6. HEALTH-CARE This will only be possible if the salaries and terms and conditions of prison health-care staff are good enough to attract and retain those skilled staff members. To provide equivalence of care, prison health-care services must also be adequately equipped and funded. Rule 24(1) is clear that prisoners should have access to necessary health-care services free of charge. The UN Body of Principles similarly states that following a prisoner’s initial medical examination, “medical care and treatment shall be provided whenever necessary. This care and treatment shall be provided free of charge”. CONTINUITY OF CARE [6.4] Continuity of care is important not only on admission to prison, but also upon release, and will generally be easier to manage when prisoners are allocated close to their usual place of residence. The requirement to provide continuity of care also includes a duty to properly manage and transfer a prisoner’s medical files. Rule 26(2) makes it clear that medical files must be transferred to the health-care service of the receiving institution upon transfer of a prisoner and shall be subject to medical confidentiality. When individuals with specific medical conditions are released from prison, health-care professionals should consider whether they need to provide them with some medication to account for the time it may take them to arrange further medical consultations and a regular supply of medication. The most effective way of ensuring continuity of care is to assign responsibility for providing health-care in prisons to the national health authority. If this is not possible, there should be close links between community and prison health-care providers. To adequately respond to health-care needs in prisons, both prison staff and prison health-care providers may require specific training opportunities and support services. This is particularly important given the difficult working conditions health-care staff may face in places of detention, and especially in remote locations. Prison health-care staff should receive training on how to report torture or other ill‑treatment within the prison system, including in cases where it may have occurred outside prison and is identified upon a prisoner’s arrival. To this end, all health-care staff should be provided with a copy of the Istanbul Protocol and be trained in applying it. The UNSPT has specified that medical examinations should “be carried out in private by a health professional trained in the description and reporting of injuries, include an independent and thorough medical and psychological examination, and the results be kept confidential from police or prison staff, and shared only with the detainee and/or the detainee’s lawyer, in accordance with the Istanbul Protocol”.338 All prison health-care staff should receive training on human rights and medical ethics, including the particular challenges that may be faced in detention settings. In accordance with Rule 76(d), all prison staff should receive training on first aid. This is important because they are often the first responders in the event of an emergency health situation. Rule 76(d) also requires that all staff receive training on the psychosocial needs of prisoners, social care and assistance, including early detection of mental health conditions. Chapter 1, paragraphs 167–220 of this guidance document deals with staff training and development in more detail. 6 The principle of equivalence of care does not mean that prisons have fewer obligations to prisoners in communities where there are no local health facilities, or where health-care is particularly poor. SPECIFIC TRAINING FOR PRISON STAFF AND HEALTH-CARE PROVIDERS [6.5] 338 338. Report on the visit of the Subcommittee on Prevention of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment to Kyrgyzstan, 28 February 2014, CAT/OP/KGZ/1, para. 57. Guidance document on the Nelson Mandela Rules 145