Just weeks after receiving an expert report calling on all prison healthcare to be brought back into public hands, the Victorian government signed a contract to outsource services to a controversial United States-based private prison operator with close connections to the company whose conduct triggered the review.
The cultural review of the adult custodial corrections system, conducted by an expert panel including a former assistant commissioner of Victoria Police and the chief executive of the Victorian Aboriginal Community Controlled Health Organisation, was handed to the Victorian government at the end of last year but was not released until last month.
A key recommendation from the review, commissioned by the Victorian government, was to bring all custodial healthcare, which was contracted out to Correct Care Australasia, back into the public sector remit.
“Health services are currently outsourced to a private provider, which is inconsistent with best practice and results in inconsistent and delayed healthcare for people in custody,” the final report said.
“We recommend a transition to a public health model for custodial healthcare, to improve the quality and clinical oversight of health services provided to people in custody and enable continuity of care.”
The Victorian government received this report at the start of December. Just a month later, it was revealed that GEO Australia, a subsidiary of the US-based GEO Group, had signed a contract with the Victorian government to provide primary health services at 13 public men’s prisons in the state. The deal was worth $33 million a year.
In its response to the report, the Victorian government said that, from July, healthcare would be made public in women’s prisons but not men’s.
“From 1 July 2023, all men’s public prisons will have a new primary health service provider delivering enhanced services under a new HealthCare Services Quality Framework, to provide people in custody with high-quality primary healthcare,” the response said.
This new prison healthcare provider is a private prison operator with strong links to the existing highly controversial contractor, which was recently referred for prosecution over the death of an Indigenous woman in custody.
In the lead-up to the release of the coroner’s findings into the death of Veronica Nelson at the Dame Phyllis Frost Centre in early 2020, the Victorian government moved to get on the front foot and remove Correct Care from most of its prison network.
It was announced in early January that responsibility for providing healthcare in women’s prisons would be handled by local public authorities, while GEO Australia would be taking over custodial healthcare for men’s public prisons from the middle of the year.
While the removal of Correct Care has been welcomed by most legal and community groups, there are widespread concerns that the Victorian government has continued to privatise custodial healthcare services for 95 per cent of prisoners in the state.
The new provider has offered to rehire all current staff, leading to concerns that change has been made in name only. Critics of the change say substandard care will continue.
Curtin University professor of health equity Stuart Kinner says the removal of private providers in women’s prisons is positive but should be done for all prisons in the state.
“If it has done it for them then it begs the question, why can it not be done for all custodial settings?” Kinner says. “It needs to explain why the current policy settings are doing the right thing for women – and why this is not right for men and children.”
Nerita Waight, chief executive of Victorian Aboriginal Legal Service, says all healthcare in prisons should be provided by public health services.
“People in prison deserve healthcare that is equivalent to what is available in the community,” Waight says. “The coronial inquest into the passing of Veronica Nelson showed that private healthcare providers are not providing adequate care but rather inflicting harm.”
The Victorian Greens have also called for custodial healthcare to be brought back into public hands.
“The government shouldn’t allow corporations to profiteer off prisons,” Victorian Greens justice spokesperson Katherine Copsey says. “Public services should be delivered in the public interest, for the public good, and not for private profit.”
In a damning report this year, the coroner investigating the death of Nelson found Correct Care Australasia had a “don’t ask, don’t tell” relationship with the Department of Justice, noting that the company withheld information from the entities tasked with investigating the death in custody.
The coroner said this “disturbing” arrangement is a matter of “grave public interest” and helps to explain the number of systemic failings that were identified during the inquest into Nelson’s death.
Correct Care has a close link to the GEO Group. Until 2013, GEO Australia had, under various names, provided healthcare in all public prisons in Victoria. At that time, its US-based parent company changed its tax classification, meaning it could no longer provide healthcare services. The Australian healthcare arm was sold to Correct Care, which has provided custodial healthcare in the state over the decade since.
Another change in tax structure by GEO Group at the end of 2021 meant the company could again offer healthcare services. Just weeks later, the Victorian government went to the market for a new healthcare provider in its public prisons, and GEO was ultimately successful.
The state government first went to the market for a new custodial healthcare provider in early 2020, but this process was delayed due to the Covid-19 pandemic. GEO Australia did not apply in this first tender process but, following the delay and its parent company’s reclassification, it was able to bid for the work.
A senior prison doctor in Australia, speaking on the condition of anonymity, says he is concerned that the change in provider won’t equate to any improvements for those in prison.
“I have to wonder if the new contractor is just a change in name,” the doctor says. “I don’t expect anything will improve if it involves the same management hierarchy making the same decisions under a different name.”
From July, three separate healthcare systems will exist across men’s, women’s and youth prisons, something the prison doctor describes as a “disjointed mess”.
The Victorian Aboriginal Legal Service has also criticised the selection of the new provider.
“It is disappointing that the government has signed contracts with GEO Group to take over from Correct Care when the companies have such a close history and operate the same business model which has cost our community members their lives,” Waight says.
GEO Australia’s parent company is currently subject to several civil suits in the US from prisoners and their families.
In one suit, it is alleged the company violated the human rights of a 21-year-old who suicided at a GEO-run facility. The suit says the company consciously ignored the high risk for suicide among prison inmates and acted with “deliberate and conscious indifference” to the prisoner’s health and safety.
In 2019, the American Civil Liberties Union launched legal action against GEO Group, alleging “extreme mistreatment” of a man detained in an immigration detention centre run by the company.
The Queensland government in 2019 said it would take over GEO’s contract to run the Arthur Gorrie Correctional Centre, following a damning Crime and Corruption Commission report on the facility the previous year.
“The history of the GEO Group and its recent performance in other countries is well documented and publicly available,” the prison doctor says. “One assumes our politicians have access to Google.”
A spokesperson for GEO Australia emphasised that the company operates separately from its parent company, with different management and a separate board. GEO Australia’s national director of health services, David Grace, has been appointed as the general manager of the new organisation and a “major recruitment campaign” has kicked off, the spokesperson said.
“A multidisciplinary team of healthcare professionals will deliver healthcare services that are person-centred and trauma-informed, recognising people in prison often have challenging and complex healthcare needs,” they said.
“GEO Healthcare is committed to providing the best possible healthcare services to men in Victoria’s public prisons, acknowledging the specific needs of people in custody. Its new model of health services and ongoing performance will be measured against enhanced service requirements set by the state.”
A spokesperson for the Victorian Department of Justice and Community Safety said a “new model” of prison healthcare will begin when GEO Australia’s contract takes effect in July.
“We are implementing a new model of health services that includes an increased workforce and multidisciplinary teams to provide high-quality primary health services, strengthened release planning, and significant improvements to better support the health of Aboriginal people in prisons,” the spokesperson said.
This article was first published in the print edition of The Saturday Paper on April 22, 2023 as "New contract offers no cure".
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