‘What they say is care, is Panadol’: Victoria’s prison healthcare mess

An Ombudsman report has found that poor delivery of healthcare in Victorian prisons is putting First Nations people at risk.

The privatisation of Victorian prisons is impeding the delivery of appropriate healthcare for First Nations people, with private contractors bound by a decade-old framework, an inquiry has found.

A Victorian Ombudsman report into the healthcare delivered to First Nations people in Victorian prisons found that a number of gaps are putting Aboriginal people at risk.

The report found numerous examples across Victorian prisons of people having ongoing medications abruptly stopped, long-running difficulties in accessing any medical care and an inability to access programs to address drug use.

The investigation also revealed different frameworks and measures are in place for private prison operators compared to the state’s public prisons, and that the privatisation of these services is hampering the delivery of effective healthcare, particularly for First Nations people.

“Over the years, the Australian and Victorian governments have made many commitments to Aboriginal peoples’ self-determination, consultation and evidence-based health policy - however, these commitments appear to end at the prison gates,” Victorian Ombudsman Deborah Glass said in the report.

“This investigation found a system that is failing to meet the needs of Aboriginal people in prison.  Some of the things we heard were deeply confronting and distressing.

“For the sake of our over-incarcerated First Peoples, I can only hope this report finally provides the spur for change.”

Decade-old standards

For the report, the Ombudsman visited the Dame Phyllis Frost Centre, the Melbourne Assessment Prison and the Ravenhall Correctional Centre.

It found significant issues when it came to privately-run prisons in the state, which have in turn subcontracted out healthcare to other companies.

The three private prisons in Victoria, which include Ravenhall, are bound by the 2014 Justice Health Quality Framework. The state government has introduced the Healthcare Services Quality Framework for Victorian Prisons 2023 which includes sections specifically focusing on the requirements of providing healthcare to First Nations people in prison.

But this has not been applied to the privately-run prisons in the state, which are still bound to the 10-year-old standards. In response to the Ombudsman, Corrections Victoria said that renegotiating these contracts to include the new framework would be “complex” and “costly”.

The Victorian awarded GEO Group a contract to run primary healthcare services in the state’s public prisons midway through last year, worth about $55 million per year.

In awarding this work to one provider, the state government opted to not use Aboriginal Community Controlled Health Organisations to deliver healthcare for Indigenous people in prison, against the wishes of Aboriginal community groups.

The government’s engagement with key Aboriginal organisations in awarding the healthcare contract was “lacking”, the Ombudsman found.

Not even a band-aid

The Ombudsman report included a number of case studies of First Nations people in prison struggling to access adequate healthcare while in prison, with serious consequences.

These included a “visibly distressed person” in a separation unit at the Melbourne Assessment Prison who was unable to access his prescribed antidepressant medication. He told the Ombudsman he was suffering anxiety and panic attacks and was unable to sleep, but had not been allowed to see a doctor.

The man said he was told to “see how you go” by staff at the prison and was left in the separation unit without medication.

“I just want to see a doctor, cos I just keep getting anxiety, and I wake up in a panic attack…you feel like you’re dying,” they said. “You feel like you’re dying, man, right in there.”

Another person was found to have performed “surgery” on their own toe due to significant delays in being able to see a doctor at the privately-run Ravenhall prison. The man resorted to attempting to address an ingrown toenail with tweezers and a pencil sharpening after attempting to see a podiatrist.

After doing this, he asked prison guards for a band-aid but was told they didn’t have any.

Another person incarcerated at Ravenhall said that at the prison, “what they say is care, is Panadol”, while the Ombudsman found that even getting access to this painkiller is difficult. 

“Basically, you’ve got to know a week before you get a headache so you can get some Panadol for you,” one person told the Ombudsman.