is composed of thirteen officers, one or two of whom are present both day and night; all of them are trained in first aid; their record book (examined at the time of the inspection by the Contrôleur général) includes the whereabouts of patients subject to physical restraint in the various units. These security teams pose a problem in terms of their role. There are three aspects to this role. Practically all of them are invested with responsibilities for action with regard to fire and first aid, after the model of a local fire brigade. Moreover, when difficulties arise with patients, these teams may provide “logistical” back-up: locking of doors, telephone calls, making the area secure etc. Finally, it has been observed that the members of these teams may come to the aid of medical staff in terms of physical force, in situations such as the placing of patients in seclusion. It is the latter element which is problematic, while the others are perfectly acceptable. There are two distinct sides to the security of specialised hospitals: the first includes all of the considerations applying to establishments visited by members of the public in general; the other involves the physical protection of both patients and staff. These two roles cannot be confused. In particular, dealing with patients requires a professionalism that only medical workers possess: it is not a matter of winning a trail of strength, but rather of resolving a patient’s agitation. In other words, as tempting as it may be to enlist the help of security teams in order to control and seclude patients in crisis, due to the number of nurses present, at night in particular, the latter should be left to manage these incidents alone. Any other solution is unacceptable. Practices of this kind should be abandoned. 2.5.2.4 Staff Discipline There are also cases of security being compromised by the behaviour of permanent, or often occasional, members of staff. Let us be clear: incidents of this nature identified by the Contrôleur général are rare in number; the behaviour of the vast majority of staff only calls for admiration for their know-how and dedication, which are clearly visible. Nevertheless, a blind eye should not be turned to the seriousness of certain cases of violence or assault on the part of a few. At the end of hospital inspections, the Contrôleur général has been obliged to make use of the second paragraph of article 40 of the code of criminal procedure170, as provided for by the Act of 30th October 2007. Although its use of this legal provision is not enough to break the inspectorate’s overall good impression with regard to the way in which patients are handled in the hospital environment, it does, however, draw attention to the absence of responsiveness on the part of the institutions in the cases of offences discovered by the inspectorate. This absence of responsiveness can be seen at two levels. The occurrence in a department of events constituting an offence and involving a member of staff is deeply disruptive, for patients in particular, who by definition are fragile and therefore vulnerable. In response to this disruption, it would therefore be appropriate for the department to collectively organise the elaboration of an appropriate response, including the victim. The immediate response is frequently the opposite: since it is an isolated act, we have to contain it and, for this reason, maintain silence about it. Yet, the patients need clarification, as do the staff, whose professional ethics have been prejudiced. Meetings should therefore be conducted in order to analyse the event, like the initiatives mentioned above for the analysis of 170 “Every constituted authority… which, in the performance of its duties, becomes aware of a serious crime or an offence is obliged to immediately inform the public prosecutor at the district court of first instance thereof…” 73

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