1) Mentally ill kept in solitary despite warnings
2) Pharmacy profits hit a nerve
Mentally ill patients are being kept in solitary confinement within maximum security NSW prisons as punishment, against the most basic principles of human rights law.
For a third time this year the Mental Health Review Tribunal has had to formally remind the departments of health and corrective services of those laws, after finding patients segregated.
Reviewing the case of a schizophrenic man left in solitary confinement nine months after he was found unfit to stand trial, the tribunal noted "serious systemic failures" in the treatment of such patients in NSW jails.
Meanwhile: Pharmacies have enjoyed big rises in profits but have failed to pass on the benefits to customers and do not need the level of protection they now have, a report has found.
Pharmacies' real returns have doubled in the past decade with the help of federal rules sheltering them from competition.
But faith in the current regulatory scheme is misplaced, the draft report commissioned by the Health Department says.
The findings in the confidential analysis, a copy of which has come after the Prime Minister, John Howard, acted before the election to defend pharmacies against competition by regulating to prevent the entry of supermarkets.
The anti-supermarket regulation expires on July 1, but Mr Howard and the Health Minister, Tony Abbott, have indicated they stand by "community pharmacies" against supermarket entry.
The pharmacy report to the Government says that while the growth in pharmacy returns is an "implicit goal" of government policy, "it is a transfer that has come, at least in part, at the cost of pharmacy customers".
Getting back to mentally ill patients: The tribunal's president, Duncan Chappell, described the isolation of 24-year-old "MA" as part of "an appalling situation" which began long before he was declared unfit to face trial.
MA has been in custody since February last year, when he was charged with property offences.
He was first segregated at Silverwater last July after attacking an officer and remained in solitary confinement when transferred to Parklea. On April 20 - two days after it was revealed his nine months of wrongful isolation - he was back in Silverwater, but not in general population custody.
"Despite the assertion made by [a prison officer] that this segregation was not intended to be a form of punishment, there is clear conflicting documentary evidence that this was precisely what was intended," Professor Chappell found.
"Basic principles of human rights law preclude the use of custodial segregation and isolation for persons suffering from a mental illness except in limited and carefully monitored circumstances to prevent self-harm or harm to others."
From the big end of town to the other big end of town: On the issue of quality of service, it says competition between community pharmacists from other sources, such as pharmacies located in supermarkets, "spurs the delivery of higher quality pharmacy services". It says consumer organisation surveys in Britain and Australia "demonstrate that blind faith in the delivery of quality by a community pharmacy model is misplaced".
The report proposes the abolition of location rules blocking new pharmacies setting up within 1.5 kilometres of existing pharmacies.
Titled Location, location, location, the report recommends allowing new pharmacies to open where they choose but with the Government varying the dispensing fees it pays pharmacies, depending on the supply of pharmacies in the area.
The report concludes "it is not reasonable to suggest that the location rules provide a net benefit to the community as a whole".
"While regulation is often justified on the basis of seeking to correct an identified 'market failure', there is no traditional market failure that justifies the regulation of the location of pharmacists," the report says.
Meanwhile: Once MA was declared unfit to stand trial in August, the tribunal was required to determine "as soon as practicable" on the balance of probabilities if he would be fit within 12 months, and where he should stay until then.
In October a hearing was set for December and the tribunal requested a psychiatric assessment from the doctor treating MA at Parklea. She told the tribunal she intended recommending MA be transferred to Long Bay hospital, but as hearing dates passed in December and February, she failed to produce the report.
"No such transfer did eventuate and it was not until inquiries were made about Mr MA's case by the Office of the Ombudsman, and by media sources, that ultimately the tribunal was able to obtain the reports it required to proceed with its reviews," Professor Chappell found.
Big Pharma: Prepared by the Allen Consulting Group and filed with the department in March, the report has surfaced as the pharmacists haggle with the Government over a new $11.75 billion, five-year agreement.
The guild, which has wielded significant political influence through 5000 pharmacies located in most suburbs, sent a letter to all federal MPs on Friday, saying the 30 per cent rise over five years would not keep pace with rising costs and warning that that "pharmacy services in their electorates may be cut".
The guild is also fighting a renewed attempt to enter the field by Woolworths, which says supermarkets could cut $500 million a year from drug costs to the Government and the consumer.
