Good and thorough follow-up of recommendations by Ålesund accident and emergency unit

Ålesund accident and emergency unit has implemented several highly positive measures since the NPM visited Ålesund police custody facility in March.

The measures are intended to safeguard patient confidentiality, among other things, and they set guidelines for clearer cooperation between the police and the accident and emergency unit.

Visited the police custody facility in March

The Parliamentary Ombudsman’s National Preventive Mechanism (NPM) made an unannounced visit to Ålesund police custody facility on 11 March 2015. During the visit, the NPM spoke with detainees in private, talked to the custody facility’s staff and management, and inspected the custody premises.

As part of the visit, the NPM examined whether the detainees’ right to receive medical help was respected. The NPM also visited Ålesund intermunicipal accident and emergency unit.

After its visit, the NPM published a report containing its findings and recommendations for Sunnmøre Police District and Ålesund intermunicipal accident and emergency unit for the purpose of preventing torture and inhuman treatment.

Recommendations for the accident and emergency unit

It was noted in the visit report that it is good that the police seem to have a low threshold for escorting detainees to the accident and emergency unit, but that this entails stringent requirements for health personnel to be aware of their role. The role of healthcare professionals is solely to assess the patient’s health situation.

When examinations are initiated by the police, there is an increased risk that the examinations become ‘conveyor belt’ decisions with a shift in focus from examination of the patient to ‘clearance for remanding in custody’. This can cause other health needs that the patient might have to be overlooked, and may undermine the relationship of trust between the patient and health personnel.

The NPM made the following recommendations in this respect:

  • It should not be possible for the police to hear what is being said in the patient room. Nor should it be possible for the police to see what is going on in the patient room, unless the health personnel so requests in special cases.
  • The accident and emergency unit should ensure that it never conducts medical examinations that are, or are perceived as, an approval of detention in the police custody facility. The police should help to prevent such a view from gaining a foothold among the detainees.
  • The accident and emergency unit should have a camera available so that any injuries sustained by detainees can be documented by the doctor in the patient records.

Read the report in full in Norwegian. (PDF).

Read the summary and recommendations in English (PDF)

Thorough follow-up

In a letter to the Parliamentary Ombudsman dated 23 July 2015, Ålesund intermunicipal accident and emergency unit described the measures introduced in follow-up of the Parliamentary Ombudsman’s report.

The follow-up measures that the unit has initiated in order to safeguard detainees on a par with other patients seems to be good and thorough work.

The accident and emergency unit has drafted a set of guidelines for the unit’s doctors giving important clarification of roles and guidance on how to cooperate with the police in a way that is fully compliant with the principles of medical ethics.

It is also positive that the accident and emergency unit has stated that it will purchase technical equipment to enable the unit to better safeguard the patient’s right to confidentiality and the need for documentation in serious cases. The unit will buy a camera to document injuries and hearing protection with radio for police officers to use if safety considerations require the police to be present during examinations.