- 39 At Malandrino Prison, the delegation found that medical staff consisted of one general practitioner who attended the establishment one day per week. In theory, he was on call the rest of the week, but he lived more than an hour’s drive from the prison. The doctor had one full-time nursing assistant who had only received some training during his military service. Such a staffing level is manifestly insufficient, having regard to the number of inmates. The situation at Korydallos Prison for Men gave particular cause for concern. According to information provided to the delegation, the only full-time general practitioner’s post was once again vacant (cf. CPT/Inf (2001) 18, Part I, paragraph 148, and Part II, paragraph 69). At the time of the visit, the health-care service employed a mere 3 general practitioners each attending the prison twice a week for two hours; the situation concerning specialists was less dramatic (12 part-time doctors - including 3 psychiatrists - each present in the prison twice a week, and 1 full-time dentist). The medical team was assisted by 2 full-time qualified nurses and 7 prison officers who had received basic in-service health-care training. This staff complement would have been barely sufficient even if the establishment had been operating within its official capacity of 780, and was totally inadequate for a prison accommodating more than 2000 inmates. The CPT finds this situation all the more unacceptable given that, after its previous visits, it has already stressed the need to reinforce significantly the health-care service at Korydallos (cf. CPT/Inf (94) 20, paragraph 151). 88. Understaffing in health-care services had inevitable consequences on access to health-care and the quality of treatment provided, especially at Korydallos and Malandrino prisons. By way of example, at Korydallos, many inmates complained to the delegation of considerable delays in seeing a doctor. Further, shortage of staff made it impossible for the nurse to pay regular visits to the different wings. At Malandrino, the delegation also met numerous prisoners who complained that there was no dentist. Moreover, in the absence of the doctor (cf. paragraph 87, third sub-paragraph), the nursing assistant sometimes took decisions of a medical nature, for example concerning the administration - without a proper prescription - to patients suffering from psychiatric problems of psychotropic drugs which require careful supervision. At Khania Prison, the distribution of medication had been entrusted to a member of the establishment's administrative staff. Moreover, in all four establishments visited, at times when there was no health-care staff present in the prison (e.g. at night and during weekends), the decision to refer a case to qualified staff - a doctor or nurse - and/or to send a patient for emergency treatment to the nearest hospital was taken by prison officers with little medical knowledge. 89. Developing a proper health-care policy in prison and catering for certain specific medical needs which arise in a prison setting require, first and foremost, adequate levels of health-care staff. When determining what is an adequate level of health-care staff in a prison, a variety of factors have to be taken into account, such as the number, turnover and profile of inmates. The CPT recommends that a detailed audit be carried out to determine the needs in terms of healthcare staff for each of the four prisons visited, having regard to their particular characteristics.