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Children in prison deserve proper healthcare

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In Australian juvenile detention facilities and adult prisons, the incarcerated are excluded from Medicare (Screenshot via YouTube)

Incarcerated children are not second-class citizens, but our Federal Government is giving them second-rate healthcare by denying them Medicare, writes Connie Georgatos.

WHEN EVALUATING the nation’s carceral system, we are unable to make it to the second level of Maslow’s pyramid of human needs before encountering a deprivation of the most basic human rights. 

There is no worse discrimination than health inequality. Australia boasts about its trillion-dollar-plus gross domestic product economy, but when it comes to the health rights of its citizens, not everybody counts.

Australia’s population is 25.5 million people, of which the overwhelming majority are citizens, thus entitled to receive Medicare. Readers may find this hard to believe, but health rights such as Medicare and the Pharmaceutical Benefits Scheme (PBS) are denied to Australia’s 40,000-plus incarcerated individuals, of whom, thereabouts,1,000 annually are children. 

This is disgraceful. This is a deprivation of basic human rights. 

There has been a long silence about this life-threatening inequality. Where is the outrage? Where are the campaigns? There are only a few online articles about this disgrace.

In my work, as a projects manager with the National Suicide Prevention and Trauma Recovery Project, I have been part of restorative and transformational projects in prisons. I have seen the effects of health inequalities and the impact of not having Medicare. 

I have a visceral memory of conducting a walk-through of a prison medical unit as part of an independent restorative project, where I encountered a young man begging in agony and desperation — pleading, on his knees, for medical help. He had been experiencing severe nerve pain in his mouth for weeks — the pain was debilitating. We addressed this inside the prison and arbitrated a just outcome immediately. He was forever thankful. 

I am saddened by his thanks for the healthcare that we all take for granted. Incarcerated individuals must not be treated as second-class citizens, so why are our governments giving them second-class healthcare? 

I know of endless horror stories — of infections untreated that led to amputations and worse: death. I will not horrify readers with more but instead urge that we rise in a targeted call for Medicare for all, for PBS and access to the National Disability Insurance Scheme (NDIS) for everyone.

In Australia, do we believe in human rights for all Australians? Or do we take them away when someone is incarcerated? Healthcare is not a gift; it is a right.

The cycle of disadvantage is perpetuated by withholding access to standard healthcare from incarcerated individuals. Think about who comprises much of the prison population – the poorest, the most vulnerable and the homeless – many of whom never had a chance from the beginning of life. 

My father, Gerry Georgatos, is a leading researcher and prison-reform advocate — in general, a prisons-abolitionist. He has long argued that post-release, former inmates (as a categorical population) are among the highest at risk of suicide and dying of unnatural deaths.

My father has long spoken about the failure of Australian prisons.

Said Gerry Georgatos: 

'The situational trauma of incarceration is punishment enough, the rest of the deal has to be an opportunity for forgiveness and redemption. Prisons have failed with the punitive and must move away from vile corrals of broken lives smashed into ruined lives, damaged into the irrecoverable. The firmament of punishment is toxic in its narrative of human misery and suffering and in little that is positive.'

Deterrence is one thing and cruelty another thing. Suspending Medicare and PBS access for those incarcerated is nothing but torment. 

In the end, though, it is not prison authorities who take away Medicare, PBS and NDIS access — it is our Federal Government.

In juvenile detention facilities and in adult prisons right across Australia, the incarcerated are excluded from Medicare and denied the same level of healthcare as the rest of us. They are denied the PBS. They are also denied the opportunity to access the NDIS. Think about this — our Federal Government denies Medicare to gaoled children as young as ten-year-olds.

Who legislates such inequalities? There have been decades of immorality by federal governments in suspending these health rights. To argue that the cost is too high in one of the world's wealthiest nations is impermissible. 

To think that there are some children as young as ten, physically suffering, isolated, in a bleak concreted fragment of reality, without access to conventional medical treatment, is unbearably heart-wrenching. Yet at the hands of successive federal governments, this is their reality. 

Tragic outcomes are often the result of second-rate healthcare.

As Gerry Georgatos recounted:

'Often someone has to collapse before they are bundled out of a prison and to a hospital. I recount an inmate who had to have part of his hand amputated after a coffee kettle incident – he begged for hospital treatment but was denied this for more than a week until the infection that had set in became evident to the naked eye. Paracetamol was all he was given for the throbbing pain.'

So, let us clarify who we need to press to make a change. Prisons – whether for adults or kids – are state and territory jurisdictional responsibilities. However, Medicare, the PBS and NDIS are federal responsibilities. It will take only minor amendments to federal acts relating to the above to ensure that all prisoners and detainees are protected with Medicare and the PBS, and entitled to the NDIS.

Our state and territory governments need to be systemic advocates for people. We are the grassroots, the coalface — the community advocates. State and territory governments are part of the Australian National Cabinet. The Council of Australian Governments (COAG) is the best placed to arbitrate changes.

The departments of Australia's various corrective services need to put pressure on their respective state and territory governments. We must prioritise awareness-raising and campaigns. We must be relentless. To know what is right and not to do it is the worst cowardice.

We must bust for amendments to the Health Insurance Act 1973', section 19(2). Governments can amend for the inclusion of Medicare and PBS subsidies for prisoners — amendments must also be made to include the NDIS for prisoners who, at this time, are excluded.

As my mother always tells me — how we treat the most vulnerable is who we are. 

We must make our government bodies aware that we will not sit idly by while incarcerated individuals – including children as young as ten – are being deprived of appropriate healthcare.

If you would like to sign a petition to help stop the deprivation of Medicare to children in Australian gaols, click here.

This story contains a video that references mental health issues and suicide. If you would like to speak to someone about mental health or suicide, you can call Lifeline on 13 11 14.

Connie Georgatos is a youth and homelessness advocate and a project manager with the National Suicide Prevention and Trauma Recovery Project.

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