2.5. Penitentiary Health Care In 2020, the number and qualifications121 of medical staff still remain a problem.122 Procession of medical documentation, protection of medical confidentiality,123 screening for non-transmittable diseases, timely execution of medical referral and the situation of preventive health care. Due to the epidemiological situation in the country in 2020, the visits of specialists and carrying out medical referrals in the the establishments were limited, which affected the timely delivery of medical services. For timely medical care, it is important to ensure access to primary health care in the establishments. As in previous years, there is still a great demand for a meeting with a primary health care doctor, it is less difficult for convicts placed in the semi-open establishments to get to a primary health care doctor, because they go to the doctor themselves but often have to stand in line. In closed type institutions, together with the high demand, the prisoner is taken to the doctor by the employee of the establishment, which increases the waiting time.124 During the visits the prisoners point out the problem of access to family doctors. According to the medical staff, they are overloaded. After the reorganization carried out within the medical department in 2019-2020, 113 medical workers were fired from penitentiary establishments. According to the response125 received from the Medical Department, 32 medical staff have been employed through open competition since November 2020.126 At the end of 2020, the number of medical staff employed in penitentiary institutions was 253, and 109 positions were vacant. Such a drastic reduction in medical staff and the existence of open vacancies affect the delivery of timely and adequate medical care. In 2019, the Public Defender addressed the Minister of Justice of Georgia with a recommendation to double the number of nurses,127 instead their number was reduced. It is important that vacancies are filled in a timely manner so as not to disrupt the delivery of medical services. A report by the European Committee for the Prevention of Torture (CPT) on a 2007 visit to Greece states that there should be no more than 300 prisoners per doctor and 50 per nurse. The ratio of the number of prisoners to nurses in large penitentiaries is high and therefore it is necessary to add support medical staff. 122 Problems in the field of continuing medical education are still noted. For medical staff. According to the information received from the Medical Department, in 2020, phthisiologists were trained in "Latent Tuberculosis Infection (LTBI) Management News", other trainings directly on issues related to the specialization were not conducted. Computers in medical centers have access only to the website of the Ministry of Labor, Health and Social Affairs of Georgia. Due to the limitations of the Internet, medical staff is deprived of access to complete, operative information on modern methods of diagnosis and treatment, guidelines, protocols and medications. This, in turn, affects the quality of medical services. 123 During the visits, the inmates again pointed out the problem of the non-medical staff attending the meeting with the doctor. 124 The lack of staff in the facilities and the busy work schedule affect the timely delivery of the patient to the doctor. In addition to taking inmates to the doctor, they take prisoners for a walk, to the bathroom, to the distribution of food, and so on. 125 Letter of Medical Department N287297/01 December 03, 2020. 126 On the positive side, in February 2020, the remuneration of medical staff in all institutions increased. See the link https://bit.ly/39yfTc6 [Last visited: 29.01.2021]. 127 Annual Report of the National Preventive Mechanism 2019, see the link: https://bit.ly/3bzHWJz [Last visited: 14.01.2021]. 121 52