of the prison service.
Is the inpatient care for prisoners provided by the prison service?no
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)?Inpatient care for prisoners is provided by inpatient care of public health system.
How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?Medical staff working with prisoners inside the prisons is included in the National Public Health Service, directly to the National Public Health Service or through agreement with private health insurance companies.
yes
If so, are prisoners insured (health insurance) in the same way as the regular citizens are?yes
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?N/A
Who pays for the health insurance of prisoners?National Health Service - private health insurance not required
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?No - Healthcare is provided through the South Eastern Health and Social Care Trust on behalf of the Department of Health.
Doctors and medical staff providing health care to prisoners in your country are:All healthcare workers, including doctors and nurses are employed by the Health and Social Care Trusts under the Department of Health
Is the inpatient care for prisoners provided by the prison service?no
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)?Prisoners requiring in-patient care are transferred to outside hospital. In-patient and specialist care is provided by the Health and Social Care Trusts (there are 5 in Northern Ireland) this is the sameas for any member of public in the community.
How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?The Prison Service manages the security of medical staff working within prisons. Prisoners who require external hospital treatment are risk assessed by the Prison Service and will be accompanied by the appropriate level of prison staff as the case requires.
no
If so, are prisoners insured (health insurance) in the same way as the regular citizens are?no
If not, how is the health-care of prisoners financed?yes
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?Medical costs are payed for by the Prison Service of the department of Justice. Health insurance by the public health system is suspended when a person is incarcerated for the duration of his stay in Prison
Who pays for the health insurance of prisoners?See question 3
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?They cas choose their own doctor but they will have to pay for this doctor themselves.
Doctors and medical staff providing health care to prisoners in your country are:Staff members of the prison service or independent collaborators payed by the prison service.
Is the inpatient care for prisoners provided by the prison service?yes
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)?N.A
How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?If the inmate is of a high risk category the presence of a prison guard is possible. If not, they are present in the immediate surroundings of the medical cabinet and they can intervene immediately if necessary. In principle the consultation takes place between the inmate and the medical personnel.
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yes
If so, are prisoners insured (health insurance) in the same way as the regular citizens are?yes
If not, how is the health-care of prisoners financed?Funding is double, as not all the services are covered by a reimbursement mechanism through the budget of the Compulsory Health Insurance Fund.
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?The prisoners are not entitled to choose their preferred insurance company for the time of their imprisonments as they are insured by the state.
Who pays for the health insurance of prisoners?The state
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?The choice is limited – the prisoners are not entitled to choose their doctor or health care provider during their imprisonment as each correctional facility has a healthcare subdivision of a Central Prison Hospital for provision of in-patient and out-patient services to prisoners. In case several doctors of the same specialization work in the same subdivision only in this case a prisoner may choose a doctor.
Doctors and medical staff providing health care to prisoners in your country are:(a) Staff-members of the prison service; c) Personnel providing medical services based on work performance agreements. The institution providing health care services (levels I and II) is an institution of the penitentiary system. Only services that cannot be provided at the institution based on its level or the license it holds are provided by public health care institutions.
Is the inpatient care for prisoners provided by the prison service?yes
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)?Under the existing license of the institution (Psychiatry, Tuberculosis, Internal Medicine and Emergency, Nursing and Supportive Medical Treatment) level II services are provided. Level III or other profile services, which are not specified in the institution's license, are provided in public health care institutions.
How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?Each room for medical consultations is equipped with an alarm button; penitentiary officers are present provided the room is spacious and more than one patient can be accepted at a time there; patients’ flows to health care premises are restricted; visits to doctors are scheduled in advance; provided patients are aggressive and at risk of assault they are escorted by penitentiary officers who stay behind the doors of the medical room.
yes
If so, are prisoners insured (health insurance) in the same way as the regular citizens are?yes
If not, how is the health-care of prisoners financed?/
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?No, the prisoners are not entitled to choose their preferred insurance company. Insurance is paid by the State.
