Health Care in Canada’s Federal Prisons

The Office of the Correctional Investigator is mandated under Part III of the Corrections and Conditional Release Act to serve as an Ombudsman for federal offenders. Perhaps as long as two years ago, the OCI reported that a prison term, particularly a lengthy prison term, could knock ten years off the life of an offender. CSC’s own resources tend to support this. Lifestyle plays a role of course, but so too does the availability and delivery of health care within federal institutions.
Referring again to the Corrections and Conditional Release Act, Chapter 86, Section (1), The Service shall provide every inmate with, (a) essential health care, and, (b) reasonable access to non-essential mental health care that will contribute to the inmate’s rehabilitation and successful reintegration into the community. Also, Section (2), The provision of health care under SubSection (1) shall conform to professionally accepted standards.
In addition, Correctional Service of Canada’s Commissioner’s Directive 800 – Health Services, provides specifics which on paper do meet CSC’s argument that federal inmates receive the same levels of care as the rest of us, although there are exceptions such as dental care where what’s approved matches services available to persons in the community living on social assistance. Two of the big BUT’s are that delivery is uneven and inconsistent across the Service, and inmates must access health care personnel via non-health care staff members.
To cite only a couple of examples from Brennan Guigue’s (Rahim) own experience, many years ago he put in a request to see the dentist at Kingston Penitentiary. This wasn’t an emergency but he had concerns that needed an examination. It was seven months until he was in that dentist’s chair. Later, at Cowansville Institution in Quebec, he was taken to the local hospital for an x-ray of a shoulder on January 9 of 2014. The x-ray had been ordered by a doctor at Port-Cartier Institution in September of 2012. That’s not a typo…..2012! The injury had occurred months earlier, but his complaints had been ignored. This is a typical response, perhaps systemic, and can be attributed to any number of reasons like liability issues, budget factors (health care is a budget line item subject to performance bonus considerations), or explanations best left to speculation.
In any case, and understandably, the results of that x-ray wouldn’t be available to him until he saw the Cowansville Institution’s doctor. He’d asked for an appointment when he first arrived there in December of 2013, but that appointment was set for April…..as long as he wasn’t transferred to yet another prison.
An inmate in western Canada with whom I’ve corresponded discovered a lump is his groin in the fall of 2012. He was in pain and his requests for help were ignored. By January of 2013, he had his lawyer call the director/warden of his institution to persuade the system to act. It was cancer, he had surgery, but the delay puts him at risk for further tumors. As well, he had to initiate a court action in order to get proper pain relief.
Yet another inmate I’ve had contact with was asking for counseling as part of his preparation for reintegration into the community. He was turned down in more than one institution. He was released on parole and sent to one of the CCC (Community Correctional Centre) half-way houses which are operated by CSC in a number of cities. While there, the staff suggested he needed counseling, and set up a date weeks down the road, but the parolee was returned to prison for a minor infraction before the process could begin. He asked again for counseling while in custody, and again was told he didn’t need it. When his parole was reinstated to the same CCC half-way house, the staff there once more set up a far off date for counseling because, according to them, it was a necessary part of his reintroduction to the community. Once more, he was sent back to prison for a minor parole infraction, and once more he was told that he didn’t need counseling.
So, how does something like this happen? Well, consider that this counseling is covered under the provincial health care system when the inmate is in the half-way house, but CSC pays when that same person is in an institution. Confusing? Well, yes, if someone is trying to get on the right course, and after all, CSC is charged under the CCRA with helping offenders reintegrate.
The pressure on the prison health care system is about to get considerably worse. A disproportionately high number of prisoners are HIV+ or are infected with Hep C, or both. As expensive as the HIV anti-retrovirals are, there are a number of effective new drugs either available or awaiting approval to treat Hep C, and these can cost many tens of thousands of dollars. CSC will be squeezed by requests for treatment on the one hand, and calls for fiscal restraint on the other.
The bottom line here is simple. The next time you hear about prison inmates being treated to free and extensive health care, don’t be too quick to sign up. It could cost you your life!

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