Ontario sets plan for prisoner health care
New protocols follow jail-cell birth at detention centre
The ministry that oversees the province’s jails has come up with a 21-point “action plan” for health care after a pregnant prisoner’s baby was born behind bars, but one critic said it doesn’t go far enough to address serious shortcomings in how inmates receive medical treatment.
The plan by the Ministry of Community Safety and Correctional Services comes after a provincewide review of health care in Ontario jails after 26-year-old Julie Bilotta gave birth on the concrete floor of her cell at the Ottawa-Carleton Detention Centre last September.
Bilotta alleged that nurses and guards ignored her complaints about the pain, telling her she was in “phantom labour” and placing her in a segregation cell.
The ministry plan — which makes no reference to what happened to Bilotta — calls for co-ordinated care for pregnant inmates by developing standardized practices and procedures for working with pre- and post-natal offenders.
The jails would have a multidisciplinary team of correctional staff to work with pregnant inmates, and ensure linkages to hospitals and support agencies, according to the plan.
It also recommends improved oversight and compliance in the province’s jails by involving the ministry’s corporate health care section at an early stage in investigations with health care implications. It recommends “immediate action” be taken whenever “serious concerns” regarding the functioning of a health care unit exist.
But Bryonie Baxter, executive director of the Elizabeth Fry Society, said the ministry’s five-year plan doesn’t address the “disrespect” that staff at the jails have for inmates with medical problems and does nothing to streamline inmate access to health care outside the jail. The Elizabeth Fry Society provides support to female inmates and other women at risk of coming into conflict with the law.
“There’s this incredible climate of disrespect and contempt and abuse of people incarcerated,” said Baxter.
“What came up in the Julie Bilotta case was the profound disrespect, the profound lack of trust in what she was saying about her own body, the profound disbelief she was even in labour,” she said.
“If the purpose of incarceration as it is in this country is to promote successful reintegration so that people won’t commit more crime when they get out it is counter intuitive to treat people so badly when they are in jail.”
Baxter complained waitlists for outside appointments are still “ridiculously large.”
Baxter said she has seen one inmate wait months for a visit to a dentist after developing an issue with a tooth.
By the time the female prisoner was taken to the dentist, the wound was severely infected and required additional treatment with antibiotics for the infection, Baxter said.
The action plan also recommends expanding the complement of mental health nurses and identifying opportunities to enhance services to mentally ill inmates.
It also recommended filling vacant positions and looking at adding more nurses in general.
Baxter said the plan doesn’t address gender inequalities
‘Expanding the complement of mental health nurses is going to do nothing to ameliorate the fact there is gender discrimination.’ BRYONIE BAXTER Executive director, Elizabeth Fry Society
in the current system.
“Expanding the complement of mental health nurses is going to do nothing to ameliorate the fact there is gender discrimination,” said Baxter, who is meeting with the ministry this week to discuss their plan.
Baxter said women are discriminated against because, unlike the men, there is no secure treatment facility for women with serious mental illness. Men can be sent to the St. Lawrence Valley Correctional and Treatment Centre, she said.
“People with serious mental illness should be in treatment facilities, not jails, where the treatment of their illness is the primary focus and perimeter security only is covered by Corrections,” she said.
Ministry spokesman Brent Ross wrote in an email that the plan will help build a “better, more responsive health care system” in jails by improving policies and training with regards to governance, oversight, women’s health issues, long-term planning, and communication.
“These recommendations are being addressed and changes to the system are being made,” wrote Ross. “The Ministry is committed to ensuring that all inmates in our correctional system have access to quality health care and the supports they need while in custody.”
The ministry announced last week that staff had been fired and disciplined with suspensions or reprimands following an investigation into what happened to Bilotta.