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Governments urged to address determinants of incarceration, and provide safe healthcare in prisons

Croakey is closed for summer holidays and will resume publishing in the week of 15 January 2024. In the meantime, we are re-publishing some of our top articles from 2023.

This article was first published on Wednesday, March 29, 2023


*** Aboriginal and Torres Strait Islander readers are advised this article contains details of a person who has passed in traumatic circumstances ***

Governments have been urged to address poverty and homelessness to help prevent the incarceration of Aboriginal and Torres Strait Islander people, and to ensure culturally safe and effective healthcare is provided in prisons, reports Alison Barrett.


Alison Barrett writes:

The Northern Territory reached record levels of imprisonment this week with one percent of the Territory’s population recorded as being in prison on Monday.

Meanwhile, in Victoria, health, legal and human rights experts are calling on the Andrews Government to “act now on the overimprisonment of Aboriginal people in youth and adult prisons”.

They are urging the Government to raise the age of criminal responsibility to 14 years, minimum age of detention to 16 years and implement “early intervention and rehabilitation as alternatives”.

The abysmal state of healthcare in prisons was the focus of a webinar hosted today by Victorian Aboriginal Legal Services. As highlighted by the Coroner’s report into the death in custody of Veronica Nelson, a proud Gunditjmara, Dja Dja Wurrung, Wiradjuri and Yorta Yorta woman, “multiple systems, services and people repeatedly failed her” and reform is urgently required.

In a pre-recorded discussion shared at the webinar, Professor Megan Williams, head of the Indigenous Health Unit at UTS and expert witness in relation to prison healthcare in the Veronica Nelson inquest, emphasised that people in prison should have access to the “same standard of healthcare available in the community and have access to the necessary healthcare services free of charge without discrimination”.

Williams, who is also Chair of Croakey Health Media, told the webinar that with their “successful, robust Aboriginal workforce”, the Aboriginal Community Controlled Health Organisation sector would be ideally placed to deliver culturally safe healthcare in prisons, especially as Aboriginal people are over-represented in prison.

“They should be providing the care,” said Williams.

Culture is protective

Jill Gallagher AO, CEO of the Victorian Aboriginal Community Controlled Health Organisation, agreed with Williams’s suggestion that many of the VACCHOS are “more than well placed to provide those services to Aboriginal people in prisons”.

They have strong connections to people in the community and the holistic model of care has culture strongly embedded throughout their services, according to Gallagher.

“Culture is a very important protective factor in delivering health services. No private provider can do that or even understand that,” Gallagher said.

Gallagher said some of the recommendations from the Victorian ‘cultural review of the adult custodial corrections system’ – of which she is an expert advisor – are easy to implement, including a public health model in all prisons in Victoria.

In addition to a public health model, “legislation needs to be changed to have a more of a rehabilitation focus” and training for correctional staff should be longer than eight weeks and “should not just have a focus on law and order”, Gallagher told the webinar.

Address poverty and homelessness

Julie Tongs OAM, CEO of Winnunga Nimmityjah Aboriginal Health and Community Services in the ACT, spoke about their experiences providing culturally safe healthcare in prisons.

They have nurses working in prisons 365 days a year from their service, as well as an Aboriginal cultural support worker based in prison.

Tongs acknowledged it is a very “challenging environment”, very punitive and “it is about power and control”.

However, despite the challenges, their aim is to provide “the right health care at the right time to our men and women who are incarcerated”.

In addition to culturally safe healthcare in prisons, it is important to prepare and support people who exit prison back into the community, to prevent reoffending.

“We want people to come out [of prison] in a better state of mind” than when they went in, Tongs said. But, they are often “coming out worse than when they went in” because they are treated so badly in prison.

Tongs also emphasised the importance of addressing poverty and homelessness, as “two of the biggest drivers for more and more of our people being incarcerated”.

If poverty could be alleviated, and external services like mental health, drug and alcohol rehabilitation were improved, “we could prevent people from ending up on the inside”, Tongs said.

From Twitter

See Alison Barrett’s thread from the webinar here.

See the Archer Magazine here.


See Croakey’s archive of articles on justice, policing and health

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