Who pays for the health insurance of prisoners?Health insurance is paid by the State, concretely the Prison Administration receives state budget for the purpose of health insurance for every inmate. Prisoners are insured in the same way as the regular citizens. It is defined so in the Health Care and Health Insurance Act. The Enforcement of Criminal Sanctions Act in the Art 58 states: “Inmates serving a prison sentence, juvenile imprisonment and juveniles serving an educational measure of placement in a correctional home, as well as persons serving alternative imprisonment who are compulsorily insured under the general regulations on health care and health insurance, have the right to health services under these regulations , excluding the right to freely choose a doctor, specialist doctor and medical institution, health care in connection with the donation of tissues and organs for transplantation to other persons, treatment and care at home, treatment abroad, spa treatment, funeral and posthumous and reimbursement of travel expenses in regarding the promotion of health services.”
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?No, prisoners are not entitled to choose their doctors or health care provider. It is defined by the law that provider in each facility is the nearby public health centre. It is decision of every public health centre who will be the doctor covering prison facility. Inmates have option to appeal to the Public Health Centre or to Representative of Patients` Rights.
Doctors and medical staff providing health care to prisoners in your country are:Staff-members of other public bodies providing health care services to all citizens.
Is the inpatient care for prisoners provided by the prison service?no
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)?The inpatient health care is provided on the decision of general practitioner who gives a referral to hospital or to specialist clinic. The governor of the prison facility is also informed about that decision. In the case of security assessment, risk of flight, there are also prison police officers present, otherwise the inmate could be referred to hospital or specialist clinic also without security escort.
How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?There is prison officer in front of the doctor's office.
no
If so, are prisoners insured (health insurance) in the same way as the regular citizens are?no
If not, how is the health-care of prisoners financed?The medical/health-care budget is part of the yearly total budget of the penal system.
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?No, the inmates are generally not health insured.
Who pays for the health insurance of prisoners?See answer to question 3
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?Generally, if needed, the access to all kinds of medical care is offered to prisoners. If inmates wish the treatment of their specific doctor of choice, they have to pay for the treatment themselves.
Doctors and medical staff providing health care to prisoners in your country are:a) Staff-members of the prison service as well as separately payed employees.
Is the inpatient care for prisoners provided by the prison service?yes
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)?Yes, if possible, the inpatient care for prisoners is provided by the prison service. In some prisons, there are hospital departments. If not and if necessary, the inmates are brought outside into public hospitals.
How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?As part of the prisons, in the hospital departments general security measures are in place as in all other areas of the prisons. In cases where inmates have to be brought into a public hospital, depending on the security level of an inmate, they are under corresponding guard. Partly, the medical staff is composed of prison guards and all medical staff in prisons receives a corresponding specialised education and trainings.
no
If not, how is the health-care of prisoners financed?Yes, from the state budget, through Ministry of Justice and National Administration of Penitentiaries.
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?No.
Who pays for the health insurance of prisoners?State.
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?Usually no, but the inmate has the right to the opinion of another doctor or medical assistance from his own account.
Doctors and medical staff providing health care to prisoners in your country are:Staff-members of the prison service.
Is the inpatient care for prisoners provided by the prison service?yes
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)?Sometimes by the public medical-sanitary institutions on a contractual basis.
How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?no
If not, how is the health-care of prisoners financed?Yes, from the state budget, through Ministry of Justice and National Administration of Penitentiaries.
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?No.
Who pays for the health insurance of prisoners?State.
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?Usually no, but the inmate has the right to the opinion of another doctor or medical assistance from his own account.
Doctors and medical staff providing health care to prisoners in your country are:Staff-members of the prison service.
Is the inpatient care for prisoners provided by the prison service?yes
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)?Sometimes by the public medical-sanitary institutions on a contractual basis.
How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?yes
If so, are prisoners insured (health insurance) in the same way as the regular citizens are?yes
If not, how is the health-care of prisoners financed?-
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?Everyone with legal recidence in Denmark, including prisoners, is covered by publicly paid health insurance.
Who pays for the health insurance of prisoners?-
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?No. However detainees have the right to use their general practitioner.
Doctors and medical staff providing health care to prisoners in your country are:A and B.
Is the inpatient care for prisoners provided by the prison service?yes
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)?For those who are admitted to the penitentiary’s special healthcare units’, it is the penitentiary’s staff who take care of their treatment. Those who requires special somatic or psychiatric attention can be placed at the healthcare units. Danish Prison and Probation Service does not have actual healthcare wards (somatic or psychiatric) but the units allows us to pay special attention to detainees who are in need of it. To the extent that the inmates healthcare cannot be handled in the penitentiary, the inmate will be admitted to the general health care system.
