NCJ Number
72875
Journal
Canadian Medical Association Journal Volume: 118 Dated: (March 4, 1978) Pages: 578,581-582,587
Date Published
1978
Length
4 pages
Annotation
Findings and recommendations of a Canadian national health services advisory committee, formed in the early 1970's to thoroughly investigate deficiencies in medical and health care services to inmates of Canada's federal penitentiary system, are summarized.
Abstract
The first of two advisory committee reports issued in 1974 identified several deficiencies. Senior health care officers in charge of federal penal health care lacked professional qualifications; medications, including controlled drugs, were inadequately supervised; and guidelines for routine examinations and handling of prisoner medical requests and complaints were unclear. Moreover, facilities, equipment, and record keeping were all seriously deficient; Medical staff responsiblities for security was creating adversary relationships between health care personnel and inmates; there were only two facilities for detailed medical and psychological examination of inmates, and one of these facilities was judged 'deplorable'; and the health care officer and the institutional physician were mainly accountable to the prison director rather than to the regional director of medical and health care services. In addition to recommending that the prison medical services be upgraded and professionalized, the first Botterell report urged that the medical health care service should be given greater recognition by directing the head of prison medical and health care services to report directly to the commissioner of penitentiaries. Also, medical judgments should be the exclusive prerogative of the medical staff, and health care personnel should not be employed in security duties. Furthermore, the number of full-time physicians in prisons should be decreased to prevent them from becoming 'institutionalized,' and psychiatric services should be integrated with all other medical services. The second committee report, completed in November 1975, produced 76 recommendations concerned mainly with improving day-to-day medical services, but also urging that more of the 1974 report recommendations be implemented. A policy and procedures manual issued by the Canadian Correctional Service in 1977 that incorporates many of the committee's recommendations is described. The need for additional time to make basic personnel and facilities improvements is noted.