Translated material
Hippocratic grid
The Ministry of Justice wants to absolve itself of responsibility for the mistakes of prison doctors
The scandalous case of Hermitage Capital lawyer Sergei Magnitsky, who died in 2009 in the Matrosskaya Tishina pre-trial detention center, where they could not and did not want to provide him with medical assistance, prompts officials from the Ministry of Justice to search for options for reforming life behind bars. The Federal Penitentiary Service (FSIN), which is subordinate to the Ministry of Justice, does not hide its desire to quickly relieve itself of responsibility for providing medical care to prisoners, delegating the relevant functions to the Ministry of Health and Social Development.Now both departments are working on launching a joint project to organize medical support in colonies and prisons in the Tver and Leningrad regions, Deputy Head of the Federal Penitentiary Service of Russia Nikolai Krivolapov said yesterday. However, so far, according to him, Tatyana Golikova’s department is not particularly enthusiastic about the upcoming reassignment of “barred” first-aid posts and medical units and is sluggish in their response to proposals from the FSIN. Therefore, there is no need to expect an immediate reform of the medical service in the penitentiary system, although the lives of more than 300 thousand prisoners, or more than a third of Russia’s prison population, directly depend on it.
The dissatisfaction of the heads of the Federal Penitentiary Service with the passivity of health officials is quite understandable, as is the reluctance of the Ministry of Health and Social Development to supervise the disgraced medical department of the penitentiary service, which allowed several well-known prisoners to die in pre-trial detention. “Only after the end of the experiment will we know for sure whether we can move our medicine towards the Ministry of Health and Social Development,” Mr. Krivolapov explained to the Vremya Novostei correspondent the reason why his department insists on the early start of the joint project.
Over time, all prison hospitals in Russia are planned to be united into a single structure and directly reassigned to the Ministry of Health and Social Development. “We want to separate medicine from the leaders of the colonies,” Mr. Krivolapov explained the essence of the project. In the meantime, as part of the experiment, as a representative of the Federal Penitentiary Service noted, existing medical institutions in regional colonies will be re-equipped with modern equipment. According to him, about 300 million rubles will be spent on repairs and purchase of equipment for regional prisons and pre-trial detention centers that will participate in the experiment. The amount is quite significant, considering that in Russia as a whole, allocations for medical needs in the penitentiary system amount to about 2 billion rubles.
At the same time, the heads of the department do not consider the current state of affairs in the medical service of the Federal Penitentiary Service to be out of the ordinary, even after a series of scandals. “Today we have a sufficient amount of medications, and we are quite capable of solving the tasks assigned to the penal system. I cannot say that there is a catastrophe,” said Nikolai Krivolapov. He clarified that 33 thousand rubles are allocated per year for the maintenance of each prisoner, of which 2 thousand are intended for treatment. At the same time, today 13.7 thousand doctors work in the FSIN system, and together with junior staff the number of doctors behind bars reaches 21 thousand people.
True, other statistical indicators cited by Mr. Krivolapov still show that the situation is rather close to catastrophic. For example, out of 846 thousand people in Russian prisons and colonies, at least 340 thousand need treatment. Of these, 67 thousand suffer from mental disorders, 15 thousand have syphilis, 40 thousand have an active form of tuberculosis and, finally, 55 thousand are HIV-infected.
According to the chairman of the association of human rights organizations “Agora” Pavel Chikov, by starting an experiment with the hope of finally transferring prison medicine to the Ministry of Health and Social Development in the future, the FSIN recognizes that such a huge burden of responsibility for tens of thousands of “potential Magnitskys” is not for the penitentiary department, and the Ministry of Justice as a whole. needed. “But in general, this is one of the few cases when departmental interests coincide with the interests of society,” Mr. Chikov noted in a conversation with a Vremya Novostei correspondent.
The human rights activist expects that the Ministry of Health and Social Development, which also does not want to bear such a burden, intends to resist attempts to transfer prison medicine to it, but will eventually be forced to give in. “It is clear that the health department does not want to take on unnecessary worries, just as it resists transferring sobering-up centers under its wing. But since the reform of the penitentiary system is a personal project of the president, and the head of the Ministry of Justice Alexander Konovalov is considered an official close to Dmitry Medvedev, Tatyana Golikova will not last long,” argues Pavel Chikov.
In his opinion, it is necessary to “remove the shoulder straps” from prison doctors, since this will make them completely independent of the colony administration and, quite possibly, will increase the level of treatment. Now, Mr. Chikov claims, it is not clear whether the doctor obeys the head of the colony or is guided by the Hippocratic Oath. “This creates a kind of conflict of interest. Their transfer to the jurisdiction of the Ministry of Health will clarify this issue,” the human rights activist believes.
However, now there is a lack of clarity in the relationship between the FSIN and the Ministry of Health and Social Development. The representative of the Federal Penitentiary Service could not name the exact start date of the experiment in the Tver and Leningrad regions, but made it clear that everything was being delayed precisely because of the position of the Ministry of Health and Social Development. “The fact that they are not eager can be seen with the naked eye,” said Mr. Krivolapov. At the moment, according to him, a working group has been created, which includes representatives of the Ministry of Justice, the Federal Penitentiary Service and the Ministry of Health and Social Development. The press service of the Ministry of Health and Social Development actually denied their participation in the project announced by Mr. Krivolapov. “We have not received any official documents regarding the experiment from the FSIN,” the department’s press service told a Vremya Novostey correspondent. Therefore, they explained, there is no point in discussing the issue of a hypothetical reassignment of prison doctors now.
Meanwhile, the Ministry of Justice, in parallel with the administrative tug-of-war, is also preparing legislative mechanisms designed to protect the Federal Penitentiary Service from scandalous proceedings regarding the death of prisoners. On Monday, draft amendments to the Criminal Executive Code were published on the ministry's website. According to one of them, a decision to send a prisoner to a punishment cell or disciplinary cell cannot be made without “conducting a medical examination and issuing a conclusion on the ability to stay there for health reasons,” that is, without the sanction of the prison doctor. This amendment, in fact, already means the transfer of powers and responsibility for disciplinary decisions from prison administration to doctors. “The initiatives of the Ministry of Justice are also in line with the so-called reform of penitentiary medicine. They are increasing the responsibility of doctors, trying at the same time to protect themselves from high-profile scandals or not to expose the authorities of the colonies,” says Pavel Chikov regarding these amendments. But, he notes, there are also people in the FSIN who may be against their reassignment. “For example, those doctors who have the right to retire early with a high rank and receive good payments will find it difficult to give up their privileges,” says an Agora representative.