How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?The Danish Prison and Probation Service consists of the Department of the Prison and Probation Service and four underlying regional penitentiary areas with associated institutions. The penitentiary areas are responsible for ensuring the safety of the imployees, including health personel. If it is assessed justifiable the inmate can transport him/herself to the hospital in the general health care system. Otherwise the inmate in question will be transported by prison officers.
yes
If so, are prisoners insured (health insurance) in the same way as the regular citizens are?yes
If not, how is the health-care of prisoners financed?In November 2011 responsibility for prisoner health care was transferred to the National Health Service (NHS) through a Memorandum of Understanding (MoU) between the Scottish Prison Service (SPS) and NHS Scotland. The MoU is set out below. Introduction 1.1 In July 2008, Ministers approved the transfer of responsibility for the health care of prisoners to the NHS. A National Programme Board for Prisoners' Healthcare was established in March 2009 to pave the way for transfer to take place, and, in August 2010, the Scottish Parliament passed a legislative amendment to enable the change (annex1). 1.2 The transfer is intended to ensure equity in health care: prisoners will receive their care from NHS as does the general population. In so doing the transfer will uphold European and International standards for the health care of prisoners. 1.3 This document provides a framework of guidance on the responsibilities of the Scottish Prison Service and with prisons on contract to it, and Health Boards in the provision of health services for prisoners, acknowledging that social care agencies, other statutory and third sector organisations, play a key role in maintaining support to prisoners, families and communities, both prior and subsequent to release from prison 2. Statement of Common Purpose 2.1 Common Purpose To improve prisoners access to an appropriate range and quality of NHS health care services according to their needs. To reduce health inequalities. To preserve life and reduce harm. To provide a safe, secure environment for the health assessment and treatment of prisoners. To ensure that all relevant information is gathered consistently, preserved, analysed and exchanged appropriately and within both the law and applicable protocols. To work with other agencies to maintain this common purpose. 2.2 Common Values Open, consistent and accountable public services. Mutual respect for stakeholders and parties, encompassing health care and staff governance. Openness in disclosure of necessary information, and reasonable notice of change. Partnership in strategy and business planning. Value for money, joint approaches to common problems, and best use of available resources. Continuous service improvement. 2.3 Service Values Assured quality of care - applying national standards derived from national health services in Scotland, applied to a prison setting. Consistency of care - allowing variation in practice where justifiable, and taking account of evidence-based national clinical guidelines and good practice. Safety for prisoners, staff and the public. Equity in health services: prisoners will receive improved opportunities to benefit from NHS care in keeping with services provided to the local community; promoting throughcare to ensure integrated support to meet health care needs across settings. Shared responsibility for multi-disciplinary functions (annex 2). Shared responsibility between the Health Boards and prisons for the identification and planning of significant service change, and development of health services to prisoners on the basis of assessed need. Provision of health services will remain the responsibility of the Health Board. 2.4 Organisational Values Promotion and development of best practice. Transparent financial and performance monitoring and strategic planning with information sharing and documentation between the parties. Resolution of disputes, where possible locally, and as rapidly as possible. 2.5 Staff Governance NHS Scotland principles and PIN Guidelines will apply for employed health care staff in prisons. Professional issues relating to health care staff working in prison will primarily be a matter for the local Health Board. Health Boards and SPS will be responsible for Health and Safety requirements relating to their respective duties. Health and Safety responsibilities will apply for NHS and its staff engaged in the process of health care, and with SPS and private contractors, where appropriate, for the overall prison setting. Elements of governance will include: training strategy; recognition for individual and team contributions; processes for investigations and discipline; and professional standards of SPS and health care staff. There will be involvement of the Prison Governor or Prison Director in NHS arrangements to select and appoint health care staff in key management positions. 3. Agreed Definition of Terms Health care services: all services associated with the direct delivery of health care to prisoners by health care staff, administrative and information technology support, and contracted health care services. Operations: activities undertaken to ensure the safety, security and wellbeing of staff and prisoners, and facilities management. See annex 1 for a definition of Scope of Service. 