the attendance of warders41. It recommended that another provision replace the current Article 52: "Respect for the secrets of Article 45 and dignity prohibits the use of handcuffs and restraints as well as attendance by prison staff during the dispensation of medical care of any kind to prisoners. The necessary security shall be ensured by other means". The CGLPL indicated that the risk of escape on which excessive security measures were founded was low, as shown by the very low number of escapes counted annually, and should not justify the precautions taken, which are uncomfortable and humiliating for tens of thousands of people and lead to several hundred turning down care. In its opinion dated 16 June 2015 on provision for patients detained in health facilities, the Contrôleur général des lieux de privation de liberté bemoaned the many situations in which medical confidentiality is breached - not least owing to prison staff being in attendance during appointments and treatments. The same year, it was referred several cases in which the provisions of Article 52 of the Prison Act had not been honoured. It submitted these cases to the Prison Administration Department. In response to the three individual cases submitted, the prison administration director stated that security considerations had prevailed in managing the medical examinations of these three female detainees. She specified that the presence of a female warder in the examination or treatment room was justified by the layout of the rooms, which did not sufficiently guarantee the safety of people. She stated that these situations are assessed on a case-by-case basis, according to the layout of the facilities and the level of dangerousness of the detainees. Via a memo dated 8 December 2015, the prison administration director had nevertheless drawn the attention of the interregional directorates for prison services to the restraint means and surveillance measures during external movements for medical reasons of pregnant women or women attending a gynaecological checkup, and reiterated the applicable rules. Lastly, the Prison Administration Department asked that these principles and requirements be strictly applied, and warned that violations would give rise to the enforcement of disciplinary sanctions. In its opinion on the situation of women deprived of their liberty of 25 January 2016, the CGLPL once again underscored the need to strictly comply with the provisions under Article 52 of the Prison Act. And yet, in August 2016, the Chief Inspector's attention was once again drawn to a problematic situation from the point of view of compliance with these provisions. This concerned a woman in temporary detention at Fleury-Mérogis, admitted on terrorist offences, who gave birth in an extremely strained atmosphere, including between the medical and prison teams, particularly because of the security conditions it was deemed necessary to apply around her. On-site verifications conducted in September and October 2016 found serious intrusion on the person's dignity, invasion of her privacy and breach of medical confidentiality. They also laid bare failures in the treatment of the prisoner during her transfer and hospitalisation. The CGLPL consequently recommended in its on-site verification report that an express reminder of the principle laid down in Article 52 of the Prison Act of 24 November 2009 be given to prison staff, clarifying that there are several stages involved in the childbirth process that does not merely refer to the mother's delivery. As such, any treatment room, at the hospital, where a female detainee has gone into labour, becomes a delivery room. In response to the submission of the report drawn up following the inspection of the FleuryMérogis women's remand prison, the Minister of Social Affairs and Health intended to reiterate "that, 41 Article 52 of the Act of 24 November 2009: "Any delivery or gynaecological examination must be performed without restraints and without the presence of the prison staff, in order to guarantee the right to respect of the dignity of detained women". 89