The dance of change in penitentiary care: window dressing or a new penitentiary care recipe?

Titolo Rivista STUDI ORGANIZZATIVI
Autori/Curatori Rocco Palumbo, Carmela Annarumma, Paola Adinolfi
Anno di pubblicazione 2018 Fascicolo 2017/2
Lingua Inglese Numero pagine 27 P. 17-43 Dimensione file 258 KB
DOI 10.3280/SO2017-002002
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This paper examines the complex and ongoing process of institutional and or-ganizational change which concerns the provision of health services to inmates hosted by Italian prisons. In particular, the reality and the appearance of organiza-tional change are confronted. The Law no. 419, dated November, 30th 1998 launched a deep reconfiguration of penitentiary health services, in an attempt to: 1) guarantee the provision of appropriate care to inmates; 2) merge the former Italian Penitentiary Health Care System and the Italian National Health Service (INHS); 3) introduce innovative organizational models to meet the special health needs of the imprisoned population; and 4) increase the timeliness and effectiveness of health and social services provided to inmates. The contents of the Italian reform are consistent with the worldwide transition from an approach that conceives imprisonment as a mere punishment to the guilty toward an understanding of personal detention as a process of inmates’ rehabilitation. However, the drawbacks of the reform on the ability of penitentiary health care units to meet the inmates’ health needs have been overlooked. Also, the potential clash between the penal institutions and the entities operating within the INHS has been neglected by both scholars and practitioners. This paper tries to fill such a gap, discussing the illustrative experience of a penal institution operating in Southern Italy. The reform of penitentiary care proposed an innovative recipe for health protection and promotion. Nonetheless, the lack of some essential ingredients of this recipe leads to question whether the organizational change of penitentiary care is real or it is merely apparent.

Il presente lavoro si propone di analizzare il complesso e tuttora in atto processo di cambiamento organizzativo e istituzionale che concerne i servizi di assistenza sanitaria negli istituti di pena italiani. La Legge 419 del 30 Novembre 1998 ha dato avvio a una profonda riorganizzazione della sanità penitenziaria, nel tentativo di: 1) garantire la prestazione di servizi di assistenza sanitaria appropriati; 2) includere il sistema sanitario penitenziario all'interno del Servizio Sanitario Nazionale; 3) introdurre modelli organizzativi innovativi, nell'intento di accrescere la capacità di soddisfazione dei bisogni di assistenza dei ristretti; e 4) accrescere l'efficacia e la tempestività dei servizi di assistenza erogati. I contenuti della riforma italiana sono in linea con la transizione - su scala globale - da una concettualizzazione retributiva della pena detentiva a un'interpretazione riabilitativa di quest'ultima. Tuttavia, il potenziale conflitto tra gli istituti di pena e gli attori che agiscono all’interno del Servizio Sanitario Nazionale è stato sottovalutato sia in letteratura che nella pratica professionale. Analogamente, le ripercussioni della riorganizzazione della sanità penitenziaria sulla capacità degli istituti di pena di soddisfare le particolari esigenze di salute dei detenuti è stata trascurata. L’articolo si propone di contribuire a colmare il gap nella letteratura scientifica, discutendo l’esperienza di un istituto di pena attivo nel Mezzogiorno italiano. La riforma della sanità penitenziaria in Italia ha ispirato la formulazione di una nuova ricetta per la tutela e la promozione della salute in carcere. D'altronde, alcuni ingredienti fondamentali per l'implementazione di siffatta ricetta non sono tuttora disponibili, impedendo la riorganizzazione dei servizi di sanità penitenziaria.

Keywords:Servizi di assistenza sanitaria; stato di salute dei ristretti; cambiamento organizzativo; isomorfismo.

  1. Anno, B.J. (1991), Prison Health Care: Guidelines for the Management of an Adequate Delivery System, Chicago, IL, National Commission on Correctional Health Care.
