6. Unresolved issues in effective prevention of ill-treatment provides for administrative punishment of social service providers in case of non-compliance with formalities, but defines no infraction covering often serious instances of interference with privacy, safety, integrity and dignity of service users. The Healthcare Services Act does not even include any infractions with regard to incorrect use of means of restraint. This results in non-punishability of less serious forms of ill-treatment and contributes to low respect towards control bodies. It is necessary to revise the Criminal Code and define infractions in the relevant sectoral laws so as to ensure that no form of intentional degrading treatment remains non-punishable. Recording and reporting medical findings of ill-treatment especially police and foreigner detention and prisons, but also other facilities Issue: The prohibition of torture and other forms of ill-treatment is always weakened when the perpetrators are not punished for their acts. If a credible complaint is received or there are injuries indicating ill-treatment, an effective investigation must be conducted. The systematic visits indicated that the medical reports on examination and treatment lack the parameters required for investigation of ill-treatment. In extreme cases, the examination is limited to several questions asked in the presence of a police officer. This is caused by a low awareness of the principles governing documentation of ill-treatment. The statutory confidentiality requirement under the Healthcare Services Act then does not permit a physician, without the patient’s consent, to submit findings on signs of ill-treatment to authorities competent to investigate. Potential solution: It is necessary to provide methodological guidance to physicians, change the legislation on confidentiality, and to initiate a professional debate so that physicians accept their role in combatting ill-treatment with understanding and without endangering the physician-patient relationship. Modify the Healthcare Services Act so that reporting on findings of marks of ill-treatment does not represent violation of the physician’s confidentiality. Confidentiality of medical examination is not ensured police and foreigner detention and prisons Issue: The right of a person restricted in freedom to see a physician is one of the basic safeguards against ill-treatment. The presence of police officers or prison guards deters the victim from disclosing information on any ill-treatment to the physician. As regards medical examinations of persons under the authority of the Prison Service of the Czech Republic, the Healthcare Services Act (Section 46 (1)(g)) provides that they shall take place in the presence of an officer who has to be “in sight” and in cases of danger even “within earshot”. The Act lays down no special regime for medical examinations of persons presented by the Police of the Czech Republic, but the Police President’s binding instruction prescribes that at least one police officer shall remain in visual contact. For the prevention of ill-treatment to be effective, CPT standards require that no police officer or prison guard be present at all unless this is requested by the physician for security reasons, and even in that case, only in sight. It is necessary to modify the Healthcare Services Act and instruct police officers and members of the Prison Service of the Czech Republic to respect the rule that their presence in treatment is only possible on the physician’s request, and in that case only “in sight”. 19