Except for very few institutions, no activity is offered to hospitalised detainees; taking a walk outdoors and inside the institution is strictly forbidden, as is access to the library. Access to a television is not allowed in most institutions and, if it is allowed, the detainee is not always given access to the remote control. Detainees complain about the lack of activity, sometimes deeming that “it is worse than prison”. Finally, a stay in a secure room is often longer than the legal duration of forty-eight hours in cities. This situation, linked to a lack of available places in interregional secure hospital units (UHSI), plays a significant role in harming the fundamental rights of hospitalised detainees. In addition to the specific anomalies of the operation of the secure rooms, their very principle, based exclusively on security concerns, must be reevaluated after analysing their occupancy rate, the installation and the operation of the UHSI. Mandatory and effective training is desperately needed for all healthcare staff intervening on detainees in hospitals, concerning the ethics, medical privilege and the rights of detainees. National rules specifying the conditions of recourse to secure rooms and the system of staying in these rooms, as well as the terms of mutual respect of the rights of detainees and the security requirements must be established jointly by the ministries of Health, Justice and the Interior, with the help of the French National Order of Doctors. 2.4 The provisions of the Prisons Act dated 24 November 2009 concerning searches are applied in all of the institutions, but monitoring and harmonising the practices is still necessary In Article 57, the Prisons Act dated 24 November 2009 states: “Searches must be justified by a suspicion of an offence or by the risks that the behaviour of the detainees may cause to the safety of people and to maintaining order in the institution. Their nature and frequency are strictly adapted to these necessities and the personality of the detainees. Full-body searches are not allowed unless pat-downs or the means of electronic detection are not sufficient.” In this respect, the Contrôleur général, in its earlier reports, formulated a certain number of recommendations that should be noted here. Searches of detained transsexuals must occur in conditions that allow preserving their dignity and by officers of the same sex as the gender they identify themselves with, without waiting for a change in the civil status (Opinion dated 30 June 2010 concerning the treatment of incarcerated transsexuals). Extraction to hospitals must not provoke a full-body search when the health condition of the patient is at risk of getting worse and when this condition makes it highly improbable for the patient to transport forbidden objects (Annual report of the CGLPL for 2011). It would be preferable to establish a register indicating the results of searches (number of persons and methods) and to show it to any competent judge on request (Annual report of the CGLPL for 2011). The ministerial directives pertaining to the traceability of full-body searches conducted on detainees must be implemented immediately (Annual report of the CGLPL for 2011). 28