6. HEALTH-CARE 30 Rules 96 to 103 detail the terms and conditions of prison labour in relation to sentenced prisoners. Rule 96 specifies that they should have the opportunity to work and/or to actively participate in their rehabilitation “subject to a determination of physical and mental fitness by a physician or other qualified health-care professionals”. Ongoing health-care provision 31 The Mandela Rules make it clear that health-care professionals should see, talk with and examine every prisoner, not only on admission, but also as is necessary thereafter. To have full access to all prisoners, medical staff must be informed about where they are located, including those undergoing disciplinary sanctions. 32 Prisoners must have the opportunity to seek medical care and must be able to access health-care services in confidentiality. They should not have to give a reason for wanting to see a health-care professional. Arrangements for ensuring access to health-care must take into account that access to health-care in confidentiality will be more difficult in shared dormitories. The involvement of “gatekeepers”, such as cell leaders or prison staff in processes for prisoners to obtain a medical appointment should be avoided. 33 Medical care must be available at all times, including when cells are locked and staffing levels are reduced. This may be a particular concern at night time, during weekends and on national holidays. The requirement for health services to be available at all times also ties in with the need for adequate staffing levels of both prison officers and health-care personnel at all times. 34 Prison staff should alert health-care staff if they feel that a particular prisoner is in need of medical attention. 35 Prison authorities must allow those engaged in prison work programmes, training or other activities to access health services even if they are usually working during regular clinic hours. 36 For all prisoners to be able to access health-care services, careful consideration should be given to the location of health-care facilities. Facilities should be easily accessible, including for those with physical disabilities. In facilities that hold both male and female prisoners, or both adults and child prisoners, there should either be separate facilities, or designated times when women and child prisoners can access health-care services without having to mix with male or adult prisoners respectively. 37 Prison staff should never be involved in providing health-care other than in the provision of first aid if no health-care staff are available. 38 Prison authorities should ensure that prisoners who are medically trained are only involved in the health-care of other prisoners in cases of emergency when there are no other health-care staff available. However, such prisoners may lead or contribute to health-care education programmes in the prison. 6 PROMISING PRACTICE: ACCESS TO HEALTH-CARE [6.3] 150 In Serbia, the majority of dormitory cells in prisons The messages are confidential so only medical have emergency buttons for prisoners to call staff are able to access information sent to them. prison staff, including if prisoners need to access Following recommendations from the French health-care services. National Preventive Mechanism (NPM), the A system in Belgium called PrisonCloud majority of prisons in France contain special post provides prisoners with the opportunity to boxes which allow prisoners to request medical book medical appointments from their cells. consultations in full confidentiality. Only medical The secure, online system allows prisoners to staff have permission to open these boxes, which book medical appointments and deal with other are checked on a daily basis.344 prison issues from a computer in their cell via a workflow system. 344 344. ODIHR/PRI regional consultation 19 and 20 April 2017, op. cit., note 278. Guidance document on the Nelson Mandela Rules