• Auditor General’s 2022 Annual Report highlights shortcomings within Prisons Dept.

Each time a well-connected person who is considered very important by societal standards is served a prison sentence, the said VIP is transferred to the Prison Hospital. The most recent incident was that of former Minister Keheliya Rambukwella being transferred to the Prison Hospital following his imprisonment, which was followed by speculation that he had requested to be transferred to a private hospital, him demanding that all his meals be supplied by his home, and that his medicines needed to be flown in from a hospital in Singapore.

While all this remains unverified, the rights of a prisoner globally adopted and proclaimed by General Assembly Resolution 45/111 (14 December 1990) in its ninth principle as listed among the ‘Basic Principles for the Treatment of Prisoners’ grants all prisoners access to health services available within the country without discrimination on the grounds of their legal situation.

However, Committee for Protecting the Rights of Prisoners (CPRP) General Secretary Attorney-at-Law Senaka Perera speaking to The Sunday Morning said: “When a person is imprisoned and is in urgent need of medical attention or even requires a paracetamol tablet, the Prison Hospital staff does not immediately attend to their medical needs. There have been reports, when we have conducted routine surveys within the Sri Lanka prison system, where inmates have shared their experiences of the negligence of doctors.”

Sharing an example of such an instance, Perera explained that once when an inmate who was a foreign national had contracted a foot infection and required urgent medical attention, the hospital wing staff, including the medical practitioner, had neglected treatment, causing the inmate considerable blood loss.

“We have a letter that was drafted by the inmate and handed over to us through their attorney that we presented to the Human Rights Commission of Sri Lanka (HRCSL) for an inquiry. Moreover, a recent audit conducted by the Auditor General’s Department indicated that there had been grave cases of medical negligence towards inmates that had resulted in life-threatening conditions to some inmates,” Perera elaborated.

While the CPRP acknowledges that every prisoner has the right to access health services, their observations have only returned unfavourable findings where priority access only gets granted when a ‘significant’ person has to serve the sentence.

Prison Health Services stance

Earlier this week, Prison Health Services Director Dr. Hemantha Ranasinghe reiterated that despite the unfounded allegations, the former Minister had not received or been afforded special treatment at the hospital wing after he was transferred following medical recommendations.

“It is a routine practice where we subject all prisoners to medical checkups upon admission. Then, based on the recommendation of the medical practitioner, it will be decided whether the prisoner should be admitted to the hospital wing or be administered the necessary medication while they are serving the sentence in the regular wing,” Dr. Ranasinghe explained.

According to the Prison Health Services Director, inmates are allowed to remain at a private hospital only if they were receiving treatment at the said hospital at the time of arrest. However, at the specialist doctor’s discretion, the person under arrest could be released to the Prison Hospital.

“If an inmate has to be transferred to another hospital from the Prison Hospital to undergo any procedure that cannot be carried out within the capacity of the Prison Hospital, we transfer them only to the National Hospital or the nearest State-run hospital along with a Prison Guard,” Dr. Ranasinghe noted.

All persons admitted to prison before 10 p.m. undergo medical checkups on the same day, while those who come after 10 p.m. get their medical checkups the following morning. In the second instance, they are held in a cell near the prison gate and not placed in prison cells. If they have medical records, the hospital staff also checks those records. If health issues that require medical attention are observed, prisoners are sent directly to the Prison Hospital.

“New inmates diagnosed with medical conditions are sent to the Prison Hospital at around 4 p.m. each day; therefore when the former Minister was admitted to the Prison Hospital it was around the same time and no special treatment was sought or provided,” Dr. Ranasinghe explained.

Prison doctors’ duty negligence

The alleged mismanagement within the Prisons Department was highlighted through the Annual Report of the Auditor General for the year 2022, which was presented during the Third Session of the Ninth Parliament.

According to the audit findings, some 33 doctors assigned to prison hospitals in Sri Lanka had clocked in only 1,296 person-hours for a month, far below the stipulated 4,570 person-hours mandated by the Ministry of Health. Essentially as stipulated through a circular issued from the Secretary to the Ministry of Health, doctors assigned to prison hospitals are required to work a minimum of six hours a day on weekdays and four hours on Saturdays. Yet the audit findings reflect that the medical staff affiliated with the prison hospitals had only covered work hours for less than half the time.

The audit report also highlighted that there was a delay in referring patients ordered for rehabilitation to rehabilitation centres. By 1 November 2022, the number of inmates who were expected to be sent to rehabilitation centres (as ordered by courts) and detained at Welikada Prison for more than six months was 1,271.

Furthermore, there had been an increase in the number of prisoners who were imprisoned due to non-receipt of test reports. Whereas by 31 December 2022, the number of remanded suspects was 5,676 due to the non-submission of the test reports related to the drug samples submitted by the Police to the Department of Government Analysts concerning the suspects who have been remanded by the court.

Following this audit report, the Ministry of Health launched an investigation over the matter in December 2023 that was to take appropriate action against those responsible for the violation of work hours.

“This audit finding is only scratching the surface of the worsening conditions within the Prisons Department. We have observed that the overcrowding in prisons too has worsened with the recent operations that are carried out under the Acting IGP’s orders. What was 1:3 capacity overcrowding has increased to 1:4 capacity, which means the prisons are crowded four times its capacity which has led to prison breaks and increased medical negligence of prisoners,” Perera claimed.

The audit findings have indicated that, as of 1 July 2022, there was a shortage of 108,689 square feet of space for male inmates in 14 prisons. As of 31 December 2022, the prison capacity was 11,291, but the number of inmates was 14,885. As of 31 December 2022, figures for each of the 27 prison institutions ranging from 62 to 1,907 inmates have been observed as overcapacity.

When The Sunday Morning contacted the Ministry of Health to inquire about the status of the investigations following the audit findings, an official noted that they were unable to provide an official statement about the investigation yet. The official said that once the investigation was concluded, the Ministry of Health with the input of the Prison Hospital and the Department of Prisons would share the findings and actions taken with the National Audit Office.

Reform recommendations

Meanwhile, the CPRP also urged that the prison policy reforms be expedited, as several years had passed since the discourse that was followed by the presentation of recommendations. These recommendations are found in a publication titled ‘The Need for Prison Reforms in Sri Lanka,’ compiled by the Centre For Policy Alternatives (CPA) in June 2020 on improving the healthcare services afforded to prisoners with the consideration of their psychosocial well-being.