Report on Conditions in Psychiatric Establishments in Georgia somatic diseases. The administration also informed the Monitoring group that during 2011 there were 3 instances of emergency services for patients in different hospitals. The administration of Psychiatric Department of Referral Hospital noted that they contact hospital call-centre in instances of somatic problems to arrange the visit of doctor. However there are no records of such instances. The administration of Psychiatric Department of Hospital N5 use the services of the hospital therapist for somatic diseases who defines “necessary measures”. However the records are never made. Dental diseases are not treated. Emergency treatment was provided to three patients during 2011. The director of Bediani Hospital mentioned that consultants – surgeon, therapist, pulmonologists, neuropathologist are invited from Tbilisi. The reimbursement for one or two visits is 200 GEL. Currently he is negotiating with Clinics “Geo-Hospital” to purchase dental treatment services. The patients confirmed that the administration takes all available measures to manage somatic diseases. As one patient mentioned, his leg was badly injured so he was taken to another hospital for relevant treatment and operation. In Tbilisi Mental health Centre there is a therapist and a neurologist; surgeon consultant is invited if necessary who consults the patients and conducts small surgery manipulations. Allocation of finances for other diseases or long-term treatment is very problematic. This issue is especially vital for this institution as the majority of patients actually live therein because they do not have another accommodation or income. In 2011 17 patients used emergency treatment in other medical institutions; 29 patients were examined (ex-rays, electrocardiogram, ultrasonographic examination, liver checks, prothrombine index, brain examination, laboratory examination). At Psychiatric Department of Gudushauri Hospital the services are provided by the doctors of Gudushauri Hospital; however we could not check this information as records concerning the medical treatment and consultancy are not made. As for the emergency services, 8 patients were moved to relevant hospitals. Surami Establishment has a contract with therapist and neurologist who visit the establishment if necessary. Administration noted that they usually face difficulties if there is a need to place their patient in another hospital for treatment of somatic diseases. They also receive services by Tbilisi Catastrophes Centre who transport patients to Tbilisi. Dental treatment services practically do not exist. According to the official written information, 15 patients were transported for emergency surgical services. Kutaisi Mental Health Centre administration noted that they have contracts with several specialists who visit the facility on a regular basis and may be called upon in case of emergency. However in reality, according to the written information provided by the Center, in 2011 no facts of emergency or examination transfer have occurred. It shall be noted that tubercular patients are also placed in this institution; DOTS program is operational. 14 patients are placed in the unit for tubercular patients (7 of them are on a voluntary treatment while 7 – on involuntary treatment as defined by the court). In addition, in units IX and XI there were two more TB patients in isolated wards. Senaki Inter-District Psycho-Neurologic Dispensary has a contract with two specialists –therapist and neurologist. The administration provides that they visit the facility on a regular basis and patients are transported for out-patient treatment immediately. Records made in the medical file of some patients confirmed the existence of transportation services. Khelvachauri Psycho-Neurologic Hospital has contracts with several specialists who regularly visit institution. They may be summoned in emergence instances. Administration considers that out-patient services might be 75 Several out of these cases are emergency assistance, f.e. fracture of heels, shanks bones, foreign body - metal wire. A patient was hospitalized with the diagnosis of bronchial tubes and lung malignant tumour. Pleura cavity rinsing procedures and drainage removal was conducted in another case. NPM Report 2012 Qutiri Mental Health National Centre has contracts with medical consultants who regularly visit the facility. The written information submitted by the centre provides that 8 patients were transported for emergency services during 2011 (in 2010 - 6 patients). In 2011 medical treatment was provided to 9 patients in different hospitals.75