ACT Government welcomes Health Services Commissioner review

Shane Rattenbury, MLA

The ACT Government today welcomed the Health Services Commissioner’s Review of the Opioid Replacement Treatment Program at the Alexander Maconochie Centre (AMC).

Released today, the Review focuses on a number of aspects of the Opioid Replacement Treatment (ORT) program. The review was a recommendation of the Moss Review into the treatment in custody of Mr Steven Freeman.

In the past year, there has been an extensive program of reform underway to improve detainee health, care and safety in the AMC as part of the Government’s response to the Moss Review. Last month, the Government tabled an Annual Report on the implementation of the Moss Review recommendations.

The provision of ORT services by Justice Health Services (JRS) is undertaken in accordance with both national and ACT guidelines. In recent months, the JHS has undertaken extensive Clinical Quality Improvement Activity for the  ORT program, including but not limited to:

  • Literature reviews and benchmarking of the JHS methadone program, both internally (with the Alcohol and Drug Service) and externally with other jurisdictions (Victoria and NSW prison-based services);
  • Ongoing JHS nursing and medical staff consultation and training on specific changes to the methadone program, including new procedures for assessment, and administration;
  • Reduced starting doses for methadone, from 30mg to 20mg. While 30mg is compliant with the National Guidelines, 20mg is the lowest starting dose recommended in the National Guideline;
  • ACT Corrective Services are notified when a detainee commences on the methadone program;
  • Forms have been updated and standardised for consistent and comprehensive documentation of clinical information;
  • Establishment of a one day delay in commencing a detainee on methadone following induction, so that clinical issues can be appropriately identified, assessed and managed;
  • Establishing a 2.00 pm deadline for the completion of methadone treatment so that more JHS staff are available on site during the most common peak time of methadone effect; and
  • Formalising the observation process undertaken by nursing staff before, during and after dosing, generally for detainees and specifically for detainees in the first six days of commencing on the program.
  • Implementation of the electronic methadone dosing system, iDose. In operation since August 2017, iDose has replaced the manual dosing system that was in place since the opening of the AMC.
  • Support is provided to detainees who are released from AMC and are on methadone. As the first three months of release from prison are considered the period of high risk for relapse, when the release of a detainee occurs, detainees can be assigned a key worker who will work with the person regarding continuation on ORT, engagement with the Aboriginal Liaison Officer and medical reviews.

The Commissioner’s Review makes 16 recommendations. Minister Rattenbury will table the Commissioner’s Review in the Assembly in the March sitting period.

The Government will then formally respond to the recommendations in the coming months.

Comments attributable to Minister for Corrections Shane Rattenbury:

“Steven Freeman’s death in May 2016 was a tragedy and the Government acknowledge the grief, loss and sadness that Steven Freeman’s family has experienced. The Government also acknowledges the significant impact that his death has had on our Aboriginal and Torres Strait Islander community.

“The ACT Government has undertaken a range of work to improve delivery of the opioid replacement treatment program at the AMC. We are committed to ensuring that this system operates as effectively as possible for those detainees who require methadone treatment.

“While we continue implementing the Moss Review recommendations, the Government will also now consider the recommendations of the Health Services Commissioner review released today.”

“The ACT Government will continue to prioritise the work to improve our justice health services at AMC to deliver better outcomes for all detainees.”

Documents relating to the Moss Review and Government response are available at www.justice.act.gov.au.