teachers have complained that the detainees are delayed on the grounds that the overwhelmed warders have no time for escorts. It has reached the point that even the disillusioned detainees, complaining of a lack of information or various delays, state that the overworked warders “have no other option”. The warders themselves, cut off from any exchanges with their colleagues, can be faced with insecurity or suffer from a continuous, excessive psychological strain. Apart from simply creating jobs, which is not possible as far as the budget is concerned, only finding a way to control overcrowding can solve these difficulties. Recruitments and assignments of warders must be matched with the identified requirements of surveillance and the reintegration of detainees, taking into account the actual strength of the prison population and not the theoretical capacity of the institutions. 2.3 The numerous and recurring failures in the use of secure rooms sometimes dissuade detainees from asking for healthcare, and must lead to a reflection on the pertinence and application of the current system In addition to what is stated in the Opinion dated 16 June 2015 concerning the treatment of detainees in healthcare institutions, the terms of removal from prison for medical reasons do not respect the dignity of the detainees. Handcuffs are systematically used; dedicated paths are not always provided, and the shackled detainees are exposed to the sight of other patients or visitors. The detainees are shackled or handcuffed in their room, sometimes even during the treatment. In certain small institutions, the terms of transporting and guarding detainees who must be hospitalised are not clearly established between the police and the prison administration, which can result in uncertainties on the possibility of conducting extractions, to the extent that they are sometimes impossible. The violation of medical privilege is also almost systematic. On the grounds of safety, the warders are always beside the detainees, attend the medical consults and examinations, are present for the doctors’ explanations and, in rare cases, for surgeries, even when the person is not conscious. The conditions of treatment during the stay of detainees are not satisfactory. There is no traceability for the hospital stays, and no specific welcome booklet; the general welcome booklet of the hospital is only rarely given to the patient; there are no internal rules or charts of the hospitalised patient, except in only one of the visited institutions; the personal effects of the patient are often stored in a garbage bag or plastic bag on the ground, since there is no cupboard; hygiene is not guaranteed: the patient has to request to go to the bathroom and is often accompanied by a warder, with the door being left open; sometimes, going to the toilet is not allowed: a urinal or a commode are given on request; sometimes there isn’t even any bathroom linen given. The hospitalisation conditions of detainees are more restricting than the detention conditions. The detainees are not informed of the date or physical conditions of their extraction; no list of objects allowed during their stay is provided; in most cases, even the terms of the lawyer visit are not provided. The family is not informed of the hospitalisation of a detainee by the prison administration, except in a few rare cases. Visits are permitted so long as a permit is obtained from the police headquarters, but is de facto impossible due to a lack of terms and procedures meant for this purpose. Access to telephones is not allowed in most cases. 27