4. The Responsibilities of Both Parties to the Agreement (see annex 2) 4.1 This agreement outlines what will be principally the responsibility of each party to the Memorandum in addition to key areas of joint responsibility. 4.2 Health Boards will be responsible for: The management, training and support of directly employed health care staff, including support functions. Ensuring that staff teams have an appropriate skill mix of professional staff, assistants and administrative staff. Contracts and contracted services associated with the delivery and support of health care to prisoners/patients. On-site managerial staff to support clinical functions. Expert advice on health protection and health promotion matters, including outbreak and incident management. Ancillary services to support clinical activities. Information management and technology and information governance that support the healthcare function. Maintenance and replacement of all clinical fixed and non-fixed assets within health care premises. National health management and clinical support for prison health. Training and development of staff for clinical and supporting purposes. Health care-related complaints. Clinical performance management and monitoring, and prison liaison. 4.3 The Scottish Prison Service and individual prisons will be responsible for: Environments within prisons that protect and promote health and good hygiene. Security and good order within health centres. General care and support of prisoners with health problems, including collaboration with care planning and delivery. Escorting functions for security purposes, both within and outwith the establishment. Facilities management and cleaning services within the health centre. Infrastructure to support the operation of the health centre. Structural maintenance of the health centre, including all fixed and non- fixed non clinical assets. Non-health care related complaints. Training of clinical staff for purposes of working effectively and safely within the prison setting. Management and training of non-clinical prison staff to support the delivery of health care and general care to prisoners. Management of National Offender Outcomes, delivery of the SPS Service Agreement relating to health and wellbeing, and related information management. Effective liaison with Health Boards and Scottish Government. 5. NHS and Prison Joint Liaison and Leadership 5.1 The parties to this agreement will be jointly responsible for: Offender Health Strategy and Outcomes development. Regular links between prison, NHS management, lead clinicians and other statutory agencies such as local authorities, and non-statutory agencies. Good governance and consistent approach to health and prison service strategy. Development of a prison health delivery plan. Reporting and investigation of critical and adverse incidents. Business continuity planning, including major service change, contingencies and resilience. Effective and appropriate sharing of management and necessary clinically-related information. Preparing and agreeing an annual statement of joint governance/assurance. 5.2 NHS standards and targets for health care provision, NHS staff governance and other procedures will apply to the provision of care within the prison setting. The National Prisoner Healthcare Network will be the mechanism to facilitate and disseminate the principles to be applied in the development of joint working arrangements, continuous quality improvement and performance measurement. MEMORANDUM OF UNDERSTANDING 8. 6. Relations with External Bodies 6.1 SPS and NHS Scotland will ensure effective working relationships with the following regulatory and stakeholder interests: SPS/Private Contractors to Lead HM Chief Inspector of Prisons, SCSWIS and other Inspectorates; Visiting Committees; Scottish Public Services Ombudsman - non clinical complaints; Media relations on prison issues (non-healthcare); and Regulation of Forensic Psychologists- Healthcare Professions Council. NHS to Lead Healthcare Improvement Scotland; Scottish Public Services Ombudsman - clinical complaints; Mental Welfare Commission and other statutory bodies; Council of Health Care Regulatory Excellence (CHRE) and regulatory bodies (e.g. GMC, NMC - excludes regulation of forensic psychologists); Media relations on health care issues; and Visiting Committees – supporting SPS regarding healthcare issues. Leadership Would Depend on the Topic Community Justice Authorities, Local Authorities, SCSWIS and Representative Voluntary Bodies. UK Government Departments. International organisations - UN and its agencies (including WHO); Council of Europe, its agencies and committees. The NPHN will maintain and develop relevant MOUs, working closely with these bodies and others to facilitate integrated and joint working to deliver high quality services and achieve the health and justice outcomes. 7. Management Links, and Resolution of Disputes 7.1 Each prison/NHS Board will convene and sustain a permanent group (Joint Steering Group on Prisoners Healthcare). It will meet regularly and the local Health Board will provide a secretariat. This group will be joint Chaired: Governor-in-Charge or Prison Director - Health Board Executive Director. NHS senior management and the Prison Governor or Prison Director will meet on a regular basis to ensure good governance, joint planning and the range of joint responsibilities and take a leading role in the Joint Steering Group on Prisoners’ Healthcare locally. 