Protocols and regulations concerning extensions of hospital stay in “Thaksin’s 14th Floor” case inquired in fourth hearing of Supreme Court

The lawyer team said it holds firm on the arguments submitted to the Court, including the reference to the “Mandela Rules” as the court deliberation has entered halfway

The Supreme Court’s Criminal Division for Holders of Political Positions held its fourth hearing on Tuesday regarding witness testimony in a high-profile court deliberation concerning the extended hospital stay of Mr. Thaksin Shinawatra, the former Prime Minister, at the Police General Hospital’s 14th floor. Six current and former executives from the Corrections Department and the Corrections Hospital were summoned to testify before the Court.

They were the former Deputy Permanent Secretary of the Justice Ministry who is currently the Director General of the department, the former first and the third Deputy Director Generals of the department, a retired Prison Superintendent of Bangkok Remand Prison who was in charge of the prison during that time, the Deputy Director of the Hospital, and the Director of the Hospital at that time.

The Court inquired about the protocols and regulations concerning Mr. Thaksin’s hospital stay at the Police Hospital. His stay was extended multiple times — from 30 days to 60 days, then to 120 days, and beyond — until he left the hospital on February 18, 2024. This was six months after his admission on August 22, 2023, and one day after he was granted parole.

The fourth hearing followed the third session, in which the hospital transportation and hospital custody arrangements were inquired into by the Court last Tuesday. (Read: Supreme Court inquires into hospital transportation and hospital custody in third hearing of “Thaksin’s 14th Floor” case)

The hearing was once again lengthy as some of the witnesses hesitantly or digressively responded to the Court’s inquiries, while others were provided with critical documentary evidence to carefully go through to accompany their testimonies.

Due to the sensitivity of the information and the issues being discussed, the Court has tightened its order by imposing a ban on note-taking during witness testimonies. Previously, note-taking was permitted, but the dissemination of detailed witness accounts and related documentary evidence was prohibited. The Court cited concerns that such practices could impede its ability to uncover the complete truth from subsequent witnesses, cause public confusion, and disclose the confidential medical records of the offender. Nevertheless, the Court still allows observers and the press to attend the hearing.

Section 7

The Court began with the former Deputy Permanent Secretary of the Justice Ministry, who is now the Director General of the department. He served as the acting Director General while still at the ministry until he officially took the position in October 2023, nearly two months after Mr. Thaksin was incarcerated.

He played various roles at different times based on his positions. As the Deputy Permanent Secretary of the Justice Ministry, he was responsible for acknowledging the decision made by the department’s Director General to extend a hospital stay beyond 60 days. He then forwarded this decision to the Permanent Secretary of the ministry for acknowledgement.

This follows the Ministerial Regulation on the Transfer of Prisoners for Treatment Outside Prisons B.E. 2563 (2020), which outlines various decisions and actions regarding hospital stay extensions for inmates.

Section 7 of the Regulation states that if an inmate must stay for treatment at a prison treatment facility under Section 3 for a long period, the prison commander shall proceed as follows:

(1) If the patient is hospitalised for more than 30 days, a letter of approval must be submitted by the Director-General, together with the opinion of the treating physician and other relevant evidence.

(2) If the patient is hospitalised for more than 60 days, a letter of approval must be submitted by the Director-General, together with the opinion of the treating physician and other relevant evidence, and the Permanent Secretary must be notified.

(3) If the patient is hospitalized for more than 120 days, a letter of approval must be submitted by the Director-General, together with the opinion of the treating physician and other relevant evidence, and a report must be made to the Minister.

Section 3 of the Regulation addresses the priority for transferring inmates to a hospital, considering their treatment rights and the proximity of the facility.

The ministerial regulation was issued under the Corrections Act, B.E. 2560, Section 55. It states that if an inmate is sick, has mental health issues, or has a contagious disease, the prison commander must arrange for the inmate to receive a medical examination by a doctor as soon as possible. Furthermore, if the inmate requires specialised treatment or does not improve after receiving care within the prison, they shall be transferred to an appropriate treatment centre for their specific condition, a hospital, or a mental health treatment facility outside of the prison.

Section 2 of the Regulation provides additional details regarding Section 55, specifically outlining the conditions for hospital admissions and transfers. It emphasises that admissions to the prison’s medical facilities should be prioritised. It also states that inmates should be returned to the prison on the same day after receiving treatment. It also requires that the opinions of treating physicians be obtained to support the approval of hospital admissions outside of the prison.

As confirmed by the department’s executives who attended the Court on Tuesday, they follow Section 55 and the Regulation to guide their decisions and actions in this matter.

The Director General

As the Director General of the department, who took on the role in October 2023—almost two months after Mr. Thaksin’s admission to prison—the then deputy permanent secretary was responsible for considering and approving an extension of Mr. Thaksin’s hospital stay beyond 120 days in late December.

The Court inquired with him about the protocol he proceeded to extend Mr. Thaksin’s hospital stay beyond 120 days. The Court further questioned how he consulted with a panel established to support his decision, how he considered opinions from the patient’s doctors at the Police Hospital regarding the necessity for surgery on an organ (neck) despite his health complications, and how these factors justified Mr. Thaksin’s health conditions and the need for an extended hospital stay. Additionally, the Court asked him to explain how he assessed the capabilities of the Department of Corrections Hospital compared to those of the Police Hospital. Finally, the Court inquired whether he followed up on Mr. Thaksin’s health conditions after approving to determine if it was still necessary for him to remain at the Police Hospital.

