latimer: canada's universal health care stops at the gates of federal prisons
prisoners and their families recount horror stories about prison health care services – from late and missed cancer diagnoses, to having to line up outside regardless of the weather to get medications, to having prescriptions cut for no apparent reason.
3 minute read
if you're in federal prison, your health needs won't get much attention.
wayne cuddington
/
postmedia
by catherine latimer
while donald trump’s recent state of the union address cited measures to rehabilitate prisoners as an accomplishment, the only indirect avenue to improving canada’s flawed corrections system referenced in our prime minister’s mandate letters is through the minister of health.
the protections of the canada health act, which safeguard our much valued universal health care, do not apply to federal prisoners. while there is nothing in a criminal sentence that subjects a person to inferior health care, those who are sentenced to two years or more in prison are expressly excluded from the definition of “insured person” under the canada health act.
the correctional service of canada (csc) bears the responsibility of providing essential health care and reasonable access to non-essential health care to professionally accepted standards. but the prison service was not designed to provide health care for an aging prison population saddled by numerous mental and physical ailments. granted, it has saved many lives through the timely application of naloxone and racing injured prisoners to hospitals but too often the appropriate treatment for chronic and other physical and mental illnesses is trumped by security concerns.
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prisoners and their families recount horror stories about prison health care services – from late and missed cancer diagnoses, to having to line up outside regardless of the weather to get medications, to having prescriptions cut for no apparent reason. it seems that the prison health service is particularly quick to cut prescriptions for pain control and other drugs that can be abused in prison but that are also needed to manage pain, adhd, and some psychiatric conditions.
many have told me that their pain meds were stopped when they were placed in administrative segregation, which combines the psychological pain of isolation with a physical one and approaches using restricted access to medicine as a punishment.
i spoke with one prisoner who was told that he would not get needed hip replacement surgery because it was too expensive and who has been denied any pain relief for the excruciating condition. according to the canadian institute for health information, the benchmark wait time for hip replacement surgery is about 180 days and not the minimum 35 years this prisoner will have to wait until he gets his first shot at parole at age 84. doctors under contract to csc often must reconcile the best interests of their patients with the constraints imposed by their employer, and the quality of health care suffers.
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recent amendments to the corrections and conditional release act implicitly recognize the challenges faced by ill prisoners and have given them access to “patient advocacy services.”. but to whom does one advocate for a federal prisoner? with one such complaint, csc and the correctional investigator advised contacting the provincial medical licensing board, which regulates doctors’ professional conduct. initially the college of physicians and surgeons suggested the correctional investigator would be better if the issue involved a federal prisoner. later the college indicated it would take a formal complaint but warned that as a provincial body, it could not compel documents or cooperation from federal authorities. this suggests no effective oversight or redress for federal prisoners receiving sub-standard health care.
the prime minister’s direction to health minister patty hajdu provides hope. the minister is to ensure greater access to doctors or primary health teams and to propose amendments to the canada health act to achieve progress. amending the definition of “insured persons” to remove the exclusion of federal prisoners would protect them from discrimination. in might also fix the current international human rights violation of relegating health care responsibilities to correctional authorities. we are pleased to see that three canadian provinces have shifted the responsibility for prisoner health care from correctional to health administrations. the john howard society of canada urges the federal government to follow suit.
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it has long been seen as barbaric to impose physical pain as part of a criminal sentence but substandard health care resulting in pain, illness and longer-term complications is a cruelty that must end.
catherine latimer is the executive director of the john howard society of canada.
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