Equivalence of care A prison health‑care service should be able to provide medical treatment and nursing care, as well as appropriate diets, physiotherapy, rehabilitation or any other necessary special care, in conditions comparable to those pro‑ vided to patients in the community. Provision in terms of medical, nursing and technical staf, as well as premises, installations and equipment, should be geared accordingly. Treating prisoners in civil hospitals As mentioned above, the prison itself cannot always guarantee all the spe‑ cialist care needed. Nearby hospitals often have to be used to fnd a solution for more difcult medical problems. In case of recourse to a civil hospital, the question of security arrangements will arise. Prisoners sent to a hospital to receive treatment should not be physically attached to their hospital beds or other items of furniture for custodial reasons. Other means of meeting security needs satisfactorily can and should be found; the creation of a custodial unit in such hospitals is one possible solution.6 1.2 Hygiene and health promotion The task of a prison health‑care service should not be limited to treating sick patients. In the absence of a specialised service, it is also their responsibility, in co‑operation with competent authorities, to supervise catering arrange‑ ments (quality, quantity, preparation and distribution of food) and conditions of hygiene (cleanliness of clothing and bedding, access to running water, sanitary installations) as well as the heating, lighting and ventilation of cells. Work and outdoor exercise arrangements should also be taken into consid‑ eration. Prison medical services should also cover mental hygiene, especially preventing the harmful psychological efects of certain aspects of detention. Unhealthy conditions, overcrowding, prolonged isolation and inactivity may necessitate either medical assistance to individual prisoners and/or general medical action by the responsible authority.7 6. CPT/Inf (2012)13. 7. CPT/Inf (2012)4. Medical ethics in prison Page 11

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