Clinic times at Barton Street jail cut just months after massive death inquest

Just months after a sweeping inquest into multiple deaths at the Barton Street jail recommended increased health protections for inmates, clinic times where people inside the jail can see a doctor have been cut, CBC News has learned.

The Ministry of Community Safety and Correctional Services says it is actively looking for a doctor to fill clinic hours after a resignation, and says that inmates won't be affected by the change.

But one Hamilton doctor who has experience working inside the jail says that invariably, inmate health will suffer.

"They're doing less than they were doing a year ago," said Dr. Lori Regenstreif, who spent 15 months working inside the jail from 2016 to 2017. She was also acontributing author for a recent study that suggested not enough is being done to help inmates access opioid dependence treatments inside the province's correctional facilities.

Before June of this year, Regenstreif said, a doctor-run clinic happened each day at the jail from Monday to Friday alongside additional weekend service. There was also a doctor on call by phone to help support nurses from the end of clinic times until 10 p.m. each evening.

They still have recommendations to follow and this sounds like backwards slippage.-Dr. LoriRegenstreif

Now, clinics have been scaled back to three days a week with additional service on the weekends, said ministry spokesperson Brent Ross, in an email. He said a doctor resigned in June, and the ministry is now "actively recruiting" to find a replacement.

"All inmates are still receiving the medical care they need and the ministry does not anticipate an increase in hospital visits as a result of the recruitment process," Ross said.

Inquest examined deaths linked to drug use

But Regenstreif said that seems impossible. There was already a backlog of inmates waiting to be seen by a doctor when she was working there, she said. "That's 30 fewer patients that can be seen a week."

"They basically have these two doctors trying to cover everything there's been apparently weekends where there is no coverage," she said.

"You have two doctors for the entire summer that's not very much."

All of this comes just a few months after a jury made 62 recommendations at an inquest that examined multiple deaths that have happened in recent years at the Hamilton-Wenthworth Detention Centre.

Those deaths were all linked to drug use. The inquest spent considerable time examining how drugs got into the jail, and the detrimental health effects the environment was having on inmates.

Recommendations from the inquest jury also touched on issues of security, the mental health of inmates and the need for better communication between jail staff, police services and area hospitals.

The recommendations also suggested limiting the number of inmates in each cell to two and that staff and that jail visitors be submitted to random searches to keep out contraband.

The jury put a specific, six-month timeline on several items, as a call for change to take place quickly.

The ministry is not required to adopt all of the jury's recommendations, but pledged at the time to take them seriously.

Appears to be 'backwards slippage, doctor says

Regenstreif said that as medical care is being scaled back, it seems like "quietly things are settling back into them doing as little as possible."

"They still have recommendations to follow and this sounds like backwards slippage," she said.

But Ross said all inmates in the ministry's correctional facilities have access to healthcare services.

"The ministry has policies and procedures in place for the delivery of health care services, and for ensuring that inmates receive necessary health assessments when they are admitted, and as needed during their period of incarceration," he said.

"Inmates have access to health care practitioners such as nurses, physicians, dentists and psychiatrists, and each facility has a Primary Care Provider who is responsible for the provision of medical services to inmates during specific hours."

adam.carter@cbc.ca