CAT/OP/MNG/1 83. Prisoners were only allowed access to showers once every two weeks. The Subcommittee recommends that access be permitted more frequently, at a minimum once per week. Prison No. 407 84. The Subcommittee is concerned at the substandard conditions of the facilities for long-stay family visits, in particular the lack of showers and the unhygienic outdoor toilets. 85. The Subcommittee recommends that the conditions in the visiting unit be improved, including the provision of indoor toilets and shower facilities. Prison No. 415 86. Several of the communal toilet and shower facilities lacked privacy, having only low-level partitions in the shower and toilet areas and glass doors to the toilet areas, and were monitored via a CCTV system. 87. The Subcommittee recommends that those arrangements be reviewed, in order to ensure appropriate levels of privacy. Prison No. 421 88. In common with several other prisons visited, toilets were outside of the buildings in separate units. In prison No. 421, this was particularly problematic given the significant numbers of prisoners with disabilities, older prisoners and prisoners who were unwell. The prison generally failed to accommodate the mobility and dietary needs of persons with special vulnerabilities and needs. 89. The Subcommittee recommends ensuring full accessibility of all areas of the prison, in particular for those persons who require appropriate accommodation. Food and access to water and sanitation, as well access to recreational activities and other basic rights, should conform to international standards. Special arrangements, including diet food, must be made available for persons with disabilities, older persons and detainees who require special accommodation. C. Health-care system Overarching concerns Independence of the medical staff 90. The Committee visited several health-care facilities for prisoners and detainees, including the central prison hospital (detention facility No. 401), the hospital unit attached to pretrial detention facility No. 461, detention facility No. 429 for tuberculosis and HIV patients, and a detention facility for those addicted to drugs and alcohol in Bayan soum. All such facilities were clean, although some were old, with plenty of natural light. Staffing levels were sufficient, and no overcrowding was observed. Moreover, the Subcommittee received no complaints of physical ill-treatment. The Subcommittee remains concerned, however, that the medical staff form part of the prison personnel, because this raises concerns regarding the independence of prison medical services. 91. The Subcommittee draws the State party’s attention to international principles relating to equivalence and integration, which suggest that medical services in criminal justice institutions should fall under the authority of the Ministry of Health, to ensure that persons in detention receive health care equal to those not detained and to ensure the autonomy of prison medical services. Medical screening and examination 92. Although initial medical screening is generally conducted upon arrival, it appears that it is routinely conducted in the presence of police officers. In pretrial detention facility No. 461, the Subcommittee received information that such screening was at times carried 15