7.2 The NPHN has a national coordinating and strategic role, supporting the delivery of primary and community healthcare to prisoners. Each Health Board and SPS will be represented and participate in the NPHN. The network will be Chaired by a Health Board representative and Vice Chaired by a SPS Senior Manager. Scottish Government (SGHD/SGJD) amongst others will be members of the NPHN. 7.3 The principles of management and dispute resolution are: fair and transparent processes; agreed procedures; for complex issues, to discuss and agree the nature of dispute, and the best avenue for resolution; to assign portions of any complex matter to relevant parties, and to nominate by agreement a single co-ordinator; matters kept to a level as local as possible (i.e. within the Health Board); and matters moved to a higher level if there is failure of resolution, or if there is a risk of dispute that persists and is significant across several prisons or Health Boards. 7.4 When a dispute cannot be resolved locally, the parties will seek resolution through the offices of the SPS Director of Prisons (or, where appropriate, Private Contractor), and the Health Board concerned. If the dispute remains unresolved, the NPHN will facilitate the resolution by agreeing a Health Board to mediate between the Health Board and prison concerned and SPS Headquarters. 8. Review 8.1 Parties to this agreement will review the document annually. Any changes or updates will be agreed through the National Prisoner Healthcare Network. Local plans that are based on this Memorandum should also be reviewed annually. 9. Funding 9.1 While transactions will occur between partners to this Memorandum, arrangements are intended to eliminate cross-charging, and rely on good communications and strong partnership links to agree joint developments and meet challenges. 9.2 Partners will jointly and regularly consider matters of accountability, resources, and value for money. 9.3 Key variances, investments and dis-investments should be subject to joint appraisal, with sufficient time given to stakeholders to assess and respond to developments. 10. Key Success Factors 10.1 The following factors are key to the success of this agreement: effective collaboration and communication and trust between both partners; partnership in the planning of access to and delivery of health care to prisoners and delivery of clear health and offender outcomes, including SPS Service Agreement commitments, specifically, Offender Outcomes 1 and 3 (mentally and physically well; substance misuse free or stabilised, supported by good quality data from NHS sources, and the requirements of the Healthcare Quality Strategy, delivering consistent, high quality, person centred and safe services. demonstrating outcomes such as reducing inequalities, improving health and reducing re-offending. evidence of commitment to continuous improvement by sharing good practice and agreeing joint solutions to challenging issues through the National Prisoner Healthcare Network. recognition of inter-dependency between prison operations and health care, and the importance of the maintenance of good order and the role that health care plays in it; and local and national plans are agreed, implemented and monitored by all relevant parties with minimal use of dispute resolution processes.
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments? Who pays for the health insurance of prisoners? Are prisoners entitled to choose their doctor or health care provider during their imprisonment? Doctors and medical staff providing health care to prisoners in your country are: If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)? How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?yes
If so, are prisoners insured (health insurance) in the same way as the regular citizens are?yes
If not, how is the health-care of prisoners financed?According with Health Care Financing Law of Latvia, prisoners’ health-care is covered by the budget of the Ministry of Health. The patient’s co-payment and the remuneration of medical practitioners of prisons, as well as the maintenance expenses of medical institutions are covered by the state budget of the Ministry of Justice. Like the rest of the population, health care services for detainees and inmates are provided within the framework of state mandatory insurance.
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?There are several private insurance companies in Latvia, prisoners are not their clients. Insurance companies do not provide health insurance for prisoners as individuals.
Who pays for the health insurance of prisoners?See answer to Question 3.
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?Prisoners are not entitled to choose their doctor or health care provider as the health care is provided by the medical institution of the relevant prison.
Doctors and medical staff providing health care to prisoners in your country are:Health care to prisoners are provided by a) staff-members of the prison service; b) staff-members of other public bodies providing health care services to all citizens.
Is the inpatient care for prisoners provided by the prison service?yes
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)?The inpatient care is provided by the Latvian Prison Hospital as well as, if necessary, other hospitals where all citizens are treated.
How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?The security of medical staff working with prisoners inside the prisons is ensured within the framework of internal procedure rules and outside the prison – by security staff (convoy).
