Prison staff Staff Alternatives to hospitalisation Removal from prison on medical grounds Medical privilege Penal institution Access to healthcare Secure rooms Hospital staff 139 Recruitments and assignments of warders must be matched with the identified requirements of surveillance and the reinsertion of detainees, taking into account the actual strength of the prison population and not the theoretical capacity of the institutions. To reduce the numerous removals from prison for medical reasons, the intervention of medical specialists in prisons must be reinforced and more thought must be put in to ensure that detainees meeting certain legal conditions can benefit from permissions to leave in order to check into a healthcare institution by themselves. Telemedicine should be developed. The terms of removal from prison for medical reasons are not satisfactory: the evaluation of the security level must be personalised and the means of restraint forced on the persons must be strictly proportional to the risk presented by the said persons. Maintaining medical privilege is every patient’s right and is an absolute duty of the doctor. The CGLPL recommends that the medical consultations should be conducted without the presence of an escort and that the surveillance must be indirect (out of the sight and hearing of the detainee). The CGLPL gives a reminder on the necessity of providing reception procedures and specific areas in the healthcare institutions in order to prevent the escorted detainees from being exposed to the sight of the public. To maintain the quality of the healthcare, the security of the staff and the dignity of the detainees, the secure rooms must be located in a department where the healthcare team is willing and prepared to receive detainees for short-term healthcare. Currently, these places resemble places of detention rather than places dispensing healthcare. The detainees must be informed beforehand of their hospitalisation conditions (list of authorised and forbidden personal effects), and on their arrival at the healthcare institution (welcome booklet pertaining to the terms of hospitalisation in secure rooms as well as the related rights). A specific internal regulation for secure rooms must be drafted. In addition to the anomalies of the operation of the secure rooms, their very principle, based exclusively on security concers, must be re-evaluated after analysing their occupancy rate, the installation and the operation of the UHSI. National rules specifying the conditions of recourse to secure rooms and the system of staying in these rooms, as well as the terms of mutual respect of the rights of detainees and the security requirements must be established jointly by the Ministries of Health, Justice and the Interior, with the help of the CNOM. Mandatory and effective training is desperately needed for all healthcare staff intervening on detainees in hospitals, concerning the ethics, medical privilege and the rights of detainees. 1 1 1 1 1 1 1 1 1 1 1