ANNUAL REPORT OF THE PUBLIC DEFENDER OF GEORGIA 2013 diagnosed and treated within the limits of the penitentiary healthcare but it is evident that transfers of prisoners to civilian medical establishments in 5,199 cases are insufficient to fully satisfy their needs for medical assistance. It is important to establish quality control over the medical services provided at penitentiary healthcare institutions, pretrial detention facilities and institutions for sentenced prisoners, and to perform patient safety assessment. In this regard, we would recommend that the Medical Regulatory Unit of the Ministry of Corrections enhance its activities and interact more effectively with the Public Law Entity “Agency for the State Regulation of Medical Activity”. Pursuant to information received from the Ministry of Corrections, a new Medical Regulatory Unit has been functioning within the Ministry since March 2013. The Unit is responsible for quality control of medical services provided. One of the key activities the Unit carries out to achieve its goals is that is conducts inspection of medical records with a view of verifying whether the relevant rules on producing and maintaining medical documentation are observed and whether the medical services provided are adequate. In addition to pre-planned monitoring activities, the Unit is authorized to conduct unscheduled check-ups on the basis of complaints it receives. From the day it was founded until January 2014, the Unit looked into 73 cases of which planned monitoring was carried out in 18 cases. The Unit deals with cases through a panel of experts. Whenever necessary, medical specialists specializing in the required area are invited to assist the panel. If the panel detects a physician’s error, the case will be forwarded to the Public Law Entity “Agency for the State Regulation of Medical Activity”. Recommendation to the Minister of Corrections: QQ To exercise quality control over the provision of medical services by strengthening the interaction between the Ministry’s Medical Regulatory Unit and the Public Law Entity “Agency for the State Regulation of Medical Activity”. CONFIDENTIALITY AND INFORMED CONSENT QQ Maintaining confidentiality of medical information remains a problem within the penitentiary system. Although the penitentiary healthcare personnel are answerable to only the Medical Department of the Ministry of Corrections, it is difficult to keep information about visits to a physician confidential. This is true about doctor consultation both within the relevant penitentiary institution and outside at a civilian medical establishment. Medical records are not protected in a manner they should be. Frequent contact between the prison healthcare staff and the prison administration as well as lack of knowledge of professional ethics norms often become reasons of unacceptable disclosure of medical information. Pursuant to the Recommendation issued by the Council of Europe Committee of Minister to the Member States, medical confidentiality should be guaranteed and respected with the same rigor as in the population as a whole.78 Under Article 72 of the Georgian Law on the Rights of the Patient, a medical service provider is obliged to keep information it possesses about the patient confidential both during the patient’s life and after the death of the patient. In this context of confidentiality of medical information, we would like to discuss compatibility of some of the provisions of the Order of the Minister of Corrections No. 38 dated 10 March 2011 with the ethical principle of confidentiality. Under the Rules approved by this Order, in order to transfer a prisoner from a penitentiary institution to penitentiary or civilian medical establishments, a doctor of the relevant penitentiary institution should apply to the Medical Department of the Ministry of Corrections with a request for transfer; the Medical Department will, on its turn, send its recommendation to the director of the penitentiary institution from where the request originated (if the request was to transfer the prisoner to a treatment facility within the penitentiary system) or to the Chairperson of the Penitentiary Department (if the request was to transfer the prisoner to a civilian medical establishment). It should be noted that when a request for an inmate’s transfer to a civilian medical establishment is made, the doctor of the penitentiary institution forwards one copy of the request lodged with the Medical Department to the director of the same penitentiary institution.79 We think this violates the confidentiality principle 78 Recommendation no. R (98) 7 of the Council of Europe Committee of Ministers to Member States concerning the Ethical and Organisational Aspects of Health Care in Prison, 20 April 1998, par. 13. 79 Article 2, the Order of the Minister of Corrections and Legal Assistance no. 38 dated 10 March 2011 approving the “Rules of NPM Report 38