  2. Ashworth, R., Boyne, G., Delbridge, R. (2009), “Escape from the Iron Cage? Organizational Change and Isomorphic Pressures in the Public Sector”, Journal of Public Administration Research and Theory, 19(1): 165-187,
  3. Baybutt, M., Acin, E., Hayton, P., Dooris, M. (2014), “Promoting health in pris-ons: a settings approach”, in Enggist, S., Møller, L., Galea, G., Udesen, C. (eds.), Prison and Health (pp. 180-184), Copenhagen, WHO Regional Of-fice for Europe.
  4. Bignami, O., Argiropoulos, D. (2016), “Percezione della salute e bisogni relazionali in carcere”, Autonomie locali e servizi sociali, 1: 111-128, DOI: 10.1447/83850
  5. Bjørngaard, J., Rustad, A., Kjelsberg, E. (2009), “The prisoner as patient - a health services satisfaction survey”, BMC Health Services Research, 9(1): 176, DOI: 10.1186/1472-6963-9-176
  6. Bowen, G.A. (2009), “Document Analysis as a Qualitative Research Method”, Qualitative Research Journal, 9(2): 27-40, DOI: 10.3316/QRJ0902027
  7. Carbognin, C. (2010), “Riforme, progettazione organizzativa e manutenzione evolutiva nelle Pubbliche Amministrazioni: quattro casi concreti, la gestione del cambiamento e il ruolo della dirigenza pubblica”, Studi Organizzati-vi, 12(1): 153-158. DOI: 10.3280/SO2010-001007
  8. Castelli, C. (2010), “Il sogno: la promozione e la gestione del cambiamento organizzativo negli Uffici Giudiziari italiani”, Studi Organizzativi, 12(1): 171-175, DOI: 10.3280/SO2010-001010
  9. Choudhry, K., Armstrong, D., Dregan, A. (2017), “Prison Nursing: Formation of a Stable Professional Identity”, Journal of Forensic Nursing, 13(1): 20–25, DOI: 10.1097/JFN.0000000000000140
  10. Condon, L., Hek, G., Harris, F. (2008), “Choosing health in prison: Prisoners' views on making healthy choices in English prisons”, Health Education Journal, 67(3): 155-166, DOI: 10.1177/0017896908094633
  11. Cowman, A., Walsh, E. (2013), “Patient and public involvement in prison health care”, Primary Health Care, 23(3): 26-31,
  12. Coyle, A. (2014), “Standards in prison health: the prisoner as a patient”, in Eng-gist, S., Møller, L., Galea, G., Udesen, C. (eds.), Prison and Health (pp. 6-10), Copenhagen, WHO Regional Office for Europe.
  13. Crescimbeni, P. (2010), “L’organizzazione che supporta il cambiamento: il modello INPDAP”, Studi Organizzativi, 12(1): 164-170, DOI: 10.3280/SO2010-001009
  14. Cressey, D.R., Galtung, J. (1961), The prison; studies in institutional organization and change, New York, Holt, Rinehart and Winston.
  15. Cullen, F.D., Gilbert, K.E. (2013), Reaffirming rehabilitation, Waltham, MA, Anderson Publishing.
  16. Cunningham, J.B., Kempling, J.S. (2009), “Implementing change in public sector Organizations”, Management Decision, 47(2): 330-344, DOI: 10.1108/00251740910938948
  17. Damanpour, F., Walker, R.M., Avellaneda C.N. (2009), “Combinative Effects of Innovation Types and Organizational Performance: A Longitudinal Study of Service Organizations”, Journal of Management Studies, 46(4): 650-675,
  18. de Arruda, A.J.C.G., da Silva, C.C., de Souza, M.C., da Fonseca, L.C.T., de San-tana, S.C. (2017), “Incarcerated Health: Profile of the Multidisciplinary Team Provider of Health Assistance in Prisons”, International archives of Medicine, 10(41), DOI: 10.3823/2311
  19. De Luca, L., Saita, E., Graffigna, G. (2017), “Representations and feelings related to organizational change: A Grounded Theory study with Italian prison workers”, Bollettino di Psicologia Applicata, 65(278): 14-23.