Yes, healthcare for people in prison in England and Wales is provided free by the National Health Service
If so, are prisoners insured (health insurance) in the same way as the regular citizens are?Health insurance is not a requirement in the UK – there is free access to public healthcare services
If not, how is the health-care of prisoners financed?Prison healthcare is funded through the Health Department
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?Health services are provided for prisoners by the Health Department. If a prisoner has private medical insurance and wishes to access private medical services they can apply for permission to do so provided that they meet all costs involved, including the cost of any security escort provided. We do not have information on prisoner’s entitlement to private health insurance.
Who pays for the health insurance of prisoners?Health services are provided at no cost to patients who are prisoners so insurance is not required for this provision. There is no arrangement for the Justice or Health Departments to purchase private health insurance for prisoners.
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?No, prison residents use the service provided in their prison. If attending hospital appointments external to the prison there may be some choice in the location of services accesses, but this is limited
Doctors and medical staff providing health care to prisoners in your country are:b)
Is the inpatient care for prisoners provided by the prison service?yes
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)?Prison residents requiring hospital treatment can be taken under security escort. They have a right to access care equivalent to that which is available to the wider community
How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?The general security arrangements operating within each prison provide for the security of medical staff. Security escorts are provided (usually 2 people) when attending hospital outside the prison
Yes
If so, are prisoners insured (health insurance) in the same way as the regular citizens are?Yes
If not, how is the health-care of prisoners financed?-
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?According to the provision § 7 par. 1 of the Act on the Public Health Insurance, inmates have the right to request for a change of the health insurance company (similarly as persons outside prisons). The change of the health insurance company is always effective from the 1st January of the following calendar year. The application form must be submitted at latest until 30st September of the calendar year.
Who pays for the health insurance of prisoners?In case the inmate is assigned to work, he/she pays the health insurance by the deductions from the gross working remuneration (these deductions are performed and drained by the Prison) according to the general system of public health insurance. If the inmate is not assigned to work, the State pays the health insurance.
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?No. According to § 11 par. 6 letter a) of the Act on Health Care and Health-care related Services, inmates have no right to choose the health care provider.
Doctors and medical staff providing health care to prisoners in your country are:Inmates are provided health care firstly by prison health care staff (generally in service or labour relation) but under special circumstances (mainly provision of specialized in-patient or out-patient care) also by civilian (also private) health care facility staff
Is the inpatient care for prisoners provided by the prison service?Yes. In Prison hospital, inmates are provided the in-patient health care on the following wards: internal, psychiatric, TB and respiration diseases, surgery and other branches such as neurology, physiotherapy, urology, dermatology and ophthalmology
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)?If necessary, also a civilian hospital can provide inmates the in-patient health care within the catchment area of the Prison or another civilian medical facility providing a specialized (oncologic, cardiologic or neurosurgical) in-patient health care.
How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?In prison premises, the uniformed prison staff is always at disposal (prison officers). If the doctor indicates a need or after an individual risk assessment before the health care provision, the surveillance or guarding of inmates is ensured before. Prison officers ensure guarding of all inmates in civilian medical facilities.
Yes
If so, are prisoners insured (health insurance) in the same way as the regular citizens are?Yes. According to the so-called normalization principle, inmates in the Swedish Prison and Probation Service (SPPS) have the same right to health care as other residents living in the country. As a result, the SPPS has no obligation to provide health and medical care, but with regard to safety and for practical reasons, the SPPS conducts certain open health and medical care at all prisons and remand prisons. The care that the SPSS provides is at the primary care level and some psychiatric outpatient care. According to the Act on Imprisonment a prisoner who needs health or medical care shall be treated in accordance with the instructions of a doctor. If the prisoner can’t be examined or suitably treated in the prison, the public health service shall be used. If necessary, the prisoner shall be transferred to a hospital.
If not, how is the health-care of prisoners financed?See the answer above
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?-
Who pays for the health insurance of prisoners?Healthcare in Sweden is funded publicly.
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?No
Doctors and medical staff providing health care to prisoners in your country are:a) Staff-members of the prison service; b) Staff-members of other public bodies providing health care services to all citizens;
Is the inpatient care for prisoners provided by the prison service?The SPPS provides inpatient care to a small extent but usually a prisoner is transferred to a hospital. If it is necessary for security reasons, the prisoner is be placed under surveillance during the stay at hospital.
