No quick health fix for Ottawa jail, advocates warn

Transferring health care responsibilities from one provincial ministry to another may not turn out to be the panacea the authors of a recent report aimed at fixing the Ottawa-Carleton Detention Centre envisioned, prisoner advocates say.

'Trash the whole system and start again,' consultant urges

A task force has recommended transferring responsibility for health care at the Ottawa-Carleton Detention Centre to Ontario's Ministry of Health. (Andrew Foote/CBC)

Transferring health care responsibilities for inmates from one provincial ministry to another may not turn out to be the panacea the authors of a recent report aimed at fixing the Ottawa-Carleton Detention Centre envisioned, prisoner advocates say.

Last week an OCDC task force came up with 42 recommendations for ways to improve conditions at Ottawa's jail. Among them: "Delivery of health care services would be more efficiently and effectively managed by the Ministry of Health and Long Term Care," according to the report.

Right now, health care in the province's jails is administered by the same correctional system that manages them.

Shae Greenfield, a spokesman for Ontario Health Minister Eric Hoskins, said the issue is on the ministry's radar, and discussions with the ministry of community safety and correctional services have begun.

Hep C, HIV, mental health issues

Earlier this spring, the John Howard Society published a report calling on Ontario to address health care deficiencies in the province's jails.

"Incarcerated populations have a higher prevalence of acute and chronic health care conditions compared to the general population," including hepatitis C, HIV, mental health issues and addictions, according to the report.

Both reports recommend integrating jails into the provincial health care system, something that's already been done in Nova Scotia and Alberta.

That would be my solution — trash the whole system and start again.- Frances Cappe, Canadian Prison Consulting

"In Nova Scotia ... the ministry of health has improved continuity of care for men and women moving from correctional institutions to the community," states the John Howard Society's report.

But Frances Cappe, vice president of Canadian Prison Consulting and a social worker with decades of experience with inmates, said she's skeptical that transferring responsibility will actually make a difference.

"It sounds like a simple fix, sounds great," said Cappe. "[But] the reason why inmates can't get the health care they have a right to have is not related to where the nurses come from. It's the culture inside the institution, and the fear of the health care staff."

Health workers 'intimidated, afraid'

Cappe said health care professionals already working in the jails are under the same management in charge of security, and often make the latter the priority over prisoners' health.

"People who are suppose to deliver health care, mental and physical health care services, cannot do so, cannot move freely, and most of them, not all, are intimidated and afraid to speak out," said Cappe.

Cappe said some prisoners arrive to jail with diseases including epilepsy, high blood pressure and cancer, but she said too often treatments and medication are withheld. That can spark withdrawal, causing further health or behavioural problems.
Ontario Human Rights Commissioner Renu Mandhane. (CBC)

"I think it's an incredible embarrassment to our country and to our province, that we can't provide basic medical care to inmates," said Cappe. "The entire system needs to be dismantled and reconstructed. That would be my solution — trash the whole system and start again."

Renu Mandhane, chief commissioner of the Ontario Human Rights Commission, got the chance to tour the OCDC late last week.

She said right away she witnessed the smells, the dirty environment and the crumbling infrastructure. Mandhane said the issues in jail are extreme, but maybe not unique. 

Mandhane has a different solution to the jail's health care problems.

"I think rather than thinking about these exchange of service agreements, I think we actually need to start 'decarcerating,' so we actually start to develop community treatment options for people who shouldn't be in jail," said Mandhane.

"Many of these people have very complex health needs. Some of them, the very reason they're in jail is because of untreated mental health disabilities, and this is a real moment for our society to put in the supports so people can get out and not re-offend," said Mandhane.