in order to avoid situations that may give rise to torture and ill-treatment that the State party should guarantee the right for a lawyer or public defender to be present from the earliest stages of detention. 90. The SPT repeats its recommendation to the State party concerning an increase in the financial and human resources of the Office of the Public Defender, within a framework of independence and functional autonomy. The SPT further recommends that, once its independence and autonomy are ensured, the Public Prosecutor ’ s Office should sign agreements with universities, bar associations and civil society organizations nationwide in order to increase its operational capacity. 7.Right of access to a doctor as a safeguard against torture and ill-treatment 91.Medical examination and proper recording of the injuries incurred by persons deprived of their liberty are an important safeguard in preventing torture and ill-treatment and in combating impunity. If someone deprived of his liberty were to be mistreated by the police, it would be understandable for him to be afraid to inform anyone of what had happened while in police custody. If someone were to decide to file a complaint of torture or ill-treatment, it would be advantageous for him to have recourse to a doctor since, in general, consultations with doctors are private and if the person had suffered an injury the doctor would be better placed to examine him and attest to its existence in the corresponding report. From a preventive standpoint, the fact that a doctor examines detainees in police premises periodically in private could dissuade officials from resorting to torture and ill-treatment. In this regard, medical examinations should be private and confidential, without the presence of the police, except where strictly necessary. 92.The SPT noted that the practice of carrying out medical examinations of detainees was lacking in all the police stations visited. In one such station, a detainee, who showed signs of recent blows and wounds, claimed to have been brutally beaten by the police during his arrest and in the initial stages of detention. He also said that, when he was taken to hospital to have his wounds treated some hours later, the police — who were present during the medical examination — forced him to say that the wounds were the result of a fall. Police personnel consulted separately stated that the detainee’s wounds had been caused by a family brawl. This case highlights the need for a confidential and private medical examination at the start of detention, which if it had existed would have been helpful in establishing the reason and responsibility for the wounds. 93. The SPT notes the need to respect the right of persons deprived of freedom to be examined by a doctor and recommends to the State party that it legally prescribe this right. 94. The SPT recommends to the authorities that all those persons detained be given a systematic medical examination as soon as possible following their entry to the police station, and that the doctor attest to the state of health of the person concerned in a register established for that purpose. This medical examination should be free of charge. 95. The SPT also recommends that medical examinations are carried out in keeping with the principle of medical confidentiality: no person apart from medical personnel should be present during the examination. In exceptional cases, for example when the doctor considers that the person detained on medical or psychiatric grounds constitutes a danger to medical staff, special safety measures can be envisaged, such as stationing a police officer a short distance away. In such cases, the doctor should record in writing the reasons for this decision and the identity of the police officer present. These cases apart, police officers should remain out of hearing and sight of the place where the medical examination is taking place. 96. The SPT likewise recommends that the medical examination of each detainee should include and place on record: (a) the person ’ s medical history; (b) the existence of any discomfort or symptoms, a description by the person examined of how any injuries were sustained, and the identity of the person held to be responsible; (c) the result of the physical examination, including a description of any injuries and an indication as to whether the whole body was examined; and (d) the doctor ’ s conclusion as to whether the three above elements are mutually consistent. When the doctor has grounds for supposing the existence of torture and ill-treatment, he should record it in the register established under the following paragraph. 97. The SPT recommends the State party to take steps to establish a national register of allegations of torture and illtreatment, which should include as a minimum the following information: (a) the identity of the alleged victim (name and surname and/or identity document number); (b) age and sex of the alleged victim; (c) place where the alleged incidents occurred; (d) identity of the alleged authors, including the state institution to which they belong; (e) methods of torture or ill-treatment used; (f) circumstances relating to the torture and ill-treatment; (g) conclusions of the doctor who examined the alleged victim; (h) result of the medical examination carried out in accordance with the Istanbul Protocol; and (i) information concerning the investigations carried out, including their outcome, the sentencing of those responsible and compensation to the victims. Other actors, such as the Public Prosecutor ’ s Office and monitoring bodies, should also inform the register of cases of suspected torture and ill-treatment of which they are aware. The alleged victim should give his/her consent with respect to the information mentioned in subparagraphs (a) and (b). 98. The SPT recommends that the State party establish a system of independent examinations, under which qualified forensic doctors and psychologists will carry out exhaustive investigations when the doctor who has checked the detainee has grounds for supposing that the person has been subject to torture and ill-treatment. 8.The submission of complaints or appeals as a safeguard against torture and ill-treatment 99.According to the information given to the SPT by detainees at the police stations visited, none of those concerned had made a complaint about ill-treatment or torture during their time in custody, either because they did not know they had the right to do so, or because they were afraid of possible reprisals. Also, none of the police stations visited had a complaints register and, according to statements made by police officers who were interviewed, officers did not inform detainees of their right to make a complaint about