The guild has rejected the Woolworths figures as "fanciful and misleading", saying most of the claimed savings would flow from Woolworths' lower rentals for floor space.
The Allen report said the location rules had led to a scarcity of pharmacies. As a result, Pharmaceutical Benefits Scheme provider numbers, which are authorities that a pharmacy must have to dispense subsidised prescriptions, had risen in value in recent years from $50,000 to $250,000. New businesses that buy pharmacies must pay for these as well as any goodwill.
While the volume of prescriptions dispensed had risen by about 60 per cent since 1990, the number of pharmacies had declined by about 10 per cent.
Are you still there MA?
The tribunal admitted it failed MA but he had since been moved to Long Bay and is reportedly keen to get better and face trial.
"Mr MA's case also demonstrates serious systemic failures in the way in which forensic patients are... managed and treated within the correctional system," Professor Chappell found.
"It is to be hoped that others who have not faced public scrutiny and criticism over the handling of Mr MA's case will also acknowledge their deficiencies and take appropriate remedial action."
A spokesman for the Justice Minister, John Hatzistergos, said the Health Minister, Morris Iemma, was responsible for MA through Justice Health.
A spokesman for Mr Iemma, who is also MA's local MP, said the tribunal's recommendations would be examined this week.
How you're treated may depend on what part of the big end of town you're from? It could even be a contradiction in terms!
By Fuckitol 300mg 16 May 05
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Prisons, Punishment, Solitary Confinement [Torture] and Mental Illness
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Mental Health Tribunal recommendations on forensic inmates
Below is the answer we have received from the Minister for Health regarding prisoners recommended for parole or release by the Mental Health Tribunal FYI
Death in custody: In memory of Scott Simpson
Scott Simpson 34 died in custody on 7 June 2004 leaving behind a child. It is alleged that he hanged himself in a segregation yard at Long Bay Prison Complex. Justice Action has reasons to believe that Scott had been mistreated from the time he was taken into custody and the subsequent events that ensued that led to his sad death. We think that his treatment may well have caused his death.
Doctor Ron Woodham I presume?
"Corrections Health staff provide medical care. However, its staff's authority is essentially limited to making recommendations to corrective services on treatment. Corrective services staff can then decide what treatment can be given."
Isolation, psychiatric treatment and prisoner' control
The 2003 NSW Corrections Health Service (now Justice Health) Report on Mental Illness Among NSW Prisoners states that the 12 month prevalence of any psychiatric disorder in prison is 74%, compared to 22% in the general community, and while this includes substance disorder the high rate cannot be attributed to that alone.
Call for royal commission into NSW prison health system
Mr Tony Ross a social justice activist said yesterday that a royal commission into the health system in NSW should be wide reaching to ensure that the Corrections Health Service is also exposed because of reported widespread cover ups in the prisons health system.
Watchdogs slaughtered in NSW
On Tuesday the Carr Government reduced transparency and accountability yet again and New South Wales is in danger of becoming entrenched with cronyism and intimidations with the Carr Labor Government that continues to slaughter the watchdogs.
Escape proof but not so the prisoners mind
Fewer prisoners escape from prison these days because they're "cemented in" by materials that do not break and by legislation that can keep prisoners in jail until they die.
Carr's Castle the real story H.R.M.U.The High Risk Management Unit Goulburn Correctional Centre. A prisoner writes, " I was unsuccessful in my letters to Dr Matthews CEO of the Corrections Health Service on my problem regarding air - claustrophobic effect the cells have on me. Just recently the management decided my injuries are not seriously affecting me so no further discussions are necessary.
Risdon prisoners' seize prison to protest mistreatment
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No Safe Place
In a brief four month span from August 1999, five men died in Tasmania's Risdon prison. Their deaths have put the state's corrections system in the dock and led to the planned demolition of a jail which even the State's Attorney-General now calls an "appalling facility".
Association for the Prevention of Torture
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Corrected or Corrupted
A psychiatrist from the prison Mental Health Team attached to Queensland Health made the comment that 25 per cent of inmates suffer from a diagnosed mental illness.
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Detention Centres, Solitary Confinement
On Friday night the NSW Council for Civil Liberties awarded Sydney solicitor John Marsden honorary life membership. Julian Burnside was invited to make the speech in Marsden's honour. In the course of his speech, Burnside referred to the unregulated use of solitary confinement in Australia's immigration detention centres, criticising it as inhumane and also as unlawful.
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