The Prison Service provides inmates with 24/7 access to specialist medical care. In 2011, an average prisoner used basic health services 21 times, consultations of specialists 3 times and specialist medical examinations 8 times. On average, every sixth detainee underwent hospital treatment. The waiting time for specialist medical consultations was about 14 days in that period.
The technical condition of facilities and rooms where prisoners are treated is alarming, though. Nearly a half of institutions audited by NIK did not adhere to recommendations of the construction supervision or sanitary inspection authorities. For instance, the Custody Suite in Białystok did not carry out required check-up of the hydrant fire protection system. It did not modernise it, either, although its damages posed potential threat to people’s health or life. The heads of penitentiary units explained that they could not comply with the recommendations of supervision authorities due to limited funds. In the period 2010-2011, the pool of funds for investments in medical care institutions was small indeed as it made up only 0.1 percent of total expenses of the prison system (PLN 140.6 thousand). In 2010, not a single investment was made in the prison health care, whereas in 2011 two investment tasks were started and then continued in 2012.
In the units audited by NIK medical services were often provided based on low-quality and old diagnostic equipment. Nearly a half of the medical devices had been handed over before 2000. In 11 institutions, x-ray machines were obsolete and did not have required technical check-ups, thus posing a real threat to the health of medical personnel and patients.
In as many as 15 of 17 audited penitentiary units the rooms where medical services were provided did not comply with the requirements defined by the regulations. Both their sanitary condition and equipment evoked some doubts, as e.g. in the Custody Suite in Wrocław where the reservations concerned 51 rooms (including the admission room, wards and seclusion rooms in mental hospitals). The costs of adapting and furnishing those rooms were estimated at PLN 216 thousand.
According to preliminary estimates of the Central Board of Prison Service, accommodating all penitentiary health care units to effective requirements will cost approximately PLN 60 million. It is justified to predict, though, that this amount may be bigger. However, if the medical care facilities in prisons are not adapted to new regulations they will have to be closed.
As a result of limited funds for investments in the prison health care in the period 2010-2011 and the lack of qualified staff, some medical care units have already been liquidated. 10 radiological facilities were closed in the audited period which is particularly alarming in the context of growing incidence of tuberculosis among prison inmates. In line with the regulations, each person admitted to a penitentiary unit has to undergo the chest x-ray. Periodic health examinations of inmates are also compulsory. Nevertheless, the findings of the Supreme Audit Office show that radiological examinations were often made with delay and in some cases were not conducted at all.
Due to the liquidation of a part of penitentiary health care units the demand for external medical care has increased. As a consequence, the expenditures for such services went up in the period 2010-2011 by 26.4 percent (from PLN 19.9 million to PLN 25.2 million). At the same time, it remains a mystery how much was spent on the treatment of prison inmates because in the expense recording system the costs of medical care for such persons are presented together with other costs of the Prison Service.
