CAT/OP/PRT/1 91. The Subcommittee recommends that all newly arrived detainees, as soon as possible and no later than 24 hours following their entry into a place of detention, be given a thorough medical examination, including a full body examination, in order, inter alia, to detect any signs of injuries sustained prior to the person’s admission. In addition, the results of such examinations should be appropriately and comprehensively recorded in a specifically designated and confidential register and, in cases of suspicion of torture and ill-treatment, reported accordingly, as described in rules 33 and 34 of the United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules). 92. Medical examinations should be carried out regularly and always in keeping with the principle of medical confidentiality: no person other than medical personnel should be present during the examination. Guards should remain out of hearing and normally out of sight, except in the rare case where the medical staff may, for reasons of safety, request otherwise. Medical records should be made available to the detainees or their legal representatives upon the detainees’ request. 93. Furthermore, the Subcommittee recommends that the State party improve its training of medical personnel working in places of detention, particularly as regards international standards, including the Istanbul Protocol, which is an indispensable tool in detecting, documenting, reporting and, as such, deterring torture and illtreatment. C. Prisons 94. The Subcommittee is concerned about the hybrid model of public-private responsibility for medical services that remains in place in some prisons. In these prisons staff of the Ministry of Health share work schedules with staff from private companies, medical specialists working for private companies visit the prisons and inmates are treated by employees of the Ministry of Health when they go to hospitals for treatment. 95. The Subcommittee welcomes the State party’s plan to transfer the responsibility for the health care of prisoners to the Ministry of Health as the single service provider and recommends that the State party carry out this plan without delay. 96. The Subcommittee welcomes the fact that medical personnel are in general well trained and that clinical files are generally well-kept and easily searchable. No major concerns were identified in relation to the preparation of medicines for distribution, with the exception of Porto Prison. At Porto Prison medications were removed from their packaging well in advance of delivery, deposited in containers and later transferred to other individual containers and distributed. This method left medications exposed for hours to humidity and possible contamination and increased the risk of mistakes during their distribution. 97. The Subcommittee recommends that the current practice of distribution of medications at Porto Prison be modified and that medications remain in a blister pack until they are administered in order to retain their properties and for reasons of hygiene. 98. The Subcommittee notes that medical care in prisons is carried out by the polyclinics in the prisons, and that the services provided are based on demand from the inmates. The Subcommittee is, however, concerned that in all the prisons visited inmates reported difficulties in obtaining access to doctors. Requests to see a doctor were usually placed through the guard, and no registry of the requests was kept. It was therefore difficult to evaluate the availability of medical consultation at the polyclinic. Inmates also had access to some specialist psychiatric, psychological and dental treatment within the prisons, but the delegation was informed that that was a very limited resource and hence of limited availability to the inmates. Specialist treatment not available in the prison was provided in coordination with nearby hospitals, but the waiting time was often long and the problem was at times compounded by a lack of transport or escort. The Subcommittee considers that 16