The model of Institut Català de Salut for Prison Healthcare.


— 38 — In October 2014 as a consequence of the implementation of the Presidential Decree of the Generalitat de Cataluña 300/2006 as of October 24th and the Order of the Department of Justice JUS/290/2014 as of September 29th, the Health Department of the Generalitat de Cataluña takes over the provision of healthcare for individuals deprived of their liberty and/or under detention of any type through the Institut Català de la Salut (ICS) (Catalonian Health Institute). The ICS is the largest healthcare provider in Catalonia, since it manages 8 Hospitals and over 280 Primary Care Teams. It counts upon almost 39000 professionals and provides both specialized and primary healthcare to over 6 million citizens. The model that the ICS has implemented for Prison Health is the same as that of the rest of Primary Healthcare. This has been implemented by means of a Primary Healthcare Team in each prison alike their non-penitentiary homonymous with the appropriate specific adaptations (basically the management of the pharmacy, «hospitalization» in the infirmary, tender of Specialists within institutions— psychiatry, dentistry, trauma, etc. — and the obligations of the Healthcare Team with the Penitentiary and Judicial Institution). Penitentiary Primary Health Care Teams (EAPP in Spanish) are structurally identical to the rest (they have a Director and Assistant Director) although not entirely as far as their composition is concerned (primary care physicians, nurses and nursing assistants but not administration staff, which still depends on the Department of Justice although it is functionally assigned to the Health Team). All in all, EAPP are teams which count upon a high number of professionals regarding the ratio of assigned population due to the need of providing healthcare 24 hours a day 365 days a year and the specificity of the pharmacist supply management. I like to underline that EAPP are a hybrid structure between Primary Healthcare Teams, low-complexity hospitals, a socio-sanitary device and a mental health resource within an organization with the major objective of socially rehabilitating those hosted within and with which we must cooperate as part of our clinical responsibilities. EAPP have been structurally and organizationally assigned to the corresponding territorial entities of the ICS also known as Gerencias Territoriales (territorial directorships) although there is a so called Prison Healthcare Program within the Corporate Centre of the ICS, in charge of cross-sectional corporate demarches in concert with the corresponding territorial entities. This program is structurally included in the Directorate of Primary Healthcare of the ICS. Within territorial entities, EAPP are grouped together with non-penitentiary teams, in the geographically corresponding so called Primary Healthcare Service (Servicio de Atención Primaria, SAP), its Director being the immediate superior authority. Practically all clinical, training and administration coordination activities (HHRR, purchases, etc) are implemented by means of the corresponding territorial SAP. In fact, as in the rest of Primary Healthcare Teams, EAPP annually conclude an «agreement», known as Management Contract, which establishes the agreements reached regarding issues of healthcare production, professional development, quality and economics, whose results have to be accounted for by the end of the year and which, on the other hand, affects variable emoluments of professionals (variable productivity).

DOI: 10.4321/S1575-06202017000200001

Cite this paper

@article{Nger2017TheMO, title={The model of Institut Catal{\`a} de Salut for Prison Healthcare.}, author={Joan Fern{\`a}ndez N{\`a}ger}, journal={Revista espanola de sanidad penitenciaria}, year={2017}, volume={19 2}, pages={38-40} }