Justice Action presented at a roundtable 31/12/09 with the UN Special Rapporteur on the Right to Health, Mr Anand Grover, who is on an official visit to Australia. His focus Is on Indigenous health, migrant health and the health of people in detention. http://www2.ohchr.org/english/issues/health/right/index.htm.

We adopted the papers prepared by the Human Rights and Law Resource Centre http://www.hrlrc.org.au/ downloadable at:
http://tinyurl.com/ylgpq9q

and that of the National Indigenous Drug and Alcohol Committee

http://www.nidac.org.au/publications/pdf/nidac_bridges_and_barriers.pdf

Additionally we presented the paper below and talked to it. JA.

HEALTH TREATMENT – THE WEAPON OF CHOICE
UN Special Rapporteur on the Right to Health in Australia meeting 30/11/09

Health support for detainees is hopelessly compromised by an authoritarian culture, where health bureaucrats have contempt for consumers and total power over their preferences. NGOs are neutralised due to funding dependency. Here we suggest a way forward.

People locked in prisons, mental health, juvenile justice and immigration facilities suffer very significantly from the process of their treatment by the state. The isolation from family and community support, and further isolation in cells for extended periods causes additional damage, and is degrading and inhuman treatment. Aboriginal people are even more affected. Women and juveniles increasingly so.

Consumer involvement is essential to bring changes, both collectively and individually, but detainees are discouraged from hope. As a leader at an international seminar on torture last week said: “we can’t put up notices. We don’t want to raise their expectations”.

Contrast this with the careful analysis: “Consumers’ perceptions and experiences of the services they receive are central to the outcomes that are achieved.” (MH‑CoPES 2006) It is immensely cost effective. Studies show 30% outcome improvement when consumers support the treatment.

We challenge the policy of dictating lifestyles to consumers in closed institutions, including forced medication to change behaviour. We focus on the forced withdrawal of tobacco as symbolic of dishonest concern for consumers’ welfare yielding counterproductive results. Justice Action supports health consumers’ “Right to Choose” as the only way to improve outcomes, mentally, socially and physically. http://tinyurl.com/y9wz36f

Involuntary medication for patients, in breach of international standards, regulations and ethics and to deal with the tension caused by the smoking ban is outrageous.

The case of Saeed Dezfouli, a patient for whom JA has primary care responsibility is held down by staff and forcibly injected every two weeks since the ban as he appears disturbed. Despite agreement that he is not a violent man he is refused access to education, exercise or proper social contact. Undertakings are made and ignored because he complains about his treatment. He and those who support him have no enforceable rights. http://tinyurl.com/yf4sbcl

The PHAA Conference “Justice Health in Australia: Beyond the Convict Era” 4/2009 resolved:
“The participation of affected communities, families, prisoners and ex-prisoners as well as those involved in service delivery is critical. We now call on Governments, Non-Government Organisations and individuals to do all within their power to ensure effective implementation.” http://www.phaa.net.au/conferenceRes.php But governments ignored it.

Proposals
After an international consultation we propose:

– using the prisoner representative structure of the Inmate Development Committees (IDCs) to present prisoner interests. This allows cost free continual monitoring, gives community training, presents collective concerns and avoids victimisation.

– consumer representation by serving prisoners and patients at the decision-making levels on the Health Boards to ensure they are responsive.

– using existing technology including the video camera monitoring in the high security cells as a communication device to families and communities. Internet access to legal databases through recycled computers in cells doesn’t cost money and makes the communication processes real.

– strengthening the NGO’s and exprisoner community to be independent of government funding and coordinating information to assist development of health policies.

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