Prisoner Health Requires Major Changes
25 August 2015
JustSpeak believes that management of prisoner healthcare needs to be turned over to an organisation with health at its
heart and Corrections needs to be independently monitored to ensure the health and safety of prisoners. Yesterday the
Office of the Health and Disability Commissioner released its first ever two reports on prisoner healthcare, both of
which found that the Department of Corrections had breached the rights of prisoners. These issues are indicative of
wider problems with Corrections management of prisoner healthcare. In 2011 the National Health Committee released a
report into prisoner healthcare in which it called for healthcare of prisoners to be moved to the Ministry of Health.
Little has been done since the release of that report to address the quality of healthcare provided to prisoners.
One of the most significant failures in the reports was the failure of medical staff to document their decisions and
actions. It was also recently discovered that Corrections does not report prisoner on prisoner assaults or prisoner
self-harm incidents to Worksafe, the Crown Entity in charge of health and safety in the workplace. It is incredibly
worrying that Corrections does not report externally on potentially significant injuries and that it does not encourage
its staff to document their behaviour internally. Corrections need to be seen to be trying to improve outcomes for
prisoners and it needs to be able to be held to account for the way it treats prisoners. To ensure that this happens
their needs to be an independent body monitoring Corrections to ensure that Corrections documents the health and safety
of its inmates and uses that information to improve prisoner health and safety in the future.
Prisoners are a high health-need group. 64% of prisoners have experienced significant head injuries, while a New Zealand
study found that 46% of prisoners reported mouth pain and trouble eating within the previous four weeks. Prisoners also
have incredibly high rates of mental health issues – over half experience psychotic, mood or anxiety disorders while 89%
of prisoners have a life-time prevalence of substance abuse issues. Although there are around 8,500 people in New
Zealand prisons at any given time, the Department of Corrections aim is to have only 1,300 prisoners receiving intensive
drug treatment programmes. Prisoners are a relatively small population with very high health needs. At a policy level
Ministry of Health should be in charge of designing and implementing health responses for prisoners which should be
carried out by local DHBs. The Ministry of Health already has the expertise to deal with high-needs groups and if local
DHBs are in charge of providing care it will mean greater continuity of service for offenders once they are released.
Poor healthcare is not part of a prisoner’s sentence. Prisoners deserve the same quality of care as they would receive
in the community, because they are members of the community. But it also makes sense from a fiscal point of view. If
healthcare issues are unaddressed or badly addressed in prison, the issues will only get worse, requiring more
interventions later on when they are released. Systematic interventions by professionals from an organisation whose core
purpose is health, accompanied by more accountability for Corrections is needed to fix this inadequate system.
ends