Provision of somatic and psychiatric care of female prisoners (TAS 91/2013, issued on 20 January 2015)
Provision of somatic and psychiatric care of female prisoners
The Ombudsman for Equality was requested to determine whether the decision by the Criminal Sanctions Agency to outsource the somatic and psychiatric care of female prisoners places such prisoners in an unequal position compared to their male counterparts. As a result of the decision, this form of care would no longer be provided at the Hämeenlinna Prison Hospital. According to the parties requesting a statement, the decision means that the health care of female prisoners will be far from equal to the health care of male prisoners and jeopardises the standard of care available to female prisoners.
In its report to the Ombudsman, the Criminal Sanctions Agency was of the view that female prisoners' access to necessary care will not be affected. According to the report, the change was solely due to the low number of female patients at the Prison Hospital, and the care of a small patient population can be organised flexibly as part of general health care services.
According to a health survey of prisoners, psychiatric morbidity in particular is more common among female prisoners than male prisoners. According to the report of the Criminal Sanctions Agency, approximately 8 percent of prisoners are women. After the change, 15 percent of treatment places would continue to be allocated to women. The Ombudsman is of the view that the allocation rate of patient places specified by the Criminal Sanctions Agency does not mean that female prisoners are in an unfavourable position compared to male prisoners.
The Ombudsman states that the outsourcing of somatic and psychiatric care for female prisoners previously provided at the Prison Hospital does not necessarily mean that female prisoners are in an unequal position based on their gender in breach of the Equality Act. The Criminal Sanctions Agency must ensure that the care received by female prisoners is of the same standard as the care of male prisoners regardless of the method by which the health care services are provided to female prisoners.
Conflicting views have been presented in the matter on the capabilities of operators outside of the Prison Hospital to provide effective care to female prisoners. Within the scope of its expertise, the Ombudsman is unable to form an opinion on the specifics of the health care of female prisoners. Further, within its competence, the Ombudsman is also unable to provide an opinion on the most suitable way of organising the health care of female and male prisoners. The Ombudsman nevertheless points out that economic efficiency of measures must not lead to discrimination based on gender. Similarly, the limited availability of economic resources does not provide acceptable grounds for an unequal allocation of resources based on gender.
The Ombudsman states that the Criminal Sanctions Agency must aim to ensure that the reform will not adversely affect the standard of care available to female prisoners compared to male prisoners. For example, contracts on outsourced health care services must be drawn up so as to ensure the same standard of care for both female and male prisoners. If it is found that the standard of care available to female prisoners does not correspond to that available to male prisoners, the services must be improved. The Ombudsman emphasises the importance of monitoring and evaluating the actual effects of the reform on the care of female prisoners. (TAS 91/2013)