14th August 2020
The Irish Penal Reform Trust (IPRT) is gravely concerned at the delay experienced by a terminally-ill prisoner, who subsequently died, in accessing urgent emergency medical care. The failure to bring the man, who was in severe pain, urgently from Midlands Prison to hospital in June 2018 is described as a “major failing” by the Inspector of Prisons in a report (published Wednesday 12th August 2020). Considered against Council of Europe guidance, these failings may have amounted to inhuman and degrading treatment, according to IPRT.
In response, IPRT is calling on Minister for Justice Ms Helen McEntee TD to ensure that the current Prison Health Needs Assessment is expedited and findings published by the end of 2020, and that strong consideration is given to transfer of responsibility for prison healthcare from the Department of Justice to the Department of Health.
IPRT was responding to the Inspector of Prisons’ report on an investigation into the death of a man in St James’ Hospital in June 2018, while in the custody of Midlands Prison, which was published by the Department of Justice on Wednesday (12.08.2020). Staffing shortages were given as the reason the man’s transfer to hospital was delayed.
The report states that efforts to have the man released on license, in light of his diagnosis of months to live, had been unsuccessful. The Inspector sets out the need for a review of the application of compassionate release policies for terminally-ill people “in order to avoid the indignity of dying in prison.”
It took two years for the investigation report to be completed and submitted to the Minister for Justice. To be compliant with the European Convention for Human Rights, such investigations must be prompt. A number of significant procedural issues relating to poor record-keeping, and critical case reviews were also identified by the Inspector, including participation of the staff involved.
Responding, Fíona Ní Chinnéide, Executive Director of the Irish Penal Reform Trust said:
“The failure to bring a terminally-ill man in severe pain from Ireland’s biggest prison to a hospital across the road due to operational reasons is not acceptable. IPRT has previously recommended that prison healthcare be transferred to the Department of Health. This report suggests that this is needed to ensure that humane treatment and dignity of all prisoners is prioritised.
“This tragic case highlights a number of systemic issues. Not only was the deceased not transferred to hospital urgently as requested by the prison doctor, but his next of kin were not informed of his critical state, despite requests from hospital staff, until shortly before he died. The man had not been granted compassionate release to a palliative care setting, and he had been moved from an open prison back to a closed prison so that his medical needs could be managed. The Inspector does note that the man had received appropriate medical management for his diagnosis from the prison service up to 12th June 2018.
“This is not the first time that a prisoner in Ireland has died shortly after delays in transfer to hospital due to non-medical staffing issues. It is absolutely paramount that the life, health and dignity of men and women in the custody of the State are the priority consideration. The report echoes comments by the former Inspector of Prisons, who stated in 2015 that the provision of healthcare to prisoners should not be dependent on operational considerations.”
Following its visit to Ireland in 2014, the European Committee for the Prevention of Torture (CPT) described healthcare in some Irish prisons as being “in a state of crisis”. The Committee specifically highlighted the deterioration of healthcare services in Midlands prison, and the need to address gaps in escort provision to ensure that prisoners receive medical attention in the community. The Inspector’s report found that 54 hospital appointments had been cancelled due to staffing shortages in Midlands Prison that year according to prison records.
Council of Europe guidance on prison healthcare is clear that the normal prison environment is harmful and amounts to inhuman and degrading treatment for some prisoners, including those with terminal illness. The guidance states that terminally-ill prisoner patients should be allowed to die in freedom and dignity, and without pain; legal and administrative arrangements must be in place to facilitate this.
The European Committee for the Prevention of Torture (CPT) returned to Ireland to inspect places of detention in September 2019. The Committee’s report along with the Government’s response are generally published one year after the visit concludes, which would be October 2020.
In response to the findings of the death in custody report, IPRT calls for the following:
For further comment, please contact Fíona at: +353 87 181 2990
NOTES TO EDITORS