15. Regarding health care, the acces­ sibility and quality of the medical services in all the prisons visited (and the IDF in Sofia) were as poor as they had been in the past. Further, the quality of medical recording had even worsened. It is noteworthy in this respect that the keeping of the register on traumatic injuries had been discontinued at Sofia and Burgas Prisons shortly after the CPT’s 2014 visit. The confidentiality of medical examinations and documentation was not respected. In addition, in prisons, the initial medical examination hardly ever took place within the first 24 hours after the inmates’ arrival, as recommended by the Committee. Such screening is essential, particularly to prevent the spread of transmissible diseases and suicides, and for recording injuries in good time. 16. It should be added that no progress was observed during the 2015 visit as regards other issues of concern to the CPT, such as prison staffing levels, discipline and segregation, and contact with the outside world. Concluding remarks 17. In its previous repor ts, the Committee has taken due note of the repeated assurances given by the Bulgarian authorities that action would be taken to improve the situation of persons placed in the custody of the police, or held in establishments under the responsibility of the Ministry of Justice. However, the findings of the 2015 visit demonstrate again that little or nothing has been done as regards all the above-mentioned long-standing problems. This state of affairs highlights a persistent failure by the Bulgarian authorities to address most of the fundamental shortcomings in the treatment and conditions of detention of persons deprived of their liberty, despite the specific recommendations repeatedly made by the Committee. The CPT is of the view that action in this respect is long overdue and that the approach to the whole issue of deprivation of liberty in Bulgaria should radically change. 18. The Committee fully acknowledges the challenges that the Bulgarian authorities are facing. In the CPT’s view, there is a real need to develop a comprehensive prison policy, instead of concentrating exclusively on material conditions (which, as should be stressed, have only improved to an extremely limited extent). Having in place a sound legislative framework is no doubt important. However, if laws are not backed by decisive, concrete and effective measures to implement them, they will remain a dead letter and the treatment and conditions of persons deprived of their liberty in Bulgaria will deteriorate even further. As regards the treatment of persons detained by law enforcement agencies, resolute action is required to ensure the practical and meaningful operation of fundamental safeguards against ill-treatment (including the notification of custody, access to a lawyer, access to a doctor, and information on rights). The Committee’s aim in making this public statement is to motivate and assist the Bulgarian authorities, and in particular the Ministries of the Interior and Justice, to take decisive action in line with the fundamental values to which Bulgaria, as a member state of the Council of Europe and the European Union, has subscribed. In this context, the CPT’s long-standing recommendations should be seen as a tool that helps the Bulgarian authorities to identify shortcomings and make the necessary changes. In furtherance of its mandate, the Committee is fully committed to continuing its dialogue with the Bulgarian authorities to this end. Appendices ► Page 73