As it is now, says Public Safety Director George Iranon, Thorburn, a University of Hawaii medical school professor, "is serving two bosses. That's ridiculous."
Thorburn has worked for the department under contract since March 1987. She resigned last month in a dispute with prison bosses over medical autonomy but agreed to remain until the contract ends June 30.
Her departure isn't likely to end conflict over medical autonomy. The Hawaii Medical Association says Thorburn is an expert in prison health care and her concerns can't be ignored. National standards and medical autonomy must be maintained, the group said.
Attorney Dan Foley, long involved in Hawaii prison reforms, said Iranon is "second-guessing his medical director" and, according to prison accreditation reports, guards are deciding whether inmates have medical problems and should go to medical units.
"That is what the consent decree was all about in 1985," Foley said. "You can't do that."
He also pointed out that Thorburn's contract position was created because there were no takers for a civil service medical administrator's job 10 years ago. She was hired because prison improvements were ordered after a 1984 lawsuit by the Hawaii American Civil Liberties Union and National Prison Project.
Alvin Bronstein, former prison project executive director, said he told state officials the consent decree medical plan requires a full-time medical director in a contract position and "expressly not a civil service position."
Public Safety officials interpret the plan differently, said department spokesman Gregg Takayama. Also, he said, the department has inquiries from physicians about the potential opening.
Friction apparently developed between Thorburn and Iranon after he succeeded George Sumner as Public Safety chief.
In a letter to the governor, Rep. Dennis Arakaki said he's "perplexed" because Sumner called Thorburn "'the best correctional medical director in the United States.' Yet, for whatever reason . . . George Iranon not only ignores her counsel but seems to have actively waged war against her."
Iranon said his relationship with Thorburn "has been misconstrued." He said she "does good work" but "our styles are different as far as what I want to do. . . . My feeling is, if there's a better way of doing it, let's try to do it."
Thornburn said a lot of problems occurred because Iranon wouldn't sign "essential standards" - medical autonomy and protection of inmates' medical information - for recertification of Oahu's four prisons by the National Commission on Correctional Health Care.
Thorburn says medical autonomy is fundamental in prisons; Iranon says he's trying to balance medical concerns with security concerns.
Autonomy is essential, Thorburn said, because it "provides a balance to operations that can get out of control" and protects against liability for failing to act on health matters. She said the body-cavity search policy also is important and Iranon wants to change it from a medical to a security policy - a violation of standards.
Iranon said the department should have access to medical information on a need-to-know basis for investigations and prosecution.
"The current policy prevents even the director from getting it (without a subpoena)."
Other states allow it, he said, adding that safeguards can be provided for confidentiality.
He said cavity searches would be a last resort but are needed at times to detect drug-smuggling.
Thorburn said increased strife between security and health staff has made it "harder to do things." She believes alleged guard abuse of inmates and two inmate suicides in Halawa prison's maximum-security unit last year occurred because medical personnel were restricted from the area.
Thorburn and Halawa's acting chief medical officer, Terence Allen, spoke out about inmate beatings and interference. Critics say one of the problems is that Allen is Thorburn's husband.
Iranon said his department is investigating the allegations with the attorney general's office.