Prisons and pre-trial detention centres This issue was raised by the experts participating in the seminar on prison health care service.65 This element of the prison health care service should be changed. The problem found in visited establishment was the lack of personnel in the prison health care service, mainly the lack of medium-level medical personnel, ophthalmologist and psychiatrist. The doctors make use of the fact that the Prison Service is uncompetitive as an employer and obtain approval for shorter working time or using unpaid leave to conduct medical practice in other health care institutions. As regards the access to doctors, the Mechanism is of the opinion that the presence of non-medical staff during the provision of health care services to inmates should be exceptional, and should take place only when it is required to ensure safety of person providing the health care services, upon explicit request of the medical personnel. In comparison with the previous years, the situation in this regard in 2012 has improved, with the presence of an officer during the provision of health care services to persons deprived of liberty recorded only in 5 M. Ksel (a member of the CPT) declared that one of the criteria for evaluation of the prison health care service is quality. Analysing this issue, the CPR examines whether a doctor was kind or brusque. According to her, “the guarantee for appropriate health care is continuous education of doctors and evaluation of their professional qualifications which should be performed by supervisory authorities as part of specialist consultation.” Presenting the motivation for transferring the heath care service in prison to the supervision of the Ministry of Health, she stated that “the most important reason was to improve the quality of health care for prisoners. The fact that the health care personnel is independent from the prison authorities is also a  guarantee for inmates that their human rights will be observed.” See M. Ksel, Kierunki reform więziennej służby zdrowia [Reforms of the prison health care service] (in:) Więzienna służba zdrowia. Obecny stan dyskusji i kierunki reform [Prison health care service. Current discussion and directions of reforms], p. 15. Z. Lasocik (then member of the SPT) stated that the reform of the prison health care service should begin with changing the paramilitary nature of the service. According to him, “a doctor who is an officer and an officer who is a doctor does not have any dilemma – who do they see when a patient enters their office? They see a  prisoner who happens to have some ailments. It cannot be any other way, since the officer receives remuneration at the end of the month for ensuring that it is a prisoner not a patient.” See Z. Lasocik, O potrzebie reformy więziennej służby zdrowia [On the need to reform the prison health care service] (in:) as above, pp. 16-17.T. Bulenda also stated that “medical personnel should be civilian”, Cf. T. Bulenda, Wątpliwości prawne dotyczące prawa więźniów do opieki medycznej. Kontekst reformowania więziennej służby zdrowia [Legal doubts concerning the right of prisoners to health care. The context of the prison health care service reform] (in:) as above, p. 18.The representative of the Helsinki Foundation for Human Rights signalled the problem while presenting legal rules applicable to temporary detained inmates, concluding that “medical procedures should be transferred to the Ministry of Health”, See P. Kładoczny, P. Kubaszewski, Opieka medyczna w  więzieniach – perspektywa więźnia [Health care in prisons – from the perspective of the prisoner] (in:) as above, p. 10.Without going into the reasons for conflicts between doctors and patients, M. Niełaczna stated that “in the letters we receive [Association for Legal Intervention] from prisoners and in interviews conducted with prisoners, they often state that they do not have problems with access to health care, but with inappropriate, despicable approach of doctors to inmates as patients”, See M. Niełaczna, Problemy systemu penitencjarnego – ocena Stowarzyszenia Interwencji Prawnej [Problems of the penitentiary system – assessment of the Association for Legal Intervention] (in:) as above, p. 5. 65 37