OPINIONS AND RECOMMENDATIONS OF THE FRENCH CGLPL 7/ In fourth and last place, the widespread practice of necessarily placing, regardless of their state of health, detainees who have been compulsorily admitted to hospital (the abovementioned Article D. 398 of the Code of Criminal Procedure) in isolation (i.e. secure) rooms, and above all, keeping them there throughout their time spent in hospital, even though they have agreed to receive treatment and there is no medical justification for keeping them in isolation, also gives rise to serious concern. This state of affairs, which is often dictated to the management of such establishments, and consequently to medical staff, by the authority responsible for law and order, compromises the health of the patient-detainee in two ways. Firstly, it denies them access, in contrast to other patients who are not held in isolation, to the collective therapies on offer (discussion groups, occupational therapy, etc.). And secondly, as a result of the restrictions imposed, it frequently prompts the patient to apply to be returned as soon as possible to the prison where they were originally held, even though they still need to be cared for in hospital. At some establishments, detainees who have been compulsorily admitted to hospital are not systematically placed in isolation, without there being a higher risk of them escaping (which is the usual justification for keeping people in secure accommodation), and this enables patients to receive care appropriate to their condition. This approach should prevail over that of automatically placing patients in isolation, which ignores the obligation to adapt care to the prisoner’s own characteristics. As previously stated, it should be emphasised that the increase in the numbers of people kept in hospital or in isolation rooms without justification may in fact create problems with managing the beds or secure accommodation available, as already observed on occasions, and with arranging admission for people whose state of health appears to call for urgent hospitalisation. 8/ As indicated at the outset, arbitrating between conflicting needs linked to protection of law and order and the patient’s state of health is a delicate task. Here, it is not possible to claim to adhere to any obvious truths representing easy solutions. However, the uncertainties and risks that remain cannot be allowed to lead to an alarming increase in the number of people whose illness no longer dictates that they be deprived of their liberty or held in isolation, without any acknowledged medical justification, on the grounds of a threat to law 82

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