5. Additional circumstances that create problems in the system for providing psychiatric medical care are the different principles of funding for SPHs and CMHs, which creates confrontation and tension between the different types of medical establishments and reflects on the quality of medical services. 6. The National Preventive Mechanism established also implementation of bad practices by the Ministry of Health. These include refusal to cooperate on important issues with other organizations or obvious omission regarding the regulation of certain activities. As an example may be given the still ongoing lack of Ordinance for occupational therapy, the need for which has been reminded by the NPM for the third consecutive year. According to the requirements specified in Art. 151 of the Law on Health, the Ministry of Health was required within 3 months after the entry into force of this Law to draw up such an ordinance. 7. There are a large number of patients treated repeatedly and with longer stays. Stays of several years with small breaks are common practice. In these cases, the psychiatric hospitals are forced to assume also the functions of specialized social institutions under the methodological guidance and control of the Ministry of Labour and Social Policy. In this case it is obvious the absence of adequate policy on the part of both ministries - the Ministry of Health and the Ministry of Labour and Social Policy, on the issues of mental health. In the institution of the Ombudsman of the Republic of Bulgaria have been received specific signals by the Directors of SPH "St. Ivan Rilski "- city of Novi Iskar and SPH - village of Tserova Koria, Veliko Tarnovo Region. They alleged that the officials of the Directorate "Social Assistance" - Vrabnitsa, and the Directorate "Social Assistance" city of Gorna Oryahovitsa, refuse to accept patients discharged, although they do not have any relatives and a place to stay. According to Art. 26 of Ordinance No 49 / 18.10.2010 of the Ministry of Health "on discharge of a patient whose condition requires an assistance, the latter is send to his relatives. In case of absence of relatives, failing to make contact with them or their disagreement to accept the discharged person expressed, the staff of the hospital shall transfer the patient to an employee of the relevant Directorate "Social Assistance". Although the employees to the directorates "Social Assistance" are obliged to implement subordinate legislation acts, the Director of the Directorate "Social Assistance" Vrabnitsa, stated that the Ordinance No 49 / 18.10.2010 of the Ministry of Health is "an act of institutional subordinate legislation which action does not extend to other departments of hierarchical subordination, as described in Instructive Letter 9100-286 / 19.11.2010 of the Executive Director of the Social Assistance Agency". On this occasion, I addressed the Minister of Labour and Social Policy. In response to my recommendation, the Minister informed me by letter No 92-133 of 20th March 2014 that by Ordinance No 49 / 18.10.2010 to the Ministry of Health are "entrusted responsibilities and commitments of the authorities for social assistance, which do not comply with the provisions of the Law on Social Assistance and the Regulations on its implementation" and "Art. 26 of the Ordinance has not been preliminary consulted and agreed with the Ministry of Labour and Social Policy. " The Minister strongly disagrees with the provisions of that law, insisting on undertaking actions in the shortest possible time to change the Regulation so as to eliminate the existing discrepancy and to find a proper solution. As a national Ombudsman, acting as the NPM, I addressed the Prime Minister with a proposal to initiate the establishment of a coordination mechanism with the representatives of MLSP and MH in order to solve these problems. After my recommendation of 27th March 2014, by letter No 0403-77 the Minister of Labour and Social Policy made a proposal to the Minister of Health to discuss possibilities for 50