Alternative report to the un human Rights Committee regarding Norway’s sixth Periodic report under the International Covenant on Civil and Political Rights December 2010



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Electronic Monitoring – an alternative to prison


156-158

Call for extension of use

We welcome the introduction of electronic monitoring as an alternative to prison and hope that the pilot project will be extended to a permanent measure for the whole country as soon as possible in order to avoid discrimination.

ICCPR Art.

Subject

State Report para

Keyword

9

Prisons: Pregnant and breast-feeding women


163(-165)




The Government reports that there is no practise in Norway of separating infants from mothers who are due to serve a prison sentence. It is positive that there is currently no such practise, but this was the practise in the 1990s. There are no guarantees that infants will not be separated from their breastfeeding mothers, if the mothers are detained or have to serve their sentences and there is considered to be a risk of escape. There is no rational reason not to let the baby stay together with its breastfeeding mother in prison. The Government has provided no documentation to show that it would be better for the baby to be separated from the imprisoned mother than to stay together with her in prison. See also our comments above regarding the arrest of the whole extended family (under the heading “Police Arrest”).


ICCPR Art.

Subject

State Report para.

Keyword

9

Health care in prisons


168-171

Psychiatry; Equal access

In Norwegian prisons, few inmates have the same access to a doctor or specialists as other citizens, particularly for their psychiatric health problems. The health care provided to inmates in prisons is lacking for many of those with serious psychiatric problems and is of a potentially discriminatory character.

In general, the local health authority in the municipality where a prison is located is responsible for the health care services for the prisoners. There are no national standards of what this health care shall include. The health care service for prisoners varies a lot from municipality to municipality depending on the resources available. Five of six prisons have their own health services, but generally these are both understaffed and incorrectly staffed with nurses instead of doctors.

Statistics show that overall about 60 % of inmates are drug addicts and 50 % have some sort of chronic disease. Several reports from different organizations and institutions show protracted29 and systematic breaches of inmates’ patients’ rights.30 The recurring problem that is documented in these reports is lack of psychiatric care. Inmates are at risk of inadequate and discriminatory treatment.

In February 2010, Norwegian authorities published a study to document the extent of the problem of psychiatric health care in prisons31. Even if that report presents important information, lack of reports is not the problem. A screening program potentially encompassing 800 inmates has also been initiated. We welcome this, but these are not sufficient measures when held against the responsibility of the Norwegian government to immediately provide adequate psychiatric health care to all inmates, by for instance establishing an appropriate institution or ward.

The report of the Ministry of Justice emphasizes the emergency of the situation, even if the numbers stated are considered as conservative by NGOs. According to the report, 85 – 90 of Norway’s approximately 3350 inmates are clearly without adequate health care; these persons are all afflicted with serious psychiatric problems, and are at the same time either particularly vulnerable or particularly dangerous. This number only counted those that do not belong in prison but should permanently be placed in psychiatric institutions. They receive emergency care, but no long-term treatment. In addition, even inmates that are in need of only emergency care may have their rights violated, as media reports show that they are placed on isolation cells awaiting openings for admission to their local psychiatric ward.32

The report of the Ministry of Justice also reveal a worrying discrepancy in how the prison authorities report far many more inmates in need of psychiatric treatment than does the prisons own health care staff. Whereas the prison authority’s count of inmates belonging to this group was 160, the prison health care only counted 120. This discrepancy indicates an additional problem of inmates not receiving the correct attention from the health professional that are supposed to look after their medical interests. Media reports also show that it is the prison authorities and not the health staff themselves that more often champion inmates’ psychiatric health rights.33

The lack of adequate psychiatric treatment for inmates is linked to a flagrant breach by the health authorities, primarily the prison health authorities, of the responsibility to establish an individual treatment plan for each inmate. This right is prescribed by law to anyone that is diagnosed with a long-term illness and is particularly highlighted in the law regulating psychiatric health care.34 For inmates this entails that it is the prison health care facilities that has the primary responsibility to draw up and carry out the individual plan. The content of such a plan involves the establishment of the duties of the health care services to cooperate and provide treatment and any duties of the patient. As for instance the reports from The Ombudsman on Tromsø prison mentioned in the footnote above, cooperation between the prison administration and the local psychiatric ward represent a separate problem to the inmates’ right to adequate health care.

Access to specialist health care is also inhibited by practical problems. If people in custody need specialist health care services they must normally be transported by the police. The police have many other obligations and are often not available when needed. Again, this is particularly a problem for mentally ill prisoners.



Recommendations to Norway:

  • Capacity of both emergency and long-term psychiatric care should be ensured to inmates, regardless of whether they represent a security risk or not, by immediately establishing separate wards or sections within prisons or psychiatric institutions.

  • Prison health care services should be properly and sufficiently staffed and all medical staff should be instructed to ensure the right of each inmate to have an individual treatment plan in accordance with Norwegian law.


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