- 33 The CPT reiterates its recommendation that in each prison a senior doctor or nurse manager be appointed as the head of health care, with responsibility for managing the health care service and ensuring there is a regular consultation process among the staff. c. medical screening on admission 74. The importance of medical screening of prisoners on admission, especially at establishments which represent points of entry into the prison system, cannot be overstated. Such screening is indispensable, in particular in the interests of identifying those at risk of self harm, screening for communicable diseases and the timely recording of any injuries. Prisoners entering the prison system for the first time were generally interviewed on the day of, or day after, their arrival by a nurse and thereafter by a doctor. However, this brief interview (anamnesis) was aimed at discovering whether there were any drug or other medication issues; no physical examination was carried out. Usually a blood test (for HIV, hepatitis, glucose) and an x-ray of the chest would take place at a later date. Further, approximately 25% of newly-admitted inmates apparently “refused” to undergo a medical examination (i.e. did not turn up to be examined at the allotted time); however, the CPT remains concerned that many of these prisoners were not properly informed about the possibility of being medical screened upon admission. As for those inmates transferring from another prison, they would usually have to wait several days or longer before being seen by a doctor. The CPT recommends that the Greek authorities pursue their efforts to ensure that every newly-arrived prisoner is properly interviewed and physically examined by a medical doctor or by a fully qualified nurse reporting to a doctor, as soon as possible after his admission. d. drug-related issues and deaths in custody 75. There was still no coherent and comprehensive drugs policy in place. Drugs appeared to be accessible in all the prisons visited and many prisoners admitted openly to using them. The comments made in the reports on the 2001, 2005 and 2009 visits remain pertinent.40 In particular, immediate steps should be taken to introduce a harm-reduction policy in prison. The CPT calls upon the Greek authorities to draw up a comprehensive strategy for the provision of assistance to prisoners with drug-related problems and to institute a harm-reduction policy. 76. The Committee remains concerned that, in the wake of serious incidents such as a death, no action or inquiry is undertaken aimed at establishing the cause of death and at identifying possible means to improve the system of prevention in place. The Greek authorities’ response to the report on the 2009 visit in which they state that an autopsy is systematically carried out on every death in custody appears to be directed at establishing criminal responsibility only. In the CPT’s view, an autopsy into a death in prison should form just one part of an inquiry into whether lessons can be learned to avoid future deaths in custody. 40 See CPT/Inf (2002) 31, paragraph 97; CPT/Inf (2006) 41, paragraphs 114 and 115; and CPT/Inf (2010) 33, paragraphs 138 and 139.