Health inequalities

Aug 16, 2012

ACT prisons announcement hailed as an “historic” decision for public health and human rights

At a justice health conference in Canberra yesterday, the Chief Minister and Minister for H

Melissa Sweet — Health journalist and <a href=Croakey co-ordinator" class="author__portrait">

Melissa Sweet

Health journalist and Croakey co-ordinator

At a justice health conference in Canberra yesterday, the Chief Minister and Minister for Health, Katy Gallagher, made the landmark announcement that the ACT’s prison will introduce a needle and syringe exchange program as part of a broad policy to reduce the spread of blood borne viruses.

(You can hear her speech here.)

In the article below, the CEO of the Public Health Association of Australia, Michael Moore, writes that Gallagher has stood up for one of society’s most vulnerable groups.  With an ACT election looming, he says: “It remains to be seen if Canberra voters are prepared to reward a politician who actually stands up for what she believes to be right.”

Meanwhile, Dr Alex Wodak, Director of the Alcohol and Drug Service at St Vincent’s Hospital in Sydney, and President of the Australian Drug Law Reform Foundation, says the announcement is historic and that Gallagher deserves recognition and support

Writing for The Conversation,  Wodak says:

“More draconian approaches to prison are always expensive, rarely effective and often have severe unintended negative consequences. But draconian approaches are political Viagra while pragmatic and effective approaches are often considered politically suicidal.

“That’s why it’s taken more than 20 years before any politician in the English-speaking world has done what Katy Gallagher has had the courage to do. Politicians who stand up for important principles deserve to be strongly supported. Katy Gallagher will be greatly admired for the rest of her life by people who understand that protecting public health and human rights is critical.”


ACT decision is a step forward for health, human rights and prisoner rehabilitation

Michael Moore writes:

The first prison needle and syringe program in the English speaking world will come into operation in Canberra.  The announcement is a major breakthrough for public health.

The one-for-one exchange program is a key driver to reduce the spread of diseases such as Hepatitis C.  It is a decision about health, human rights and rehabilitation.

The Chief Minister and Minister for Health, Katy Gallagher revealed that the Alexander Maconochie Centre, the ACT’s prison will have a one for one needle exchange operating at the prison as part of a broad policy to reduce the spread of blood borne viruses.

The Chief Minister has withstood the barrage of arguments about “quasi legalisation”, being soft on prisoners and “just keep the drugs out” to give priority to the health of the prisoners, their families and to the broader community.  The average prison stay in Australia is less than a year.  Prisons are now a high risk environment for contracting Hep C or HIV through the sharing of infected needles. 

It would clearly be much better if there were no drugs in Australian prisons at all.  This is the line pushed by opponents of the program.

However, the methods needed to keep drugs out all would be draconian in the extreme. This would require full body cavity searches of all visitors and the staff at the prison each time they entered the buildings.  Visits would be reduced to a minimum as detainees would not want their wives and daughters searched in this way.  Prison officers have a difficult enough job at the moment without having to start the day being subjected to this sort of indignity.  Then there would be searching all the food and other deliveries.

The reality is that no prison in the world has been able to exclude drugs.  Establishing a needle and syringe exchange program is a pragmatic approach.  For economic and health reasons taking action to stop the spread of disease is appropriate.

These programs operate in many countries.  In visiting such programs in Berlin, Luxembourg, Switzerland and Spain it was evident that the understandable fears some people have prior to implementation of the programs are recognised as unfounded.

Most interesting was a case in Germany where following an election one of the local governments closed a needle and syringe program that had been operating for some years.  The same prison officers that had originally opposed the introduction stridently opposed its removal.

The ACT prison was established by the ACT government within the Framework of the Human Rights Act with the express intention of ensuring that the punishment of being imprisoned was specifically about the deprivation of liberty, rather than also being characterised by the host of prison-related hardships that are often experienced by prisoners in Australia.

A three-pronged approach was announced by Katy Gallagher at the opening of the Public Health Association of Australia’s Justice Health Conference in Canberra. In a manner consistent with the three pillars of the National Drug Strategy, the methodology will be based on supply reduction, demand reduction and harm minimisation.

Prison officers will still be expected to apply their best efforts to exclude drugs from the prison.  Prisoners will be encouraged to come off drugs through abstinence programs that are already available in the prison.  For those who still use drugs there will be clean needles available on a one-for-one swap system to be managed at arm’s length from the warders by the prison health service.

There are strong arguments suggesting Australian governments are, at the very least, morally obliged to take this sort of action. The United Nations 1990 General Assembly Resolution on the Basic Principles for the Treatment of Prisoners (Article 9) states: “Prisoners shall have access to the health services available in the country without discrimination on the grounds of their legal situation”.

The World Health Organization view is “All prisoners have the right to receive health care, including preventive measures, equivalent to that available in the community without discrimination” (WHO 1993).

While Australian jurisdictions use health measures such as needle and syringe programs in the general community it is appropriate that they be available to prisoners.  It is even more important considering the greater danger of spread of blood borne viruses because of the concentration of drug users in the prison environment.

The announcement at the Justice Health Conference in Canberra breaks new ground.  The conference heard that the literature and analysis undertaken both in Australia and abroad consistently demonstrates that the range of needle and syringe programs implemented in overseas prisons have produced comprehensive benefits across a broad range of indicators, well beyond the primary intended outcomes of reducing the use of shared injecting equipment and BBV transmission among prisoners.

The ACT Chief Minister is two months away from an election.

Most political observers would say there are no votes in prisoners.  However, Katy Gallagher has nailed her colours to the mast and has stood up for one of the most vulnerable groups in society.

It remains to be seen if Canberra voters are prepared to reward a politician who actually stands up for what she believes to be right.

• Michael Moore is the CEO of the Public Health Association of Australia and was lead author of a report that recommended a needle and syringe program in the ACT prison.  He is an Adjunct Professor at the University of Canberra.

The report, Balance Access and Safety, is here.



And some of the reaction from the Twitterverse…




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One thought on “ACT prisons announcement hailed as an “historic” decision for public health and human rights

  1. Jennifer Doggett

    I absolutely agree that this is a human rights (as well as a public health) issue. People who inject drugs in the general community have access to legal means of keeping themselves safe and people in prison should have the same entitlement. Governments who know that injecting drug use occurs in prison and fail to provide the information, means and support required to minimise the harms associated with injecting drug use are morally (and potentially legally) culpable.

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