CAT/OP/UKR/3 56. Moreover, the Subcommittee notes that access to medical care is inconsistent, with many reported cases of medical assistance being delayed or denied. Despite the general availability of medical personnel in places of detention, different institutions are disparately equipped and often detainees must ask family members or donors to provide needed medication and personal hygiene products. Visits to outside specialists and institutions are rarely undertaken. Moreover, during its visit, the Subcommittee regularly encountered medical professionals who were insensitive to the medical needs of detainees, including staff who hesitated to respond to reports of worsening physical and psychiatric symptoms they interpreted as merely bad behaviour. 57. Reiterating the recommendations made in 2011 (see CAT/OP/UKR/1, paras. 76 and 80), the Subcommittee encourages the State party to guarantee that, as a routine matter, all persons undergo a thorough medical examination as soon as they are deprived of liberty. It is recommended that such an examination record: (a) A detainee’s medical history, including any allegations of recent violence, torture or ill-treatment; (b) The existence of any discomfort or symptoms; (c) The result of the clinical examination, including a description of any injuries observed and an account of how such injuries were sustained; (d) An indication of whether the whole body was examined; (e) The health professional’s conclusion as to whether all recorded elements are consistent. 58. The Subcommittee recommends that all medical examinations maintain the principle of medical confidentiality: only medical personnel should be present during the examination. It also recommends that the State party discontinue the practice of performing medical examinations through bars, since such examinations are demeaning by nature and lack the thoroughness envisioned in the Istanbul Protocol. 59. The Subcommittee recommends that the State party ensure that all persons deprived of liberty are given a thorough medical examination, regardless of whether they are held in a location officially registered as a place of detention in the State party or not. 60. The Subcommittee also recommends that the State party improve its training of medical personnel working in places of detention, particularly on the Istanbul Protocol and other international standards, as well as on the duty to detect and report torture and ill-treatment. If a health professional has grounds for suspecting the existence of torture or ill-treatment, the Subcommittee recommends that this be registered in a national register of allegations of torture and ill-treatment, either with the consent of the examined person (so that the case may be referred to expressly) or, if such consent is refused, as an anonymous case. In addition, the Subcommittee recommends that health professionals immediately report suspicions of torture and ill-treatment to the appropriate authorities, with the consent of the detainee, so that an independent examination may be conducted in accordance with the Istanbul Protocol. The confidential medical report should be made available to the detainee and to his or her counsel. 61. Finally, the Subcommittee recommends that medical care and assistance be guaranteed and accessible to all detained persons upon their request. Registers 62. The Subcommittee notes that the current system for recording the status of detainees needs improvement. In particular, during its visit the Subcommittee observed that registers in SIZOs contained individual sheets of paper originating from a number of different institutions that, together, made up a single file. That record-keeping system was made more complicated by the transfer of detainees from SIZOs to ITTs — sometimes in other parts of the country — for investigative purposes and court hearings during which time the files were transferred with them. Such transfers were inconsistently recorded, making it difficult to track the location of a person under investigation. In addition, in some instances, no record was left at the sending institution that would account for a transferred detainee’s 11