Commissioner Recommends Higher Standards of Medical Care for Patients in Correctional Centres
When Albertans experience a medical crisis, they expect health services will be delivered in a way that cares for their needs and protects their health. The healthcare profession shoulders a significant responsibility to provide patient-focused medical care at the highest possible industry standards.
In October 2023, the Commissioner issued a public report outlining serious lapses in medical standards of care for individuals incarcerated at the Edmonton Remand Centre. Although the operation of provincial correctional centres is the responsibility of the Correctional Services Division of Alberta Justice, the treatment of patients is the responsibility of Alberta Health Services (AHS). AHS is the largest province wide integrated healthcare system, responsible for delivering services to over 4.7 million people living in Alberta.
A whistleblower came to our office concerned for the health and safety of persons incarcerated at the centre. They identified five patients who had severe medical outcomes. Later, the whistleblower contacted our office to identify two additional patients. After preliminary inquiries, the Commissioner opened an investigation to determine whether medical staff at the correctional centre created a substantial and specific danger to the life, health, or safety of individuals—a wrongdoing as described in the Act.
The ensuing investigation was substantial and examined health care protocols, patient records, and the treatment history of the seven identified individuals. Also, an expert nursing consultant was retained to review medical records of the five patients initially identified and provide an opinion whether the standard of care was met. In several examples, evidence showed pain management and drug withdrawal protocols were not followed; gaps existed in the documentation of key patient vital signs records; and standards of care were not met.
The Commissioner concluded the investigation and shared his findings with AHS in February 2023.
Given the lack of clarity surrounding institutional protocols, the Commissioner did not view the wrongdoing as being the sole responsibility of any particular individual. Rather, he found systemic lapses in the medical care of incarcerated individuals at the correctional centre stemmed from the lack of clarity surrounding treatment standards when a patient shows abnormal or abnormally trending vital signs.
Through the investigation, AHS reported that they were already aware of some of the issues the Commissioner was investigating and was in the process of taking corrective steps. These measures, supplemented by the Commissioner’s recommendations, focused on the need for improvements within the medical corrections field, which would elevate the care given to incarcerated individuals to a standard consistent with that in all other Alberta medical settings.
In July 2023, Alberta Health Services reported back to the Commissioner that it had implemented corrective measures to address all recommendations and observations made by the Commissioner, in addition to implementing ongoing corrective measures already underway. AHS was fully cooperative during the investigation.
The Commissioner’s investigation was released publicly and reported on nationally. In a media report, a spokesperson for Alberta Health Services stated that AHS has taken action to directly address each of the recommendations included in the report; “It is imperative that all individuals in our corrections system are provided with the same consistent, high-quality care as every Albertan. Our actions will continue to ensure this.” In another article, the mother of an inmate who died in custody (not related to this investigation) said the release of the Commissioner’s report was “enraging and validating”.
AHS’ approach to this investigation and response to the Commissioner’s findings is a model for what Alberta’s whistleblower protection legislation is intended to achieve. A whistleblower safely and confidentially brought forward concerns and AHS took substantial and meaningful steps to remedy the wrongdoing. It was evident that there was a desire to understand what had transpired and to ensure that the proper standard of patient care was being provided in correctional centres.
The identity of the whistleblower remains confidential and continues to be protected under the Act.