Page Section: Centre Content Column
Prison health services
Terminally ill
prisoner
Getting a
specialist referral
Misunderstanding
about special diet
Appointment
for an artificial limb
Mental health support
in prison
Access to appropriate services while
imprisoned
Difficulty getting a special diet
in prison
Overcoming problems getting
access to the doctor
Risk of ongoing damage due to delays in
getting an urgent referral
Terminally ill
prisoner
A prisoner, terminally ill with metastatic melanoma, and his
wife, complained to an advocate about his treatment in prison.
Although his prognosis was poor with a limited life expectancy his
family were trying hard to be up-beat and positive.
Their concerns were about past treatment for his terminal
illness and the need for a care plan for the future.
Problems with his care included:
1. No pain relief provided overnight for up to 16 hours
2. No consistent monitoring by medical staff. (He had had
major surgery three times for his melanoma.)
3. Prolonged delays with referrals to oncology after new
lumps appeared
4. Treatment and medical care being given during lock down
procedures and at times that suited custodial staff rather than
according to his needs.
5. An incident where he had to be rushed to hospital after
being found gravely ill in his cell - requiring further surgery
6. Another incident where five stitches from recent chest
surgery were missed by the prison health service resulting in a
severe infection over a three-week period - delaying other
surgical consultations.
The advocate spoke with the prison health service on his behalf
and agreed to remain involved to support the couple and monitor the
situation.
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Getting a specialist
referral
A man in a correctional facility had seen the medical officer a
number of times regarding ongoing pain in his right hip. He was
prescribed mild pain relief, which did not relieve his pain. He
felt that health staff saw him as a drug seeker and did not take
his concerns seriously.
With the support of an advocate the man wrote a letter of
complaint, asking for a referral to the appropriate specialist for
a full assessment of his condition, and asking to receive adequate
treatment to resolve the pain.
The Health Manager spoke with the man about his needs. As a
result, an x-ray was ordered and he received physiotherapy at the
local hospital. He also received confirmation that a referral had
been sent for further assessment of his condition.
The man was pleased with the outcome and felt he was taken
seriously because he received formal support through the advocacy
service.
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Misunderstanding
about special diet
A resident of a Corrections facility contacted advocacy as she
had a condition that required her to receive a special diet which
she was not being provided. She understood that her specialist had
given specific instructions to Corrections regarding her diet and
that her GP had also expressed concern that she was not getting the
correct diet.
She had attempted to address her concerns directly with health
staff but had not been able to progress the matter. After
discussing the options with the advocate the consumer requested the
advocate contact health staff on her behalf.
The health team advised that at the appointment with the
specialist both they and the consumer had been given information on
how to manage her condition and that a special diet was not
required. As a result of receiving the woman's complaint it had
become obvious that she had not fully understood the information
from the specialist. The health team provided her with
further information and offered to make an appointment with a
dietitian if she wished.
The woman advised she had been given further information and was
satisfied that the appropriate action had been taken.
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Appointment for an
artificial limb
A consumer in a corrections facility contacted advocacy to
discuss concerns about his artificial limb, which needed replacing.
This would usually be processed as urgent and a hospital
appointment booked, but two weeks after his initial request, he had
still not heard when he could expect an appointment.
The advocate assisted him to write a letter to the health unit
manager outlining his concerns. The manager apologised for the
administrative oversight, and made an urgent referral to the
hospital. The man later advised he valued the input of advocacy
services, thought that without that assistance he would still be
waiting for his limb.
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Mental health support in
prison
A prisoner contacted the advocacy service saying the judge who
sentenced him had said he was to have help from the local forensic
mental health team. However, nothing seemed to be happening and he
was becoming quite stressed about it. He had seen someone on one
occasion earlier on in his sentence, but they had not come back as
promised, and he couldn't remember who they were. He had asked
within the prison what was happening but had been unsuccessful in
getting an answer.
The advocate spoke with the prisoner and described what he could
do. It was agreed the advocate would email the team leader of the
medical unit to search out the information he needed and arrange
for him to be seen.
The nurse emailed back saying there was meant to be an
arrangement for the forensic mental health service to come back and
see him. She set up a new appointment for him and he was happy
about that.
