CAT/OP/ESP/1
C.
Pretrial detention
51.
According to the data that the State party provided to the Subcommittee during its
visit, as at 20 October 2017, the prison population stood at 48,814, of whom 7,121 were in
pretrial detention and 41,693 were convicted offenders. The Subcommittee observed over
the course of its prison visits that there are often no cell blocks specifically designated for
pretrial detainees or convicted persons, thereby increasing the risk of criminal behaviour,
especially among pretrial detainees.
52.
The Subcommittee recommends that the State party make it clear to the prison
authorities that pretrial detainees and convicted offenders should be held separately
so as to fully respect the former’s right to the presumption of innocence in keeping
with rules 111 and 120 of the Nelson Mandela Rules.
V. Health
A.
Introduction and professional independence
53.
The medical services that cater to persons deprived of their liberty come under
various ministries. Prison doctors who provide services in correctional facilities are staff of
the Ministry of the Interior, except in the Basque Country, where they report to the
Autonomous Community Health Department. That department is headed by a medical
subdirector who falls under the authority of the prison warden. Forensic doctors are
attached to the Ministry of Justice. Psychiatrists come under the health department, as do all
other specialists to whom inmates are referred. There is also a fourth group, as was
observed at the migrant holding centre in Valencia, where the health services are
outsourced and/or subcontracted by the Ministry of the Interior. In temporary reception
centres for migrants, some of the health services are provided by the Red Cross.
54.
The Subcommittee is concerned by the fact that health-care services are under
the authority of the Ministry of the Interior; accordingly, it recommends that the
State party transfer responsibility for those services to the health-care sector as part
of an effort to ensure the clinical independence of doctors in keeping with rule 25 of
the Nelson Mandela Rules.
B.
Structure and operation of health services
55.
The Subcommittee examined the health-care system in jails, juvenile detention
centres, police stations and migrant centres, both closed and open (migrant holding centres
and temporary reception centres for migrants). It noted that medical services are
appropriately structured and that there is the necessary staff to run polyclinics, 24-hour oncall services, infirmaries and dispensaries and to keep medical records, as well as
psychologists and educators. It also noted that there is sufficient medication and a properly
prepared drug formulary list. Examination rooms are clean.
56.
The Subcommittee observed that, in most of the places it visited, persons deprived
of their liberty have easy and rapid access to medical services and that, when they require a
referral, such as for the services of a dentist or ophthalmologist, they sign up and get an
appointment within a relatively short period of time. In terms of mental health services,
psychiatrists conduct examinations, prescribe medication and monitor treatment, while
psychologists are available for occasional therapy sessions. Mental health professionals do
not provide regular psychological treatment other than medication. Substance abuse
treatment is the priority in many places, and some prisons, including Alhaurín de la Torre
prison, house a large number of inmates undergoing methadone treatment.
57. However, the Subcommittee observed that the situation is different in police stations,
which do not have medical personnel on staff; doctors are called in only if requested by a
detainee or when there is a special administrative inspection, for instance in the event of
injury or illness.
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