CHANCELLOR OF JUSTICE AS THE PREVENTIVE MECHANISM depend on the type of accommodation facility in which an asylum seeker stays, i.e. whether they are staying in the reception centre or in the premises of the PBGB for the performance of procedural acts. The Chancellor of Justice made the following recommendations to the reception centre: 1) enable performing the initial health examination of asylum seekers arriving in the reception centre; 2) ensure to the asylum seekers both general and specialised medical care within the initial as well as subsequent medical examination if this is necessary for the treatment of essential diseases. In case of certain health services gender differences need to be taken into account; 3) ensure that both within the initial as well as subsequent medical examination the need for psychological or psychiatric counselling of asylum seekers is assessed; 4) inform asylum seekers about the possibilities of the initial health examination as well as psychiatric and/or psychological counselling; 5) ensure, in case of necessity, the involvement of an interpreter in the provision of health services; 6) when entering into contracts for the provision of health services, take into account that it is advisable that the service provider has been prepared for work with asylum seekers, is aware of the distinct character of asylum seekers as a group, as well as their cultural, linguistic and religious particularities; 7) consider the possibility of organising provision of regular psychiatric and/or psychological counselling in the reception centre; 8) analyse the organisation of health services as a whole and consider whether any changes are needed, so as to ensure that the service is provided on the spot in the reception centre and asylum seekers have access to immediate medical care by a service provider who is aware of the distinct character of asylum seekers as a group, and ensure confidentiality in the processing of health data, dispensing of medicines and documenting of services and costs; 9) if necessary, specify in the contract for the provision of health services the content of the services to be provided to asylum seekers, the requirements for the service provider and compliance with the principle of confidentiality during the transfer of documentation concerning the provision of health services. The Chancellor of Justice made the following recommendations to the Director General of the PBGB: 1) ensure performing of an initial health examination of asylum seekers if necessary. This includes first and foremost situations where (a) an asylum seeker arrives for performing initial procedural steps and no health examination has been carried out previously and the asylum seeker expresses the wish to undergo such an examination; (b) during an interview with officials an asylum seeker refers to ill-treatment or the use of excessive coercion in respect of him or her; or (c) there are visible signs indicating ill-treatment or need for medical care; 2) revise the information materials for asylum seekers, so as to indicate the right to an initial health examination and treatment of diseases in addition to emergency medical care, also explaining which steps asylum seekers need to take to exercise these rights. As was mentioned above, the Chancellor also sent a memorandum to the Minister of Social Affairs for specifying the regulative framework for the provision of health services under the Act on Granting International Protection to Aliens. The Minister of Social Affairs in his reply to the Chancellor’s enquiry admitted that in 2010 the Ministry did not reach to complete the analysis of health services provided to asylum seekers. The reception centre explained in reply to the Chancellor’s recommendations that health examination for all the asylum seekers arriving in the centre has been enabled but the health examination has taken place when the asylum seekers have had a need and have expressed a wish for it. When concluding contracts for the provision of health services it is not possible to ensure that the service provider has undergone preparation for work with asylum seekers, is aware of the distinct character of asylum seekers as a group, as well as their cultural, linguistic and religious particularities. Currently, no doctor trained at the University of Tartu receives such preparation and the reception centre cannot offer such training. Since June 2010, a psychologist within the programme operated by Johannes Mihkelson Centre deals with asylum seekers in the reception centre. Provision of health services on the spot in the centre is not conceivable within the current budgetary resources. 43