  20. De Viggiani, N. (2007), “Unhealthy prisons: exploring structural determinants of prison health”, Sociology of Health and Illness, 29(1): 115-135,
  21. Destler, K.M. (2016), “Creating a Performance Culture Incentives, Climate, and Organizational Change”. American Review of Public Administration, 46(2): 201-225, DOI: 10.1177/0275074014545381
  22. Diefenbach, T. (2009), “New Public Management in Public Sector Organizations: The Dark Sides of Managerialistic ‘Enlightenment’”, Public Administration, 87(4): 892-909,
  23. DiMaggio, P.J., Powell, W.W. (1983), “The iron cage revisited: Institutional isomorphism and collective rationality in organizational fields”, American Sociological Review, 48(2): 147-160.
  24. Duffee, D. (1974), “The Correction Officer Subculture and Organizational Change”, Journal of Research in Crime and Delinquency, 11(2): 155-172, DOI: 10.1177/002242787401100206
  25. Dul, J., Hak, T. (2008), Case Study Methodology in Business Research, Burling-ton, MA, Elsevier.
  26. Elger, B.S., Ritter, C., Stöver, H. (2017), Emerging Issues in Prison Health, Dordrecht, Springer.
  27. Enggist, S., Møller, L., Galea, G., Udesen, C. (2014), Prisons and Health, Copenhagen, WHO Regional Office for Europe.
  28. Esposito, M. (2010), “The Health of Italian Prison Inmates Today: A Critical Approach”, Journal of Correctional Health Care, 16(3): 230-238, DOI: 10.1177/1078345810366867
  29. Esposito, M. (2014), “The Rehabilitation Role of Punishment in Prisons in Italy. Theoretical Development and Sociological Considerations”, Sociology Mind, 4(2): 183-191,
  30. Etzioni, A. (1961), A Comparative Analysis of Complex Organizations, Glencoe, IL, The Free Press.
  31. Farrington, K. (2012), “Modern Prison as Total Institution? Public Perception Versus Objective Reality”, Crime and Delinquency, 1: 6-26, DOI: 10.1177/0011128792038001002
  32. Faulkner, P.L., Faulkner, W.R. (1997), “Effects of Organizational Change on Inmate Status and the Inmate Code of Conduct”, Journal of Crime and Justice, 20(1): 55-72, DOI: 10.1080/0735648X.1997.9721565
  33. Fernandez, S., Rainey, H.G. (2006), “Managing Successful Organizational Change in the Public Sector”, Public Administration Review, 66(2): 168-176,
  34. Ferracuti, S., Biondi, M. (2015), “Dove vogliamo andare? Il DPCM dell’1/4/2008 è una spada a doppio taglio”, Rivista di Psichiatria, 50(3), 101-102.
  35. Forlini, M.P. (2011), “Il passaggio della sanità penitenziaria al Servizio Sanitario Nazionale nella Regione Abruzzo”, Autonomie Locali e Servizi Sociali, 1(3): 133-142, DOI: 10.1447/35076
  36. Fraser, A. (2014), “Primary Health Care in Prison”, in Enggist, S., Møller, L., Galea, G., Udesen, C. (eds.), Prison and Health (pp. 173-179), Copenhagen, WHO Regional Office for Europe.
  37. Frumkin, P., Galaskiewicz, J. (2004), “Institutional Isomorphism and Public Sec-tor Organizations”, Journal of Public Administration Research and Theory, 14(3): 283-307,
  38. Gardner, M.R. (1976), “The Renaissance of Retribution – An Examination of Doing Justice”, Wisconsin Law Review, 56: 781-815.
  39. Goffman, E. (1961), “On the Characteristics of Total Institutions”, in National Research Council (ed.), Symposium on Prevention and Social Psychiatry (pp. 43-84), Washington, DC, Walter Reed Army Institute of Research.
