Evidence of meeting #39 for Public Safety and National Security in the 40th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was corrections.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Commissioner Marc-Arthur Hyppolite  Senior Deputy Commissioner, Correctional Service Canada
Commissioner Elizabeth Van Allen  Deputy Commissioner for Women, Women Offender Sector, Correctional Service Canada
Lisa Allgaier  Director General, Aboriginal Initiatives Directorate, Correctional Service Canada
Peter Ford  Physician, As an Individual
Kim Pate  Executive Director, Canadian Association of Elizabeth Fry Societies
Mary Campbell  Director General, Corrections and Criminal Justice Directorate, Department of Public Safety and Emergency Preparedness
Douglas Hoover  Counsel, Criminal Law Policy Section, Department of Justice
Lyne Casavant  Committee Researcher

12:25 p.m.

Bloc

Maria Mourani Bloc Ahuntsic, QC

Thank you, Mr. Hyppolite.

Mr. Chairman, I would like Mr. Hyppolite to submit two documents that I mentioned earlier. I would also like him to submit a document on the manner in which persons with disabilities and autistic individuals are managed at CSC. I would like that document to be brought to our attention in view of the fact that these kinds of individuals may wind up in the correctional system. These are very special individuals who must not necessarily be confused with those who have mental health problems.

In any case, I would like someone to explain to me a little how the CSC manages that.

12:25 p.m.

Conservative

The Chair Conservative Garry Breitkreuz

Make that request to him and he can try to supply it to the committee.

12:25 p.m.

D/Commr Marc-Arthur Hyppolite

That's the third request?

Would you restate the request?

12:25 p.m.

Bloc

Maria Mourani Bloc Ahuntsic, QC

Yes, absolutely.

I would like to know how the Correctional Service manages, in its penitentiaries, individuals with severe cognitive impairments—or simply individuals who have disabilities—identified as such and autistic individuals.

12:25 p.m.

D/Commr Marc-Arthur Hyppolite

All right. You want to have a document on that?

12:25 p.m.

Bloc

Maria Mourani Bloc Ahuntsic, QC

That's correct.

12:25 p.m.

Conservative

The Chair Conservative Garry Breitkreuz

We'll suspend for a moment.

Thank you.

12:25 p.m.

Conservative

The Chair Conservative Garry Breitkreuz

We're pleased to have with us Dr. Peter Ford, physician, appearing as an individual; and the Canadian Association of Elizabeth Fry Societies, represented by Ms. Kim Pate.

We welcome you to our committee. We're afraid we're going to be pressed for time. You will probably not have nearly as much time as we originally thought. We're going to have to compress the proceedings, as we have a bill to deal with.

Dr. Ford, please begin.

November 5th, 2009 / 12:25 p.m.

Dr. Peter Ford Physician, As an Individual

My name is Peter Ford. I am a physician recently retired from the department of medicine at Queen's.

For the past quarter of a century I have been looking after patients with HIV and associated diseases. Also for about a quarter of a century I have been looking after federal prisoners with HIV, which I do by going into the prisons on a regular basis.

At any one time I have 35 to 50 patients in the eastern Ontario area with HIV. Ninety-five percent of these have hepatitis C, which is, in this particular context, a marker of intravenous drug use.

Because of this high prevalence of hepatitis C in the HIV population, we did some studies back in the nineties--the first one was in 1994--to see what the prevalence of HIV and hepatitis C was in the institutions generally. We looked at a medium security institution in the Kingston area and did an anonymous study, which showed us that 28% of the inmates had hepatitis C and 1% had HIV.

We repeated that study in 1998, by which time 33% of the inmates had hepatitis C and 2% had HIV. With the second study we did a detailed questionnaire, which could be linked to the blood samples anonymously. What we discovered was that almost everybody who had hepatitis C had a history of intravenous drug use. The people who gave a history of sharing injection equipment had the highest incidence of hepatitis C. But the most alarming thing that came out of that study was that there was a group of people who had not injected outside prison but had shared injection equipment in prison, and two-thirds of these people were positive for hepatitis C.

So what we're looking at is a problem with a communicable blood-borne disease, which is being imported into the prisons and is proliferating within the prisons. That has some very serious public health overtones, because these folks are going to get out and they're going to go on doing what got them infected in the first place. In addition, hepatitis C can be spread by sexual transmission--just under 10% is spread by sexual transmission--so the risk is going to move beyond the intravenous drug users to their sexual partners.

