05 August 2024
C182179
Caleb
[FYI request #26874 email]
Tēnā koe Caleb
Thank you for your email of 19 May 2024 to the Department of Corrections – Ara Poutama
Aotearoa, requesting information about medical services in prisons. Your request has been
considered under the Official Information Act 1982 (OIA).
Corrections manages some of the most complex and vulnerable people within our society.
People in prison are known to have had limited access to healthcare in their communities
prior to entering prison and are therefore likely to have unmet health needs. We have a
duty of care to all people in prison, which we take seriously. Our Health Services staff work
hard to ensure all people in prison receive a standard of healthcare that is reasonably
equivalent to that available to the public.
Every New Zealand prison has a health centre, and primary healthcare services are delivered
by our Health Services team. This includes basic dentistry, general practitioner (GP) services,
nursing, physiotherapy and mental health services. Where secondary or tertiary healthcare
services are required, referrals are made on the same basis as any person in the community.
You requested:
I am writing to request information under the Official Information Act (OIA)
regarding the waiting lists for medical services at the fol owing prisons: Rolleston
Prison, Otago Correctional Facility, Rimutaka Prison, Mt Eden Prison
Specifically, I would like to know:
The current length of waiting lists for seeing a nurse, a doctor, and a dentist at each
of the mentioned prisons.
The longest time an individual has been on the waiting list for each of these services
at each prison.
Please provide this information in a tabular format, specifying the prison name, type
of service (nurse, doctor, or dentist), current waiting list length, and the longest
waiting time.
NATIONAL OFFICE, WELLINGTON
Mayfair House, 44 – 52 The Terrace, Wellington, 6011, Private Box 1206, Wellington 6140,
Phone +64 4 460 3000
www.corrections.govt.nz
Staffing Levels and Resources:
How many healthcare professionals (nurses, doctors, dentists) are currently
employed at each prison?
For ease of response, these parts of your request are answered together.
Please refer to Appendix One, which provides the fol owing information:
• Table One: wait times for dentists, medical officers (GPs), and nurses at Rolleston
Prison, Otago Corrections Facility, Rimutaka Prison and Mt Eden Corrections Facility
• Table Two: healthcare staff employed at each prison, as at 24 May 2024.
When reviewing this information, please be aware that the reasons for waitlists are multi-
factorial and there are many different circumstances which may have contributed to longer
wait times. These factors, some of which are not unique to the prison population, include
staffing levels of medical officers, dentists, nurses and other health staff; the availability of
custodial staff to supports movements for health centre appointments; and the need to
prioritise those with urgent health needs.
A triage process is used to identify people who need more urgent care. Some conditions
may be monitored outside formal appointments and escalated if required. Triage processes
apply after hours with systems to determine escalation processes including transfers to
hospital emergency departments when necessary.
Are there any shortages of medical staff, and if so, how is this affecting service
delivery?
Like many other organisations and businesses around the country, Corrections has been
facing ongoing chal enges related to staffing levels. Our health services teams have been
under pressure since the COVID-19 pandemic began and we have experienced the same
recruitment issues as our Te Whatu Ora/Health New Zealand and other health sector
col eagues. However, we have strong business continuity plans which prioritise responding
to emergency or acute clinical care needs, access to medications and access to nurses or
doctors as required. Triage and prioritisation processes are in place to support access to
care and in some cases the use of virtual (AVL) health medical officer or specialist/hospital
outpatient consultations may be provided.
We fully acknowledge the pressure this has placed on staff working in prisons, which is why
we are making a concerted effort to recruit, retain and train. This includes launching a new
recruitment campaign, strengthening our recruitment processes, improving our onboarding
processes, implementing new rosters which provide our staff with better work/life balance
and help them to avoid fatigue, and continuously working to improve staff safety. Our staff
have also been carrying out recruitment activities in their local communities, for example,
information evenings for people interested in working with Corrections.
