This is an excerpt from Prison Before & After part 2.

Prison Before & After (part 1) mentioned roles leading to prison: ‘offender’ (person charged); criminal ‘associates’; victims; Police; prosecutors; prison & custodial service officers.

Non-custodial staff, prisoners & prison itself are also important parts of the experience: doctors, nurses, pharmacists, social workers & occasional consultants. Volunteer services provide further support, otherwise neglected by the official system, particularly upon release.

I saw a doctor only once or twice in 14 months & was treated without any evident prejudice related to my imprisonment. Prisoners seemed generally satisfied with the quality of medical services but gaining access to doctors is difficult & slow.

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Example: I completed the appropriate form, explaining my symptoms — coughing up both clotted & fresh red blood, difficulty breathing & chest pain severe enough to prevent sleep — & waited… & waited. I had received no response 2½ weeks later when I was moved to another facility, at which I was treated by excellent nurses; no doctor. I am a cancer survivor (so far) & had previously had a chest scan showing a partially collapsed lung while in prison. These symptoms & evidence are ‘red lights’ for possible lung cancer.

I was offered further investigation; that would have required transfer from the low security facility, at which I was allowed an individual cell, to a high security one in which I would again have to share a cell, almost certainly with a smoker. I refused.

Most prisoners smoke. (I estimate 85%; Australian population average ~15%. Why?). I had twice been inducted into the high security prison: the first time immediately after conviction; the second after re-arrest while on home-detention. On both occasions I had reported serious lung disorders — asthma, bronco-pulmonary aspergillosis & bronchiecstasis — asking not to share a cell with a smoker; on both occasions I received the same response: ‘this is not a hotel’.

One of my cell-mates was so addicted that he would wake during the night to smoke. In a cell measuring approximately 2½ x 3½ metres, exposure is necessarily heavy, ‘though forced ventilation eventually clears it. Inevitably I became ill.

Forced exposure to cigarette smoke & failure to provide timely & appropriate medical care are breaches of prison regulations.

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In my case, the Court ordered a psychiatric assessment. This service was provided at the prison by an external consultant. A typical psychiatric consultation takes ~90 minutes; this was interrupted, after ~15' & only four questions, by a prison officer unwilling to allow more time. The psychiatrist reported that he had insufficient opportunity to form a view, offering only speculation clearly identified as such. His report was nevertheless referred to by all three parties in Court — judge, prosecutor & even my defence lawyer — as though authoritative.

Parsimonious access to professional services in prisons is commonly claimed by other prisoners & apparently typical. However, demand is sometimes trivial & even mischievous, motivated by boredom or contempt for costs to ‘the system’. Official attitudes to prisoners’ needs are inevitably affected by these & other oppositional behaviours.

They are also shared. Many prison staff regard waste as of no consequence & will openly say so (don’t worry, the government is paying). This is one consequence of structural & procedural problems in prisons.

Like much else, these attitudes & problems vary greatly between prisons. At the low security facility, in particular, nursing staff were accessible, caring, encouraging & proudly professional.

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