……TO NEED HELP

When Kingston Penitentiary was still a prison years ago and not the tourist attraction it’s become, an inmate with a toothache followed procedure and filled out a request to see the dentist.  And then he waited, as is also a part of procedure with health-care in the prison industry.  And he waited.  By the time two other inmates were hospitalized and put on intravenous antibiotics because of delays in dental care, this inmate was in pain constantly.

His family had had enough, stepped up and wrote to the Assistant Commissioner, Health Services at the Correctional Service of Canada national headquarters in Ottawa.  She acknowledged the family’s concern, passed the information to the Deputy Commissioner at the regional headquarters in Kingston, who called the family with assurances that something would be done.  That’s not usual.  Does it pay to go to the top?

And something was done.  This prisoner was escorted to a dentist in the community, where an examination had the dentist concerned and distressed.  He told this man that he had been asked to only do an assessment, but he couldn’t believe that the prison had left him in the state he was in, and he would help him if he wanted.  Three teeth were removed, possibly four, and they were extracted in blackened pieces.  The inmate didn’t care; he only wanted relief.

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This dentist knew the fault did not lie with dentistry.  He knew CSC contracted for a dentist to service inmates in the institution for a specified number of hours/visits per week, or month.  What couldn’t be done within those parameters was left undone.  And this community dentist couldn’t complain after seeing this patient.  CSC is a major employer in Kingston and his practice would easily be negatively affected if he spoke up.

“We believe that that’s really the crux of the issue.  When your jailor is your health-care provider, it creates an irreconcilable set of conflicts,” said Catherin Latimer, executive director of the John Howard Society of Canada.  “As the jailor, you’re preoccupied with security issues and fiscal issues, and those often trump the medical needs of the individual prisoner.”

The John Howard Society wants to see CSC out of the health-care business and care for federal prisoners delivered by those who provide health-care in the community under the Canada Health Care Act.  Having jailors deliver health-care inevitably leads to substandard and unaccountable care.  JHS is not the first to make this recommendation; the Office of the Correctional Investigator has chimed in over the years more than once.

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An active inmate in his mid-40s suffers a knee injury in the gym.  He thinks a few days rest is the solution.  The discomfort continues, he asks for help and is diagnosed with either a tear in a tendon or a meniscus by the institution’s doctor.  Surgery is the remedy.  That was almost three years ago.  COVID has negatively impacted hospital services, but restrictions are being lifted and hospital procedures have resumed.  This inmate recently had a virtual doctor’s appointment to revisit his untreated injury.  The doctor’s response was, “We’ll have to see what can be done about that.”

Leandra Keren, an articling fellow with the John Howard Society of Canada who was quoted in the previous entry, “Prison is no place to be unhealthy, sick or injured,” went on to write in her December 1 Toronto Star contribution from last year, “The fox is providing the hens with health-card…..In the eyes of CSC, medical staff, prescription drugs, and specialist consultations, all constitute major costs which detract from CSC’s budget…..This, along with the punitive culture of prisons, results in the mistreatment of prisoners through the denial of their health-care.”

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Did you know…..?
Offenders transferred to a federal prison are assessed by a nurse at reception.  Prescription and over the counter meds are discontinued pending a review by the institution’s doctor.  An inmate does without while waiting. 
Correctional Service of Canada has its own formulary, a list detailing the medicines that may be prescribed.  A doctor cannot prescribe meds the list doesn’t cover which can have a negative impact on treatment options.  As one example, consider the range of drugs available for bi-polar disorder.  Patients may not respond well to one drug, or may get relief for a time, and alternatives are a necessity.  At CSC, only limited meds may be authorized.

Did you know…..?
An inmate who has a complaint against the health-care received from a doctor or a nurse in a federal institution cannot file a complaint with the regulatory colleges for either profession. By doing so, that nurse or doctor against whom the complaint is made cannot continue to treat a patient filing the grievance.  That inmate then has no health-care at all until the matter is resolved.

Next….there’s always a next with prison health-care.