VII)  Health care The lack of medical staff carries the risk that convicts would not receive a timely and adequate health care. This problem has also been repeatedly noted by the CPT during its visits in the Czech Republic. In its Report on the visit to the Czech Republic carried from 1 to 10 April 2014, the CPT notes that its delegation received a number of complaints from prisoners about difficulties and delays in seeing a doctor. It recommended to the prisons that the Czech authorities redouble their efforts to fill the vacant posts of prison physicians, although the findings from prisons show this is a very difficult problem that needs to be addressed on the conceptual level. Generally speaking, there are three possibilities. 1. The current situation stays the same, i.e. the duty to provide health care will remain with the Prison Service with all the associated problems (availability and quality of care, lack of prison physicians, etc.). 2. A new organisational unit of the Ministry of Justice is created (a parallel to the Healthcare Facility of the Ministry of the Interior). The amendment of the Prison Service Act (through Act No. 157/2013 Coll.), effective as of 1 September 2013, introduced Section 4d which stipulates the possibility of creating a State contributory organisation to ensure provision of health care services to imprisoned persons and officers as well as civil employees of the Prison Service, based on an agreement between the Ministry of Justice and the Ministry of Health. In reality, however, the aforementioned amendment has not yet been put into practice. 3. The responsibility for provision of health care to imprisoned persons is transferred to civilian health care system, which is the direction taken by many European and other countries in recent years; this approach adheres to the CPT recommendations. Similar health care reforms concerning imprisoned persons (transfer of the responsibility for prison health care to the Ministry of Health) have been enacted in a number of European WHO member states: Norway, France, the UK, and partially also Italy, several Swiss cantons and two autonomous regions in Spain. Some other countries have initiated such reforms or are seriously considering them (Finland, Kazakhstan, Kosovo, Moldavia). 57  58 I recommend that the Ministry of Justice: •• Carries out a feasibility study of transferring the responsibility for provision of health care to persons imprisoned in Prison Service’s facilities from the Prison Service to civilian health care system; this should be implemented by 2016. 2) Interpreting for convicts who do not know the language Pursuant to Section 28 (1) of the Healthcare Services Act: Medical services may only be provided to a  patient with his or her free and informed consent, unless this Act stipulates otherwise. “Free consent” means that the patient cannot be forced to accept medical services and can revoke his or 57 ENGGIST, Stefan et al. Good governance for prison health in the 21st century. Copenhagen: World Health Organization, 2013, p. 18. 58 Norway completed this reform already in the 1980s while France implemented a similar law in 1994 (the Ministry of Health has the responsibility); the UK has finished the transition in 2002. Cf. MOLLER, Lars et al. Health in prisons. A WHO guide to the essentials in prison health. World Health Organization, 2007, p. 9-10. /27/