QAIHC Public Health Medical Director, Associate Professor Sophia Couzos, provides an overview of the QAIHC Prison health position statement.
QAIHC advocates for Aboriginal and Torres Strait Islander peoples in Queensland prisons to have equal access to healthcare. Despite being just 3.8 per cent of the total population, First Nations people make up 33 per cent of the prison population, reflecting historical injustices, intergenerational marginalisation and disproportionate contact with the justice system. Many experience chronic illnesses, disabilities and mental health issues, yet face limited preventive care and cultural support.
Barriers include constrained funding arrangements preventing full use of Medicare and the Pharmaceutical Benefits Scheme, inconsistent assessments that depend on custodial staff, and minimal cultural training for prison personnel. Multiple record-keeping systems also hinder continuity of care when individuals re-enter the community. Recognising prisons as part of public health, QAIHC stresses the need for integrated, culturally appropriate services.
ACCHOs provide culturally safe, holistic care and already serve many First Nations people in the wider community. However, few inmates receive ACCHO-led support, missing opportunities for early detection and ongoing management of health conditions. The Department of Health and Aged Care’s National Review of First Nations Health Care in Prison acknowledges the need for systemic reform, including better partnerships with ACCHOs and clear quality standards for culturally safe healthcare.
Reducing barriers to health and wellbeing: The Queensland Prisoner Health and Wellbeing Strategy 2020–2025 recognises the severe over-representation of First Nations people but offers no specific targets or strong ACCHO collaboration. QAIHC concludes that urgent partnerships between government agencies and ACCHOs are essential. Approaches such as trauma-informed training, integrated record systems and continued Medicare/Pharmaceutical Benefits Scheme entitlements would improve continuity of care, reduce health inequities and lower recidivism among Aboriginal and Torres Strait Islander people.
Recommendations
Recommendation 1:
Queensland Corrective Services support a partnership with QAIHC and ACCHOs, in relevant regions, to allow for appropriate and effective healthcare focused on holistic health and safe transition back to the community for Aboriginal and Torres Strait Islander offenders.
Recommendation 2:
Queensland Corrective Services co-develop with QAIHC a policy framework which encompasses actions to ensure that all offenders have access to quality, comprehensive, culturally safe and holistic primary healthcare provision whilst in custody, an optimised program of cultural education for prison staff; effective data sharing to optimise transitions of care; and performance measures including vital statistics on prison health.
Recommendation 3:
Queensland Corrective Services co-develop a program to support the safe transition of care from prison health services to local community-based primary healthcare services for all prisoners.
Recommendation 4:
The Queensland Government fund ACCHOs to provide culturally safe primary healthcare and rehabilitation programs within the justice system to Aboriginal and Torres Strait Islander inmates. This includes programs that allow increased access to allied health services and improved referral pathways from primary care to specialist services.
Recommendation 5:
The Queensland Government fund evidence-based support programs outside and within the justice system that can assist prisoners and people at risk of committing crime to enhance their social, emotional and physical health and wellbeing.
Recommendation 6:
The Commonwealth and Queensland governments negotiate the retention of prisoners’ entitlements to the Medicare Benefits Scheme (MBS) and the Pharmaceutical Benefits Scheme (PBS) throughout all stages of the custodial cycle, or permits custodial services exemptions to Section 19(2) of the National Health Insurance Act (1973)19 to ensure consistent access to essential healthcare and treatment for individuals in custodial settings.
Recommendation 7:
Queensland Corrective Services establish tailored MBS items that ‘mirror’ those available in the community, particularly Item 715 (Aboriginal and Torres Strait Islander Peoples Health Assessment), emphasising preventive care and targeted interventions to address prevalent health issues (e.g. smoking), and ensuring the well-being of individuals in custody.
Recommendation 8:
Queensland Corrective Services and Queensland Health to support an integrated health information electronic record system for those in custody that integrates with public and private medical records systems to ensure continuity of healthcare.
Recommendation 9:
Queensland Corrective Services and Queensland Health to support the implementation of effective screening and supports for First Nations children with disability.
Read the full position statement on our website via the QR code.
