Investigation of the Department of Corrections in relation to the provision, access and availability of prisoner health services
This own motion report, unlike others we have undertaken, did not arise from specific incidents within the prison system, nor from the number of complaints we receive from prisoners. In fact, health-related complaints we do receive are not overly represented as a source of prisoner complaint. Rather, we considered that Health Services to prisoners are so fundamental to the general welfare of prisoners that they merited examination by the Ombudsmen as part of their general oversight of prison administration. We therefore began from a neutral position not making any assumptions about the Prison Health Service.
Many prisoners come from deprived backgrounds and have had less exposure and access to healthcare than the rest of the population, despite having a significantly higher incidence of mental health and drug and alcohol problems. Thus, we felt it was important, in the public interest, to identify whether or not prisoners receive medical treatment that is reasonably necessary, and whether or not the standard of healthcare provided is reasonably equivalent to the standard of healthcare members of the public could expect.
The main focus of the Department of Corrections is the “safe and humane containment” of prisoners. We felt that it was also important to examine how effective the delivery of health services to prisoners is within a restrictive environment where security concerns and risk management, rather than individual health needs, take priority.
The New Zealand prison population is currently approximately 8,000 prisoners. The demands on healthcare in prisons can therefore be considerable. Certainly, our view is that prison nursing has become more complex over recent years with an increase in prisoners with multiple health problems. However, the prison environment can provide opportunities to address the health needs of a particularly vulnerable sector of society, and, for some prisoners, an opportunity to access healthcare which, for a variety of reasons, they have not been able to access previously.
Our investigation has identified that prisoners have reasonable access to Health Services and generally they receive healthcare equivalent to members of the wider community. However, the service is not without its problems and in the future, it may not be able to meet the healthcare needs of such a diverse population effectively.