Protection of Healthcare in Penitentiary System and Torture Prevention Mechanisms 9.1 Included in HIV infection antiretroviral program 10 Tested for hepatitis 2432 11 Tested or venereal diseases 1930 12 Included in Methadone program 13 Consulted by doctor-consultants of various profiles 14 Included in state program of treatment and rehabilitation of patients with insulindependent and non-insulin dependent diabetes (hormone provision) 0 72 20838 224 When comparing the above two tables it becomes clear that according to the table N2 in 2012 primary examination in the penitentiary system was passed by 16 644 individuals, and according to table N1, the said examination was passed by 17 264 individuals while the number of individuals admitted was 16 161. Therefore, the above data show clear discrepancy that provides ground for doubting reliability of the reports provided by the penitentiary establishments. According to the same table N2, it is impossible to determine number of convicts having undergone intervention and its forms. For example, according to the tables provided, outpatient visits and treatment was carried out in 408 737 cases, though the report does not clarify the exact number of individuals. At the same time the same monthly reports state that average number of inmates in 2012 in Georgia’s healthcare in the penitentiary system amounted to160 individuals. According to this data, frequency of inmate visits was on average 5-6 visits per annum which given the discontent expressed by inmates towards the healthcare system of the Georgian penitentiary, is hard to imagine. Also, number of diseased inmates and diagnosis established by forensic examination that will be discussed below in relevant chapters, indicate to late and often inadequate medical treatment. After interviewing inmates it was concluded that there was a long waiting period for a visit to a doctor and even after undergoing relevant tests it was impossible to access adequate treatment due to lack of appropriate medications. Herewith it should be noted also that dental care, therapeutic and surgical, as well as orthopedic care is accessible in all establishments and relevant para-clinical tests and consultations are being provided. Though, monitoring revealed that inmates’ access to alternative examination or/and medical tests were quite limited up until the well-known events of September 2012. And their requests were not met or/ and were fulfilled belatedly, when the inmate practically no longer had any traces of injury. Especially limited in this respect were inmates that appealed to the European Court of Human Rights alleging violation of the article 3 of the Human Rights European Convention that implies torture, inhuman treatment and, also, inadequate medical treatment. The tendency established by the end of the year with regards to strengthening of civil healthcare intervention, as well as opening of primary medical care centres can be seen as a step forward. Though, implementation of the principle accessibility to a doctor should be considered in systemic complex of the penitentiary healthcare reform. Based on the above, large-scale intervention of civil healthcare programs, inter alia psycho-social rehabilitation projects, into the penitentiary system and broadening of civil monitoring mechanisms is recommended that ensures, if needed, inmates’ accessibility to alternative or/and medical service of other kind and increases possibility of enforcement of the right to choose doctor. The above recommendations are based on the international standards,33 as well as Georgia’s law “On rights of the patient”.34 The facts of torture revealed in September 2012 and documented cases of inspection of medical cards, revealing that the right of those individuals to access medical care was infringed, clearly indicate to necessity of intervention of civil 33 34 Recommendation of the European Council #R (98)7, chapter 1. main characteristics of healthcare service in prisons, A0 access to a doctor/ doctor accessibility The law of Georgia “on the rights of patients”, article 7, article 8. ANNUAL REPORT OF THE PUBLIC DEFENDER OF GEORGIA NPM Report 2012 We shall note that, there is no special guidelines or legislative provision on activity regulations for medical personnel of the penitentiary establishment and medical units on the spot, as well as there is no special brochures for inmates on right to access the doctor. Brochures published by various international organizations were found in some of the establishments though it was not enough for education of inmates on their right to healthcare.