The long-term health costs of this are very considerable. It costs about $20,000 to treat somebody with hepatitis C. The treatment is not always successful. The treatment is not always possible because the patients don't identify themselves or because they're not suitable for treatment--and there are some reasons why people do not get treated.

The end product of hepatitis C is liver failure. Liver transplantation due to liver failure from hepatitis C is now the largest cause of liver transplantation in North America, and we're only in the early stages of this epidemic. The epidemic of hepatitis C infection has blossomed with the increase in intravenous drug use, but it takes 20 years to get to end-stage liver failure. So the big bulk of this problem is not going to arrive for quite some time yet.

Corrections is going to find itself looking after people with terminal liver failure, and this is a very expensive prospect. As a physician, I am very concerned about the amount of hepatitis C, and to some extent HIV, that is related to intravenous drug use in our institutions.

I have brought with me something that can be passed around, but if it is going to be passed around I would really asked that you don't open this container. This contains a syringe that was brought into our clinic in Kingston by a very frightened guard who had just stuck himself on it while doing a cell search. This syringe was probably the only syringe on the range from which it came. It's probably been used by at least 10 to 15 different people, several of whom would have been infected with hepatitis C and some of whom would have been infected with HIV.

You will see that this syringe, which is made from a ballpoint pen, tape, and a needle that probably came from an insulin syringe, is dirty. It's not possible to clean it. There is no way you can clean this syringe, even with the best intentions. These syringes are not only responsible for transmission of hepatitis C, HIV, and hepatitis B, but they are also responsible for a large number of rather nasty injection site abscesses that I see in the course of my work in the prison. I think this is a problem that also needs to be addressed.

Thank you, sir.

12:30 p.m.

Conservative

The Chair Conservative Garry Breitkreuz

Thank you very much.

12:30 p.m.

Physician, As an Individual

Dr. Peter Ford

I don't know whether you want me to pass this around.

12:30 p.m.

Conservative

The Chair Conservative Garry Breitkreuz

Does the committee want this passed around? If you'd like to see it, maybe you could go over to that corner.

Ms. Pate, please go ahead.

12:30 p.m.

Kim Pate Executive Director, Canadian Association of Elizabeth Fry Societies

I want to thank you for inviting us here. I also want to bring regrets from my president, Lucie Joncas, who had hoped to attend, but I think it's in part a reflection of the volume of what's coming before us that she was not able to.

One of the things I'd like to start with was also one of the questions posed to the Correctional Service of Canada in the last session. One of the reasons that women are the fastest-growing prison population also relates to this increase in more federally sentenced women serving shorter sentences, and it is in fact going to get worse, I would suggest, especially with the recent passage of Bill C-25.

One of the reasons we're seeing this is that with the cutbacks to social services, health care, and educational services in the community, those who are most marginalized and most dependent on those services are more likely to fall through the cracks and end up being criminalized and ultimately institutionalized, as there are fewer options, fewer places to go to for services, fewer places to get the assistance they require. We're actually seeing individuals coming in and asking for sentences under the real and well-intentioned assumption or belief--by crown counsel, by defence counsel, by the individuals themselves--that they'll actually be able to access more programs and services in the federal system.

Our federal prison system is likely the best in the world. We say that without necessarily having a great deal of pride in that right now, because it is not very good at this stage. In fact, there are many deficits, and I'd like to speak to some of those. Some of them have already been spoken to. You have copies, I'm sure, of the recent report of the correctional investigator that was tabled by the Minister of Public Safety last week. I'm also aware that you're familiar with the reports into the death of Ashley Smith and other Office of the Correctional Investigator reports.

I was just at the RPC in Saskatchewan yesterday, the regional psychiatric centre, about which you heard. It's always interesting to me to hear the descriptions of these institutions from the perspective of those who have a responsibility to uphold the work that they do as part of the Correctional Service of Canada, and to uphold the policy. I would suggest to you, though, that the reality belies the representations that you heard, not because there aren't well-intentioned people--there are very many good people working within the corrections system--but increasingly because they are unable to actually talk about what's really happening in the system.

