The "Problem of Health Care" in Canada's Federal Prisons

Abstract

ABSTRACT: Background: The United Nations states that "prisoners should enjoy the same standards of health care that are available in the community." However, persons in custody continue to face barriers to care worldwide. The health of persons in federal custody in Canada is governed by the Corrections and Conditional Release Act (CCRA), which states that Correctional Services Canada is responsible for the provision of "essential health care" to all inmates. In the absence of concrete definition, these "essential" services provided in Canadian federal prisons often fall below standard. More research is needed into how "health care" is represented as a problem in Canada's federal prisons, and the impact on the incarcerated population.

Methodology: Carol Bacchi's "What's the Problem Represented to Be?" (WPR) (Bacchi, 2009) framework was applied to the CCRA with a specific focus on health care. Questions one, three, and five of the WPR approach were applied, respectively, in order to analyze how the "problem" of "health care" is represented, how this particular representation came about, and the effects of this representation on the health of persons in custody.

Findings: In applying the WPR approach to the CCRA, three main themes emerged. First, the notion of what services are constituted as "essential" in the context of federal prisons is more limited compared to the broader community. Second, the creation of the CCRA involved a great deal of discussion around the rights of persons in custody versus the protection of society, a dichotomy that has significant bearings on the treatment of those in prison. Third, this representation has negative effects on the health of those in custody.

Conclusion: The representation of health care in the CCRA has negative effects on the health of persons in custody. Greater attention must be paid to these inequities in health care provision in order to meet UN standards.

Keywords: Prison Health, Essential Health Care, Carol Bacchi, Inequity