Organisation of health care
Ministry in charge
the Ministry of Justice
Every prison facility has a health care unit
Number of medical staff (FTE)
All types of medical care are provided: primary (general medicine), secondary (specialised medicine) and tertiary (hospitalisation). Each prison has a dental service.
The average wait time to be seen by a specialist is 90 days. The wait time for a general practitioner is 14 days.
Inmates complain that all types of health problems are treated with basic medications.
Inmates do not always have access to necessary care. The treatments required are sometimes unavailable or considered too costly. Permission to be treated outside of the prison is difficult to obtain, whether it is to see a specialist or for a costly treatment.
The presence of medical staff is not always guaranteed at night. Emergency services are called if necessary. The CPT considers the number of full-time nurses and medical staff insufficient1.
In 2016, the Commissioner for Human Rights pointed out the lack of doctors in prison settings. This shortage is particularly notable in remand centres and solitary detention. The problem tends to be exacerbated by holiday periods, especially during summer.
Health professionals are typically not qualified for the responsibilities entrusted to them. Inmates complain of the superficial nature of examinations and of the low quality of prescribed treatment.
The CPT reported a positive experience in the care unit of Strzelce Opolskie. The capacity of the unit is 64 individuals. The medical staff is made up of two psychologists, an occupational therapist and an instructor. The inmates benefit from a wide range of activities and individual therapies2.
European Committee for the Prevention of Torture, “Report to the Polish Government on the visit to Poland from 11 to 22 May 2017”, 2018, pp.35-36. ↩
13 hospitals and 37 specialised wings accommodate prisoners. The national ratio is 13 beds for 1000 inmates (two times higher than for the rest of the population).
Access to health care
Health care is free
A medical examination is performed upon admission
The first meeting is a medical interview, complete with an examination by stethoscope. The interview and examination are completed in the three days following the inmate’s arrival. Within 14 days, the inmate must see a dentist and be X-rayed, which will then be repeated every two years1.
The CPT pointed out the superficial nature of the medical examinations, which are typically a few general questions without a full examination
This period of three days is often disregarded. Some inmates wait up to a week for this exam. Minors questioned by the CPT also reported that the exam was superficial and delayed2.
Helsinki Foundation for Human Rights, “Improving Prison Conditions by Strengthening the Monitoring of HIV, HCV, TB and Harm Reduction”, 2015, p.38. ↩
European Committee for the Prevention of Torture, “Report to the Polish Government on the visit to Poland from 11 to 22 May 2017”, 2018, p. 37-44. ↩
A medical file is opened upon admission
Prisoners can access health care units after
- a written request
- a verbal request
Medical examinations are carried out on a confidential basis
in most cases
The respect of doctor-patient confidentiality is guaranteed for most inmates, but high-risk prisoners are escorted by a guard. The doctor may request his presence.
The violation of doctor-patient confidentiality is the subject of complaints1.
Ongoing health care is guaranteed for the duration of the incarceration. Each inmate should theoretically benefit from 20 or so medical consultations each year, including three with a dentist.
Medication is provided free of charge by licensed staff members.
The Helsinki Foundation for Human Rights pointed out again, in 2015, the lack of specialised treatment. A person suffering from HIV/AIDS criticised the fact that the administration did not provide him with the anti-retroviral medication that he needed.
In case of emergency, the inmate is transferred to a penitentiary hospital. If this is not possible, he is brought to the nearest civilian hospital. Theoretically, he must pay for this transfer.
Physical health care
The most common diseases are Hepatitis C, tuberculosis and HIV/AIDS.
Each year, prison health services carry out HIV/AIDS screening on 4000 inmates. On average, 4% of the results are positive. Some inmates conceal their HIV-positivity. New infections detected each year range from 30 to 50.
8500 to 9000 screening tests for Hepatitis C are carried out each year. On average, 900 are positive.
There are 400 cases of tuberculosis detected each year. The medical examination upon entry into the prison includes TB screening1.
European Committee for the Prevention of Torture, “Report to the Polish Government on the visit to Poland from 11 to 22 May 2017”, 2018. ↩
Screening for and treatment of sexually transmitted diseases is compulsory.
Staff members receive basic training on HIV/AIDS, its causes, its prevention and its treatment.
Harm reduction measures do not seem to be seriously considered. This is also the case for HIV/AIDS. There are not enough condoms provided. Inmates are poorly informed about diseases and their methods of transmission.
In 2015, an HIV-positive inmate reported that he did not receive adequate treatment upon his arrival. His spouse had to provide him with the necessary medication[^4].
HIV-positive inmates are lodged in individual cells.
The CPT observed that its earlier recommendations had been ignored and that harm reduction, such as programmes to trade in used syringes or condom supplies, were not always implemented1.
European Committee for the Prevention of Torture, “Report to the Polish Government on the visit to Poland from 11 to 22 May 2017”, 2018, p.38. ↩
Mental health care
Several thousand individuals suffering from mental disorders are held in special units, also under the responsibility of the Ministry of Justice. Some mentally ill prisoners do not have access to these units.
Representatives of the Polish Commissioner for Human Rights visited the Gostynin “National Centre for the Prevention of Anti-Social Behaviour” (NCPAB). They discovered that the recommendations put forward in 2019 were not all implemented. There is still overcrowding, with 91 people in a facility meant for 60. The head of NCPAB pointed out that it is impossible to provide necessary treatments under the present conditions. The lack of spaces is causing numerous conflicts.
Guards and medical staff posted in specialised units are trained in the care of individuals with mental disorders, but the Commissioner for Human Rights does not consider this training to be sufficient. Some doctors who are untrained in psychiatry care for these patients.
In 2013, the CPT observed an excessive use of restraints in the psychiatric wing of the prison of Warsaw-Mokotów. The inmates were restrained for an average of 12 hours, usually at night. The delegation reported the cases of patients restrained for 25 to 32 hours. The CPT recommends not exceeding six hours and, in extreme circumstances, no more than 24 hours1.
In 2016, the National Prevention Mechanism noted the inadequate psychological treatment of incarcerated individuals. Each psychologist was responsible for the care of over 200 patients.
Committee for the Prevention of Torture, “Report to the Polish government on the visit to Poland from 5 to 17 June 2013”, 2014, p.41. ↩
Inmates with addictions benefit from several specific programmes. Methadone is the most-distributed substitute treatment. These programmes include daily visits to the infirmary. Awareness campaigns are conducted to combat dependence on products, including tobacco.
Thirty-one units are dedicated to individuals suffering from alcoholism; fifteen units, to individuals addicted to other drugs. Patients are taken into care for a period of three to six months. They participate in therapeutic meetings.
Methadone was available in all of the institutions visited by the CPT in 2017.