Annual Report 2012: Spain’s National Preventive Mechanism Those prisons which are far from urban areas or have large occupancy rates should have 24 hours medical assistance at the center A specific protocol should be established for an initial medical check-up The planned medical consultations should not be delayed over time, in order to satisfy inmates’ demands Specialized assistance is also provided There should be a register of requests for medical assistance 84 83. The prisons of A Lama (Pontevedra), Alava and Murcia II –the visited pris­ ons with the largest prison population– have a 24 hours on-site medical service. At the other centers visited, outside opening hours of the medical surgery it is necessary to call the physicians or registered nurses who are on-call and may be reached. In addition, these are centers are located in urban areas (the women’s prison of Barcelona and the prison of Ocaña II (Toledo)] or very near to them (the prison of Alcala de Guadaira (Seville)]. This situation is deemed correct, as the criterion of this Institution is that those prisons with largest occupancy rates or which are far from urban areas with emergency medical services should have 24 hours on-site medical assistance at the center. 84. At the time when an admission is carried out at a prison, a full medical ex­ amination should be carried out by the medical team of the center. However, at the women’s prison of Barcelona there is no protocol for such initial exam. It has therefore been reported to the Department of Justice of the Government of Cata­ lonia that it is convenient, for a better uniformity of criteria among physicians, to establish a specific protocol for an initial medical check-up of inmates, including analysis to detect consumption of intoxicating substances or the existence of con­ tagious diseases and an evaluation scale for the risk of suicide. 85. The frequency of the medical consultations planned for the different mod­ ules of the prison should be adequate to meet the demands of inmates. During the visit to the prison of Murcia II it was detected that, although theoretically weekly consultations on demand were established, while reviewing the records it was noticed that the frequency was generally lower, since it was normally delayed for two or, even, in some cases, more weeks. For its part, on the basis of what was observed at the prison of Alava, it was concluded that it would be advisable to alternatively organize the medical consultations on demand so that they would be more frequent, thus avoiding an excessive request for urgent consultations. 86. As regards specialized assistance at the center, it should be positively pointed out that there is a large number of specialists going to the women’s prison of Bar­ celona to cater to the demands of this kind of medical assistance, with a frequen­ cy which avoids the existence of a waiting list as well as facilitates that adequate promptness in handling the needs of the prison population. At the prison of Murcia II a collaborative agreement has been signed with the Health Department from the Murcia Autonomous Government for the provision of specialized sup­ port in psychiatry, internal medicine and gynecology. Nonetheless, it would be advisable to extend this agreement to include the assistance of an internal medi­ cine specialist, in order to conduct a better control of diseases, which play a major role at the center. 87. In the opinion of this Institution, prisons should have a register of requests for medical assistance and of the programmed appointments with the health ser­ vices, in order to know exactly who demands medical assistance, how many con­ sultations are provided every day and which periodical appointments are made THE OMBUDSMAN OF SPAIN