in the National Centre for Mental Health cite sudden death and acute cardiovascular failure in most cases. The possible reason could be insufficient monitoring of patients’ somatic condition and the failure to take risk factors into account. The inaccessibility of medical services and the problems of managing physical healthcare in the centre can be proved by the fact that an inpatient medical card gives information only about mental health and there is no entry about the state of somatic health before the deterioration of a patient’s condition or his/her death. The examination of the certificates of the state of health (form no.100/A) issued by referral clinics in the medical cards of deceased patients shows that the state of health had worsened several days before their transfer to a general hospital; whereas, according to the medical cards kept in the National Centre of Mental Health, deterioration of the state of health is registered only on the day of the transfer. In several cases, worsening problems of somatic health could be attributed to the overdose of antipsychotic medicines220 or risky combination of prescribed medicines such as “Zopin” (“Clozapine”) in combination with other antipsychotic medicines.221 5.5. PROCUREMENT OF ANTIPSYCHOTIC MEDICINES Psychiatric establishments, more than 50% of the shares of which is owned by the state, purchase antipsychotic medicines in accordance with the Law of Georgia on Public Procurement. Therefore, stemming from tender terms, usually, the cheapest and low-quality medicines are procured. In the 2017 parliamentary report, the Public Defender stressed the importance of quality medicines. In this regard, the Public Defender recommended to the Government of Georgia considering the priority of the quality of medicines, in accordance with Article 3.a-h) of the Law of Georgia on Public Procurement, to approve the special procedure of procuring medicines by psychiatric establishments (LTD), more than 50% of shares of which is owned by the state and to determine that these establishments are allowed to use simplified procurement procedures for these medicines. However, unfortunately, this recommendation has not been fulfilled. 5.6. THE RISK POSED TO THE PROVISION OF UNINTERRUPTED PSYCHIATRIC CARE IN THE LTD CENTRE OF MENTAL HEALTH OF EAST GEORGIA Inpatients should receive adequate medical care. In this regard, it is noteworthy that the Internal Audit Department of the Ministry of Internally Displaced Persons from the Occupied Territories, Labour, establishment and 18 patients died in a short period, from 1 day to 2 weeks, after being transferred to another medical establishment. 220 According to one of the deceased patients’ medical card, one of the medicines is prescribed with a maximum dose in combination with either average or minimum dose of another antipsychotic medicine and sometimes in combination with the third antipsychotic medicine, among others, Zopin. 221 One of the patients was prescribed pill treatment: “Haloperidol” (maximum dose) – 30mg three times a day, “Zopin” (“Clozapine”) 300mg and benzhexol – 6mg a day. 80