ever he considers that a prisoner's physical or mental health has been or will be injuriously affected by continued imprisonment or by any condition of imprisonment. IMPLICATIONS In countries where health care in the population at large is not of a high standard, there must be particular concern about health-care standards in prisons. It is not appropriate to argue that, because a person is in prison, he or she is entitled to a lower standard of health care than that provided in the community. On the contrary, in depriving a person of his or her liberty, the State takes on a special responsibility to provide adequate health care. PRACTICAL RECOMMENDATIONS ■ It is important to have a system for prisoners to have access to a doctor which is clear and understood by everyone. ■ Every prisoner who asks to see a doctor should be able to see the doctor as soon as possible. ■ Every prisoner who is sick must be seen daily by the doctor. ■ Women in prison should have access to reproductive health services. ■ There should be close links between prison medical personnel and community medical personnel. ■ The best examples of prison health care often occur when it is under the control of community health-care authorities. ■ The European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment has recommended that the direct support of a fully equipped hospital service should be available to prisons, in either a civil or a prison hospital. Furthermore, a prison health-care service should be able to provide medical treatment and nursing care, as well as appropriate diets, physiotherapy, rehabilitation or any other necessary special facility, in conditions comparable to those enjoyed by patients in the outside community. TOPICS FOR DISCUSSION What are the main advantages of linking prison health care closely with that provided in the community as a means of observing the requirements of the international instruments? Discuss how prison doctors and other health-care staff can develop links with their professional colleagues in the community. CASE STUDY In the community in which your prison is situated there is a shortage of psychiatrists and of good health care for the mentally ill. The prison has a number of prisoners who have some form of mental disorder. How can the prison director ensure that they receive the medical care they need? 66