Report on the Performance of Activities of the National Preventive Mechanism for 2016 they refuse to act in accordance with some warnings or recommendations, because their perception of the situation is completely different from the one established or because they have other reasons for such conduct. Not only is this contrary to Act on the NPM, which provides that state bodies or institutions are obligated to implement measures determined by a warning or recommendation, but the reasons for which they act in such manner, whether they be lack of financial resources, staff, legal framework deficiencies or other, must not be an excuse for limiting or violating prisoners’ rights. Despite the fact that certain measures have been undertaken, recommendations from the Ombudswoman Report for 2015 have either remained completely unimplemented or have been implemented to a lesser extent. When it comes to submitting reports on steps undertaken, cooperation with COPSD and penal institutions was satisfactory; however, Ministry of Justice and Ministry of Health failed to deliver their responses regarding two recommendations. 1.3. Assessment of state in the prison system In 2016, no significant changes occurred in the prison system; and, therefore, the level to which human rights of persons deprived of their freedom are respected, is the same as the one last year. Systematic problems when it comes to organizing the manner in which healthcare services are provided, still persist, which is something we dealt with in more detail in the Report for 2015, claiming that this may lead to violation of prisoners’ rights. Neither the Prison Hospital nor the so-called infirmaries or prisoner healthcare wards, which are available in every penal institution, are medical institutions nor have they been organized in line with the Healthcare Act. In addition, most of them do not meet requirements of the Ordinance on Minimum Standards regarding Premises, Staff and Medical-Technical Equipment of a Medical Institution Providing Healthcare to Persons Deprived of Their Liberty. Ombudswoman did not receive information requested from the Ministry of Health, regarding implementation of Constitutional Court Decision U-III/64744/2009 from 2010, on establishment of efficient supervision system over provision of healthcare in the entire prison system; nevertheless, based on information available, this decision has not yet been implemented, despite the fact that considerable amount of time has already elapsed. Due to insufficient numbers of prison doctors, certain penal institutions are unable to ensure continuous healthcare, a problem that is temporarily solved by concluding piecework agreements. This does not represent a permanent solution because instead of being present on a full-time basis, a physician is normally present Most problems would be easier to only several hours a week. Healthcare is thus not resolve were the Ministry of Health to readily available to prisoners, who spend weeks accept the responsibility for ensuring waiting for the requested medical check-up. adequate healthcare services to Moreover, due to insufficient numbers of prisoners and population in general. 21