- 32 At Korydallos Women’s Remand Prison, there is no full-time doctor but a system of duty doctors working in shifts between 16h00 and 07h00 every day. A variety of specialists visit the prison two times every week for approximately three hours (dentist, dermatologist, cardiologist, gynaecologist, urologist, orthopaedic surgeon, psychiatrist). There are, however, still no trained nurses; nursing duties are performed by a number of prison officers acting as medical orderlies and a couple of inmates. At Thiva Prison, the health care team was limited to one qualified nurse and five prison officers with some nursing qualifications, all of whom worked 12 hour shifts; in addition, a general practitioner and a gynaecologist visited twice a week. As was the case in 2009, a number of specialists visited the prison once a week for a couple of hours (dentist, surgeon, paediatrician, psychiatrist, etc.). In sum, the situation had hardly improved since the 2009 visit. 71. The CPT must stress once again that the provision of adequate levels of qualified health care staff is a prerequisite for implementing a proper health care strategy in prison, capable of catering to the specific medical needs present within a prison population. The CPT has already recommended that the general state of health care services in prisons be reexamined (see paragraph 68 above). As regards more specifically the prisons visited, the Committee recommends, as an initial measure, that steps be taken immediately to reinforce health care staffing levels in order to ensure: - at Domokos Prison, the recruitment of a full-time general practitioner to oversee the delivery of health care services; at Thiva Prison, the recruitment of the equivalent of a full-time general practitioner; at all the prisons visited, apart from Amfissa Prison, the recruitment of additional qualified nurses, at least one of whom should be a qualified mental health nurse. Further, as regards Korydallos Women’s Remand Prison the Committee requests to be informed as to the reasons for the presence of doctors between 16h00 and 07h00; access by prisoners to the health care service is extremely difficult during these times. 72. In all prisons, inmates were to varying degrees working in the health care services. In the CPT’s view, prisoners should never carry out triage functions, distribute medication, be present during consultations, have access to medical records or deliver care to other prisoners. The CPT reiterates its recommendation that the necessary steps be taken to replace prisoners performing such nursing duties with qualified health care staff. 73. The findings of the delegation in the course of the visit highlighted, once again, the fact that in all the establishments visited there was a lack of coordination and consultation among the various medical staff. The lack of coordination was particularly evident at Korydallos Women’s Prison where the organisation of the medical service was chaotic, with each specialist recording their findings in a separate register without any consultation among the medical staff on an individual prisoner’s health care. The smooth operation of a health care service presupposes that doctors and nursing staff are able to meet regularly and to form a working team under the authority of a senior doctor in charge of the service.