Failure to transfer terminally-ill prisoner urgently to hospital may have amounted to inhuman and degrading treatment – IPRT

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:

1. The Prison Health Needs Assessment initiated in 2019 should be expedited and published by end 2020
2. The Department of Health and the Department of Justice should consider the transfer of prison healthcare governance and oversight to the Department of Health, in order to adhere to the principles of continuity and equivalence of healthcare in prisons, and ensure healthcare provision is not compromised by wider operations issues.
3. The Department of Justice should lead on a cross-agency protocol and process to ensure that all terminally-ill prisoners can be released into appropriate care, and thereby have their right to protection against inhuman and degrading treatment respected.

For further comment, please contact Pamela at +353 (0) 86 043 3060 

NOTES TO EDITORS

• The Irish Penal Reform Trust (IPRT) is Ireland's leading non-governmental organisation campaigning for the rights of everyone in prison and the progressive reform of Irish penal policy, with prison as a last resort. See www.iprt.ie
• IPRT was responding to ‘Investigation Report into the Circumstances Surrounding the Death of Mr I 2018’ by the Office of the Inspector of Prisons, published by the Department of Justice.
• This death in custody investigation report is just one of several such reports published in recent days, all of which relate to deaths that occurred in 2018 and 2019. Additional reports are available on the Department of Justice website.