6. Segregation for the Purpose of Medical Oversight

6.1 Segregation for the purpose of medical oversight
Section 60(1)

The Prison Manager (or his / her authorised delegate) may direct segregation for the purpose of medical oversight under section 60(1) of the Corrections Act 2004 if a medical officer of the prison recommends that a direction of this kind is desirable for either or both of the following reasons:

1. In order to assess or ensure the prisoner's physical health (section 60(1)(a));
2. In order to assess or ensure the prisoner's mental health, including, without limitation, the risk of self-harm (section 60(1)(b)).

Note: Under section 20 of the Corrections Act 2004 a medical officer of a prison must be a medical practitioner (i.e. a doctor, including a psychiatrist) registered with the Medical Council of New Zealand as a practitioner of the profession of medicine. A nurse, psychologist, or counsellor employed or engaged by the Department is not a medical officer for the purposes of the Corrections Act 2004.

To avoid doubt, any segregation direction made by the Prison Manager (or his / her authorised delegate) under section 60(1) for the purpose of medical oversight can only be made on the recommendation of the medical officer of the prison.

6.2 At-risk prisoners may not require segregation

It is important to note that in practical terms section 60 of the Corrections Act 2004 does not mean that prisoners considered to be at risk of self harm who are placed in a dedicated at-risk unit need to be so placed under a direction for segregation. This is because prisoners who are accommodated in an at-risk unit are able to associate with other prisoners in the unit under the unit's routines.

A direction under section 60(1)(b) of the Corrections Act 2004 is only required when a prisoner is either denied association with other prisoners altogether or is subject to a more restrictive routine (in terms of ability to associate with other prisoners) than the normal unit.

6.3 Prisoners at risk of self harm
Reg. 63

Where a prisoner who is, or may be, at risk of self-harm is subject to a segregation direction under section 60(1)(b) of the Corrections Act 2004, the following requirements of regulation 63 of the Corrections Regulations 2005 must be complied with:

• A suitable registered health professional must keep written notes of each visit to the prisoner under section 60(5)(b) of the Act and arrange for those notes to be placed on the prisoner's medical record; and
• A medical officer must visit the prisoner and prepare a report on the prisoner within 24 hours after the direction takes effect, unless a report has been prepared by the medical officer in connection with the decision to issue that segregation direction.
• A medical officer must record any recommendation or advice given under section 60(1) or 60(4) of the Act in relation to a prisoner who is or may be at risk of self-harm in the medical records of the prisoner concerned and arrange for a copy of any report prepared under sub clause (1)(b) to be put in the medical records of the prisoner.
• After visiting the prisoner a medical officer must recommend to the prison manager:
  • Whether or not the prisoner should be denied access, under section 69(2)(c) of the Act, to all or any of the minimum entitlements referred to in section 69, or, if the prisoner has already been denied access to all or any of those entitlements under section 69(2)(c), whether the prisoner should continue to be denied access to those entitlements; and
  • Whether or not the prisoner should be denied access to any other item.
• A medical officer must record the recommendation on the prisoner's prison record.

Note the difference between a "medical officer" and a "registered health professional" above:

• Under section 20 of the Corrections Act 2004 a medical officer of a prison must be a medical practitioner (i.e. a doctor, including a psychiatrist) registered with the Medical Council of New Zealand as a practitioner of the profession of medicine. A nurse, psychologist, or counsellor employed or engaged by the Department is not a medical officer for the purposes of the Corrections Act 2004.
• A registered health professional is defined by section 3(1) of the Corrections Act 2004 as a health practitioner who is, or is deemed to be, registered with an authority established or continued by the Health Practitioners Competence Assurance Act 2003 as a practitioner of a particular health profession - this would include a nurse employed or engaged by the Department.

6.4 Continuing segregation for medical oversight
Section 60

A segregation direction for the purpose of medical oversight continues in force while the prisoner continues to be detained in prison unless the prison manager or Chief Executive, or his or her delegate, revokes it.

The Prison Manager (or his / her authorised delegate) may not revoke a direction for segregation for the purpose of medical oversight, unless the medical officer advises that there has ceased to be any justification under section 60(1)(a) and/or section 60(1)(b) for continuing the direction (section 60(4) of the Act).

While a direction is in force, unless the medical officer directs otherwise, the prison manager must ensure that a registered health professional visits the prisoner at least once a day, or if the prisoner is assessed to be at-risk of self harm, at least twice a day.