partnership between the social and the health care systems, as well as for amendment of Regulation 49 of 18.10.2010 , and refine of the mechanism of interaction with the territorial structures of the SAA. The Ministry of Labour and Social Policy expressed willingness to participate in a meeting with the representatives of the Ministry of Health with the aim of solving the problems affecting the coordination of the institutions in the discharge of patients with mental illness from specialized hospitals and the provision of adequate support for the use of social services. Due to the continued omission of the Ministry of Health and other relevant institutions, the NPM also in this report is forced for the third time to underline its recommendations to the competent authorities: 1. The Ministry of Health and the Ministry of Labour and Social Policy to begin to solve the problems of mental health by: - activating the procedures for legislative changes through which the medical institutions providing psychiatric medical care in the Republic of Bulgaria are aligned to the level of medical institutions providing health care in the other (somatic) medical specialities; - starting procedures for issuance of a document with a certain level of competence of state psychiatric hospitals in accordance with Art. 6 (1) of Law on Medical Establishments and medical standards in psychiatry, approved by Decree No 24 / 07.07.2004 of the Ministry of Health; - preparing the respective additional regulations related to the improvement of the performance of SPH, e.g. Ordinance on occupational therapy; - triggering the procedures for transfer of part of the patients to state institutions providing social care corresponding to their condition; - finding ways for adequate funding for health care institutions in the system of psychiatric medical care; - introducing the strict control of medical institutions for mental health care in the Republic of Bulgaria by the competent authorities. 2. To take measures on alignment of the hospital laboratories in accordance with the provisions of the current legislation and the requirements of Regulation No 35 of 6th August 2010 on the establishment of the medical standard "Clinical Laboratory". To provide the above with the necessary specialist "Clinical Laboratory". 3. In the process of operation the medical institutions to comply with the requirements of Regulation No 24 of 07.07.2004 on establishing the medical standard "Psychiatry". 4. To carry out regular monitoring of patients in both psychiatric and somatic respect, and the consultations, examinations and medications prescribed to be entered into documents. 5. The Ministry of Health and the Ministry of Labour and Social Policy to cooperate to solve problems related to the provision of health care and social services with each other and with the relevant organizations dealing with similar problems. XIII. ISSUES REQUIRING LEGISLATIVE DECISIONS 1. Prisons The findings of the Ombudsman as NPM, and the CPT's findings, specify as a major problem of the Bulgarian penitentiary system overpopulation and poor conditions in the prisons. The government's motives related to the lack of financial resources to 51

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