The Prosecutor General's Office of Russia has checked compliance with prisoners' right to medical care

The Prosecutor General's Office of the Russian Federation has checked compliance with legal requirements regarding the provision of the right to qualified medical care for convicts and persons in custody in correctional facilities and pre-trial detention centres across 80 regions of the country.

The conducted checks showed that over 90% of persons in custody and convicts have various, often socially significant, diseases (tuberculosis, hepatitis, HIV infection). In 2009, more than 1.2 million cases of illness were registered in the institutions of the penal system, including nearly 400,000 with a newly established diagnosis.

Shortcomings in the sphere of medical provision for convicts and persons in custody are widespread. Almost every tenth complaint concerns inadequate medical care.

The conditions in which medical units are located are unsatisfactory and do not allow for the proper organisation of the treatment process; equipment with medical apparatus does not meet existing standards.

Due to the imperfection of regulatory legal regulation, cases of refusal by the administrations of state and municipal healthcare system institutions to diagnose and provide medical care to convicts and persons in custody are common.

Most of the problems in the functioning of penitentiary medicine are related to its financial provision. In 2010, only 24% of the necessary volume was allocated for the medical care of convicts and persons in custody. Regional authorities participate in the co-financing of penitentiary medicine rarely and in insignificant volumes.

A lack of modern medical technology hinders the diagnosis and treatment of oncological, ophthalmological, and a number of other diseases. Many institutions lack the most basic medical instruments. Almost 60% of the medical equipment in use was produced in the 70s and 80s of the last century. Depreciation of fixed assets exceeds 50%.

The majority of correctional facilities and pre-trial detention centres experience a shortage of medicinal products, which reflects on the efficiency of the treatment process.

The centralised system of medicine supply is also insufficiently effective; it does not ensure the rational expenditure of budget funds. The distribution of medicinal products is often carried out without taking into account the needs of the penal system institutions. Many of them lack basic groups of medicines, including reserve-line drugs for the treatment of pulmonary tuberculosis, which affects the efficiency of the treatment process. At the same time, medicines for which there is often no acute need are sent to correctional facilities.

The medicines available to medical and prophylactic units are used irrationally. Improper storage leads to the loss of functional properties and, accordingly, to a decrease in the efficiency of the treatment process, and the forced destruction of such medicines causes significant damage to the state. Systemic violations in the storage and use of medicines were identified by prosecutors in the Republic of Khakassia, as well as in the Leningrad, Novosibirsk, Ulyanovsk, and many other regions.

Numerous violations exist in the sphere of licensing of medical activities carried out by pre-trial detention centres and correctional facilities. In practically each of them, violations of legislation were established, consisting of the absence of licences for performing work with sources of ionising radiation, as well as for individual or all types of medical activities.

The quality of medical care provided to convicts and persons in custody is declining due to unsatisfactory staffing. In the medical units' payrolls, there is a universal absence of much-needed infectious disease specialists, dermatologists, venereologists, and cardiologists; therefore, the diagnosis and treatment of corresponding diseases are hindered.

A natural result of the listed shortcomings is numerous violations of the standards for providing medical care in the treatment of convicts and persons in custody. Prosecutors have identified over 250 such facts, which in many cases contributed to the death of these persons.

The absence in pre-trial detention centres of conditions for providing multi-profile, specialised care that meets modern requirements is not always taken into account when taking persons suffering from severe diseases into custody and extending the terms of custody.

Over the first 5 months of the current year, investigative and judicial actions were postponed over 1,500 times due to the unsatisfactory state of health of the accused and defendants. However, investigative bodies changed the preventive measure for only 71 accused persons in connection with the lack of possibilities for providing proper medical care via the means of penitentiary medicine.

The President of the Russian Federation, Dmitry Medvedev, has been informed about the results of the checks, and a representation has been submitted to the Director of the FSIN of Russia, Alexander Reymer, for the purpose of eliminating the identified violations of the law.