Health Services and Welfare
What the domain tests
This domain tests the prison's duty to provide equivalent healthcare and basic welfare: screening, treatment, referral, consent, confidentiality, mental health, nutrition, sanitation and protection of vulnerable inmates.
Core rules
- Article 43 read with Article 51 requires accessible health care for persons in custody; security cannot justify denying urgent care. Care should be equivalent to what is available in the community.
- On admission, screen for infectious disease, injuries, mental health risk, medication needs and vulnerability. Record findings and refer promptly.
- Sick parade and clinic services must be staffed and documented. Medical officers decide clinical matters; officers maintain security without overriding treatment.
- Consent and confidentiality apply. Information is shared only on a need-to-know basis. A prisoner may refuse treatment unless the law permits involuntary care for mental disorder or public-health risk.
- Welfare includes safe water, sanitation, nutrition, exercise, bedding, hygiene, visits and religious support. Pregnant women, children, older and disabled prisoners need specific protection.
Worked example
An inmate reports chest pain after a fight. Reasoning: treat as a medical emergency first; call the clinician, arrange referral if needed, and record injuries with a body map. Separately secure the scene and investigate the fight. Do not ask the inmate to sign a statement before care, and do not handcuff during treatment unless an individualised risk assessment requires it.
Traps
Do not let discipline delay referral. Do not disclose HIV status or mental-health records to other inmates or unnecessary staff. Do not assume a prison clinic can replace hospital care.