Prison is no place #3…….

……TO EXPECT ANYONE TO CARE

The College of Family Physicians of Canada’s 2016 overview of health care in jails/prisons had three key points.
1)  The health of persons who experience detention or incarceration in provincial, territorial and federal facilities is poor compared with the general Canadian population.
2)  Health status data can be used to improve health care services and health for this population, with potential benefits for all Canadians……The time in custody provides an opportunity to intervene.  (Emphasis is ours.)
3)  Information on health status is also important for defining areas of focus for improving health and health care…..the lack of data on some key indicators of health is striking.

The College recommended that provinces and territories transfer responsibility for inmate medical and mental health care from their ministries of justice to the ministries of health.  Similarly, delivery of medical and mental health care services in federal prisons be “separated completely from the Department of Justice Canada.”

Today, the CFPC continues to speak out on the care prisoners receive.

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The Corrections and Conditional Release Act requires Correctional Service of Canada to provide health care to federal prisoners.  This was confirmed in law by Harnois v Canada (Attorney General) in 2010 when an inmate with multiple medical conditions went before the Federal Court to compel CSC to allow him to receive treatment from the same physician who looked after him in the community.

In part, the prisoner claimed a right to a doctor of his choice because the CCRA does not limit this right.  The Court decided that if legislators wanted prisoners to have a right to a doctor of choice, it would have been clearly indicated in the Act.  Further, the Court confirmed the Act makes an institution’s doctor the arbiter of an inmate’s health care.  The Court wasn’t asked to rule on limitations in CSC’s formulary but did find that available treatments met medical standards.

One last point to be taken from this decision is the Court noted the absence of a complaint or grievance from the inmate.  The inmate didn’t file a grievance against CSC over the treatment and care he received.  The grievance process is primarily a sop, of little importance or value offered to stop complaints or unhappiness, as one dictionary defines it.  Inmates should be warned though that this is a necessary step for the record, regardless of how little import it has.

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Legal actions against Correctional Service of Canada citing health care deficiencies are ongoing and will persist, given that advocacy groups will join the lawsuits.  One that has attracted media attention began with 39-year-old federal inmate Michael Devlin, in custody since he was 17, who claims his care for a bad back was not up to medical standards while in custody at Atlantic Institution in New Brunswick, or Springhill Institution in Nova Scotia, or in Millhaven Institution in Ontario.  The John Howard Society has joined in the action because Devlin’s experience is shared by many prisoners helped by the organization.

Catherine Latimer, the Society’s executive director, said the statement of claim, filed with the Supreme Court of Nova Scotia, “indicates that he’s experienced the deterioration of his health and considerable amount of pain and suffering, as a result of the delays in his treatment, and the inadequacy of the treatment that he received.  We will be introducing evidence from prisoners from across the country who have experienced similar issues to Mr. Devlin.”

Latimer remembers the case of a prisoner who was in pain due to deteriorating hip joints and required hip replacements.  CSC told him the surgery was expensive and he would have to wait until he was paroled, even though he was not parole eligible for another 30 years.  Treatments are often delayed because health care for paroled inmates becomes a provincial responsibility.

Leandra Keren’s summation from her December 1st Toronto Star column:  “Prisoners are denied their liberty, not their right to health care.  The inhumanity and injustice of excluding them from our universal health care protections and allowing them to suffer needlessly with inadequate medical services must end.”

Right?  Right!

Next:  Poor health care can lead to poor outcomes….including death.

 

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