Not easy. Solutions never are, not even when there’s a will.

Yes, under pressure, politicians heading the relevant ministries admit “we can always do better”, but then turn to their underlings to take up the question. That’s where ‘change’ gets shuffled into committee consideration, becomes an item on management agenda, and from there too often slid into a dead file, or given summary rejection. ‘Change’ championed from the outside is anathema, a challenge to authority.

Activist bodies and their supporters face a brick wall. Why do our governments become reactionary in the face of criticism? Why do their progressive policy announcements flag and fade? Why do our elected bodies and civil service never get ahead of the curve? Why do we have to push and drag these people to peer over the horizon, to embrace positive program reforms?

These are questions that impact more than just health care in our jails and prisons. These are far-reaching riddles we’ve examined in the past and to which we will return often.

As a first step to address health care, provincial and federal agencies overseeing jails and prisons must concede there are problems with accessibility. Intransigence, obstruction, denial, and feigned ignorance are out.

How many institutional health care units are staffed 24/7, and equipped to handle inevitable night and weekend emergencies? To that point, and given the delays EMS personnel face in reaching an inmate quickly, how many health care units can respond to emergencies at any time, and stabilize a patient waiting for an ambulance?

A long ago posting referenced a male nurse at Ontario’s old Toronto West Detention Centre telling one inmate that “medication is a privilege, not a right.” That is not policy anywhere, but it’s an experience that underscores the need for dedicated provincial inmate ombudsman’s offices that report directly to their respective legislatures, and not through ‘correctional’ ministries.

Canada’s federal Office of the Correctional Investigator must likewise be able to report directly to parliament, an important privilege it hasn’t had. And, federally and provincially, transparency becomes a new watchword. That, and collaborating with community resources to fill in the gaps can only improve outcomes.

Why is this important? It points to who we are as a people and a nation to begin with. But to be practical, prioritizing the health of prisoners, subjugating risk assessment to making an offender physically and mentally ‘whole’, goes a long way to lowering recidivism, reducing costs, and living in safe communities.