Report of the HRD on the activities of the National Preventive Mechanism in Poland in 2011 treatment and the application of ointments and “lozenges” for all afflictions. In order to use health care services, the boys have to notify the need for a visit to an outpatient clinic to a pedagogical staff member. The said staff member decides whether a visit to the nurse is necessary, pursuant to the procedure for referring juveniles to a nurse or a doctor in the establishment and outside (placing them in hospital). The National Preventive Mechanism found that medical examination of juveniles took place in the presence of a security officer, staying in the room along with the doctor and the patient or waiting in the corridor – then the door to the consulting room is open. It must be emphasized that a person standing in the corridor can hear the conversation between the patient and the doctor. The National Preventive Mechanism is of the opinion that the presence of non-medical staff during the provision of health care services to juveniles should be exceptional and take place only when it is required to ensure safety of person providing the health care services. Otherwise, the juveniles’ right to intimacy, right to respect their dignity and right to keep medical secret are violated. The CPT draws attention to this problem in its 9th General Report, stating that it is axiomatic that all juveniles deprived of their liberty should be able to have confidential access to a doctor at any time, regardless of the regime to which they may be subjected193. Furthermore, in the opinion of the National Preventive Mechanism, the Procedure for referring juveniles to a nurse or a doctor in the establishment and outside (placing them in hospital) did not regulate the grounds for making, or refusing to make, a decision to refer a juvenile to a nurse or a doctor. It must be emphasized that the list of employees and their education presented by the Juvenile Detention Centre proves that none of pedagogical staff was additionally trained in health care. In reply, the director of the establishment informed the NPM that the relevant recommendations had been implemented. The NPM found that in all but one establishment (JDT in Nowe) the obligations related to proper health care of juveniles had been fulfilled appropriately. The establishments ensured both basic and specialist medical care to juveniles. The widely understood preventive health care also must be praised. In the opinion of the NPM, such activities are particularly important for juveniles who, for various reasons, usually are more prone to take risks. The National Preventive Mechanism recommended: • Providing health care services to juveniles out of sight and hearing range of nonmedical staff. e) Living conditions Generally, the technical condition of visited establishments was in very good or good. Good conditions were ensured both in boarding houses and in schools. The condition of the building housing the workshops of the JS in Dominów, however, was poor. The visiting team was also concerned about the conditions in bedrooms used by the therapeutic  See: § 40 CPT/Inf (99)12. 193 108