1. 2 MEDICAL PAROLE Presentation to Portfolio Committee Date: 12 August 2008

2. PURPOSE To provide an overview on the application of the release of offenders on Medical Parole 2

3. MANDATES 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. 3

4. MANDATES continued Correctional Services Act 111 of 1998: Section 79 – Correctional supervision or parole on medical grounds Any person serving any sentence in a correctional centre 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 to die a consolatory and dignified death 4

5. TERMINAL DISEASE Can be defined as an active and malignant disease which cannot be cured and is expected to lead to death. Palliative care is often prescribed to manage symptoms and improve quality of life. A patient who has such an illness is referred to as a terminal patient or terminally ill Certain types of cancer, emphysema, liver failure, kidney failure, asbestosis, mesothelioma and heart disease may be considered fatal, although liver failure, kidney failure and even heart disease could possibly prolong life with an organ transplant. People with acute immune deficiency (AIDS) suffer from other terminal diseases 5

6. CONSOLATARY AND DIGNIFIED DEATH Proper care and support which should include physical care and spiritual support. Would preferably be ensuring that the offender is amongst family members before passing away. Problems associated with placement with families: Families refuse to accept responsibility Addresses cannot be confirmed 6

7. HEALTH CARE SERVICES Health services are rendered by health care professionals including medical practitioners within DCS facilities. Visits for medical services to Correctional Centre vary from Centre to Centre. In Gauteng and WC sessional visits are daily due to service level agreements with these provinces. Other regions use private medical practitioners and sessional visits range from weekly to monthly. Critical cases are duly referred and priortised by medical practitioners during sessional visits In cases of emergency in the absence of the medical practitioner the nurses will refer the case to the nearest public health facilities 7

8. PROCESS OF IDENTIFICATION A registered nurse initiates the process by submitting a detailed report and recommendations 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 8

9. PROCESS OF SUBMISSION 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 (CMC). 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. The CMC compiles a profile report with a recommendation on possible placement which is then submitted to the relevant authority as per next slide 9

10. DELEGATION LEVELS 0 – 12 months: Head of the Correctional Centre More than 12 months: Parole Board Lifers: sentenced before 1/10/2004: Minister Lifers sentenced as from 1/10/2004: Court Persons declared dangerous criminals in terms of section 286 of the Criminal Procedure Act, 51 of 1977: Court In the case of lifers and dangerous criminals the matter is referred to the CSPB who the makes a final recommendation to the Minster or the Court 10

11. CONSIDERATION BY PAROLE BOARD (1) Should be relevant to all delegated officials/ bodies 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/ Head Correctional Centre. 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. 11

12. 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. Should medical parole be approved, conditions are set by the Board which the offender must accept. Whilst on medical parole the offender is subject to monitoring 12

13. RESPONSIBILITY OF DELEGATED PERSONS The Law provides for consideration of terminally ill offender for medical parole Accordingly, the delegated person/s should amongst others consider: Balancing public safety and the human dignity of offender. Uncertainty of life expectancy and possibility of recuperation with increased risk to the community Sufficient after care by families 13

14. TOP CAUSES OF NATURAL DEATHS PUBLICDCS (2000-2006) 1.HIV/AIDS relatedTuberculosis 2.Heart diseasesPneumonia 3.StrokesCardiac failure 4.TuberculosisAsthma 5.Lower respiratory infections Heart diseases 14

15. TOP CAUSES OF NATURAL DEATHS Continued PUBLICDCS (2000-2006) 6.Hypertensive diseasesMeningitis 7.Diarhoeal diseasesBronchitis 8.DiabetesRespiratory failure 9.Chronic Obstructive Pulmonary Diseases Other respiratory causes 10.AsthmaPulmonary diseases 15

16. 16 Sentence1/4/2006 – 31/03/20071/4/2007 – 31/03/2008 0 – 12 months50 > 12 months7550 Lifers: Minister10 Lifers: Court00 Dangerous Criminals00 Total8150 MEDICAL PAROLE: STATISTICS PER FINANCIAL YEAR

17. 17 Region1/4/2006 – 31/03/20071/4/2007 – 31/03/2008 FSNC73 LMN919 GAUTENG3712 KZN82 WC1411 EC63 TOTAL8150 MEDICAL PAROLE: STATISTICS PLACEMENTS PER REGION

18. Inconclusive reports from medical practitioners due to ethical reasons. Department to audit all deserving cases for consideration of medical parole in the next three months. Current DCS procedures are rather long and will be subjected to review. 18 CHALLENGES AND REMEDIAL MEASURES

19. THANK YOU Renewing our Pledge: A National Partnership to Correct, Rehabilitate and Reintegrate Offenders for a safer and secure South Africa 19