Chapter 1 – Report of the Policy, Law and Complaints Group carrying out its study visits, and was accompanied by nominated prison officials during certain visits. While the Commission was not provided with full access to the prisons, it was allowed to visit certain blocks and cells, all kitchens, and all recreational areas, and was also allowed to speak in private to prisoners. (a) General Observations (i) The Commission found that some prison doctors failed to meet basic ethical standards, such as aspects of doctor-patient confidentially. The Commission emphasises that the relationship between physician and prisoner is governed by the same ethical principles as that between the physician and any other patient; therefore, they must adhere to the same national codes of professional practice and standards as doctors and medical professionals in the community. (ii) In general, health services offered for prevalent diseases such as tuberculosis, human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/ AIDS), as well as services in the field of obstetrics and gynaecology, were found to be strictly limited. Although the health services offered often correspond to the types of health problems reported by prisoners, many health issues remain unaddressed, in particular asthma, drug and substance abuse, and gynaecological screening. (iii) Although in general, screening, testing, and treatment at the point of admission to prison have increased, there is no standard policy for routine physical exams at almost all facilities, particularly for female prisoners (e.g.: giving them pap smear examinations). (iv) As part of primary health care delivery, the services of a psychiatrist and a dentist should also be available in prison at all times. (v) The authorities must take immediate steps to ensure that the conditions in which prisoners are kept, whether on remand, under quarantine, or as punishment once sentenced, do not contribute to the development, worsening, or transmission of diseases and do not encourage the spread of diseases. (vi) The authorities must ensure that upon admission or transfer to a different prison, the prisoner’s health status is reviewed within 24 hours of arrival by a qualified medical professional. (vii) It was observed that prisoners were involved in the prison’s healthcare service, particularly in the distribution of medicines. Medication must be dispensed only by a nurse, or a trained pharmacist, or the doctor himself. (viii) Prisoners who are mentally ill are entitled to the same treatment and services that are available in public hospitals. However, there were no psychiatrists or psychologists 71 BOOK-ANR2016-01-latest.indb 71 08/04/2016 3:32 PM