Registed Nurses' Association of Ontario

Transformation of Ontario’s correctional system

Transformation of Ontario’s correctional system

Dear Kathleen, Marie-France and Eric,

We want to wish you all a healthy and fruitful 2018.

We also want to thank you for the opportunity for RNAO and the President of our Ontario Correctional Nurses' Interest Group to attend the Nov. 21 Ministry of Community Safety and Correctional Services (MCSCS) and Ministry of Health and Long-Term Care (MOHLTC) joint update on the proposed correctional legislation. We recognize that transforming the province's correctional services, similar to the ongoing transformation of Ontario's health-care system, will be tremendously complex and contain both policy and political challenges. What is also true of both systems is that principle-based changes that are evidence-informed will improve health and save lives, especially for people who are marginalized. We know that some of these changes will require great political courage. Rest assured, nurses are eager and ready to support government in this area.

As we have documented in our previous correspondence, RNAO urges transformation of Ontario's correctional system to address health inequities and meet international law on human rights. We urge and are keenly anticipating the introduction and passage of modernized correctional legislation in the course of the current legislative session.

In his recent independent review of Ontario's correctional system, Howard Sapers reported that more than 150 people have died in provincial custody over the past decade. Astonishingly, the exact number of individuals who have died is unclear due to varying definitions of what constitutes a death in custody. The majority of deaths in custody are not subject to thorough, independent, and arms-length reviews. Jury recommendations from coroner inquests that have been conducted over a decade have not been implemented or even tracked, which is not surprising given the lack of effective oversight. Mr. Sapers concludes that many of the deaths in custody could have been prevented through improved health services, better emergency response, making cells safer for vulnerable individuals, implementing harm reduction measures, and enhanced use of compassionate release.

Premier Wynne, Minister Lalonde and Minister Hoskins, the status quo within our provincial correctional system is killing people. We don't even know exactly how many have died, let alone how many incarcerated people are left with worse health outcomes after being in the province's care. To address these deadly flaws, we urge the full implementation of all the recommendations made by Mr. Sapers in his first report on segregation and his second report on the broader correctional system. People who are incarcerated, their families and Ontario as a community need and deserve no less.

While we understand it is the intention of the MCSCS to work with the MOHLTC in a staged approach to reform correctional health services, it is imperative that the path ahead be enshrined in legislation and that the responsibility for health care in corrections be transferred from MCSCS to MOHLTC. This is something RNAO has requested since 2012 in meetings with Premier Wynne and with our current and previous ministers of health and corrections.

RNAO urges that the following key principles identified by Mr. Sapers for correctional health services be incorporated into revisions of the Corrections Act for Ontario:

  1. A broad definition of health and health care
  2. Ensuring equivalency, accessibility and continuity of care
  3. Clinical independence
  4. Integration with the provincial health-care system
  5. Robust accountability mechanisms
  6. A stable, health-focused employment environment for health-care service providers within corrections

Moving beyond these principles, we urge you to implement the World Health Organization's whole-prison approach, which includes foundational principles of human rights, decency, health promotion, and social determinants of health.

The changes nurses are asking for are long overdue. They are enshrined in international standards and in our lived experience as practitioners in the correctional system. They are contained in Mr. Sapers' report, which you commissioned. These changes – all of them – are principle-based and driven by strong evidence. These are changes essential to improve the health of incarcerated people and save their lives. We need you to take immediate action. We are eager and ready to support you in delivering what is right for inmates, their loved ones and Ontario as a society for all.

With warmest regards,

Doris Grinspun, RN, MSN, PhD, LLD(hon), O.ONT.
Chief Executive Officer, RNAO

Carol Timmings, R.N. B.N.Sc., M.Ed. (Admin)
President, RNAO

Patrick Brown, Leader, Official Opposition
Andrea Horwath, Leader, New Democratic Party of Ontario Rick Nicholls, PC Critic for Correctional Services
Taras Natyshak, NDP Critic for Community Safety and Correctional Services Jeff Yurek, PC Health Critic
France Gélinas, NDP Health Critic

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Letter to Premier and Ministers CSCS314.69 Ko
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