August 15, 2012
Information about Justice Health: http://www.justicehealth.nsw.gov.au/publications/fmhsymposiumweb.pdf
JA paper to Symposium: "The Emperor has no clothes: Justice Health’s lack of concern for the welfare of its clients is blindingly obvious and yet the health industry still pretends it is fulfilling its obligations. download
Justice Health, which has responsibility for the health of consumers in mental health hospitals and prisons, lacks the ethical foundation for patient-centred care on which to base its policies and practices. It needs structural change and supervision by the mainstream medical profession to achieve its stated goals.
Justice Health faces a conflict of interest in that while it is funded and legally bound to serve the health needs of those people held in detention, it is dominated by a culture of hostility towards its clients. The World Health Organisation identified it as “multiple loyalties”, where issues including the power of the security authorities, common source of payment, cultural separation, distrust and ease of servicecombine to reduce empathy for the patients. It is failing dismally in its legal and moral obligations towards a vulnerable community with high physical andmental health needs.
Torture of prisoner in the care of Justice Health
Justice Health has been party to the torture of an elderly prisoner under its healthcare. For 15 of his 20 years in jail, Malcolm Baker (file) has been held in effective solitary confinement in super maximum security despite his non-violent prison history. He is moved from cell to cell every four weeks, which denies him the stability of a home. When he is out of his unit, he is put in leg irons andhandcuffs. He is assaulted and his possessions smashed while guards watch. He is told that he is mentally ill and was forcibly medicated until we protested. Justice Health has refused to intervene or support his request for us to be nominated as his primary carer, or be present at his Mental Tribunal hearings, or visit him. We have reconnected him to his family and friends, and maintain a mentoring relationship with him. Additionally we have arranged an independent lawyer and psychiatrist for him.
The allegations of corruption and the proposals for independent consumer representation, contained in the “OUR PICK Report” have so far been ignored, despite its national distribution to stakeholders two years ago. Then we produced the “Changing the Driver Report” (May 2012), which analysed the key principle of consumer controlled funding. This principle was adopted by the Productivity Commission in its National Disability Insurance Scheme, and will solve many of the problems currently experienced with Justice Health. Choice and a market are essential for a fair delivery of detainee services. These reports are critical to issues to be raised at this symposium and must be addressed.
On behalf of all detainees, Justice Action demands that a working group be set up to address the independent delivery of health care, and that it include serving prisoners, mental health patients and their representatives.
JA’s CURRENT WORK
Since the launch of the “OUR PICK Report”, JA has maintained its focus on people subject to abuses by authority. We support those who are the most harshly treated and isolated, offering them community assistance instead of exclusion. This approach was effectively used during the Dennis Ferguson furore to highlight his humanity and present alternative ways of dealing with such issues.
We are currently mentoring detainees across Australia, focusing on health services in prisons and mental hospitals. Health authorities have responded with strong resistance to any suggestion that patients have residual rights of self-determination. The authorities themselves openly admit that they have a cultural problem, and while they say they welcome our involvement, they block us at every turn.
EVIDENCE OF ENDEMIC CULTURAL PROBLEMS
Details of our current campaigns on the physical and mental health of detainees are on ourwebsite. We have taken several cases to the NSW Supreme Court and the Administrative Decisions Tribunal. These concern the rights of political expression, identity, education, and the right to refuse medication. Despite these legal wins, westill have to confront antagonistic administrators in a culture that does not respect patients’ human rights.
In NSW, the 2012 health budget of $17.3 billion includes the funding of patient advocacy support groups but we have refused any funding to avoid a situation of conflict of interest. We stand alone, funding ourselves.
Here are some of the issues:
Right to education: blocking administrative decisions tribunal settlement
On 30 May 2012, a settlement was reached in which the NSW Justice Health agreed to forensic patient Saeed Dezfouli’s right to education. They then refused him the necessary access to his computer after he had enrolled in a course. Furthermore, Justice Health refused to supply the wording of the settlement to Justice Action, Saeed’s primary carer, which could ensure it was being enforced. Justice Health instructed its lawyers to only communicate via Saeed’s appointed litigation guardian or with Saeed himself without support. We aretaking this matter back to court.
Forced medication appeal to Supreme Court
On 31 May 2012, an attempt was made to block our appeal to the Supreme Court against Saeed’s forced medication. Initially, Justice Health refused the independent psychiatrist entry to the tribunal hearing. It also wrongly stated that no request had been made to stop the forced medication, thus no appeal could be made. We are going to court over the matter.
Attack on primary carer
The government pursued a $32,000 costs order against Saeed Dezfouli’s primary carer (Brett Collins of JA) after losing a court case. The Greens Justice spokesperson, David Shoebridge, said: “the decision for costs has sent a chilling message to other public interest advocates”. The Attorney General has threatened the carer’s arrest if he doesn’t submit to his cost demands by mid-September.
Political expression and refusal to accept the Supreme Court’s settlement
The Supreme Court settlement that allowed political material like JUST US from external organisations into hospitals has been subverted. On 10 July 2012, Justice Health ignored its new policy and voiced their “unhappiness with the wording” on a poster, especially in regards to the “competition with prizes for patients’ stories about the best and worst doctor”, claiming it would not help their relationship with the hospital. This was the first test after the settlement and still awaits their final decision on access to political material for patients.
Breach of agreements by NSW Justice Health
The highest personnel in NSW Justice Health have ignored their own undertakings. They had promised to make a statement regarding issues affecting several patients’ welfare “before the week’s end” on 13 July 2012. They still haven’t done so.