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New Approach To Prisoners' Health Needed

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Fuseworks Media
Fuseworks Media
New Approach To Prisoners' Health Needed

A custodial approach to managing inmates' behaviour is taking priority over their health needs, says the National Health Committee in a report describing numerous inadequacies in prison health services.

Responsibility for prisoners' healthcare must shift from the Corrections Department to the Ministry of Health, says the committee.

It's a move committee chair Pauline Barnett identifies as the most important step the country must take toward better healthcare and health outcomes for inmates and families.

Dr Barnett is associate professor at Canterbury University's health sciences centre and at Otago University's department of public health and general practice in Christchurch.

Dismal health outcomes

The committee traverses dismal territory - from Kiwi male prisoners' excessive incidence of schizophrenia, smoking, heart disease and COPD, to the stress and communicable-disease risk of double-bunking.

Its 165-page report Health in Justice: Improving the health of prisoners and their families and whānau, released today, makes 13 recommendations.

A key one sees the health ministry, in partnership with the Department of Corrections, develop a new framework for delivery of health and disability services to prisoners.

Primary care services patchy

Primary care in prisons - where nurse-led clinics are the norm and GPs are contracted in - is patchy, the report shows. It says problems include:

prison health services that are not well defined or recognised within the prison service

a lack of consistency and national co-ordination

quality standards that do not match the standards in the health sector

inadequate funding and no mechanisms to ensure ongoing adequate funding

inconsistent arrangements with external providers

low levels of nursing availability

delays in prisoners being seen by a GP and unacceptably short GP consultation times

an absence of strategic leadership and no staff and service development focus

a lack of a Māori approach to health services

communication difficulties between health and custodial staff

no information systems for health management, data sharing, or analysis

inconsistent stocks of vital medical items and equipment.

Improvements suggested

The committee suggests the agency responsible for primary care:

advances the development of multidisciplinary primary healthcare teams in prison

develops a continuing professional development programme for the prison health workforce

supports prison health staff to: establish clinical networks for all health professionals who work in prisons; and join regional clinical networks with colleagues who work outside prisons

strengthens the quality assurance framework to closely align it with the frameworks used by other primary healthcare providers

ensures prison health services collect and analyse the same health status and service measures as primary healthcare providers in community settings.

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