Report of the HRD on the activities of the National Preventive Mechanism in Poland in 2011 some juveniles are undergoing psychotropic pharmacotherapy. A recommendation was issued to employ medical personnel (concerns Youth Care Centres in Antoniewo, in Wielkie Drogi, and in Kraków, Youth Sociotherapy Centre in Ustka, and Youth Care Centre No 2 in Warsaw). The Mechanism also noted that juveniles did not undergo preventive medical examinations e.g. dental or gynaecological check-ups. The failure to provide preventive health care violates the provisions of the Recommendation of the Committee of Ministers to member states on the European Rules for juvenile offenders subject to sanctions or measures159, i.e. Rule 71: Juveniles shall be given preventive health care and health education. Rule 75: Health care in juvenile institutions shall not be limited to treating sick patients, but shall extend to social and preventive medicine and the supervision of nutrition. The importance of preventive health care and health education in establishments for juveniles was also emphasized by the CPT in its 9th General Report160 (concerns Youth Sociotherapy Centres No 4 and No 5 in Warsaw, Youth Sociotherapy Centre in Ustka, and Youth Care Centre No 2 in Warsaw). It is worth mentioning here that the NMP found that in the Youth Care Centre in Rzepczyno juveniles were examined in the presence of a tutor. The National Preventive Mechanism is of the opinion that the presence of non-medical staff during the provision of health care services to juveniles should be exceptional, and should take place only when it is required to ensure safety of person providing the health care services. Therefore, the Mechanism recommended that the health care services should be provided out of sight and hearing range of non-medical staff due to the right to privacy, medical confidentiality and a special relationship between a doctor and a patient. The Director of Youth Care Centre in Rzepczyno accepted the above recommendation and emphasized that the health status of juveniles in his care was confidential. Regular controls of the expiry dates of medicines and dressing materials are also important to ensure that the juveniles’ right to health care is executed properly. The NPM recommended relevant controls at the Youth Care Centres in Łękawa and in Rzepczyno where random controls had showed that some medicines were past their expiry date.  CM/Rec(2008)11.  CPT/Inf (99)12: 40. Further, it is axiomatic that all juveniles deprived of their liberty should be able to have confidential access to a doctor at any time, regardless of the regime (including disciplinary confinement) to which they may be subjected. Appropriate access to a range of specialist medical care, including dentistry, should also be guaranteed. 41. The task of the health care service in any place of detention should not be limited to treating sick patients; it should also be entrusted with responsibility for social and preventive medicine. In this connection, the CPT wishes to highlight two aspects of particular concern as regards juveniles deprived of their liberty, namely, inmates’ nutrition and the provision of health education. Health care staff should play an active part in monitoring the quality of the food which is being provided to inmates. This is particularly important for juveniles, who may not have reached their full growth potential. In such cases, the consequences of inadequate nutrition may become evident more rapidly – and be more serious – than for those who have reached full physical maturity. It is also widely recognised that juveniles deprived of their liberty have a tendency to engage in risk-taking behaviour, especially with respect to drugs (including alcohol) and sex. In consequence, the provision of health education relevant to young persons is an important element of a preventive health care programme. Such a programme should, in particular, include the provision of information about the risks of drug abuse and about transmittable diseases. 159 160 90