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Healthcare in Prisons

Ending Preventable Harm for Aboriginal and Torres Strait Islander People in Victoria

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Aboriginal and Torres Strait Islander people are advised that this webpage contains information and names of Aboriginal and Torres Strait Islander people who have died in custody.

Please read on with care. If you find the content of this page distressing, please reach out to Yarning Safe’N’Strong (1800 959 563).

Why Custodial Healthcare Reform Is Urgent

Aboriginal and Torres Strait Islander people in Victoria’s prisons continue to face preventable harm because the current custodial healthcare system is structurally flawed, culturally unsafe, and governed through a justice framework rather than a health framework.

Despite decades of evidence, reviews and recommendations, healthcare in Victoria’s prisons continues to be delivered by private operators whose profit-driven models are not designed to meet the complex health, cultural and social needs of Aboriginal people. These arrangements operate within a broader justice system shaped by systemic racism, where Aboriginal people are overrepresented and their health needs are routinely deprioritised.

The result is fragmented care, a lack of cultural safety, poor continuity between prison and community health services, inadequate responses to mental health and social and emotional wellbeing, and ongoing preventable harm including deaths in custody.

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What VACCHO is Advocating For

VACCHO is calling for urgent reform of custodial healthcare in Victoria to ensure Aboriginal and Torres Strait Islander people receive culturally safe, public, and self-determined care.

Specifically, we are advocating for:

1. Governance Shift to Health
Transfer oversight of prison healthcare from the Department of Justice and Community Safety to the Department of Health to ensure clinical accountability and transparency as recommended by the Yoorrook Justice Commission.

2. End Private Custodial Healthcare
All custodial healthcare services should be delivered by a public provider, accountable to government and community, not private corporations.

3. ACCO-Led Model of Custodial Health and Wellbeing (AMOC)

Establish an Aboriginal Community Controlled Organisation-led Model that centres Aboriginal ways of knowing, being, and doing, providing culturally safe, community-led care. VACCHO is calling on the Victorian Government to fund the design of an ACCO-led model of prison healthcare that is holistic, culturally safe, and meets the health and social needs of Aboriginal and Torres Strait Islander people in custody.

 

We acknowledge these three reforms cannot, on their own, resolve all the health and wellbeing issues Aboriginal and Torres Strait Islander people face in prison but they do represent critical changes that will provide the foundations for culturally safe custodial healthcare Mob, and others, need.

The Evidence is Clear

These reforms are supported by:

All have highlighted systemic failures in prison healthcare and the urgent need for ACCO-led models to promote health and prevent deaths.

Benefits of an ACCO-Led Model

Evidence demonstrates that ACCO-led healthcare models deliver:

  • Stronger accountability

  • Greater trust in healthcare systems for Aboriginal and Torres Strait Islander people in custody

  • Continuity of care when Aboriginal and Torres Strait Islander people enter and exit prison

  • Culturally safe, high quality, trauma-informed healthcare

  • Better health, wellbeing, rehabilitation and reintegration outcomes

Jurisdictions such as the ACT show this model is feasible, effective, and economically responsible.

Latest News

Listen to Dr. Jill Gallagher AO speak on Culturally Safe Healthcare in the Criminal Justice System

ABC Speaking Out presented by Larissa Behrendt

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Organisations, peak bodies, and stakeholders can publicly support custodial healthcare reform in Victoria

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Thank you to the following organisations who have signed onto our position statement

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Frequently Asked Questions

Why does custodial healthcare need reform in Victoria?
Aboriginal and Torres Strait Islander people experience significantly poorer health outcomes in custody due to a system shaped by systemic racism, where prison healthcare is frequently privately delivered, culturally unsafe, and governed through a justice framework rather than a health one.

Decades of inquiries have repeatedly identified these structural failures continue to cause preventable harm and deaths in custody.

What is wrong with private healthcare in prisons?

Private custodial healthcare prioritises profit over people.

This model has consistently failed to deliver culturally safe, clinically accountable care, particularly for Aboriginal and Torres Strait Islander people. Public health services are better equipped to ensure transparency, continuity of care and accountability to the community.

Why should prison healthcare be overseen by the Department of Health?
Prison healthcare is about people’s health, not managing crime.

The Department of Health in responsible for delivering safe, accountable, and appropriate care, while the Department of Justice and Community Safety (DJCS) focuses on delivering community safety, managing prisons, enforcing laws, and ensuring the justice system runs efficiently.

This means that healthcare is often not a priority for prisons and people leave sicker, and less able to return to be a productive member of society, then when they went into prison.

Transferring oversight of prison healthcare to the Department of Health aligns prison healthcare with the broader public health system and ensures high-quality, safe and appropriate healthcare for people in custody.

What is an ACCO-led Model of Custodial Health and Wellbeing (AMOC)?

AMOC is a self-determined model of healthcare led by Aboriginal Community Controlled Organisations.

It centres Aboriginal ways of knowing, being and doing, and ensures culturally safe, community-led care for Aboriginal people in custody.

Is there evidence that ACCO-led healthcare works?

Yes. Evidence consistently shows that ACCO-led healthcare models improve trust, continuity of care, cultural safety, and health outcomes. Similar models operating in other jurisdictions, such as the ACT, demonstrate that this approach is effective and achievable.

For information check out the Winnunga Prison Health Study.

Who supports these reforms?

These reforms are supported by the Royal Commission into Aboriginal Deaths in Custody, the Yoorrook Justice Commission, the Victorian Ombudsman, multiple coronial inquests, and numerous reviews over more than 30 years.

How can organisations support this campaign?

Organisations and stakeholders can publicly support reform by signing on to VACCHO’s position statement and advocating for public, ACCO-led custodial healthcare.

Sign onto the position statement here

What happens next if reform is implemented?

Reform would create a safer, more accountable custodial healthcare system that supports rehabilitation, improves health outcomes, and ensures Aboriginal and Torres Strait Islander people receive culturally safe care during and after incarceration.

All people in prison would benefit from these reforms and return to society after their prison term healthier, in a better position to return a productive member of society and reduce burden on tertiary, acute, expensive healthcare.

Why should we help Aboriginal people in custody? They’re in jail for a reason

Aboriginal and Torres Strait Islander people are significantly overrepresented in Victoria’s prisons, making up a disproportionate share of the incarcerated population despite being a small proportion of the overall population.

This overrepresentation reflects systemic racism, intergenerational disadvantage, and structural inequalities in health, education, housing, and justice. Aboriginal people are also overwhelming in prison for crimes of poverty -rather than crimes against a person.

Providing culturally safe, accountable healthcare in prisons is not about excusing crime — it’s about rehabilitation, human rights, and reducing reoffending.

Evidence shows that improving health and wellbeing, offering culturally appropriate support, and addressing underlying trauma significantly increases the chances that people will successfully reintegrate into the community.

Helping Aboriginal people in custody is therefore an investment in safer communities, stronger families, and a fairer justice system.

 

 

 

 

 

 

Further reading