For recent employment vacancy numbers, we refer you to the fol owing Written
Parliamentary Question:
https://www.parliament.nz/en/pb/order-paper-questions/written-
questions/document/WQ_37236_2024/37236-2024-dr-tracey-mclellan-to-the-minister-of-
corrections
Appointment Scheduling and Prioritization:
How are appointments scheduled? Is there a centralized system, or do individual
units/prisons manage their own scheduling?
Are appointments prioritized based on urgency (e.g., emergency cases, chronic
conditions, preventive care)?
Communication Channels:
How do inmates request medical appointments? Is there a formal process, and are
they informed about their place on the waiting list?
These parts of your request are answered together.
Access to health services is usually requested in writing on a Health Request Form (HRF),
however some people wil raise health issues directly with health staff when they are in the
units completing other tasks such as medication rounds, or custodial staff may contact
health staff on a person’s behalf. HRFs are collected daily and are reviewed as soon as
possible by a member of the health team. Triage systems are used to prioritise the order
and timeframe in which a person is assessed. The person who submits an HRF is informed of
the outcome of their request within 72 hours. In some cases, people wil be advised that
their request has been triaged and informed of what they can to do to help support their
wellness until an appointment is available. If it is not clear from the HRF as to the urgency of
need, a nurse wil fol ow up with the person to support access to the right service.
Corrections does not operate a centralised system for scheduling medical appointments and
each prison’s health centre manages their own appointments. However, Corrections has
overall policies and procedures relating to the triage of HRFs.
Are there any communication barriers (language, literacy, etc.) that might affect
inmates’ ability to seek medical attention promptly?
Corrections takes steps to ensure that people who have difficulty with language or literacy
are able to access health services. As noted above, requests for health services are largely
made via an HRF, which usual y requires the person to put their request in writing. However,
if there are concerns regarding a person’s ability to do this, including any indication of
language or literacy issues, staff would speak directly with them to better understand their
health issues and ensure appropriate triaging.
Data Col ection and Reporting:
How frequently are waiting lists updated? Is there a real-time tracking system?
Are there regular reports on waiting times, and are these accessible to the public?
Corrections has internal quarterly health dashboards which measure the average number of
days between when an appointment is scheduled and the date of that appointment. As
mentioned above, this is a site-level practice and each health centre manages its own
scheduling.
Quality of Care:
Are there any quality assurance mechanisms in place to monitor the healthcare
services provided?
All prison health centres are certified via the
Royal New Zealand College of General
Practitioners Foundation Accreditation. This is a quality assurance mechanism to ensure the
standards of health care meet expected standards and includes a variety of key audits. This
is the same programme that all community general practices are required to demonstrate.
Corrections participates in this programme voluntarily.
The quality of healthcare is also monitored via various mechanisms such as complaints,
clinical event reviews, learning reviews and external assurance processes such as Death in
Custody reviews, Ombudsman reviews, OPCAT inspections, Office of Inspectorate
inspections and reviews, and Health and Disability Commissioner processes. Qualitative
Observation Exercises provide another mechanism with a different perspective to review
the quality of health services being delivered.
How satisfied are inmates with the care they receive?
We consider this part of your request is not a valid request for official information, but
rather, a request to form an opinion. The Office of the Ombudsman has previously
confirmed that the OIA does not require an agency to form an opinion or create new
information to respond to a request for official information.
However, we can advise that work is underway to strengthen processes relating to “My
Health Experience” patient satisfaction surveys, which are completed as a component of the
Foundation Accreditation noted above. These are typically done by each individual health
centre. Corrections plans to use these surveys to build a more comprehensive collective
picture of satisfaction and identify areas for improvement.
Please note that this response may be published on Corrections’ website. Typical y,
responses are published quarterly or as otherwise determined. Your personal information
including name and contact details will be removed for publication.
I hope this information is helpful. I encourage you to raise any concerns about this response
with Corrections. Alternatively, you are advised of your right to raise any concerns with the
Office of the Ombudsman. Contact details are: Office of the Ombudsman, PO Box 10152,
Wel ington 6143.
Ngā mihi
Dr Juanita Ryan
Deputy Chief Executive Pae Ora
