Differences in triage and medical confidentiality between prisons of Belgium and the Netherlands

Objectives: The aim of this study is to describe the opinions of prison doctors, and to compare the primary health care in prisons between Belgium and the Netherlands.Methods: Structured interviews, audio-recorded and transcribed verbatim, were conducted with prison doctors in Dutch-speaking prisons in Flanders/Belgium and in the Netherlands. Two investigators analysed the content of the interviews and discussed each individual interview.Results: In total 37 interviews were conducted in 28 prisons (14 in each country). In Belgium, 14 of 17 prison doctors, compared to 1 of 12 in the Netherlands, experienced higher time pressure during their consultations in prison, compared to their private medical work (P < 0.001). In the Netherlands, compared to Belgium, there is more access to psychiatric support (14/14 vs 11/22, P = 0.002), psychological care (13/13 vs 7/22, P < 0.001), and interpreter facilities (15/22 vs 0/14, P < 0.001). Prison doctors in both countries agree that the possibility for a strictly personal encounter with the patient - without the presence of other medical staff - can be very useful (21/22 in Belgium vs 15/15 in the Netherlands). In Belgium, individual consultations with the detainee are not possible.Conclusions: Compared to the situation in the Netherlands, the medical work of prison doctors in Belgium is characterized by time pressure and lack of psychiatric and psychological support. The absence of interpreter facilities in Belgium handicaps the quality of the primary health care in prisons. In addition, the lack of private encounters with a doctor in Belgian prisons violates the patient rights of the detainee.