When I was in the regional psychiatric centre, I saw women in what was described to you as intensive psychiatric care. Intensive psychiatric care is essentially segregation, with chemical restraints in addition to the mechanical restraints and the uses of force that you've heard about and seen chronicled in various reports. I was looking into the treatment that was used with people like Ashley Smith. You'll pardon me, but I'm using that example because there have been so many publicly discussed descriptions of her treatment that it probably will generate some images that you're able to link this to.

The only difference I saw in the treatment of the women compared to the last time I was there was that women are now less likely to be in security gowns unless they're actively suicidal. If they're self-harming, they may instead be in institutional sweats. When you're visiting that institution, that's what you'll likely see, if indeed you meet with the women there--and some of them are interested in meeting with you; you need to know that.

Also, although we are repeatedly advised that the prisoners there are treated as patients, when I was at the courthouse where the corrections supervisor who has been charged with assaulting Ashley Smith is facing those charges and is now on trial as I speak, successive staff talked about the fact that even for nursing staff and mental health staff within a psychiatric hospital that is also duly designated as a penitentiary, the priority issue is security, not the treatment needs of the individuals who are there.

Even though that is not the law and is not the policy, it is the perception of the staff who were testifying, who presumably were also prepared for that testimony. To them, in fact, the priority issue is security. When you look at issues of mental health as you're going around the institutions, I would suggest that you ask questions of all of those programs you heard about. They are very good programs, and some of them are excellent programs, but ask how often they are offered and how many people have been through those programs recently. Are they operating currently? How many people in the last year have been through those programs? What is the duration of those programs? How long have they been fully staffed?

A benefit of this committee is in fact that there has been an increase in resources going into those areas over the past few months. It's a credit to all of you that you're doing this work, because in fact there are individuals who are benefiting.

There are individual women who have been released, and I'll talk a bit about some of those cases in a minute. They were also alluded to by the previous speaker.

I also want to say that I disagree, however, with the notion that we need to improve the mental health strategies within the prisons, for the very reason I just spoke about. I think it will be very difficult to improve mental health services in the prisons. The women's prisons have the best mental health resources in the country, and yet in the special living environments—or they may be called something else now—the mental health units that were just described to you are essentially for those who have intellectual disabilities or less severe mental health issues.

The women with the most significant mental health issues, as I sit here today, are still the women who are in segregation units, are still the women who are self-harming and are experiencing the response to their self-harm as punitive responses, whether or not that's the intention of staff. I agree that in fact for many staff it is not their intention; however, that's how it's experienced by the individual women. And if they try to speak out or grieve those situations using the mechanisms available, they are often encouraged to remove the grievances or not follow through on them. You just need to look at the reports into Ashley Smith's death to have an excellent chronicling of how this occurs and how those responses are systematically not an effective way to deal with either individual issues or systemic issues.

I also want to ensure that you are aware that, as we try to raise some of these issues, we have some very real difficulty in being able to gain access. We are in discussions right now. We have been denied access to segregation units. Concerning the very areas we have documented over the years with the correctional investigator and others, or have asked the correctional investigator to examine after we have identified issues in set areas, whether it be concerning the Prison for Women in 1994, or Ashley Smith recently, or other women now who are in those areas, one of the responses has been that we may not be allowed access any more.

We have been denied access; it is unclear right now what the official position is. The last letter I have from the Commissioner of Corrections said that we were not permitted to go into segregation units. Since that time, in discussions with the commissioner we've been advised that it will be at the warden's discretion. I've been allowed into one of the units and not allowed into another.

So I encourage you also to ask those questions—of who is monitoring what's happening—and as you're examining this issue, to really focus on the recommendations made by Louise Arbour, by the Human Rights Commission, by the Office of the Correctional Investigator, and by Corrections Canada's own task force on the use of segregation, which recommended limits to the use of segregation and changes to the classification. Even though there's a new classification scheme, it is still predominantly the needs of women—and of men, I would suggest—that are translated into risk factors that allow them to be classified as requiring higher security, allow them to be kept in segregation.

And I can't stress sufficiently the need for external oversight of corrections. Even though the Privacy Commissioner has ruled that we should have access to the records of Ashley Smith, we still don't have them, so I can't tell you some of the things that I'm pretty certain existed and happened, based on what she told me and what other prisoners told me and what staff have told me.

I also want to reiterate something that I have said to a number of you in other committees and other contexts, which is that we are increasingly being asked by the Correctional Service of Canada itself—not officially, but by corrections staff—to take on these issues in courts and with human rights complaints in various other venues, because people are feeling impotent within. People feel that they can't speak out about the very real issues of the limits being placed upon them.

