Shared from the 7/23/2022 Sydney Morning Herald eEdition

Coroner calls for Medicare for prisoners


A smoking ceremony for Douglas ‘‘Mootijah’’ Shillingsworth (inset), with supporters and family including cousin Ruby Dykes (second from left).

Main photo: Dean Sewell

A NSW coroner has supported the idea of Medicare becoming available to Aboriginal inmates on a trial basis after a 44-year-old man died in custody from a preventable ear infection.

Douglas ‘‘Mootijah’’ Shillingsworth, a Budjiti and Murrawarri man, died at Sydney’s Westmead Hospital in February 2018 after an otitis media middle ear infection spread to his brain, causing sepsis and neurological injury.

In findings yesterday, Deputy State Coroner Joan Baptie said Mootijah’s death was preventable and there were missed opportunities over many years to address his recurring ear infections and hearing loss.

‘‘Mootijah’s death was the result of the systemic failures prevalent in the public health system, the custodial health system in NSW and the lack of identification and appreciation of this silent killer, otitis media,’’ Baptie said.

‘‘Whilst his manner of death was from natural causes, this was clearly precipitated by the failure to identify and treat his ear disease whilst in custody.’’

In the days before Mootijah was taken to hospital, he presented for medical care at the Metropolitan Remand and Reception Centre at Silverwater jail with toilet paper in his ear. The paper had broken down to a paste-like consistency. A doctor believed his issue was having the paper stuck in his ear, and gave him ear drops to dissolve it.

By the time an ear infection was suspected and Mootijah was taken to hospital, an emergency CT scan detected an abscess on his left temporal lobe. He had surgery the next day and spent periods in intensive care, but died on February 2.

Baptie said she hoped the inquest highlighted ‘‘the insidiousness and perniciousness of ear disease, particularly within the Indigenous communities in Australia’’.

‘‘Given the high, and disproportionate rates of Indigenous incarceration in NSW, it is reasonable to conclude that there is a high incidence of otitis media, chronic suppurative otitis and related difficulties among Aboriginal persons in custody in NSW,’’ she said.

She recommended that the Justice Health network, which provides healthcare to prisoners, should advocate for Aboriginal inmates to access Medicare on a trial basis, potentially by liaising with prison medical services in other states.

Inmates in NSW cannot receive Medicare benefits, because the Health Insurance Act prevents a health service from receiving Commonwealth funding if it also receives state funding.

This means inmates are blocked from receiving a yearly Aboriginal health assessment, a screening that is intended to pick up chronic issues before they progress. No similar screening operates outside the Medicare system.

Jeremy Styles from the Aboriginal Legal Service, who represented the family during the inquest, said any one of these Aboriginal health assessments would have documented, recorded and discovered Mootijah’s ear disease.

He said this inquest was the second inquest this year that had raised the Medicare issue, describing it as a large structural problem that could be easily remedied and make ‘‘a major difference to outcomes for Aboriginal prisoners’’ including reducing deaths in custody.

‘‘This was a simple medical tragedy, and it was the death of a man – a brother, a son, a father – which should not have happened,’’ Styles said.

‘‘The Aboriginal Legal Service, for the family, shares the family’s horror that this occurred at all.’’

After the findings were handed down, Mootijah’s family including his cousin Aunty Ruby Dykes held a smoking ceremony outside the Coroners Court in Lidcombe, in Sydney’s west, to allow his spirit to finally rest.

Dykes said Mootijah – whose name means ‘‘strong one’’ – had endless love and affection for his family, and it was hard to accept that an ear infection killed him in the 21st century.

‘‘We want prisoners to have access to Medicare, because healthcare is a human right,’’ she said. ‘‘A prison sentence should not be a death sentence.’’

During the ceremony, children helped to pile greenery on top of a smouldering wooden vessel and smoke wafted over a small crowd who gathered to watch. Dykes sobbed, wiping her eyes with a tissue and hugging her loved ones.

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