  40. Heckman, J.L. (2013), Competing Logics and Organizational Failure: The Structuring of California Prison Health Care, dissertation presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy, “Anneberg School for Communication and Journalism”, Los Angeles (CA), University of Southern California. Retrieved from: http://digitallibrary.usc.edu/cdm/ref/collection/p15799coll3/id/251645. Last accessed: July, 25th 2017.
  41. Hallevy, G. (2013), “General purposes of punishment”, in Hallevy, G. (ed.), The right to be punished (p. 15-56), London, Springer.
  42. Hayes, A.J. (2017), “Aging Inside: Older Adults in Prison”, in Elger B., Ritter C., Stöver H. (eds.) Emerging Issues in Prison Health (pp. 1-12), Dordrecht, Springer.
  43. Hays, P.A. (2004), “Case study research”, in de Marrais, K.B., Lapan, S.D., Foundations for research: Methods of inquiry in education and the social sciences (pp. 217-234), Mahwah, NJ, Lawrence Erlbaum Associates.
  44. Hean, S., Ødegård, A., Willumsen, E. (2017), “Improving collaboration between professionals supporting mentally ill offenders”, International Journal of Prisoner Health, 13(2): 91-104, DOI: 10.1108/IJPH-12-2016-0072
  45. Hepburn, J.R. (1985), “The Exercise of Power in Coercive Organizations: A Study of Prison Guards”, Criminology, 23(1): 145.164,
  46. Howell, P. (2016), “The Impact of Coercive Isomorphism on the Interorganizational Network Effectiveness of Accountable Care Organizations”, UB School of Management Review, 1(1): 96-111.
  47. Italian National Committee of Bioethics (2013), La salute dentro le mura, Rome, Italian Council of Ministers.
  48. Kuipers, B. S., Higgs, M., Kickert, W., Tummers, L., Grandia, J., Van der Voet, J. (2014), “The Management of Change in Public Organizations: A Literature Review”, Public Administration, 92(1): 1-20,
  49. Lægreid, P., Sarapuu, K., Rykkja, L., Randma-Liiv, T. (2014), Organizing for Coordination in the Public Sector. Practices and Lessons from 12 Europe-an Countries, New York, NY, Palgrave Macmillan.
  50. Lindquist, C.H., Lindquist, C.A. (1999), “Health behind bars: utilization and evaluation of medical care among jail inmates”, Journal of Community Health, 24(4): 285-303, DOI: 10.1023/A:1018794305843
  51. MacFarlane, I.A. (1996), “The development of healthcare services for diabetic prisoners”, Postgraduate Medical Journal, 72: 214-217.
  52. Marshall, T., Simpson, S., Stevens, A. (2001), “Use of health services by prison inmates: comparisons with the community”, Journal of Epidemiology & Community Health, 55(5): 364-365,
  53. Mei, X., Iannaccone, B., Stohr, M.K., Hemmens, C., Hudson, M., Collins, P.A. (2017), “Confirmatory Analysis of an Organizational Culture Instrument for Corrections”, The Prison Journal, 97(2): 247-269, DOI: 10.1177/0032885517692831
  54. Meyer, J., Rowan, B. (1977), “Institutional organizations: Formal structure as myth and ceremony”, American Journal of Sociology, 83(2): 340-363.
  55. Muro, P., Enjuanes, J., Morata, T., Palasí, E. (2016), “Health Promotion in a Prison Setting: Experience in Villabona prison”, Health Education Journal, 75(6): 712-720, DOI: 10.1177/0017896915615150
  56. Morin, K.M. (2013), “‘Security Here is Not Safe’: Violence, Punishment, and Space in the Contemporary US Penitentiary”, Environment and Planning D: Society and Space, 31(3): 381-399,
  57. Oliver, C. (1991), “Strategic Responses to Institutional Processes”, Academy of Management Review, 16(1): 145-179, DOI: 10.2307/258610
  58. Opperman, G. (2014), “Change Your Prison, Change Your Outcomes, Change Your Community”, Economic Affairs, 34(2): 224-234,
  59. Palumbo, R. (2013), “Dalla ‘cura’ all’empowerment del paziente in vinculis: prospettive evolutive dell’assistenza sanitaria negli istituti di pena italiani”, Mecosan, 87: 29-43.
