54 alien affairs Health care • With regard to health care, the NPM was left with the impression that the staff were strongly committed to their care work and were keen to develop their practices, but that this was not possible owing to the shortage of resources. The Ombudsman emphasised the particular role of health-care professionals in the prevention of ill treatment. • According to the City of Helsinki, the implementation of requirements concerning the arrival medical examination and the daily consultations with a customer held in segregation with one duty nurse is a challenge. This aspect of staffing requires reconsideration when the Detention unit is handed over to the state administration. It became apparent during the visit that the arrival medical examination is still not automatically carried out on all detainees and, instead, the need for a check is assessed on a case-by-case basis. If a newly arriving detainee seems to be in poor health, they may be referred directly to a physician. Otherwise the medical examination is carried out within 3 to 4 days. The nurse interviewed during the visit was aware of the Ombudsman’s recommendation, but because of the staff resources the medical examination for all new arrivals could not be carried out within the recommended 24 hours. The Ombudsman reiterated his earlier recommendation on the medical examination. A health-care professional should meet all new arrivals at the detention centre and carry out a medical examination, subject to their consent. Examination should be carried out as soon as possible and always within 24 hours of arrival. This would also allow for the documentation of any signs of violence that a detainee may present. According to the Ombudsman, the Finnish Immigration Service will, in the future, be responsible for ensuring adequate staffing for the health-care services at the Metsälä Detention Unit. • The identification and referral to treatment of victims of torture or other cruel or degrading treatment The Ombudsman recommended that, after the nurse has made a record of the injuries and a report from the detained person on how they sustained the injuries, the detained person is referred to a physician for immediate examination of the injuries and more detailed documentation. The Ombudsman recommended that the arrival medical examination be based on a standard form or other template to ensure the consistency of interview outcomes. The Ombudsman recommended that the form contain a separate section for notes on signs of violence and questions presented to the interviewee on possible violence during their transportation or apprehension. It would be important to ask the interviewees at the arrival interview about their possible experiences of torture or other cruel and degrading treatment.