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Access to appropriate
services while imprisoned
Prison health service ~ Care of
chronic condition ~ Pain management ~ Education ~ Dignity and
independence ~ Complaints process ~ Rights 3, 4, 10
A prison inmate made a complaint to an
advocate about the management of his colostomy and difficulties he
was having with receiving adequate pain relief. Prior to his
imprisonment, his care was provided by a family member. This meant
he was not familiar with details of his care and he lacked the
confidence to change his own colostomy bag. He also needed to
arrange for an ongoing supply of colostomy bags. He was frustrated
at the lack of help provided by the prison health service.
The advocate arranged a meeting
between the manager of the prison health service and the inmate.
The advocate attended to provide the inmate with support. At the
meeting, the inmate had an opportunity to explain the difficulties
he was having in changing the bags and in getting new bags brought
into the prison. He also discussed his current pain management. The
meeting ended with an agreement from the manager that the doctor
would review the inmate's pain relief, and they would invite an
ostomy nurse to come to the prison to show him how to change and
maintain his bags, and provide him with additional bags.
When the advocate contacted the man a
month later, the education session and additional bags had not yet
been supplied. A follow-up letter to the manager ensured that these
services were provided.
The man advised the advocate that he
was pleased with the outcome, and that, as a result of his
experience and the support that was offered, he would like to be an
advocate/educator to others in prison with colostomies. He was
given the contact details of the local Prisoners' Aid and
Rehabilitation Society and advised to speak to them about his
plan.
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Difficulty
getting a special diet in prison
Prison health ~ Coeliac Disease ~ Special diet ~
Dietitian
A consumer contacted an advocate because of the problems she had
encountered getting an appropriate diet in prison. She has Coeliac
Disease and told the advocate that both her specialist and GP in
the community who had seen her recently had expressed their
concerns about her diet.
With the consumer's agreement the advocate sent an email to the
prison health team outlining the consumer's concerns. An email
response was received to say that staff had spoken with the
consumer and clarified with her what she could and could not
eat.
When the advocate contacted the consumer, she advised she was
happy with the outcome of her complaint as not only had she been
given more dietary information but she had been offered a
consultation with a dietitian.
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Overcoming
problems getting access to the doctor
Prison health ~ Surgery complications ~ Access to doctor ~
Right 4
A prisoner contacted an advocate about his lack of success in
getting a medical assessment for the complications of prostate
surgery. Although the surgery had been some months before, he had
experienced ongoing problems following his discharge from hospital.
He developed an infection and had experienced blood clotting
problems. He had always had some pain but increasing pain prompted
him to contact the advocate after two appointments with the prison
doctor had both been cancelled. He felt the nurses were not
listening to him and that something serious might be developing, as
the Panadol he was being given was no longer controlling his
pain.
He felt that he had exhausted the avenues available to him
without making any progress and requested the advocate speak with
the Team Leader of the Medical Service on his behalf. The Team
Leader agreed to organise a reassessment and contacted the advocate
to say everything had been taken care of.
The consumer confirmed he had been seen by the doctor and that a
referral was being made back to the hospital so he could have his
symptoms investigated further. He was pleased with the outcome and
the support he had received from the advocate.
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Risk of ongoing damage
due to delays in getting an urgent referral
Prison health ~ Referral delay ~ Standard of care ~ Right 4
~ Communication ~ Right 6
A prisoner contacted an advocate seeking assistance to find out
whether a referral had been made to a specialist to assess his
injured finger. He said he had injured it three months previously
and when seen by the doctor he was told an urgent referral would be
made to a specialist to assess for tendon damage. He said he
attempted to follow the matter up on a number of occasions but the
nurses kept advising they had heard nothing. He said the finger
remained painful and that the work he did meant he often knocked
the finger causing more pain. He was concerned there may be
permanent damage.
After discussing the options, he requested the advocate make
direct contact with the Prison Health Team to see if there had been
any progress.
Three days later a member of the team advised the advocate they
had contacted the local hospital who said they had never received
the referral and requested an urgent referral be sent straight
away. They had also spoken with the appropriate registrar who had
advised how they should be managing the consumer's finger in the
meantime. This information had been relayed to the consumer, along
with an apology for the delay in following the matter up. They were
reviewing the system for managing referrals to the local hospital
to ensure this type of situation does not happen again.
The advocate contacted the consumer who confirmed that he had
received an apology. The specialist said that had he been seen
earlier, he would have had a much better clinical outcome as a
ligament graft would now need to be done to ensure full use of the
finger. The consumer was happy with the support he received from
the advocate and the quick action that resulted from making contact
with the advocacy service.