8. Long‑standing issues in effective prevention of ill-treatment Social services inspectors are not authorised to access to medical records If the inspectors are to effectively protect the rights of recipients of residential social services and prevent ill-treatment, they must have the right, within the inspection, to peruse the health care (treatment) documentation and make excerpts or copies even without the patient’s consent. The Ministry of Health and the Ministry of Labour and Social Affairs are unable to agree who will prepare the necessary amendments to the law. It is necessary to amend the Health Care Services Act and include inspectors among entities authorised to peruse the health care documentation even without the patient’s consent. Psychiatric hospitals The pending reform of psychiatric care aims to develop community services – many patients would thus no longer receive care in large institutions. However, large psychiatric hospitals will remain the main care providers for several years. The reform is yet to affect court-ordered forensic treatment. ee the Strategy of Reforming Psychiatric Care http://bit.ly/2Fvyzay The use of means of restraint will not decrease without policy of their prevention and development of alternative measures, and without a clear signal from the Government that we no longer want care built on restrictions. Unsatisfactory standard in psychiatric hospitals persists ―― Patients who cannot independently leave the unit due to their medical condition are not offered the possibility of access to outdoor exercise on a daily basis. ―― A number of facilities provide accommodation in dormitories housing several patients. The attitude to the use of net beds has not changed It is unknown how many net beds are used in Czech health care facilities. There were as many as 120 of them in psychiatric facilities in 2012. In response to criticism from the CPT, the Government of the Czech Republic stated in 2015 that it would abandon the practice of using net beds and would seek ways of replacing them by other means in the future. Since then, in view of the risks involved, it has been prohibited to use net beds in sobering-up stations, but remain a legal means of restraint in other health care services. The Ministry of Health remains inactive and some physicians are concerned that net beds will simply be replaced by other means of restraint. There is a pressing need for a strategic approach that would include search for and promotion of effective alternatives to the use, not only of net beds, but of means of restraint in general. 28