–7– overnight in law enforcement establishments. It is axiomatic that the fact that a remand prisoner has been returned to a law enforcement establishment should be duly recorded (at both the prison and the law enforcement establishment concerned) and that, upon re-admission to the remand prison, the prisoner concerned should again be subjected to medical screening (see paragraph 72). If further police questioning is necessary, it is far preferable for this to be carried out at the remand prison, rather than transferring the remand prisoner concerned back to a law enforcement establishment. 5. Remand detention and health care 71. In the CPT’s experience, remand prisons in particular are not always equipped with a healthcare system that is able to provide medical treatment (including preventive and specialised treatment) and nursing care, or psychological assistance and physiotherapy, in conditions equivalent to those enjoyed by patients in the outside community. In this regard, the CPT considers that all detained persons, irrespective of their legal status and the place in which they are being held, should have effective access to medical services. Further, remand prisoners should in principle be given the opportunity to consult and be treated by their own doctor (it being understood that this may be carried out at their own expense).16 72. The CPT has repeatedly stressed the importance of medical screening of newly-arrived prisoners, especially in establishments which constitute points of entry to the prison system. Such screening is essential, in particular to prevent suicide and the spread of transmissible diseases (such as tuberculosis, hepatitis B/C, HIV). Prison health-care services can also make a significant contribution to the prevention of ill-treatment during the period immediately prior to imprisonment, namely when persons are in the custody of law enforcement agencies, through the systematic and timely recording of injuries and, when appropriate, the provision of information to the relevant authorities.17 Every newly-arrived remand prisoner should be properly interviewed and physically examined, as soon as possible and no later than 24 hours after his/her admission, by a medical doctor (or a fully qualified nurse reporting to a doctor), under conditions guaranteeing medical confidentiality. In this connection, particular attention should be paid to the specific needs of vulnerable groups such as juveniles, elderly persons, substance-addicted persons and persons with mental disorders. 73. In the CPT’s experience, medical treatment which has been started in the outside community is sometimes interrupted when a person is remanded in custody and placed in a prison. Likewise, treatment is on occasion interrupted when a prisoner is released or transferred from one establishment to another. In some countries, the CPT has observed that treatment which requires a longer-term commitment is not provided to remand prisoners because of the short-term or uncertain remand period. Such an approach is contrary to the state’s duty of care vis-à-vis persons it has deprived of their liberty. The Committee considers that the necessary arrangements must be made to ensure continuity of care after admission to, or release from, prison, as well as following a transfer from one penitentiary establishment to another. As regards more specifically newly-arrived substance-addicted remand prisoners, particular attention should also be paid to withdrawal symptoms resulting from the use of drugs, medication or alcohol, and opiate substitution treatment which has started prior to their admission to the prison should be continued in prison.18 16 See also paragraph 37 of Recommendation Rec(2006)13 of the Committee of Ministers to member states on the use of remand in custody, the conditions in which it takes place and the provision of safeguards against abuse. 17 For further details, see paragraphs 71 to 84 of the 23rd General Report on the CPT’s activities (CPT/Inf(2013)29). 18 See also World Health Organization (WHO) Europe, Status Paper on Prisons, Drugs and Harm Reduction, May 2005, available on-line at http://www.euro.who.int/__data/assets/pdf_file/0006/78549/E85877.pdf.