Treatment of Prisoners with Serious Health Conditions Who Are Prone to Infections

11 Mr Gerald Giam Yean Song asked the Coordinating Minister for National Security and Minister for Home Affairs whether the Singapore Prison Service will review its facilities and procedures to give public confidence of its ability to handle prisoners with serious health conditions who are prone to infections.

The Senior Minister of State for Home Affairs (Assoc Prof Dr Muhammad Faishal Ibrahim) (for the Minister for Home Affairs): The Singapore Prison Service (SPS) has a healthcare delivery system that is aligned with national standards. Inmates receive appropriate levels of primary medical care within the Prison Medical Complex.

In the case of inmates with complex medical conditions, medical experts may advise that there is a need for highly specialised treatment, which is not available in the Complex, unless our prisons are to be outfitted to be exactly like public healthcare institutions (PHIs) and National Specialty Centres (NSCs), with the same type of medical expertise – which is not a sensible option. In such cases, the inmate may receive his/her treatment at the PHIs and NSCs.

Mr Speaker: Ms Denise Phua. Yes, Ms Sylvia Lim?

Ms Sylvia Lim (Aljunied): Speaker, I would like to ask supplementary questions for Question No 11. I raised my hand. May I ask some supplementary questions?

Mr Speaker: Okay, I will allow you to do so.

Ms Sylvia Lim: Thank you, Speaker. So, I have three supplementary questions for the Senior Minister of State on this matter.

First, I would like to understand more about the Ministry's response to the recent sentencing judgment in Mr Ong Beng Seng's case. Because in the judgment, it was found by the sentencing judge that, as mentioned by the Senior Minister of State, SPS has an adequate healthcare system to manage inmates with complex and serious medical conditions in conjunction with the public healthcare institutions. But that does not address the enhanced risk of potentially fatal infections and falls. So, based on what Senior Minister of State said earlier, does he accept that there is no way that Prisons can actually address this concern of the Courts with regard to potentially fatal infections and falls?

The second question is, I would like to have his affirmation that, in the public interest, the law should apply evenly to everyone and there should not be any perception that ill health is seen as a licence to commit crimes and escape punishment. So, to that extent, the Ministry and SPS should always review whether its facilities should be enhanced to care for, perhaps, even more complex healthcare situations, as healthcare technology improves.

And last of all, on a broader level in handling prisoners with serious health conditions, I understand from the Prisons Act that there is an option – if the Court were to sentence a seriously ill prisoner to imprisonment, there is an option for the Minister to actually issue an external placement order, meaning that he orders the Commissioner of Prisons to move the inmate to a more suitable place in view of the inmate's, perhaps, terminal illness, and so on. So, I wonder if he could confirm whether the Minister has actually ever exercised this power since the provision came into force.

Assoc Prof Dr Muhammad Faishal Ibrahim: I thank the Member for the supplementary questions. Indeed, as I have shared earlier, our healthcare delivery system is aligned to the national standards. Maybe the Member is not aware of what we have in place.

We have medical care protocols in place and a healthcare system that can manage inmates with varying conditions. I work very closely with Prisons and I have come across many of such cases, including those with serious and complex medical conditions, such as those requiring dialysis, active chemotherapy and radiotherapy, stroke or post-operative care. And also, we have established infection control protocols in place that are aligned with standards practised in the PHIs. Healthcare staff in SPS also adhere to infection control standards, such as observing all the different protocols. Practically, you will find the standards very similar to what you can get outside.

We also have negative pressure cells for infection control, for example, COVID-19 or even tuberculosis. To that extent, ours is not something very different from what you see outside. We are also subjected to inspection or audits by the Ministry of Health regularly.

What we also do is that we make our medical centre relevant. For example, we have the electronic medical records and we have telemedicine, which we enhanced. We also have things in relation to how we provide opportunities for those with chronic illnesses; we even have dialysis machines.

So, we will continue to make sure that we provide the necessary healthcare standards to our inmates.

At times, I receive messages or emails from the loved ones of our inmates. Definitely, they are worried about the healthcare of their loved ones. SPS would try their best to address the issues. If there are needs relating to their medicine or even the care that they require, SPS will do so.

Nevertheless, we must recognise that the majority of our inmates have drug addiction matters, so the medicine that we give have to be appropriate for them. So, sometimes you may hear, "I would like to have stronger medicine" and so on. But I want to assure Members that our doctors and our healthcare staff are very much attuned to the needs of the inmates.

The Member also mentioned about the judgment that has been made. Essentially, we maintain that we have an adequate healthcare system and protocol. But the judge will have to decide based on the facts of the case. And we have, as the Member quoted, the external placement scheme. I think it is an option that Prisons can take on and this is not something relating to what Prisons can decide. We have a medical advisory panel and we have an external placement review board. And we have done so; we have had cases where we have allowed the person to go on such a scheme.

Essentially, I want to assure the Member that we will look after our inmates. They are fellow human beings; they need the care. But if we cannot take care of them within the prison set-up, we will work with the PHIs. And it is not only PHIs which are close to us. If there are needs that you cannot find in a certain PHI, we will go to a setting that is more appropriate. For those who may need additional support or the circumstances vary, we have the external placement scheme.

At the end of the day, you need not worry how your loved ones as well as your constituents will be looked after when they enter the prison. We will also continue to improve the setting – because whoever you are, we want to take care of you, and we want to make sure that you have a meaningful rehabilitation and reintegration journey.