Auditor identifies gaps in health-care system at Sask. jails

The provincial auditor has highlighted several gaps in the health-care system for Saskatchewan's inmates.

Judy Ferguson released her first report of 2018 on Thursday. The audit looked at the primary medical care services of four secure adult centres in the province — Prince Albert Provincial Correctional Centre, Regina Provincial Correctional Centre, Saskatoon Provincial Correctional Centre and Pine Grove Correctional Centre.

"A person that's in a correctional facility, you know, has rights to make sure they receive appropriate medical care," Ferguson said, adding those who are incarcerated are vulnerable and often have medical issues before coming into the facilities.

"They often are people that don't go to their doctors regularly. They may have mental health and addiction issues."

Furthermore, the risk of infectious disease spreading is higher in closed communities — a risk to other inmates, and to the public if they are released while still sick, she said.

About 1,800 inmates populate the four centres. About half of them are remanded to custody and have yet to be convicted. 

The report included nine recommendations for the Ministry of Corrections and Policing, including recommendations around first-aid certification for staff, how inmates' medical files are handled, and ensuring complaints are handled in the timeframe required.

The audit found that the ministry responded to adult inmate complaints about medical care later than the law requires — which is within five business days of receiving the complaint — nearly 30 per cent of the time.

"There's no doubt there is gaps, and we'll work to try and close those as best they can," said Ministry of Justice spokesperson Drew Wilby. He noted the ministry accepts all recommendations from the auditor.

At one centre, only 65 per cent of staff at one jail held current first-aid certifications.

"Seeing that number was there is unacceptable," Wilby said.

He said some of the report's recommendations weren't surprising, given the internal investigations and public inquests that have resulted from in-custody deaths.

Ferguson highlighted gaps in policy and directives. For example, she said the policy on "dealing with drug-addicted inmates" was lacking and noted those issues were also reflected in the inquest into Breanna Kannick's death — a death that occurred in a facility that was not part of the audit.

The audit found the nurses employed in the jails were key to delivering medical services, especially as medical staff do not work at night. However, it was found their orientations were too brief and limited.

Additionally, the audit found physical medical files were being kept for inmates, which meant the centres did not transfer the entire medical file of an inmate if they moved to another correctional centre or if a former inmate re-entered the system.

Ferguson said a shift to electronic files is "important" to ensure inmates receive the care they need and to avoid repetitive tests.

The information released by the auditor is concerning, said NDP member Nicole Sarauer.

"Jails are often the catch-all for the other ministries, when all the other ministries fail," she said. "Corrections is usually what ends up having to step in."

She said it's important "to be able to provide a continuity of care to ensure that inmates are given the supports they need."

Sarauer said access to all health services, including those that address mental health, is a key element of preventing recidivism.

Concerning mental health, Wilby said the province conducted a "snapshot in time" study a couple of years ago for Saskatchewan Hospital North Battleford Project.

At that time, 25 to 30 per cent of the inmate population was diagnosed with mental health issues. Wilby said the number of inmates with undiagnosed mental health issues is significantly higher.

"From an addictions perspective, we're probably talking anywhere from 75 to 90 per cent of our population in our facilities."