1.1 Obiski v zavodih za prestajanje kazni zapora in mladoletniškega zapora 1.1 Visit to prisons and juvenile prisons Sanitarno-higiensko nadzorstvo v ZPKZ Sanitary and hygienic supervision in prisons Do zanimivih ugotovitev smo prišli tudi v zvezi s sanitarno-higienskim nadzorstvom v zavodih za prestajanje kazni zapora, kot ga opredeljujeta ZIKS-114 in Pravilnik o izvrševanju kazni zapora.15 V zvezi z našim zaprosilom v poročilu DPM o obisku ZPKZ Ig z dne 7. 5. 2014 za pojasnilo o tem, kdaj je bilo nazadnje opravljeno sanitarno-higiensko nadzorstvo nad higieno prostorov, v katerih živijo obsojenke, razporejene v prostorih v drugem nadstropju, nam je Generalni urad UIKS sporočil naslednje (dopis št. 070-1/2014/63 z dne 15. 8. 2014): »Sanitarno-higienski pregledi se izvajajo tedensko oziroma na 14 dni. Zavodska medicinska sestra v spremstvu vodje oddelka za vzgojo in delo oziroma v spremstvu pravosodne policistke – operativne vodje opravi higiensko-sanitarni pregled po sobah in dnevnih prostorih. Občasno se opravi tudi poseben pregled hladilnikov (posebno preverjanje rokov uporabnosti živil), pri katerem se tudi izloči vsa hrana, ki ne ustreza rokom trajanja. Ugotovljena odstopanja zavodska medicinska sestra zapiše v dnevno poročilo, da se lahko nadalje ustrezno ukrepa in zagotavlja ustrezna higiena v zavodu.« Ob tem smo se spomnili na pojasnilo s strani istega naslova, ki smo ga na smiselno enako vprašanje prejeli nekaj mesecev pred tem v zvezi z obiskom DPM v ZPKZ Dob pri Mirni (dopis št. 070-1/2014/12 z dne 10. 4. 2014), in sicer »da zavod nima posebej organizirane zdravstvene službe, ima zgolj zaposlene zdravstvene delavce, ki izvajajo naloge po navodilih zdravnikov iz javne zdravstvene mreže in opravljajo tiste naloge, ki jih javna zdravstvena mreža ne izvaja (npr.: urejanje hospitalizacij, urejanje specialističnih pregledov, doziranje terapije, razdelitev terapije). Zavodski zdravstveni delavci redno nadzirajo bolniške sobe in izvajajo nadzor v skladu s POBO,16 za druge bivalne prostore ni določen poseben protokol nadzora. Zavod se zaveda, da bi bilo s sanitarno-higienskega vidika dobrodošlo, da zdravstveni delavci izvajajo nadzor v vseh prostorih, vendar tega niso zmožni uvesti zaradi kadrovskih težav«. We encountered interesting findings relating to sanitary and hygienic supervision in prisons as determined by the ZIKS-114 and the Rules on the implementation of prison sentences.15 Relating to our request in the NPM report on the visit to Ig Prison on 7 May 2014, about when the last sanitary and hygienic supervision of the hygiene of the premises in which the female prisoners on the second floor live was conducted, the Prison Administration of the Republic of Slovenia replied as follows (letter no. 070-1/2014/63 of 15 August 2014): “Sanitary and hygienic supervisions are implemented every week or two weeks. The prison nurse accompanied by the head of the educational and work section or by a female judicial police officer/operations manager conducts a sanitary and hygienic supervision of rooms and living quarters. Special supervision of refrigerators (verification of expiry dates of foodstuffs) is conducted occasionally, whereby any food which does not comply with expiry dates is removed. The nurse records the established discrepancies in her daily report, so further actions can be taken and suitable hygiene in the prison is ensured.” In this regard, we remembered a clarification from the same authority which we received in connection with virtually the same question a few months before relating to the NPM visit to Dob pri Mirni Prison (letter no. 070-1/2014/12 of 10 April 2014), i.e., “the prison does not have an specially organised health service; it merely employs medical staff who implement tasks according to the instructions of general physicians from the public health network and conduct tasks which the public health network does not implement (e.g. arranging hospitalisations and specialist examinations, dosage and distribution of medications). The prison medical staff regularly supervise patient rooms and implement supervision according to the POBO;16 no special supervision protocol is in force for other living premises. The prison is aware that it would be suitable from the sanitary and hygienic aspects for health staff to implement supervision in all premises; however, this is not possible due to a staff shortage.” Zgoraj predstavljena različna odgovora sta terjala dodatna pojasnila, zato smo se odločili ponovno obrniti na Generalni urad UIKS. V odzivu slednjega (dopis št. 070-1/2014-83 z dne 7. 10. 2014) je bilo uvodno pojasnilo, da 60. člen Pravilnika o izvrševanju kazni zapora napotuje na izvajanje higienskosanitarnih pregledov, ki ga izvaja zdravstvena služba zavodov za prestajanje kazni zapora in da v tem delu pravilnik ne sledi sistemskim spremembam na tem področju, »saj v zavodih za prestajanje kazni zapora nimamo več zdravstvene službe, ampak zdravstvene naloge izvajajo v večjem delu pristojne zunanje zdravstvene organizacije, le v delu pa še pri nas zaposleni medicinski tehniki in medicinske sestre«, temu pa je sledilo tudi zagotovilo, da bo problematika izvajanja higiensko-sanitarnih pregledov ena od vsebin prihodnjih pogovorov z Ministrstvom za zdravje. Nadalje je Generalni urad UIKS posebej poudaril, »da vsebina teh pregledov ni enaka, kot so naloge drugih pristojnih zunanjih institucij (sanitarne, zdravstvene in druge inšpekcije), ki nadzore v zavodih za prestajanje kazni zapora izvajajo na podlagi splošnih