There are examples of very positive things that have happened. I was going to give you a list of 15 women whose cases.... I won't do that, because I see the chair shaking his head.

I will tell you about the one alluded to by Ms. Van Allen, the deputy commissioner for women. She talked about the very good progress that has happened with a woman who was released recently after being in segregation. Let me tell you, that was one of the examples of people coming to us asking us to push at every level we could to have this woman out. I'm very pleased that Corrections Canada and the National Parole Board saw fit to release this woman. I'm very pleased to tell you that I've now seen her three times in the community. She's doing very well; she's in her own place; she's working; she's blossoming. People from Corrections whom I introduced her to last week, when I was at a conference and invited her to come and have lunch with us, did not recognize her, three months after she was out of that segregation cell. That should tell you something about the difference in her mental health, just being free. I use “free” loosely, because she's under supervision; but being in the community, having some support, having a place to live, having something to do, and having community support around her.

Let me also tell you—I have yet to have this confirmed, although I've requested the information—that it cost, I'm told, $2 million to keep that woman in the conditions she was in in prison, just for overtime, and there is something on the order of $10,000 per year being spent on that kind of support in the community.

I would strongly urge that when you're looking at these issues you examine ways in which the resources can be developed in the community, not within the prison, so that individuals can go into the community for those services. From day one of a sentence, for health reasons people can go into the community and access services.

I understand that we need to move to questions now. I look forward to those questions.

12:40 p.m.

Conservative

The Chair Conservative Garry Breitkreuz

I'm going to have to limit every party to one round. There will be seven minutes for the Bloc, the NDP, and so on, and then we'll have to wrap it up there. I'll be very strict on the seven minutes.

12:45 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Mr. Chairman, I have a point of order and an objection to that.

In the last hour I very clearly raised this issue. I said that we would agree to go over on the previous witnesses on the condition that we have the full hour for these witnesses. My understanding was that it was accepted.

12:45 p.m.

Conservative

The Chair Conservative Garry Breitkreuz

But then you accepted the fact that Ms. Mourani used her turn in the last round. She said that clearly. So we're going to cut this round off seven and a half minutes earlier.

Is there any other solution to this?

12:45 p.m.

Liberal

Mark Holland Liberal Ajax—Pickering, ON

If we do the math on this, it should all make sense.

The first question is, when did we start?

12:45 p.m.

Conservative

The Chair Conservative Garry Breitkreuz

It was at 11:15.

12:45 p.m.

Liberal

Mark Holland Liberal Ajax—Pickering, ON

I think it was more like 11:20.

12:45 p.m.

Conservative

The Chair Conservative Garry Breitkreuz

No, we started, actually, at 11:14 and some seconds afterwards. Then we dealt with some business. We started at about fourteen and a half minutes after 11:00 or something like that.

What's your point?

12:45 p.m.

Liberal

Mark Holland Liberal Ajax—Pickering, ON

We had agreed to go to a quarter after. I think that's when we—

12:45 p.m.

Conservative

The Chair Conservative Garry Breitkreuz

We will. One round will take us to that point.

12:45 p.m.

Liberal

Mark Holland Liberal Ajax—Pickering, ON

That's fine.

12:45 p.m.

Conservative

The Chair Conservative Garry Breitkreuz

Go ahead.

12:45 p.m.

Liberal

Mark Holland Liberal Ajax—Pickering, ON

Thank you, Mr. Chair, and I thank the witnesses.

Time is limited, and there's a lot of ground to cover.

First, Dr. Ford, I share your concerns around the rates of infectious disease in our prison system. I'm wondering specifically whether you have any information on the impact the government's strategy of zero tolerance towards drugs has had on infectious disease. We know that millions of dollars have been spent, which random testing has shown have had no impact on the use of drugs in prisons. In some cases it has gone down 1%; in other cases, it has shown drug use up 1%.

What I'm hearing anecdotally is that the strategy has had a major impact on the rate of infectious disease; people are using dirtier needles and methods of getting drugs. That creates a huge health concern, and not just in the prison population. I think sometimes we don't consider that over 90% of inmates then come out, and that this creates a major health issue for the population more generally.

Do you have any specific figures on the impact this government's strategy is having in relation to infectious disease?