More than fifty thousand prisoners pass through the correctional system of Australia annually due to the increase in the general population. The health status of prisoners is poor and is linked to poor socio-economic status and lack of education. They have high levels of chronic and communicable diseases, mental illness and disabilities, following their previously lived careless lives (Lawrence et al. 2010). In Australian prisons, one in four prisoners has a chronic health condition, thirty-five per cent of them have a mental disorder and are more likely to have experienced domestic violence, and childhood sexual abuse and the disabled are represented disproportionately among them (Australian Institute of Health, 2012). Therefore, in their wellbeing, the average length of sentence is thirty-nine months whereby they are supposed to return to the community.
However, if they are not re-offending and quickly returned to prison in a repetitive and vicious cycle, then the officers in charge ensure that during their sentence, they receive adequate and appropriate rehabilitative services. Also, the Australian jurisdictions have invested a lot in the social, rehabilitative programs that are of high standards and evidence-based. However, little has been done to solve the physical and mental health needs of prisoners who often return to their communities in poorer health. Reason being, ten per cent of prisoners, inject themselves with drugs for the first time while in prison causing high hepatitis C infection rates on discharge (McCloughen et al. 2012). This activity highlights the high health care needs of the prisoners upon discharge and the allocation of resources for health care services in and outside the prison system.
Barriers that Prisoners may Face when Accessing Health Services
Prisoners tend to be from backgrounds that are disadvantaged, characterized by low educational attainment, unemployment, insecure housing, innumeracy, illiteracy, and drug and alcohol addiction. The barrier that Australian prisoners may face when accessing health services is an effective exclusion from the Medicare and Pharmaceutical Benefits Scheme (PBS). The health insurance act of the commonwealth precludes services provided under the PBS or Medicare if the services are provided by the territory and state government authorities (Gulliver, Griffiths & Christensen, 2010). While they intend to curb double dipping, the underinvestment in the health services in prisons by the Australian jurisdictions means that prisoners often miss out some medications and treatments that are available in the wider community. For example, the Aboriginal and Torres Strait Islander health check, screening for bowel cancer for the aged, some pharmaceuticals and access to psychologists (Acharya et al. 2017). Also, the exclusion activity provides no financial incentive for the community health service providers to enter prisons, mostly in the rural and remote areas (Weinstein et al. 2014).
Aspects of Existing Health Service Provision that are in Place to Remove the Barriers and Support Prisoners
The two aspects that are in place to curb the barriers and support prisoners are the World Health Organization (WHO) and International frameworks from the United Nations (UN). These agencies stipulate that everyone is equal in matters of health and prisoners should receive health care that is equivalent to that which is available in the community, without discrimination based on their legal state. The World Health Organization monitors and assesses the health trends and concerns in prisons (Enggist et al. 2014). While communicable diseases and mental illness are supporting high mortality rates and poor health conditions for prisoners after being released, the organization assesses the trends to ensure that its resources are well incorporated in prisons to enhance good health and the community at large. WHO often ensures that prisoners are given fast medical attention following the situation and condition of people behind bars. They also give the prisoners priority in health programs as they know the prisoners cannot access certain health requirements as well as the medical institutions in prisons (World Health Organization, 2012). The organization also advocates for evidence-based and ethical policy in promoting the global health of prisoners. WHO takes most responsibilities for building strong foundations on evidence-based science and ethical policies by ensuring that their work is backed by sound science. They can assess the bodies of the prisoners to ascertain good health conditions and advocate for better treatment of the critically ill prisoners (World Health Organization, 2012).
The United Nations, on the other hand, advocates that in every institution, there shall be at least one qualified medical officer available in the service who should have good psychiatry knowledge. The medical services must be organized in close relationship to the general administration of health of the nation or community (Forsythe, Coate & Pease, 2013). Also, the prisoners who are sick and require specialist treatments should be transferred to institutions that are specialized or to civil hospitals. Where an institution has been provided with hospital facilities, their furnishings, equipment and pharmaceutical supplies will be proper for treatment of sick prisoners, the medical care, and there will also be a staff for trained officers who are suitable (Kinner & Wang, 2014).
Deficits in the Health Provisions for Prisoners
The deficits in the health provisions for Australian prisoners that have not been mentioned are human vaccination and immunotherapeutic. Vaccination is the intervention that has helped to improve most human life expectancy in prisons. It is a very cost-effective and efficacious intervention because it may eliminate and eradicate some infectious diseases. Therefore, the health interventions in prisons that are potential, the ones related to vaccine-preventable diseases should be a priority in the prisons (Fazel et al. 2016). Nonetheless, prisoners accessing vaccination have a direct impact on the population that is targeted and the community at large. High coverages that are achieved by vaccination routine result in herd immunity that can reduce or avoid the spread of contagious diseases. Prisons with a population that is detained in a confined place offer a paradigmatic opportunity for the intervention of vaccination (Kavanagh et al. 2010).
Also, there is the shortage of vocational health training teachers in prisons as community and welfare justice groups have warned that the cuts to services of education in jails will reduce employment opportunities in the future and increase the rate of prisoners reoffending. People argue that without health education in the systems of prisons, rehabilitation becomes more difficult (Santora, Arild Espnes & Lillefjell, 2014). Therefore, the education officers for prisons have reported some course hours being cut as changes in the government means that prisoners are no longer eligible for concession rates for the courses.
Proposal about How the Deficit might be Better Addressed by a Fictitious Service.
Therefore, I propose that the deficit of vocational health training teachers be addressed by the Prisoners Health Training program. This program advocates for the right of prisoners and is always in favour of prisoners who stand to be corrected. The program might help prisoners adopt good health practices and caring for their health as well as their brother's health. Thus, the program might enhance the reduction of mental disorder, and the spread of communicable diseases as prisoners will feel cared for, and having the companies of other responsible prisoners taking care of them that erase negative thoughts of correction institutions. Also, the service might make released prisoners visit other prisoners and offer donations to help them due to the proper treatment they were offered while in jail.
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