Systemic failures in Dutch women’s prisons leave inmates without critical medical care

Medical neglect is a persistent and widespread issue in Dutch women’s prisons, according to Bureau Clara Wichmann (BCW). The organization, supported by Loonstein Advocaten and De Brauw Blackstone Westbroek, collected testimony from more than 50 current and former female prisoners, exposing a pattern of severe healthcare failures, as reported by Trouw.

One of the most alarming cases documented involves Carla, who screamed in agony throughout the night due to excruciating pain in her lower abdomen. Her cries for help were ignored until guards found her nearly unconscious in her cell the next morning. Only then was she rushed to a hospital, where doctors performed emergency surgery to remove an abscess on the verge of bursting. As a result, she continues to suffer from both physical and psychological trauma.

Another inmate, Danique, was allegedly given nothing but paracetamol despite screaming in pain from a serious intestinal condition. Hours later, she began vomiting black bile. Only then was an ambulance called. A doctor later told her she would not have survived had she been left untreated any longer.

“The fact that these incidents follow the same pattern shows that this is not a series of isolated failures—it is a structural issue,” said Lilianne Ploumen, a senior advisor at BCW and former minister, to Trouw.

One of the most dangerous flaws in the system, BCW found, is that prison guards—not medical professionals—determine whether an inmate’s health issue is serious enough to warrant treatment. If a guard dismisses a complaint, medical personnel may not even be informed. Outside of office hours, professional medical staff are often unavailable altogether.

“This is an unacceptable situation,” Ploumen said. “Medical care must be available at all times, just as it is outside prison walls. The state has a legal and moral obligation to provide adequate healthcare to prisoners.”

According to BCW, the Dutch prison system operates under a policy of providing only “medically necessary” care—defined as treatment that cannot be postponed. However, this vague standard allows cost-saving measures to override basic medical needs, leading to life-threatening delays in specialist care.

In 2016, the European Committee for the Prevention of Torture (CPT) criticized the Netherlands for substandard medical care in both men’s and women’s prisons. Nearly a decade later, many of the problems remain unresolved, Trouw wrote.

One major issue is the lack of a permanent on-site doctor in prisons, a policy change implemented to cut costs. Now, a rotating roster of external doctors is responsible for inmates, making continuity of care impossible. Patients often receive conflicting medical advice, and critical information is frequently lost between physician changes.

A failure to properly monitor medication also puts inmates at risk. The 2023 death of Suzanne de Vries, a young mother serving time in a Dutch prison, is an example. She was given a dangerously mismatched combination of medications without any doctor fully overseeing her treatment. She died as a result.

Compounding the crisis, BCW found that sedatives and painkillers are routinely prescribed to female prisoners—even those with a known history of addiction. De Vries, for example, was given morphine despite having recently undergone detoxification.

Ploumen called the practice “extremely troubling,” emphasizing that prisons should be working to help incarcerated women recover from substance abuse, not feeding their addictions.

BCW’s report also highlights the absence of gender-sensitive healthcare in women’s prisons. Many female inmates are survivors of sexual violence, yet they receive no specialized mental health support. The lack of trauma-informed care further exacerbates their suffering.

A recent study from Leiden University confirmed these findings, warning that the Dutch prison system fails to meet the specific healthcare needs of incarcerated women.

A spokesperson for the Dutch Custodial Institutions Agency (DJI) acknowledged BCW’s findings and said the agency had engaged in “very constructive conversations” with the organization. However, the spokesperson did not confirm whether any immediate action would be taken.

“Multiple valuable reports and recommendations have been made regarding women in detention,” the spokesperson stated. “DJI is working on much-needed improvements to women’s prisons.”

Ploumen, however, says vague promises are not enough. She is demanding immediate changes, including round-the-clock medical staffing, improved oversight of prescriptions, and the reintroduction of permanent prison doctors.

“These women are under the care of the state,” she told Trouw. “Their lives depend on the system working. Right now, the system is failing them.”