"Access to Health Care Is a Human Right": CASWA at the AHCWA Prison Health Workshop

Insights

"Access to health care is a human right — we must ensure people who are incarcerated have their fundamental needs met, both in care and after release."

Vicki O'Donnell, Chairperson of the Aboriginal Health Council of Western Australia, said that at the AHCWA Prison Health Workshop. It should not need saying. In a State with one of the highest Aboriginal incarceration rates in the country, it does.

Rule 24 of the UN Nelson Mandela Rules sets the international benchmark: prisoners are entitled to the same standard of health care available in the community. No discrimination, no exceptions for legal status. It is not Australian law, but it is the standard we should be judged against — and Western Australia is not there yet.

The barrier is written into Commonwealth law. Under section 19(2) of the Health Insurance Act 1973 (Cth), prisoners are excluded from Medicare and the Pharmaceutical Benefits Scheme. The single biggest funding mechanism Aboriginal Community Controlled Health Services rely on in the community simply does not apply in prison settings.

Donnella Mills, Chair of NACCHO, named the shape of the fix: health care in prisons for Aboriginal people cannot stop at tertiary care — it has to include primary health care. The 2024 National Review of First Nations Health Care in Prisons said the same thing formally: services designed and delivered by Aboriginal Community Controlled Health Services, not services delivered to Aboriginal people by systems never built with us in mind.

WA is now working towards a blueprint for structured reform, led by AHCWA in partnership with the Department of Justice and Aboriginal Community Controlled Organisations across the State. CASWA supports this work, and we are ready to help make it real.