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)?See the answer above
How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?Medical staff that are employed, which are mainly nurses, are educated by the SPPS in a way that are considered relevant for their work where, among other things, security issues are addressed. They also, like all staff, have a personal alarm device. Doctors, which are hired as consultants, work together with the nurses. If deemed necessary when a prisoner have an appointment with the medical staff, there are prison guards nearby to ensure the security. If a prisoner has to be transferred to a hospital,he or she will be placed under surveillance if it is necessary for security reasons. Such reasons might be the risk that the prisoner will a commit crime, evade the full enforcement of his or her sentence or otherwise misbehave.
The health care of prisoners is part of the public health care system, but it is organised by a state body that operates separate from the public municipal health care system.
If so, are prisoners insured (health insurance) in the same way as the regular citizens are?According to the principle of normality, prisoners are guaranteed the same level of health care as other citizens. However, the health care of prisoners is financed in a slightly different way than the public health care, which means that the municipalities have no financial responsibility for it.
If not, how is the health-care of prisoners financed?The health care of prisoners is financed entirely by the state, the municipalities have no financial responsibility.
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?If, with the permission of a prison physician, prisoners want to use a private health care provider, they can do so at their own expense, in which case the cost of their medical treatment is covered by the national insurance system (Social Insurance Institution of Finland) or a private health insurance if they have one.
Who pays for the health insurance of prisoners?The state.
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?The prison physician and other staff members of the Health Care Services for Prisoners are responsible for all treatment. Prisoners are entitled to seek treatment also outside the prison at their own expense if the prison physician authorises it. However, the treatment prescribed by an outside health care provider must be approved by the prison physician. If a prisoner is sent to a hospital for specialised health care outside the prison, the treatment is carried out based on the same principles as elsewhere in municipal health care.
Doctors and medical staff providing health care to prisoners in your country are:The Health Care Services for Prisoners is an independent state organisation that provides public health care for prisoners. It provides health care services to all prisoners in Finland.
Is the inpatient care for prisoners provided by the prison service?The Health Care Services for Prisoners provides primary health care services, dental health care services, and psychiatric health care services for all prisoners. Other specialised health care services are outsourced to municipal or private specialised health care providers.
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)?See the previous answer.
How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?The supervision staff of the prisons are responsible for security when prisoners are using health care services either inside or outside the prisons.
In Spain, and therefore in Catalonia as well, health care is publicly funded and follows the universal access principle. Inmates must receive the same health care services that the rest of the population. The Ministry of Health of the Government of Catalonia covers health care for prison population under the Prison Health Care Programme. The extent and quality of health care services available to prisoners is the same that is available to the rest of the citizens in the community. The type of services and professionals are the same as those provided to the rest of the citizens except for some adjustments needed in order to ensure equal health care to inmates in a prison setting with the particularities it entails. The Prison Health Care Programme has autonomy to access part of the health care data. For the rest of the data, the health care staff in prisons use the Information System of the Primary Care Services called SISAP (Sistema d’Informació dels Serveis d’Atenció Primaria), which is the information system of the primary health care system in the community, also belonging to the Ministry of Health. The medical staff in prisons us the same medical record that regular health care services use in the community for that inmate, hence medical staff of the prison and that in the community have access to all health information of that person. Every prison has a primary health care team comprised by doctors and nurses and there is a doctor available in every prison 24/365. Moreover, these primary health care units will refer patients to specialised health care services in the same way that it is done in the community. Specialised doctors will visit inmates in the prison as much as needed and if the inmate requires immediate attention and the appointment cannot take place at that moment, a phone or VCO consultation will be done with the speciality doctor. With regard to mental health care, in what follows the outpatient and inpatient care services in prisons are briefly described: • Outpatient Mental Health Care: inside every prison in Catalonia there is a Mental Health Unit which consists of a psychiatrist, clinical psychologist, a nurse specialised in mental health and an occupational therapist, all of them full time. They provide support to the prison Primary Health Care team when addressing mental health in their prison. • Psychiatric Hospital Unit for Intensive Rehabilitation: for patients with a chronic mental health condition which requires intensive rehabilitation. It is located inside the prison of Brians 2 and it also serves all prisons in Catalonia. • Prison Psychiatric Hospital Unit: for acute and sub-acute patients. It is located inside the prison of Brians 1 and it serves all prisons in Catalonia. Mental health care for patients who are in open regime or conditional release is provided by the regular Mental Health Care Services in the community. However, before the patient is going to be progressed to open regime or released, the health care staff will thoroughly prepare his/her transition into the community services by scheduling the required medical appointments with the community services for the following 15 days to the open regime or release. The patient will also be provided with the medication required for the following 14 days. Should the patient have a severe mental health condition, the psychiatrist has the possibility to activate the Individualised Services Plan (Pla de Serveis Individualitzats), which entails the appointment of a professional from the community health care services, that will accompany and support the patient in the transition process from the mental health teams of the prison to the mental health teams in the community.
If so, are prisoners insured (health insurance) in the same way as the regular citizens are?Yes, exactly in the same way as they are all served by the same publicly funded service based on the universal access principle.
If not, how is the health-care of prisoners financed?N/A
If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?As any other citizen, inmates have the right to choose a private health insurance. This private insurance doctors will be allowed to enter the prison for medical appointments with the inmate. However, if the inmate wishes to have a prison leave to attend a medical appointment of his private health insurance doctor, s/he will have to justify that the public health care system available in the prison cannot provide that type of services the private insurance doctor will provide. Also, should the private insurance doctor prescribe a medication that is not considered appropriate by the doctor of the prison health care teams, the inmate will not be allowed to have this medication.
Who pays for the health insurance of prisoners?Health care for inmates is publicly funded as that for the rest of the population because belongs to the public health care system. If they wish to have a private health care insurance, inmates or their families will need to pay for it.
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?Currently is not possible for inmates to choose their doctor amongst those available from the public health care system in prison. If they wish to cover the cost of a private insurance, they will be able to choose.
Doctors and medical staff providing health care to prisoners in your country are:Staff-members of the public health care services hired by the Ministry of Health of the Government of Catalonia, like the medical staff working in the public health care system for the rest of the population.
Is the inpatient care for prisoners provided by the prison service?Inpatient care is part of the health care services provided by the public health care system of the Ministry of Health, hence it is also available to inmates as it is for the rest of the population. It will take place in the Prison Hospital Pavilion of Terrassa, which is a hospital wing connected by a hallway to the regular public hospital of Terrassa. In the event that an inmate requires a type of treatment not available within the Prison Hospital Pavilion, s/he will be transferred to the public hospital part of the building, or to any other public hospital where the required treatment can be administered. Should an emergency inpatient service be required, the inmate will be transferred to the public hospital that is nearest to the prison where s/he is placed.
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)?N/A
How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?The security of medical staff working with inmates inside prisons is ensured by all the security means available in all catalan prisons.
Yes.
If so, are prisoners insured (health insurance) in the same way as the regular citizens are?Yes.
If not, how is the health-care of prisoners financed? If there are more health insurance companies in your country (and prisoners are their clients), are the prisoners entitled to choose their preferred insurance company for the time of their imprisonments?Not available
Who pays for the health insurance of prisoners?The National Healthcare Service
Are prisoners entitled to choose their doctor or health care provider during their imprisonment?Yes. The system provides for the possibility for prisoners and inmates to be examined, at their own expenses, by their own health care practitioner; the authorization is provided by the prosecuting judge for the accused until the sentence of first instance is pronounced; for the accused after the pronouncement of the sentence of first degree, for the convicted and for the inmates the authorization is provided by the director.
Doctors and medical staff providing health care to prisoners in your country are:b) Staff-members of other public bodies providing health care services to all citizens.
Is the inpatient care for prisoners provided by the prison service?Health care services are guaranteed and provided by the National Health Care Service. It is forbidden to ask the inmate or internee to participate in the cost of the services themselves.
If not, who provides the inpatient health care (could you briefly describe how the inpatient care system works in general – who is responsible / where is it provided)? How is the security of medical staff working with prisoners inside the prisons ensured? How is the security of medical staff working with prisoners in public health care facilities ensured?During the medical examination or at the time of the distribution of drug therapy in prison, the prisoner is subjected for security reasons and in respect of privacy only to visual and non-auditory control by a prison police officer, unless specifically requested by health personnel. Visual and non-auditory control is guaranteed by the Penitentiary Police to health personnel even on the occasion of medical examinations or hospitalization of the prisoner.
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