npm annual report 2016 / observations and recommendations In a final report the Ombudsman also recommended that the patients be informed better of their rights, including the right to obtain a second opinion on continuing their treatment at the hospital’s cost and the right to, at their own cost, be assessed by a doctor chosen by them. Patients in involuntary treatment should also be clearly informed of their right to receive a decision that can be appealed on having their possessions removed from them if they do not accept the ward’s practice of keeping the patients’ possessions in the office. The Ombudsman pointed out that any assaults committed on the wards should, as a rule, be reported to the police. The hospital should have instructions on documenting the injuries of a patient brought in by the police. The Ombudsman also expressed his view that a security guard cannot perform duties that belong to health care professionals. Following the visit, the Ombudsman launched an own-initiative investigation of the following matters: – The Regional State Administrative Agency was asked to establish if the staffing ratio of Pitkäniemi Hospital is adequate. – The Regional State Administrative Agency was asked to investigate if keeping a patient restrained for a long period had been appropriate. – The Ministry of Social Affairs and Health was asked to investigate and give a statement on how a patient who has lost the ability for self-determination is represented in connection with an important decision on his or her treatment and commitment to involuntary treatment. A view from a balcony at the geriatric psychiatry ward in Pitkäniemi Hospital (visit on 20 April 2016). 61