MEDICAL PAROLE Building a caring correctional system that truly belongs to all Presentation to Port Folio Committee 12 September 2006

PURPOSE To provide an overview on the application of the release of offenders on Medical Parole.

MANDATE (1) Constitution of the RSA, Act 108 of 1996 Section 35 (2) Everyone who is detained, including every sentenced prisoner, has the right:- (e) to conditions of detention that are consistent with human dignity, including at least exercise and the provision, at state expense, of adequate accommodation, nutrition, reading material and medical treatment .

MANDATE (2) Correctional Services Act 111 of 1998: Section 79 – Correctional supervision or parole on medical grounds Any person serving any sentence in a prison and who, based on the written evidence of the medical practitioner treating that person, is diagnosed as being in the final phase of any terminal disease or condition may be considered for placement under correctional supervision or on parole, by the Commissioner, Correctional Supervision and Parole Board or the court, as the case may be, to die a consolatory and dignified death

PROCESS OF IDENTIFICATION A registered nurse initiates the process by submitting a detailed report to the medical practitioner regarding the offender’s medical condition. The medical practitioner can also initiate this process. The medical practitioner will assess the offender’s condition and complete a G 337 form (Medical Status Report of offender) and attach a specialists report together with any other medical reports (if any). A medical practitioner must indicate if the illness is terminal and also whether the offender is in the final phase – life expectancy

PROCESS OF CONSIDERATION Once the medical practitioner has concluded his/her finding the medical report (G337) must be submitted to the Head of the Correctional Center for comments, recommendation to the Case Management Committee. If the medical practitioner recommends medical parole proper after care must be arranged for the offender. This is normally the family but may also be a hospice or other suitable institution. A written undertaking must be provided by the after care responsibility.

CONSIDERATION BY PAROLE BOARD(1) A parole profile report (G326) is generated by the Case Management Committee together with a recommendation where after it is forwarded to the Correctional Supervision and Parole Board. As no legislative minimum period has to be served regarding a submission for placement on medical parole, this is the first time the Board is aware of a submission for medical parole. As the submission is urgent the Parole Board must schedule a sitting as soon as possible. Parole Boards even convene over weekends and after hours if necessary for this purpose.

CONSIDERATION BY PAROLE BOARD (2) If the medical report is not clear additional information may be requested from the medical practitioner on an urgent basis. If the first report was submitted by a General Practitioner and the Parole Board needs more specialized information a second report may be requested from a Specialist. If after care arrangements are inadequate or absent (does not comply to the offenders needs) the case may be referred back to the CMC on an urgent basis in order to arrange proper after care.

CONSIDERATION BY PAROLE BOARD (3) Should medical parole be approved pertinent and clear conditions must be set by the Board which the offender must accept in writing. Whilst on medical parole the offender is subject to monitoring by officials from the Community Corrections Office in the Area where he/she is placed on medical parole. Should the offender’s medical condition improve once released on medical parole he/she cannot be re-admitted to a Correctional Centre unless the conditions as referred to above are violated.

CHALLENGES (1) Balancing the protection of the community with the medical condition and expectancy of the offender. Risk of recommitting of crimes especially sexual and aggressive. Prevalence of HIV/ AIDS and uncertain life expectancy. Lack of sufficient after care by families – poverty and lack of resources e.g. distance to medical facilities, transport, proper nutrition, etc. Lack of sufficient community structures and hospices to provide after care. Reluctance by hospices because of financial burden.

CHALLENGES (2) Reports from medical practitioners are inconclusive with result that report from second medical practitioner must be requested – causes time delays. Second reports are sometimes also inconclusive and places Parole Boards in position that it cannot approve placement due to lack of information/ inconclusive reports.

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