The Court also asked about the legal grounds he used to make his decision, including Section 55 and relevant regulations. Additionally, he referenced the “Mandela Rules” in his reasoning and noted that he did not intervene against the doctors’ opinions or medical treatment given to Mr. Thaksin. (As noted by the UN, the Nelson Mandela Rules represent the universally acknowledged blueprint for prison management in the 21st century, outlining minimum prison conditions, providing guidance, and setting clear benchmarks for prison staff on how to uphold safety, security and human dignity for prisoners.)

The Court spent about an hour questioning him, as he occasionally struggled to respond to its inquiries. Afterwards, the Court moved on to the next witness, who was the Deputy Director General and the department’s spokesperson at that time. The Court inquired with him about his role in holding a press conference regarding Mr. Thaksin’s hospital transfer and his involvement in deciding to extend Mr. Thaksin’s hospital stay beyond 30 days on behalf of the Director General, who was unavailable at that moment.

The Court was informed about the role of the department’s panel in assisting him to justify his decision before receiving additional documentary evidence from him. The Court further questioned him about how he considered the opinion suggesting that Mr. Thaksin needed surgery and post-treatment on an external organ (finger). This was different from the matter addressed in the opinions supporting the 120-day extension proposal from the patient’s doctors at the Police Hospital. The Court asked how he compared the capabilities of the Department of Corrections Hospital with those of the Police Hospital, and whether he followed up on Mr. Thaksin’s health conditions after approving the extension to determine if it was still necessary for him to remain at the Police Hospital.

After spending approximately 30 minutes questioning him, the Court then proceeded to the third witness. This witness is the Deputy Director General of the department who approved the extension of Mr. Thaksin’s hospital stay beyond 60 days in late October for his shoulder surgery. He was acting on behalf of the Director General, who was still serving as the Deputy Permanent Secretary at the ministry at that time (the first witness).

The Court questioned him similarly to the second witness but spent more time with him, as he sometimes provided digressive responses to inquiries, leading the Court to repeat questions and remind him to answer directly.

The Prison Warden

After spending an hour questioning him, the Court moved on to the fourth witness, who was the Prison Warden at that time. The Court received information about Mr. Thaksin’s admission to the prison on August 22, including details about the procedures that took place, including his prison registration and health checks conducted in the late morning.

The Court inquired with him about his awareness of Mr. Thaksin’s deteriorating health conditions during the night and his role in issuing an order for corrections officials and warders to be on standby on the evening of August 22, prior to the incident.

He was also questioned about his role in preparing the initial assessments that accompanied the Director General’s decisions to extend Mr. Thaksin’s hospital stays during those multiple periods. Additionally, he chaired the department’s panel that evaluated his parole, which was issued one day before Mr. Thaksin left the Police Hospital.

The Court further inquired how he justified Mr. Thaksin’s health conditions and the necessity for extended hospital stays. It also asked how he assessed the capacity of both the Department of Corrections Hospital and the Police Hospital. Additionally, the Court questioned whether he monitored Mr. Thaksin’s health to determine if it was still necessary to propose extensions for his stays at the Police Hospital.

The Court also asked about the legal basis for his consideration of hospital stay proposals and parole, including Section 55 and the relevant regulations.

The Court questioned him for about an hour before adjourning the morning session. In the afternoon, the hearing resumed for the last two witnesses, who are doctors at the Department of Corrections Hospital.

In a capacity as the Deputy Director of the Hospital and a cardiac doctor, the fifth witness was questioned about his consultation role in the Director-General’s panel in late December for the extension of Mr. Thaksin’s hospital stay beyond 120 days. He was also asked about his opinions based on the note of the nurse at the prison, and the doctors’ progress notes and the nurses’ notes at the Police Hospital to assess Mr. Thaksin’s actual health conditions, the capacity of the Department of Corrections Hospital to provide medical treatment to Mr. Thaksin, and the needs for him to have and continue medical treatment outside the prison.

The Court also questioned the sixth witness, who was the Director of the Department of Corrections Hospital at that time. He appeared hesitant to answer the Court’s questions directly, but eventually provided a response similar to that of the first doctor. The Court spent approximately two hours with them before concluding the session.

No Concern or Endgame?

The fourth session lasted nearly six hours in total. During this time, various protocols and regulations were discussed, along with justifications for Mr. Thaksin’s prolonged hospital stays. Some witnesses hesitated to respond to the Court’s questions, opting for silence, while others claimed they were unaware of the issues being addressed or could not recall the specific details of the incidents in question.

The next session of the court hearing, the fifth, will be held this Friday.

Mr. Thaksin’s lawyer’s team said the case was not a concern as it is the fact that Mr. Thaksin was sick and he had received treatments in accordance with the law. As the court deliberation has entered halfway, the team still holds firm on the arguments submitted to the court, including the reference to the “Mandela Rules”. Asked how Mr. Thaksin’s has responded to the hearings so far, the lead lawyer, Winyat Chatmontree just replied: “He has had no comments.”

Mr. Thaksin’s opponents, including Dr. Warong Dechgitvigrom, expressed after the hearing that the case is nearing its “endgame.” They believe that the facts regarding his actual illness, its severity, and the justifications for his extended hospital stays have been thoroughly clarified through the witness testimonies.