Ministry of Justice plans to merge prison medicine with general healthcare

Tallinn Prison.
Tallinn Prison. Source: Siim Lõvi /ERR

The Ministry of Justice is preparing a draft bill to change the way healthcare is provided to prisoners — In the future, the Ministry of Justice would only be responsible for ensuring that inmates serve their time, while the Health Insurance Fund (EHIF) would finance and administer their healthcare.

The Tartu, Tallinn and Viru prisons are licensed as distinct healthcare providers, and staff a total of 136 medical professionals.

The Ministry of Justice finances and coordinates prison health services.

Given the declining number of prisoners and the changes in state administration, it makes little sense to keep the prison health service separate from the national healthcare system, Rait Kuuse, deputy secretary-general for prisons at the ministry, told ERR on Friday.

"Sooner or later, the question would arise as to whether it makes sense to maintain and operate the separate system for such a small number of people," Kruuse said. "All standards, treatment criteria, certification requirements, wage agreements, etc. also apply to health professionals who work in correctional facilities. This system already incorporates all norms established outside of the legal system."

According to the proposal, €4.3 million would be transferred from the ministry's budget to the Health Insurance Fund (EHIF, or Haigekassa).

This means that in the future the EHIF will be responsible for healthcare providers in prisons as well as manage everything associated with health service delivery.

The medical staff would no longer be employed by the prison, but rather by a regional hospital or another medical institution.

The fund declined to comment on the changes at this time; but, in a letter sent a few days ago, the organization stated that the planned reorganization of the healthcare system would require additional analysis and discussion.

The Estonian Hospitals Association (Eesti Haiglate Liit) stated in a letter to the Ministry of Justice that a clinical audit of prison medicine should precede the proposed changes because the summaries provided in the draft's explanatory memorandum do not reflect the actual situation.

Kuuse said that an agreement with the Ministry of Social Affairs had been reached earlier this year, and that the process of merging will continue. Consultation proposals will be implemented.

"It does not seem now that everyone is in agreement, that such a reform should not be undertaken. However, everyone understands that it makes little sense to administer a healthcare system from many locations. Especially since we have a national prison medical system for a few thousand inmates only."

The draft will be tabled later this month, and the changes would take effect in January of the following year.


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Editor: Kristina Kersa

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