In addition to the abovementioned, as a result of the reorganization, the Tuberculosis Treatment and Rehabilitation Institution N19 was liquidated and merged with the Medical Institution for Accused and Convicts N18. At the same time, the surgical and resuscitation and anesthesiology departments in the N18 facility were abolished, and the long-term care department was merged with the therapeutic department. The staffing problems in the facility N18 are noteworthy, in particular the lack of medical and support staff. 128 Especially the psychiatric department, where three out of five positions of doctors are vacant.129 This situation leads to professional burnout of psychiatrists and adversely affects the quality of medical care for patients. Due to the epidemiological situation in the country, the ban on the employment of medical staff in the civil sector also contributed to the aggravation of the situation, after which part of the medical staff chose to work in civilian clinics. Timely referral to relevant specialists is important for receiving timely and adequate medical care. Due to the epidemiological situation in the country, visits to specialists in the penitentiary institutions were limited. Medical referrals are performed only in emergencies and for scheduled dialysis, chemotherapy, or repeated consultations/medical manipulations due to the postoperative period. In other cases, registration is made for a planned referral, although the referral is suspended at the moment.130 In December 2019 the project was started, which is the aimed at the service of the medical queue, i.e. medical service waiters, and the annulment of this queue, however, a study of the unified electronic database revealed that there are still patients waiting for a medical referral from 2018 and 2019.131 In 2020, the procession of medical documentation in a complete manner remained a problem,132 which is important in terms of continuity of medical services. The inconsistency of medical records and the lack of information on treatment outcomes make it difficult to assess the adequacy of treatment. No summary epicrisis are made by medical staff,133 which briefly reflects the dynamics of the prisoner's health during the past year, the consultations conducted, the consultations carried out, the referrals carried out, the examinations, the diagnoses made, the treatment carried out and its results. Based on the study of medical cards, it can be said that in some cases the patient's condition and test results are neglected by According to the response received from the Medical Department, as of November 13, 2020, there were a total of 36 vacancies in the Medical Institution for Accused and Convicts N18, including 4 doctors, 3 heads of departments, 14 support staff, 3 house-care, 3 nurses, 2 endoscopists, 1 doctor-narcologist 3 radiologists, 1 dentist, 2 pharmacists. 129 During the visit of the special prevention group, 50 patients were placed in the psychiatric ward. 130 It should be noted that the members of the special preventive group were not allowed to study the unified electronic database in N6, N10 and N18 institutions. The most important component of the mandate and methodology of the Special Preventive Group is the processing of voluminous information obtained from various documents in accordance with the principle of confidentiality. It is unfortunate that this is not the first time that members of a special preventive group have encountered obstacles in terms of accessing a particular category of personal data. 131 For example, one of the patients was registered on October 16, 2018 for a neurosurgeon consultation, post-discectomy period, itching and burning. One of the patients was registered on August 31, 2018, with Stable Angina pectoris, Shunting Ltd. for holteromonitoring; also one of the patients was registered for venous ultrasonography on April 5, 2019. 132 Deficiencies were found in the procession of the medical cards, there are no courses (medical records) in the cards, and where there are records, there are no indications for appointments, diagnoses and treatment results. 133 A doctor's report, a comprehensive written explanation of the origin, development, course, nature and outcome of the disease. 128 53

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