The following op-ed by John Howard articling fellow Leandra Keren appeared in the Toronto Star on Nov 30, 2021

When your jailor oversees your healthcare, neglect and torture inevitably ensue

When an individual serves a federal prison sentence in Canada, they leave their health card, and all the rights that card affords them, at the prison gates. It is hard to keep track of an offender’s healthcare records from there. This is bad policy which fails the medically vulnerable while violating the law and costing taxpayers millions.

The Canada Health Act explicitly excludes federal prisoners from its definition of ‘insured person’. This, combined with the provisions of the Corrections and Conditional Release Act (CCRA) which assign responsibility for providing prisoner healthcare to the Correctional Services of Canada (CSC), result in a healthcare standard which is woefully inadequate inside our prisons. Yet, this population has healthcare needs far more severe than most – high rates of addiction and other mental illnesses, sky-high HPV rates, various chronic diseases, and the many issues associated with aging.

While those of us who have access to our provincial health care systems can walk into our local health clinic, federal prisoners wait months to see a physician who may not believe in employing a harm reduction approach to treating addictions, or who denies you a prescription that you’ve been taking for decades before arriving at prison due to pressures from CSC surrounding cost and security.

This system undermines a healthcare hallmark – independence for medical practitioners. Independence for doctors is required, yet out of reach inside our prisons. In the eyes of CSC, medical staff, prescription drugs, and specialist consultations, all constitute major costs which detract from CSC’s budget. The fox is providing the hens with healthcare. This, along with the punitive culture of prisons, results in the mistreatment of prisoners through the denial of their healthcare.

The lack of accountability that CSC provides its physicians also allows for the negative stigma associated with criminal behaviour to infect those treating prisoners. Worse, provincial oversight bodies struggle to regulate physicians who are operating in a federal context. Often pain goes untreated, which sometimes results in cancers reaching lethal stages before being detected. All of this, along with the cumbersome process required to gain access to one’s own health records, denies individuals their human rights.

With previous efforts to engage the government proving unsuccessful, the John Howard Society of Canada has filed a claim in the Nova Scotia Superior Court, along with Mr. Michael Devlin, a federal prisoner suffering from deteriorating health and severe pain because of CSC’s substandard care. He is one of countless nation-wide who continue to suffer. John Howard’s claim alleges the federal health care system is outside of CSC’s jurisdiction (ultra vires), and that it violates prisoner’s human rights as guaranteed by sections 7, 12 and 15 of the Charter.

Prisoners are denied their liberty, not their right to healthcare. The inhumanity and injustice of excluding them from our universal health care protections and allowing them to suffer needlessly with inadequate medical services must end.

Leandra Keren is the Articling Fellow for the John Howard Society of Canada.