Incarceration in Ontario’s correctional facilities is becoming more fatal. Deaths in custody have increased almost 50 per cent since 2020 despite a decreasing number of incarcerated people, according to a report published in December.
This is but one of many highly worrisome reports released over the past year sounding the alarm on the health of people in the province’s correctional facilities: the Ontario chief coroner launched an investigation last summer into deaths in the province’s correctional facilities over the past seven years, and the Ontario ombudsman’s office noted in its annual report last August that one of the highest categories of complaints were accessing health care in correctional facilities.
In Canada, the Correctional Service of Canada manages federal correctional institutions that hold those incarcerated for two or more years. Sentences of less than two years, inmates awaiting bail, trial or sentencing as well as those on immigration hold are managed by provincial and territorial correctional institutions.
While many people are under the assumption that health care in provincial facilities is the same as health care for the general population since both are administered by the Ontario government, the reality is that the health-care system as most of us know it does not exist in provincial correctional facilities. From booking an appointment to maintaining confidentiality, health-care needs are compromised once someone enters the correctional system. Requests to see a health-care provider are written and delivered by correctional officers, compromising confidentiality and dissuading people from accessing care. There is widespread understaffing of health-care workers with less than half of all facilities in Ontario having 24-hour nursing coverage, and those workers are paid at a lower rate than their community counterparts. Access to lifesaving opioid agonist therapy is severely lacking, resulting in the high overdose risk. Mental health care also is in short supply.
One of the major culprits for this difference relates to oversight and management. Outside of provincial correctional facilities, health care is managed by Ontario’s Ministry of Health and Long-Term Care. Inside, the management falls to the Ministry of the Solicitor General (MSG), who also manage almost every other aspect of provincial correctional facilities, and all from the same budget. There are clear competing priorities with this mandate and the health-care needs of people they serve. Imagine your landlord being responsible not only for the property upkeep of your house, but also for your health care. Do you think the landlord would have your best health interests in mind? Or, would the landlord hope to save a few bucks on your cardiologist appointment to pay for the water heater?
The call for the transfer of health-care management to the Ministry of Health and Long-Term Care is not new, but it is more urgent than ever. Many professional organizations support the transfer of health-care management, including the World Health Organization and the Canadian College of Family Physicians. Several Canadian provinces, including Alberta, Nova Scotia and Newfoundland and Labrador have made the transfer, with B.C. being the most recent in 2017. A 2022 PhD thesis from British Columbia shows numerous improved health-care outcomes after B.C. transferred these services, including reduced deaths due to overdoses and improved rates of accessing health care both during and after incarceration. Transferring health-care services could be a life-saving intervention for the incarcerated people of Ontario.
We remain one of the last provinces in Canada to continue with this system, and the consequences are becoming more and more dire. We need swift and appropriate action from our Ministers of Health and Long-Term Care (Sylvia Jones) and Ministry of the Solicitor General (Michael Kerzner) to initiate this transfer before more lives are lost. Incarcerated Ontarians deserve to have their health care managed by experts in health care, not their landlord.