Organisation of health care
Access to health care
Health care is free
Prisoners may also consult a doctor of their choice, at their own expense (Article 42 of the PBW).
A medical examination is performed upon admission
The medical examination is carried out by a team formed of authorised psychiatrists, psychologists, doctors and nurses. The team assesses whether any care is needed and whether placement in the institution’s psychiatric care unit or in a specialised penitentiary facility is required.
Screening for tuberculosis is carried out on a routine basis. A chest x-ray is taken for high-risk inmates.1
Eveline Thoonen, “Death in State Custody”, Maklu Uitgevers N.V, 2017, p.182. ↩
A medical file is opened upon admission
Prior to the first medical examination, prisoners must complete a form in which they detail, for example, any medical treatment that they receive a regular basis.
Prisoners can access health care units after
a written request
Every morning, the nursing staff pre-select the inmates who will be seen by the doctor that day.
Medical examinations are carried out on a confidential basis
Physical health care
There is no specific data on HIV/AIDS, syphilis, chlamydia, hepatitis B and C or the co-infection of tuberculosis and HIV (TB-HIV). The prevalence of any given disease can therefore not be established.
In 2016, the number of arrivals tested, who were either born or who had been convicted within the last five years in a country particularly affected by tuberculosis1, was 12,222. Thirteen tested positive.
more than 10 cases per 100,000 people ↩
Testing for HIV, hepatitis B and C, and sexually transmitted infections (STIs) is available in all facilities. These tests are not mandatory.
Infectious diseases other than tuberculosis are not routinely screened for. Only tests for tuberculosis are regularly carried out.1.
Council of Europe, “Report to the Government of the Netherlands on the visit to the Netherlands from 2 to 13 May 2016”, January 2017, p.28. ↩
Measures are taken to prevent communicable or epidemic diseases. Vaccination against hepatitis B is available to men who having homosexual relations.
Work, outdoor and shower times were all cut by 50% in the Arnhem prison due to a new wave of Covid-19. In exchange, the prisoners have received extra snacks and drinks from the prison commissary. Prisoners who test negative for Covid-19 are authorised to shower, receive visitors, make phone calls and cook in groups of twelve.
Prisoners are reluctant to disclose Covid-19 symptoms in the Arnhem prison, as doing so would result in confinement to their cells for one week without access to activities. Plexiglass screens separate prisoners from visitors, and physical contact is strictly prohibited, including for conjugal visits. The prison governor wishes to avoid a generalised quarantine, which could be met with protests from the prisoners, as was the case at the Rotterdam prison, where police intervention and a helicopter became necessary.
Mental health care
When a mental disorder is identified in a person entering detention, an individual psychiatric treatment plan must be drawn up within ten days of arrival. 1 Outpatient care is provided.
Prisoners with serious mental disorders can be placed in ‘extra care units’ (Extra Zorgvoorziening, EZV), which are present in every prison. Placement is by decision of the head of the institution. The waiting time for placement is very long.
Dedicated psychiatric facilities
Persons suffering from a mental disorder at the time of the offence should, by law, not be subject to a sentence but to an obligation of care called “government disposal” (TBS).
They can be placed in three types of institutions:
- A Penitentiary Psychiatric Center (PPC), if they refuse treatment or if the “security risk” they pose is deemed high2.
- A forensic psychiatric centre (Forensisch Psychiatrisch Centrum, FPC), if they suffer from major psychiatric disorders (such as schizophrenia).
- A forensic psychiatric clinic (Forensisch Psychiatrische Klinieken, FPK), if they pose a lesser risk. Their consent to treatment is required. A detainee can only be transferred there if he or she is released on parole. The FPKs are the only specialised institutions under the control of the Ministry of Health.
Persons with mental disorders can be placed in a prison if the specialised institutions lack space.
Prisoners may be transferred from prisons to a specialised institution if their state of health and the “security risk” require it.
The Caribbean Overseas Territories do not have specialised facilities for people with mental health problems. People are transferred to the mainland or remain in prison.
Vulnerable care units (FOBA in Curaçao, IBA in Aruba) accommodate detainees requiring psychiatric care. The CPT highlights the deplorable living conditions at the IBA in Aruba: the cells are not maintained and no activities are offered to the detainees, who are usually left without care. It warns that this situation is inadequate to meet the needs of the detainees in this unit.
General Psychiatric Hospitals
Patients are transferred to a psychiatric hospital if their condition requires special treatment.
General psychiatric hospitals may also receive detained persons in an emergency if they present a serious danger to themselves or others.
Scientific Research and Documentation Centre (WODC), Trajectories of Forensic Care in the Prison System, 2016, p. 32. (in Dutch) ↩
Council of Europe, Report to the Government of the Netherlands on the visit from 2 to 13 May 2016, 2017, p. 30. ↩
The guards assigned to the dedicated units (EZVs) within prisons receive training in patient care. The CPT observes that “they work in cooperation with psychologists and social workers”. The staff/prisoner ratio here is higher than elsewhere1.
Council of Europe, “Report to the Government of the Netherlands on the visit to the Netherlands carried out from 2 to 13 May 2016”, January 2017, p.24 . ↩