European Committee for the Prevention of Torture
and Inhuman or Degrading Treatment or Punishment (CPT)
Strasbourg, 21 August 2017
CPT/Inf (2017) 20
(Former CPT (2010) 102 REV)
Inspection of a prison medical service by a CPT doctor
This list is not exhaustive, but rather a tool to be used during CPT visits, and will be reviewed on a regular basis.
Initial interview with the doctor in charge
Questions to raise (keep in mind the following general areas of concern): 1. Access to a doctor,
2. Equivalence of care (with special attention to the higher morbidity and the greater health-care needs of
prisoners), 3. Patient's consent and confidentiality, 4. Preventive health care (vaccination, addiction, opiate
substitution, condoms, needle and syringe exchange, etc.), 5. Vulnerable inmates: elderly, women, disabled,
LGBT, juveniles, ethnic minorities, undocumented foreign nationals, 6. Professional independence,
7. Professional competence
Number of doctors (GPs, psychiatrists, dentists), other specialists, psychologists, nurses,
auxiliaries (full-time/part-time; other employment) in relation to the number of inmates
Presence of staff in prison (times of arrival and departure)
Training, qualifications, remuneration terms
Involvement of third parties in care: guards, prisoners?
Outside medical support
Back-up hospitals for emergencies/serious conditions?
Specialist outside consultations (what, who, when, number?)
Method and conditions of medical transfer of sick prisoners (in particular, emergency cases)
Medical care work
Transmission of health care information / continuity of care
New prisoners: number per month, content/moment of medical examination upon admission
Consultations during imprisonment: availability, number and duration of consultations by type of
health-care staff, access arrangements respecting confidentiality (oral/written requests, giving
reasons for requests to non-medical staff, filtering of requests - by whom?)?
Waiting times by type of health-care service
Emergencies: procedure during/outside working hours; medical staff on call in prison: who?
Care provided free of charge / copayment by prisoners? health insurance?
Medical service also responsible for prison staff/families?
Type / specific ailments encountered by the service
Gender sensitive health care and prevention (pregnant women / mothers and infants / screening
for sexual abuse and other forms of violence / screening for breast and gynaecological cancer)
Groups with special needs: e.g. disabled / LGBT / elderly
Mental disorders (psychotic disorders, consent to treatment, use of seclusion and restraint)
List of deaths: causes, autopsies conducted?
Prevention, addiction and harm reduction
Suicide prevention, self-harming
Transmissible diseases (e.g. Hepatitis, HIV, TB, syphilis, skin infections): screening, counselling,
prevention, follow up and treatment
Condom distribution in a confidential manner?
Prevention of transmission of diseases through tattooing, piercing and other forms of skin
Systematic screening for drug, alcohol and tobacco use/abuse upon entry?
Drug testing (type of tests used, reference lab for supervision?)
Is opiate substitution treatment offered to prisoners and under what conditions (free of charge /
exclusion of undocumented foreign nationals / confidentiality)?
Are needles and/or syringes found during cell searches? Frequency of needle- and syringerelated problems? Needle and syringe exchange programs (NSP) in the community/in prison?