CAT/OP/CRI/CSPRO/1 and care effectively provided, pursuant to the Subcommittee’s recommendation, as outlined above. 97. In addition to the institutional health services provided in every prison, specialized care, emergency services and care in the event of acute illness may be provided in external health facilities, pursuant to an agreement with the Costa Rican Social Security Fund. To that end, prison officers regularly take detainees to and from external health facilities at the request of medical staff. 98. Most medical personnel receive continuous in-service and refresher training on the human rights of persons deprived of liberty. 99. It is of the utmost importance for the Ministry of Justice and Peace and the Costa Rican State to ensure that the medical assistance provided to persons deprived of liberty complies with the minimum conditions required in prisons with respect to confidentiality, lighting, comfort and security. In this regard, most of the medical clinics under the Ministry’s authority meet the minimum requirements established by the Ministry of Health. Those clinics that have not yet been certified by the Ministry of Health are currently engaged in the certification process. 100. In the prison context, it is important to strike the right balance between the confidentiality of medical care and the safety of medical personnel in cases where the patient has a history of violence. For this reason, a procedure has been established for assessing patients’ behaviour against the criteria of dangerousness, level of violence exhibited, reason for the consultation, and emotional state at the time of the intervention. In consultation with prison security staff, medical staff use these criteria to determine whether it is appropriate and feasible for care to be provided in a space allowing for total privacy. 101. All medical services must include a review of the detainee’s medical history and a physical examination, during which any unusual injuries or pain detected must be recorded in the detainee’s file. Medical personnel must record any injuries resulting from physical assault in a report and submit this report to the competent authorities. 102. The Ministry of Justice and Peace is committed to raising awareness among and reminding prison staff of the importance of the process outlined above and of the importance of affording persons deprived of liberty due discretion where possible and warranted by the reason for the consultation. It is also committed to ensuring that all medical clinics under its authority are certified by the Ministry of Health as a matter of priority. Management of high-risk persons deprived of their liberty (para. 71) 103. Persons held in the National Special Detention Centre are subject to the regulations of the national prison system. Persons serving sentences in the Centre are permitted to exercise in their cells, which most do on a daily basis, and every two weeks they are allowed out in the yard for an hour of outdoor exercise, in accordance with the regulations. Some detainees are held together in group cells that can house up to four persons. Such cells respect the spatial requirements and measures prescribed in the regulations and allow detainees to communicate with one another at all times. 104. Persons held in the National Special Detention Centre have televisions and radios in their cells, giving them immediate access to information from the outside world, are provided with national newspapers and can make two telephone calls a week. In view of the COVID19 pandemic, the inmates are currently allowed to make a third telephone call on weekends. The Centre does not have solitary confinement cells, only individual and group cells that respect the spatial requirements and measures prescribed in the prison regulations. 105. According to the statistics available in the medical registers consulted, patients from the San Rafael National Special Detention Centre represent the highest proportion of prisoners requiring medical assistance. However, pursuant to the Subcommittee’s recommendation, a system for recording medical consultations and medical care effectively provided is currently being developed, which will make it possible to detect and address long waiting times. GE.20-17766 13