The problems of the medical treatment in
the Korean correctional facilities are mostly caused by an increase in the
number of inmates and inmate patients, the shortage of medical staffs, and
inadequate medical facilities. These issues have existed throughout the history
of correctional facilities. Thus, this study investigates the current medical treatment
in Korean correctional facilities for its overall improvement and the
environment for its inmates.
For this purpose, researchers visited
over 26 correctional facilities across Korea for five months from June to
October 2017 and surveyed 2,089 inmates to examine the actual condition of
medical treatment in Korean correctional facilities. Also, in-depth interviews
from 88 inmates and medical staffs, primarily physicians, were conducted for
the overall understanding of correctional facilities and considered various
aspects to improve its medical treatment, environment, and system. Furthermore,
an online survey of 2,007 people asked questions to figure out the public
awareness and compare their responses with the perception of the inmates.
Lastly, a comparative study on the medical treatment at overseas correctional
facilities was conducted by collecting related-data through online and offline
means and inquired information regarding corrections, the justice departments,
and correctional facilities in foreign countries.
Based on the results, this study
proposes the following to overcome the current limitations of medical treatment
in Korean correctional facilities and increase the number of opportunities for
its inmates to receive better medical treatment:
1. The Expansion of Specialized
Correctional Institutions for Medical Treatment
The best way to improve medical
treatment in correctional facilities is to build a general, hospital-scaled
medical institute for inmates in correctional facilities across the country.
For this, however, a significant increase in correctional facilities' budget
and personnel are required to establish and operate the proposed hospital.
Therefore, a long-term discussion and preparation are necessary for its
Regarding the alternative establishment
of the specialized hospital, it could be an option to open a correctional ward
in a public or private medical institute. In other words, a public medical
institute could have a separate building/floor for a correctional ward to take
care of the inmate patients from correctional facilities. In this case, inmate
patients can receive professional medical services while correctional
facilities can save funds on their workforce, which could be applied for its
medical care. Also, the public medical institute can make profits regularly and
reduce debt with the patients from the Ministry of Justice.
In addition, correctional facilities and
the regional correctional departments need to promote exchanges with regional
doctoral associations, advertise the publicity of medical care in correctional
buildings, and expand partnered medical institutes by signing an MOU with
public medical institutes under the Ministry of Justice. As well, to promote an
invited medical exam and telemedicine as an alternative to medical care in
correctional facilities is required, if there is a plan to prevent any side
effects of telemedicine such as a drug overdose before its implementation.
2. The Improvement of Hospital Environments
In reality, resolving prison
overcrowding is the most important priority to keep patients free from
accidents, mental health, and infection. Therefore, the size of living space
which at least ensures the minimum quality of life for inmates ought to be
stipulated first. Then, the quota of current correctional facilities should be
reset and adjusted by increasing the parole, suspension of punishment, and
investigation without detention.
In the aspects of medical treatment, it
is essential to provide sufficient water for cooling and heating and bathing to
protect the inmates’ human rights and keep them safe from infectious diseases
in the summer. Furthermore, treatment and examination rooms in women's ward and
a solitary room for the isolated treatment of infectious diseases such as T.B.
are required. Notably, it is desirable to open additional hemodialysis units
for non-convicted prisoners and accommodate them in the correctional facilities
which have hemodialysis units. In addition, outdated medical equipment such as
an X-ray system should be replaced with new ones to have patients receive
medical exams at the correctional institutions.
Building a Public Health Care System for the Correctional Facilities
It is necessary to have a medical
administrative control tower for correctional facilities, which differs from
prison administration in the Ministry of Justice. Also, it could be considered
to invite professional medical staff to the Policy Advisory Council in the
Ministry of Justice, and receive advisory and assessment services on the
medical treatment policies of correctional facilities.
Furthermore, the establishments of
cancer and significant disease management system and an emergency medical
service system in the correctional facilities in close cooperation with related
agencies and regional medical institutions should be established. For this, an
effective plan could be developed through a legislative method which requires a
written consent when an inmate is imprisoned and a computer system which is
connected to the BORAMI system and the National Health Insurance Service
Securing Medical Staff
For the securement of medical staff in
correctional facilities, their salary, which is significantly lower than
private hospitals, should be reviewed to ensure a reasonable compensation.
Considering the unique and particular aspects of the public health care for
inmate patients, furthermore, the salary of medical staffs in correctional
facilities should be increased to a reasonable level and include overnight and
holiday pay and special medical examination benefits.
Also, it is necessary to offer a
scholarship to medical school students and establish an internal scholarship
program in the correctional facilities for the recruitment of qualified medical
staff. Additionally, promoting exchanges with regional medical staff, such as
the regional doctors association, and creating ads to secure medical staff
employment for correctional facilities are beneficial. Paramedical staffs such
as nurses, radiologic technologists, and emergency medical technicians should
be secured, too.
5. The Reinforcement of Medical Staff’s
There is a demand for a legal support
system which can prevent and properly respond to inmates’ appeals and
complaints relating to the medical treatment in correctional facilities. The
Ministry of Justice needs to introduce the Practitioners Malpractice and
General Liability Insurance coupled with the Doctors Benefit Association or
private insurance company to mitigate a medical staff’s burden of malpractice.
It is also desirable to offer more opportunities to receive medical technology
and information through regular maintenance training, workshops, and field
trips to advanced correctional facilities.
The Rationalization of Medical Treatment for Inmate Patients
Regarding inmates’ external medical
examination costs, the payment rule on applying the expenses of the government
and one’s own should be clarified with the standards according to the National
Health Insurance rates and the medical benefit recipient criteria. Also, the
types of drugs provided by correctional facilities need to be increased, and
the regulations on first-aid medicine such as pain relief pills should be
mitigated for the rationalization of inmate patients’ medical treatment.
Furthermore, it is required to provide patient meals and expand mental health
programs for the benefits of correctional facility inmates.
7. Improved Awareness on Medical
Treatment in Correctional Facilities
The trust between
medical staff and inmates should be the base to improve the medical treatment
in correctional facilities and provide a better understanding between the
medical and non-medical staff. Furthermore, the perception of the general
public on medical treatment in correctional facilities should be changed as
awareness increases on the public medical treatment, and it is necessary to
take countermeasures on the pan-government
Korean Correctional Facilities, Medical Treatment