Director of Proceedings v Chief Executive, Department of Corrections

Director of Proceedings v Chief Executive, Department of Corrections [2021] NZHRRT 34 (20 July 2021)

The Director filed proceedings by consent against the Chief Executive of the Department of Corrections (“the defendant”) in the Human Rights Review Tribunal, regarding the care it provided to Ms A, a person in prison.

The defendant exercises statutory functions conferred under the Corrections Act 2004. Under section 75 of the Corrections Act 2004, the defendant is required to provide people in prison with “medical treatment that is reasonably necessary”, and the “standard of health care that is available to prisoners in a prison must be reasonably equivalent to the standard of health care available to the public”. Every prison has a health service that employs and contracts health practitioners to provide health and disability services to people in prison.

Prior to Ms A’s incarceration, she had a history of significant respiratory issues, was on a number of medications for multiple co-morbidities including type 2 diabetes, a painful lipoma on her back, a prolapsed disc, pain in her lower back and right leg, and numbness of the toes on her right foot. She was able to mobilise with crutches for short distances, but otherwise required a wheelchair. Ms A was also morbidly obese with a BMI of 53.9.

On admission to prison, health staff did not perform a full health assessment or develop an adequate care plan for Ms A as required, despite Ms A’s complex needs. Health staff also failed to write a new prescription for the regular pain relief medication Ms A required, based on her current blister packs. Therefore, once her blister packs ran out, Ms A went for four days without her usual opiate pain relief medication, and experienced increased pain and withdrawal symptoms. During her incarceration, health staff failed to assess Ms A adequately following a fall, or after cessation of her insulin despite her increased blood sugar levels. On at least one occasion, custodial staff administered repeat Panadol to Ms A within the recommended 4–6 hour time frame.  However, on several occasions, custodial officers failed to record the administration of Panadol to Ms A, and on other occasions they failed to record the Panadol dosages (recording only the time of administration).  Further, health staff failed to perform a full respiratory assessment on Ms A when her respiratory condition started to deteriorate and she was in physical distress, and in light of her history of respiratory issues. The delay in assessing her respiratory condition resulted in her hospitalisation. In addition, the clinical documentation by prison health staff of assessments, treatments, and outcomes was poor and risked compromising the quality and continuity of Ms A’s care.

The defendant accepted that there was a pattern of failures in the delivery of health care to Ms A by multiple providers responsible for her care, indicating broader systemic issues for which, ultimately, the defendant was responsible. The defendant accepted that its failures in care amounted to breaches of the Code of Health and Disability Services Consumers’ Rights (“the Code”), and the matter proceeded by way of an agreed summary of facts. The Tribunal was satisfied that the defendant failed in the care it provided to Ms A, and issued a declaration that the defendant breached Right 4(1) and Right 4(2) of the Code.

The Tribunal’s decision can be found at: