fundamental and human rights �.� national preventive mechanism against torture – Northern Ostrobothnia Hospital District, Care of the developmentally disabled / Lounastuuli, Oulu, 11–12 December 2018, 8 places, municipal (6389/2018) A physician specialising in intellectual disabilities participated in six of the visits as an external expert. An expert from VIOK took part in one visit as an external expert. Experts from the Human Rights Centre also participated in some of the visits. Some of the key opinions and recommendations issued on the basis of the visits are presented below. Certain remarks relate to visits made in 2017, but with opinions issued in 2018. Use of cage beds In connection with a visit to institutional care and housing units for the intellectually and developmentally disabled, it was noted that cage beds were used in one ward. This was the first time such beds were observed during a visit made by the Parliamentary Ombudsman or NPM. For one child under the age of 10, the bed was used to prevent the child from falling out of the bed during epileptic seizures. The bed was not a normal cot for small children (0–3 years), but a larger metal cage bed with a roof. The bed had been made by a local workshop. A cage bed was also used for another child in the same ward. The restrictive measure decisions required by the Act on intellectual disabilities had been made for the use of the beds. The European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) has stated that the use of cage beds can be considered to offend human dignity and must therefore be stopped immediately. In its report (StVM 4/2016 vp), the Social Affairs and Health Committee of Parliament has stated that other means shall always be used in preference to restrictive equipment when possible. Instead of a restrictive measure, it can be possible to use a wide and low bed, or a bed whose height can be electronically adjusted according to the situation. The Ombudsman urged that the use of cage beds be discontinued and that alternative solutions be found instead. The legality of restrictive measures used in the care of the intellectually disabled can be referred to a court for evaluation. The court will make the final decision on whether the restrictive measure or piece of equipment can be considered legal in each specific case. The Ombudsman also highlighted that restrictive equipment must comply with the requirements of the Act on Health Care Devices and Equipment. Such equipment can include hospital beds with bedrails (visits to the North Karelia social welfare and health care joint authority’s (Siun Sote) care units for the intellectually disabled, 6311* and 5920/2017*). The joint authority reported that it would look for replacement beds compliant with the requirements of the Act on Health Care Devices and Equipment, without endangering the health and safety of the residents. A metal cage bed with a ceiling. 112