CAT/OP/ROU/1 systematically transmitted to the relevant criminal prosecution body for investigation. Persons who have complained about torture and ill-treatment should be protected from physical, disciplinary or administrative reprisals. G. Health 59. The delegation is concerned about the situation of health care in most facilities visited. Medical services were generally inadequate and insufficiently funded and staffed. The medical staff was not receiving training on specific themes related to health in detention facilities, on health standards in prisons developed by the World Health Organization or on the Istanbul Protocol. 60. Except in psychiatric hospitals, the initial medical examination of persons deprived of liberty was superficial and the description of their health status was incomplete. 61. The delegation also observed that thorough screening for infectious and contagious diseases was not systematically performed upon the arrival of detainees in the detention facility, including for multiresistant tuberculosis. It noted that the prolonged period of placement of new inmates in quarantine (21 days) increased the risk of transmission of infectious and contagious diseases to healthy detainees. Furthermore, the delegation was alarmed by the inadequate screening and assessment of detainees suffering mental disorders and in need of psychosocial care and psychological or psychiatric treatment. The delegation was concerned about the prevalence of self-harm in the prisons visited, which may reflect the lack of appropriate psychological care. 62. Access to qualified professional staff, primary health care and basic medication was problematic in most penitentiary institutions visited, and requests for medical attention often went unattended. The systematic absence of dental, psychological and gynaecological care for persons deprived of liberty was also observed with grave concern. 63. Medical staff working in police facilities and in penitentiary facilities are accountable and answerable to the Ministry of Justice and the Ministry of the Interior respectively, which poses questions of independence and conflict of interest. Further, the delegation noted with concern that medical doctors were asked to give their consent for disciplinary measures, raising issues of dual loyalty. 64. The delegation observed that hygienic conditions in some of the prisons visited were such that they presented a public health hazard. 65. The Subcommittee recommends that the State party ensure access to and examination by an independent doctor as soon as possible after arrest or transfer to a detention facility, with appropriate recording of medical information in a register, in full respect of medical ethics and deontology. Requests for medical attention by persons deprived of liberty should be attended to in a timely and professional manner, without exception. 20 The Subcommittee reminds the State party that it has the primary responsibility for protecting the health and well-being of persons deprived of their liberty. 66. The State party should urgently conduct a countrywide audit of the needs in all institutions, in order to meet both basic and specialized health-care needs and facilitate the provision of sufficient medical supplies. The Ministry of Health should be involved in monitoring health in prisons, in the recruitment process of health professionals and in the delivery of training to health professionals. 67. The State party should ensure that health professionals are trained to identify injuries that are characteristic of torture or ill-treatment in accordance with the Istanbul Protocol. The Subcommittee recommends that health professionals be available in all places of detention to diagnose, monitor and treat serious withdrawal symptoms and any other consequences of substance abuse. 21 20 21 12 Nelson Mandela Rules, rules 24–27, 30 and 31. European Prison Rules, rule 42.3 (d).