Department of Correctional Services reports back on medical parole

On Tuesday, 5 March, the Department of Correctional Services briefed the Portfolio Committee on Correctional Services on the implementation of the Medical Parole Provision of the Correctional Matters Amendment Act 2011 (Act no 5 of 2011).

As the Constitution makes provision for inmates to have the right to adequate health care services, the Department provides primary health care services and refers patients to external health care facilities for secondary and tertiary levels of health care.

James Smalberger, Chief Deputy Commissioner of Incarceration and Corrections at the Department, told MPs that the Medical Parole Board receives an average of 13-14 inmate applications a month. Of the 276 medical parole applications received last year, 66 were recommended, 132 were not recommended, 23 inmates died, 21 are pending review and 40 were not assessed.

Smalberger added that the list of medical conditions that qualify an inmate for medical parole includes, but is not limited to:

• Stage 4 AIDS
• Stage 4 malignant cancer with metastasis being inoperable or with both radiotherapy and chemotherapy failure
• Multi-Drug-Resistant and Extensively-Drug-Resistant TB
• Cardiac disease with multiple organ failure
• End Stage renal disease
• Liver cirrhosis with evidence of liver failure
• Brain lesions
• Tetanus
• Severe Debilitating Rheumatoid Arthritis
• Dementia

Prior to taking a decision, Smalberger explained that the Parole Board considers whether the risk of re-offending is low and if the inmate can be cared for, treated and supervised by a family or community member.

He added that families are often reluctant to accept terminally ill offenders after they have been released either because they cannot afford the added financial burden or because they offender may have committed a crime, such as rape, against their own family members.

Citing the example of Clive Derby-Lewis after the presentation, Democratic Alliance MP, Lennit Max, asked whether certain categories of criminals, notably those who had committed political crimes, are denied medical parole due to the kinds of crimes they committed.

Clive Derby-Lewis, convicted of murdering SACP’s Chris Hani in 1993, has been denied medical parole for cancer on two occasions. Originally given the death penalty, Derby-Lewis' sentence was later changed to life in prison after South Africa abolished the death penalty in 1995. Derby-Lewis has served nearly 20 years in jail.

Smalberger replied that if they met the criteria above, no one was automatically denied the right - “Any person can apply for medical parole - irrespective of the crime they've committed”. He added; however, that “the individual you mentioned was considered for parole in 2013 but his case was not recommended because he did not qualify in terms of the criteria”.

Although Smalberger did not elaborate it appears that Derby-Lewis' cancer might therefore not be as severe as stage 4.

Responding to a question from Committee Chairperson, Vincent Smith (ANC), about why 23 of the 276 inmates that had applied for parole had died – and whether enough is being done to curb this - Maria Mabena, Deputy Commissioner of Health Care Services in the Department, explained that sometimes inmates who applied for medical parole died while they were incarcerated due to delays in specialist reports on diseases such as cancer and renal failure. There are a limited number of specialists operating in the public health realm.

Smith then voiced his concern that it seemed that “the poorer you are the more the system is unfair to you...someone who has money has access to a private doctor who can initiate a medical parole process... How are we mitigating this?”

Smalberger responded that although the system has made improvements, the way to initiate the medical process internally was now much better. “Many [inmates] used to rely on private doctors but now our nurses are duty bound to start the process”.