Canada’s provincial and federal penal systems spend tens of millions of dollars each year on health care, including funding for mental health services.

That’s how we began on April 15…….

Spokespeople for Correctional Service of Canada, and its counterparts in the provinces, have always insisted the men and women in their custody….and care….have the same access to the health care that is available to us all. What’s on paper tends to support the claim….practice and delivery say otherwise.

And, that’s how we left off last week.

So for example, how long do you wait to see your dentist when you need help? Would you be put off for more than a day? Would you be offered a speedy alternative if you couldn’t be accommodated immediately? Of course, that’s what you’d expect, and if it wasn’t forthcoming, one call and another dentist’s chair would be waiting, PDQ.

That’s how it is for us in the community, and that’s how it is for anyone and everyone who works in a jail or prison in Canada, and that’s how it is for anyone and everyone who works in a jail or prison health care unit in Canada.

That’s not how it is for inmates.

Inmates submit a request, a request that will pass through non-medical staff hands before it gets to the health care unit. Then, it’s a matter of waiting. Even ‘urgent’ requests can wait weeks for attention, if not longer.

As for dental maintenance programs which would lower costs to the system over time, is there any institution in the country that subscribes to such a service? We think not.

The attention here has focused on dental care because the discomfort of an aching tooth can easily be a worst-case scenario, aside from a life-threatening injury or medical emergency event.

Looking beyond, and to its credit, Correctional Service of Canada has seen improvements in the delivery of acceptable standards of care in some areas. This is in large part due to pressure and criticism from multiple community sources, and legal actions intended to bring practice in line with policy. Provincial agencies don’t get the same scrutiny, and a lot of work is waiting for dedicated advocates at that level.

Nonetheless, and despite changes, most federal inmates would testify that unless they are lying in a pool of their own blood, or in cardiac arrest, or showing obvious signs of severe medical distress, the mantra is……wait, wait, wait.

We like to cite the case of a long-time federal British Columbia inmate who was diagnosed with a cancer a few years ago and given an ominous prognosis, failing proper medical response. In the end, this inmate took CSC to court to access necessary surgery. He’s alive today and living in the community.

Solutions? Next week.