If the health care unit in Toronto South Detention Centre, Ontario’s 2 year-old superjail located in the southwest corner of the city, was moved to a location outside the institution, let’s say two kilometers or so away at the corner of Islington and Evans Avenues, and was open to the public, it would be a health care clinic threatened with a criminal investigation.

Strong words, yes, and not the first time we’ve addressed the subject. Ameliorating this critique if only a little, it may be unfair to single out this one penal institution when other provincial jails are comparable. TSDC, though, is supposed to be the end-all and be-all for custodial management in Ontario, and is an easy target.

While we are unaware of how jails in other provinces and territories stack up, we can speak to health care in our federal prisons under the domain of Correctional Service of Canada. This won’t be a lengthy analysis of any shortcomings to the health care our prison populations can access, but rather challenges bureaucratic misrepresentations of the quality of care in Ontario and federal institutions.

Prison populations have higher rates of mental health issues, substance abuse and communicable diseases than the community at large. This circumstance has been a constant, and subject to numerous studies. Fiona Kouyoumdjian, a postdoctoral fellow with the Centre for Research on Inner City Health of St. Michael’s Hospital in Toronto, has recently released the first-of-its-kind comprehensive portrait of prisoner health across the country. Nothing in this paper is new to jail/prison administrators, but the ‘party line’ everywhere has always been that inmates get the same level of health care as the general population.

This just isn’t true. Not only that, but these same administrators know it.

To cite only one example in the federal penal system, we had an ongoing letter exchange over a few years with an inmate in Agassiz, British Columbia. He was diagnosed with testicular cancer at one point during his sentence, and had to retain his lawyer and take Correctional Service of Canada to court in order to get the surgery he needed and the necessary after-care.

As for Ontario, we’ll go into more detail. Mary Dwyer is the current manager of health care services at the Toronto South Detention Centre. She came to our attention when she testified in early February in an action by a TSDC inmate looking for redress from the lack of proper medical care in the institution, particularly during lockdowns which are rampant there. Lauren Callighen, a spokesperson for the ministry, when asked for a comment, said, “We work hard every day to ensure that inmates receive the same access to health care in our institutions as they would in the community.” I believe firefighters were then called to her office to extinguish the flames from the lightning strike.

The court’s decision is pending in that case, but we contacted Mary Dwyer for another inmate in a similar situation at TSDC. This particular inmate had more than one health concern but of immediate import was an infected pre-molar in his fourth quadrant. He had been able to pierce the infection with a sharpened staple and was able to drain the puss every couple of days. He made two requests to see the dentist, plus a dental referral was placed in his file by a doctor at the institution. It still took almost four weeks before he got some attention. The inmate was put on penicillin for seven days and then left for another two weeks before he saw the dentist again, and the infection returned in the meantime. This has been ongoing now since the beginning of February.

I pointed out to Ms Dwyer that, in the same situation, she would have seen her dentist the day an infection became apparent. Nonetheless, her email response to mine included this: “I can say that the Toronto South Detention Centre takes the healthcare concerns of all inmates in our care very seriously.”

Consider that the Ontario Ombudsman’s 2014-2015 Annual Report noted there were 2138 health care complaints from inmates in Ontario’s jails during that reporting period. Consider that not all healthcare complaints end up crossing the ombudsman’s desk. Consider that, unlike the federal system where there is some recourse for prisoners, Ontario’s inmates have no substantive remedy other than the courts.

We did indicate this wouldn’t be a long analysis, didn’t we. Lengthy this may be, but an analysis it is not. There’s one more thing we’ll add, just for comic relief, if that’s possible.

The TSDC inmate with the abscessed tooth? In one of his requests to see a dentist, he had described how he was able to drain the infection with a sharpened staple and thereby avoid the pain that normally accompanies this kind of condition. About two weeks after submitting that request, a Sergeant Tsonga showed up at his cell to ask for his “weapon”. The institution’s security department had sent her to retrieve the staple! No kidding!

All this is but one indicator that a person consigned to a provincial jail in Ontario is no longer in Canada!