  60. Palumbo, R. (2015), “Reforming penitentiary health. The transition from ‘cure’ to ‘care’ in Italian prisons”, International Journal of Healthcare Management, 8(4): 232-243, DOI: 10.1179/2047971915Y.0000000005
  61. Pearce, J.L. (1983), “Comparing Volunteers and Employees in a Test of Etzioni's Compliance Typology”, Nonprofit and Voluntary Sector Quarterly, 12(2), 22-30, DOI: 10.1177/089976408301200204
  62. Piening, E.P. (2013), “Dynamic Capabilities in Public Organizations. A literature review and research agenda”, Public Management Review, 15(2): 209-245, DOI: 10.1080/14719037.2012.708358
  63. Piscopo, G., Palumbo, R., Ambrosino, G. (2013), “La motivazione al lavoro dei medici penitenziari: un'indagine presso gli istituti penitenziari della Regione Campania”. Mecosan, 88: 55-70.
  64. Pont, J., Stöver, H., Wolff, H. (2012), “Dual Loyalty in Prison Health Care”, American Journal of Public Health, 102(3): 475-480, DOI: 10.2105/AJPH.2011.300374
  65. Rebora, G., Meneguzzo, M. (1990), Strategia delle Amministrazioni Pubbliche, Milan, Egea.
  66. Reed, J. (1997), “The quality of health care in prison: results of a year’s programme of semi-structured inspections”, British Medical Journal, 315(1420),
  67. Robertson, P.J., Seneviratne, S.J. (1995), “Outcomes of Planned Organizational Change in the Public Sector: A Meta-Analytic Comparison to the Private Sector”, Public Administration Review, 55(6): 547-558, DOI: 10.2307/3110346
  68. Rogan, M. (2017), “Human rights and correctional health policy: a view from Europe”, International Journal of Prisoner Health, 13(1): 3-9, DOI: 10.1108/IJPH-08-2016-0049
  69. Ross, M.W. (2011), “Pedagogy for Prisoners: An Approach to Peer Health Edu-cation for Inmates”, Journal of Correctional Health Care, 17(1): 6-18, DOI: 10.1177/1078345810378251
  70. Rubin, A.T. (2015), “A Neo-Institutional Account of Prison Diffusion”, Law & Society Review, 49(2): 365-400,
  71. Rubin, A.T. (2014), “Three Waves of American Prison Development, 1790-1920”, in Deflem, M. (ed.), Punishment and Incarceration: A Global Perspective (pp. 139-158), Bingley, Emerald Publishing.
  72. Santora, L., Arild Espnes, G., Lillefjell, M. (2014), “Health Promotion and Prison Settings”, International Journal of Prison Health, 10(1): 27-37,
  73. Shereen, S., Razdha, P. (2014), “Imprisonment and Health: Issues and Concerns”, International Journal of Advanced Research in Management and Social Sciences, 3(9): 121-140.
  74. Signori, R. (2016), “Autorità e identità in carcere. Le risposte ai cambiamenti organizzativi del personale di polizia penitenziaria”, Etnografia e Ricerca Qualitativa, 2: 249-266, DOI: 10.3240/84120
  75. Slack, T., Hinings, B. (1994), “Institutional Pressures and Isomorphic Change: An Empirical Test”, Organization Studies, 15(6): 803-827, DOI: 10.1177/017084069401500602
  76. South, J., Woodall, J., Kinsella, K., Bagnall, A.M. (2016), “A qualitative synthesis of the positive and negative impacts related to delivery of peer-based health interventions in prison settings”, BMC Health Services Research, 16(525),
  77. Starnini, G. (2009), “Il passaggio della sanità penitenziaria al Servizio Sanitario Nazionale”, Autonomie Locali e Servizi Sociali, 1(1): 3-14.