predpisov. Vsebina pregledov, ki se izvaja po omenjenem členu pravilnika, je predvsem nadziranje higiene zaprtih oseb in nadziranje higienskih pogojev (čistost oblačil in posteljnine, sanitarije, gretje, osvetlitev, prezračevanje sob)«. The aforementioned differing replies required additional clarifications, so we contacted the Head Office of the Prison Administration of Slovenia again. The latter initially explained (letter no. 070-1/2014-83 of 7 October 2014) that Article 60 of the Rules on the implementation of prison sentences dictated the implementation of sanitary and hygienic supervision implemented by the prison health service, and that in this section the Rules failed to follow systemic changes in this field, “since the health service is no longer present in prisons, but health tasks are for the most part implemented by relevant external health organisation, and partly by the employed medical technicians and nurses.” This was followed by an assurance that the issue of implementing sanitary and hygienic supervision would be one of the topics at future discussions with the Ministry of Health. The Head Office of the Prison Administration of Slovenia further stressed that, “the content of such supervision is not the same as the tasks of other relevant external institutions (sanitary, health and other inspections), which implement supervisions in prisons on the basis of general regulations. The content of supervisions implemented according to the above article of the Rules includes particularly supervision of prisoners’ hygiene and control of hygienic conditions (cleanliness of clothes and bed linen, toilet facilities, heating, lighting, airing of rooms).” 14  In this regard, the first paragraph of Article 42 of the ZIKS-1 must be emphasised: “Premises in which prisoners live must comply with health and hygienic requirements and enable the realisation of a personal plan.” 14  V tej smeri gre izpostaviti predvsem prvi odstavek 42. člena ZIKS-1: »Prostori, v katerih prebivajo obsojenci, morajo ustrezati zdravstvenim, higienskim zahtevam in omogočati realizacijo osebnega načrta.« 15  V prvem odstavku 60. člena je določeno: §1 »Sanitarno-higiensko nadzorstvo nad pripravo in delitvijo hrane, vode, osebno higieno obsojencev, higieno prostorov, kjer obsojenci živijo in delajo, ter obleko, perilom in obutvijo obsojencev opravlja zavodska zdravstvena služba.« §2 »Zavod mora izvajati ukrepe, ki jih odredi sanitarna inšpekcija, ki v zavodu po splošnih predpisih opravlja sanitarno-higienski nadzor.« 16  V nadaljevanju (glej spodaj) smo nato med drugim preverili, ali se je pri kratici POBO mislilo na program za obvladovanje (in preprečevanje) bolnišničnih okužb – in če da, za kateri tak program gre – in zvezi s tem prejeli pojasnilo Generalnega urada UIKS, »da se pri kratici POBO misli na Program o izvajanju preprečevanja in obvladovanja bolnišničnih okužb (POBO), ki so ga v ZPKZ Dob pri Mirni izdelali na podlagi 7. člena Zakona o zdravstveni dejavnosti (Ur. l. RS, št. 23/05 – ZZDej – UPB2, 23/08, 58/08 – ZZdrS-E, 15/08 – ZPacP, 77108 – ZDZdr, 40/12 – ZUJF), Zakona o nalezljivih boleznih (Ur. l. RS, št. 69/95, 25/04 – OdI. US, 47104 – ZdZPZ, 119/05) ter v skladu z določbami Pravilnika o pogojih za pripravo in izvajanje programa za preprečevanje in obvladovanje bolnišničnih okužb (Ur. I. RS, št. 74199, 92/06, 10/11). POBO so bili dolžni pripraviti za bolniške sobe in imajo POBO za bolniško sobo 1. oddelka in bolniško sobo 5. objekta«. 56 poročilo o izvajanju nalog DPM v letu 2014 DržavnI preventivnI mehanizEm po Opcijskem protokolu h Konvenciji OZN proti mučenju in drugim krutim, nečloveškim ali poniževalnim kaznim ali ravnanju 15  The first paragraph of Article 60 determines: “The sanitary and hygienic supervision of the preparation and distribution of food and water, personal hygiene of prisoners, the hygiene of premises where prisoners live and work and their clothes, underwear and shoes is implemented by the prison health service.” “The prison must implement measures ordered by the sanitary inspection which conducts sanitary and hygienic supervision in the prison as per general regulations.” 16  In the continuation (see below), we verified whether the abbreviation POBO refers to the programme for controlling (and preventing) hospitalacquired infections, and if so, which programme was referred to. In this regard, we received the explanation of the Head Office of the Prison Administration of Slovenia that “the abbreviation POBO referred to the Programme on the prevention and control of hospital-acquired infections (POBO) which was prepared in Dob pri Mirni Prison on the basis of Article 7 of the Health Services Act (Official Gazette of the Republic of Slovenia, nos. 23/05 – ZZDej – UPB2, 23/08, 58/08 – ZZdrS-E, 15/08 – ZPacP, 77108 – ZDZdr, 40/12 – ZUJF), the Contagious Diseases Act (Official Gazette of the Republic of Slovenia, nos.69/95, 25/04 – OdI. US, 47104 – ZdZPZ, 119/05) and in accordance with the provisions of the Rules on the preparation and implementation of the programme on the prevention and control of hospital-acquired infections (Official Gazette of the Republic of Slovenia, nos. 74/99, 92/06, 10/11). The prison was obliged to draft the POBO for patient rooms, and they have the POBO for the patient room of the first unit and the patient room of the fifth facility.” IMPLEMENTATION OF THE DUTIES AND POWERS OF THE NPM IN 2014 National Preventive Mechanism under the Optional Protocol to the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment 57