The Minister for Health has released the Nous Group’s National Review of First Nations Health Care in Prisons: Final Report and the Health Ministers’ joint response to the review.
‘As a National Network of Incarcerated and Formerly Incarcerated Women and Girls, we welcome the effort to shine a light on the health care challenges faced by First Nations people in prison but remain deeply concerned about critical oversights,’ said Tabitha Lean.
Tabitha Lean said: ‘While the report comprehensively raises many long standing issues—including difficulties accessing health care, substandard health services, the exclusion of Medicare in prison, poor continuity of care from prison to the community, medication management failures, and a lack of culturally appropriate and gender-specific health care—it falls short in key areas:
- Access to Disability Support Services: The report fails to adequately address the inability of disabled prisoners to access the National Disability Insurance Scheme (NDIS). It acknowledges that “disability care is not considered health care in the custodial system” and often falls through the cracks between health and justice departments. Given the high numbers of people in prison with a disability and the government’s recent legislative changes that have a direct impact on criminalised people and their access to the NDIS and their ability to self-manage their plans, the omission of NDIS scrutiny leaves disabled prisoners vulnerable to ongoing systemic neglect.
- Absence of Prisoner Consultation: While the Nous Group acknowledged their limited consultation time, they conducted state-based roundtables and engaged with 21 organisations but were unable to consult with actual prisoners themselves. This lack of direct engagement with those most affected reflects a broader systemic erasure of incarcerated voices. This is not a criticism on Nous specifically, but rather an opportunity for us to highlight the way issues affecting us as criminalised people are theorised about rather than informed by. In this case, recommendations were determined without input from people currently incarcerated. We are left questioning; how different might the report’s recommendations be if prisoners’ direct experiences had been centred?
- Therapeutic Custody Models: Most disappointing is Recommendation 6, which calls for piloting “alternative, therapeutic models of custody for First Nations people”, referencing international examples. The report lacks critical reflection from Indigenous groups on whether these models have proven culturally safe or effective in reducing criminalisation. In fact, many reports indicate that the models that have been implemented in Canada have proven unsuccessful, with the numbers of Indigenous people being recriminalized actually increasing. Most importantly in the Australian context, this recommendation neglects to recognise that the criminalisation of First Nations people stems from colonisation and racial capitalism, not cultural failings or individual deviance.
- History of Inaction: This report risks becoming just another glossy document without real change. Governments have failed to implement the recommendations of the Royal Commission into Aboriginal Deaths in Custody and the many coronial inquests that have followed. Why should we believe this report will lead to meaningful action? It is a privilege to call for incremental change, to hold onto hope, and to as for patience while people continue to live and die in a broken system.’
The National Network submit that if the government is serious about the health and wellbeing of First Nations prisoners, it must:
- Establish national standards with national oversight to ensure compliance with Australia’s international human rights obligations.
- Reform the exclusion of prisoners from Medicare and the Pharmaceutical Benefits Scheme (PBS).
- Commit to genuine engagement with incarcerated people and those with experience of being incarcerated in prison to inform policy and practice.
‘The problem is not a lack of knowledge about the issues—they have been well documented for decades. The problem is the absence of political will to act,’ said Debbie Kilroy. ‘Until that changes, reports like this will remain empty gestures, andthe lives and humanity of Aboriginal prisoners will continue to be disregarded,’ said Debbie Kilroy.
For further comment, please contact Tabitha Lean on 0499 780 226 or Debbie Kilroy on 0419 762 474