  78. The Lancet (2005), “Prison health: a threat or an opportunity?”, The Lancet, 366(9479): 1, DOI: 10.1016/S0140-6736(05)66795-5
  79. Thomas, E.H., Wang, E.A., Curry, L.A., Chen, P.G. (2016), “Patients’ experiences managing cardiovascular disease and risk factors in prison”, Health & Justice, 4(4),
  80. Trulson, C.R., Marquart, J.W. (2010), “Who rules the Joint Revisited: Organizational Change and the Importance of Prison Leadership”, International Journal of Punishment and Sentencing, 6(3): 71-83.
  81. Tunick, M. (2016), “Should We Aim for a Unified and Coherent Theory of Punishment?”, Criminal Law and Philosophy, 10(3): 611-628,
  82. van de Ven, A.H., Huber, G.P. (1990), “Longitudinal Field Research Methods for Studying Processes of Organizational Change”, Organization Science, 1(3): 213-219,
  83. van de Ven, A.H., Poole, M.S. (1995), “Explaining Development and Change in Organizations”, Academy of Management Review, 20(3): 510-540, DOI: 10.2307/258786
  84. Van der Voet, J., Kuipers, B.S., Groeneveld, S. (2016), “Implementing Change in Public Organizations: The relationship between leadership and affective commitment to change in a public sector context”, Public Management Review, 18(6): 842-865, DOI: 10.1080/14719037.2015.1045020
  85. Venter, H. (2016), “A Three-Dimensional Action Plan to Raise the Quality of Care of US Correctional Health and Promote Alternatives to Incarceration”, American Journal of Public Health, 106(4): 613-614, DOI: 10.2105/AJPH.2016.303076
  86. Voller, F., Silvestri, C., Martino, G., Fanti, E., Bazzerla, G., Ferrari, F., et al. (2016), “Health conditions of inmates in Italy”, BMC Public Health, 16(1162),
  87. Watson, R., Stimpson, A., Hostick, T. (2004), “Prison health care: a review of the literature”, International Journal of Nursing Studies, 41(2): 119-128, DOI: 10.1016/S0020-7489(03)00128-7
  88. Weiner, B., Graham, S., Reyna, C. (1997), “An attributional examination of retributive versus utilitarian philosophies of punishment”, Social Justice Re-search, 10(4): 431-452, DOI: 10.1007/BF02683293
  89. Wettenhall, R. (2003), “Exploring Types of Public Sector Organizations: Past Exercises and Current Issues”, Public Organization Review: A Global Journal, 3(3): 219-245, DOI: 10.1023/A:1025333414971
  90. White, K.L., Jordens, C.F., Kerridge, I. (2014), “Contextualising Professional Ethics: The Impact of the Prison Context on the Practices and Norms of Health Care Practitioners”, Journal of Bioethical Inquiry, 11(3): 333-345,
  91. Woodall, J. (2016), “A critical examination of the health promoting prison two decades on”, Critical Public Health, 26(5): 615-621, DOI: 10.1080/09581596.2016.1156649
  92. Woodall, J., de Viggiani, N., Dixey, R., South, J. (2014), “Moving prison health promotion along: towards an integrative framework for action to develop health promotion and tackle the social determinants of health”, Criminal Justice Studies, 27(1): 114-132, DOI: 10.1080/1478601X.2013.873208
  93. Woodall, J. Dixey, R. (2017), “Advancing the health-promoting prison: a call for global action”, Global Health Promotion, 24(1): 58-61, DOI: 10.1177/1757975915581760
  94. World Health Organization (2014), Prisons and Health, Copenhagen, WHO Regional Office for Europe.
  95. Yin, R.K. (2014), Case study research: Design and methods, Thousand Oaks, CA, Sage Publishing.
  96. Yin, R.K. (2011), Applications of Case Study Research, Los Angeles, CA, Sage Publications..

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Rocco Palumbo, Carmela Annarumma, Paola Adinolfi, The dance of change in penitentiary care: window dressing or a new penitentiary care recipe? in "STUDI ORGANIZZATIVI " 2/2017, pp 17-43, DOI: 10.3280/SO2017-002002