The ACT Government is failing in its duty of care to prisoners by not providing a needle and syringe program (NSP), the territory's peak drug and alcohol sector says
It comes after it was revealed a prisoner was re-infected with Hepatitis C at the Alexander Maconochie Centre (AMC) despite being treated with direct-acting antiviral medication.
The ACT Government committed to having a NSP program at the "human rights complaint prison", but put the policy on hold before the last election when prison guards voted in opposition to the move due to safety fears.
Rates of drug use at the prison sit at about 30 per cent, according to a recent report by the Health Services Commissioner.
A study published in the Harm Reduction Journal, "Why is there still Hepatitis C transmission in the AMC?", concluded without a needle and syringe program hepatitis C would continue to plague prisons, despite new and effective treatments available.
"Hepatitis C infection will continue to test both the strengths and the weaknesses in the relationship between health and corrective services in Australia," the study said.
"Nothing less than full implementation of all harm minimisation modalities will be necessary to eliminate the clinical and public health risks of Hepatitis C infection, both in prison and by extension into the general community."
The study said a 39-year-old prisoner at AMC was successfully treated for Hepatitis C for 12 weeks and returned a negative result four weeks after the therapy was finished.
The patient said he then shared an needle with a known Hepatits C positive contact about four to six weeks after his negative result.
"Bleach had been accessed, and a well-described method of flushing the injecting equipment with diluted bleach was used," the report said.
"The patient was receiving a stable dose of 95 mg methadone at the time."
Further test results showed the prisoner was again positive for Hepatitis C, and the sample was clearly different from the sample taken pre treatment.
The authors of the report, Ben Harkness, Michael Levy, Ruth Evans and Jillian Wenke, were all from ACT Health's Justice Health Services.
"The ability to cure Hepatitis C viral infection, with specific reference to the prisoner population and the prison environment, will be challenged, even if opiate replacement therapy is concurrently offered, and even if bleach is available," the study said.
"The missing elements, widely available in the community, are a regulated injecting equipment exchange and tattooing parlours."
The authors said while the new treatment had reduced transmission of the disease, the constant flow of new prisoners meant there would be an ongoing transmission of the disease from community to prison.
ACT's Alcohol Tobacco and Other Drug Association (ATODA) chief executive Carrie Fowlie said the ACT Government was failing in its duty of care towards prisoners.
"ATODA remains deeply concerned that the ACT Government has made no public announcements about what actions it is taking, following the September 2016 ballot of AMC correctional officers that rejected the proposal to provide sterile injecting equipment to prisoners, to introduce this crucial public health service," she said.
"In ATODA’s view, the ACT Government is seriously failing in its duty of care to the AMC’s prisoners, their families, the AMC staff, and the broader community, by failing to provide an NSP in the prison, a service that is available to the rest of the ACT’s community."
Hepatitis ACT interim executive officer Rebecca Vassarotti said the research around reinfection demonstrated exactly why a NSP service was needed.
"The work that has happened to reduce the prevalence of Hepatitis C in the facility is absolutely to be commended," she said.
"But it's not the sole solution to the problem.
"While we recognise that correction staff have safety concerns, we think these concerns can be overcome."
A spokeswoman for Corrections Minister Shane Rattenbury said the prison guards' union had veto power over implemeting the program, leaving him hamstrung.
“When the AMC opened, the Minister responsible, Jon Stanhope provided a veto power to the CPSU in the enterprise agreement. This meant a NSP could not be introduced without agreement from staff. Subsequent Ministers have been hamstrung since that time," the spokewoman said.
“Minister Rattenbury made some progress in removing the direct veto power from the agreement, and inserting a voting process. Despite agreeing in principle to a model for an NSP at the AMC, staff voted against the proposal 150-4.
“While the government remains committed to introducing an NSP, these arrangements, put in place in 2008, continue to stymie progress.”