Singapore’s prisons can manage inmates with varying health conditions: Faishal Ibrahim

SINGAPORE – Prisons here have an adequate healthcare system and protocol to treat inmates, and they can manage those with varying conditions.

Senior Minister of State for Home Affairs Faishal Ibrahim gave this assurance in Parliament on Sept 25 after two Workers’ Party MPs asked about healthcare services for prison inmates.

WP chairwoman Sylvia Lim (Aljunied GRC) asked about prison facilities in the light of the recent sentencing of billionaire property tycoon Ong Beng Seng.

WP’s Mr Gerald Giam (Aljunied GRC) had initially asked a parliamentary question about whether the prisons would review their facilities and procedures to give the public confidence in their ability to handle prisoners with serious health conditions who are prone to infections.

Associate Professor Faishal replied that in cases of inmates with complex medical conditions, medical experts may advise if there is a need for highly specialised treatment not available in the Prison Medical Complex.

He said it is not sensible for the prisons to be outfitted exactly like public healthcare institutions (PHIs) and national specialty centres, with the same type of medical expertise.

But in cases where such specialised treatment is required, inmates may receive treatment at these institutions and centres.

Ms Lim then asked a supplementary question relating to Mr Ong’s case.

Mr Ong, 79, was fined $30,000 on Aug 15 for abetting the obstruction of justice in a case linked to former transport minister S. Iswaran. He was handed the maximum fine the district court could impose, with the court granting him judicial mercy due to his ill health.

Judicial mercy is the discretionary power Singapore’s courts have to give a more lenient sentence because of exceptional mitigating circumstances.

Mr Ong’s lawyers made the case that imprisonment would dramatically increase the risks of fatal falls and infections.

Ms Lim said that while the prisons may have an adequate system to manage inmates with complex and serious conditions, this does not address the risk of potentially fatal infections and falls noted in the court judgment.

She asked if the Singapore Prison Service and Ministry of Home Affairs (MHA) could address this.

“Based on what (Prof Faishal) said earlier, does he accept that there’s no way that the prisons can actually address this concern of the courts with regard to potentially fatal infections and falls?”

She added that MHA and the prisons should review whether facilities should be enhanced as healthcare technology improves.

“I’d like to have (Prof Faishal’s) 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,” she said.

Ms Lim also asked about the option of an external placement order, which allows an inmate to be moved to a more suitable place outside of prison in the light of terminal illness or other conditions.

In response, Prof Faishal said the prisons’ healthcare system was aligned with national standards and can manage inmates with varying conditions.

He said that, having worked closely with prisons, he has come across many complex and serious cases, including those that require dialysis, chemotherapy, radiotherapy, stroke or post-operative care.

“Practically, you’ll find the standards very similar to what you can get outside,” he added.

“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.”

As for the external placement order, Prof Faishal said there is a medical advisory panel and external placement review board that help with the decision for such an order, and it has been used before.

In response to queries, MHA said there are dedicated facilities in the Prison Medical Complex and assisted living cells to manage inmates who are prone to infection and falls. Most cases can thus be managed in the prisons.

However, there may be some inmates with very complex medical conditions and a very high risk of infection, requiring highly specialised treatment. MHA said these would be rare cases and will have to be assessed based on medical advice.

In the case of Mr Ong, who suffers from incurable cancer, medical experts said the risk of infection was high in prison conditions. He also needed highly specialised cancer treatment.

MHA said: “Treating such conditions, while ensuring low level of infection, is possible only if the prisons’ medical facilities are fitted out like our PHIs and national specialty centres, with the same type of medical expertise.

“That is not a sensible option. We don’t seek to replicate the facilities in our PHIs and national specialty centres in our prisons.”

MHA noted Ms Lim’s question on whether ill health may be seen as a licence to commit crimes and escape punishment.

It said this is not the case, and people will be charged and punished if they commit crimes.

But health conditions may sometimes be relevant in considering punishment, and this will have to be based on expert medical opinion that the court will have to assess.

In Mr Ong’s case, the court had accepted the views of a professor from the National University Cancer Institute, Singapore, that his life would be at risk if he was sent to prison.

As for external placement, MHA said inmates may be placed on the scheme and serve their imprisonment in facilities outside of prison if their medical prognosis deteriorates significantly.

There have been 43 inmates who were emplaced on the external placement scheme since the provisions came into force in 2014.