The NPM finds it worrying that there are no regular reviews of the state of patient health in the special medical facility by visiting physicians. Rather, the detainees being held there must actively request to be seen by a physician. The attitude of the medical and nursing staff observed by the commission has led to the conclusion that – in the NPM’s opinion – they have a highly dubious understanding of what nursing entails. No visits Regarding the criticism of the nursing measures and the medical and therapeutic care, the Federal Ministry of Justice referred the final report of the working group on “reorganisation of the special medical facility”, which was deployed in December 2014 and led by the (former) prison administration. The final report submitted in mid-2015 confirms the need for action and improvement with respect to the medical, nursing and hygienic conditions of the special medical facility as had been reported by the NPM. Based on this information, the Federal Ministry of Justice is currently deciding whether the Stein special medical facility should retain its license under the law governing special medical facilities. Working group confirms NPM’s concerns In the meantime, personnel changes were labelled as emergency measures. The heads of the medical and nursing services were replaced. A hygiene manager was appointed. It is gratifying that two additional physicians (11 to 14 and 8 hours per week) will provide service in the out-patient clinic and the special medical facility of the Stein correctional institution. Ministry reacts to criticism by the NPM Moreover, a strict separation between daytime and night-time physicians ensured a more efficient allocation of responsibilities. Under the new duty roster, a third nurse is now available in the ward area of the special medical facility. In addition, according to the Ministry, physicians now carried out daily visits in the special medical facility and in some departments with closed detention. A reorganisation of the nursing service has also been promised. Daily physician’s visits The Federal Ministry of Justice did not agree with the observations of the commission with respect to the individual cases described. It pointed out that patients are generally offered assistance by the nursing staff. They attempt to avoid hospitalisation and to maintain and foster independence. The NPM sees the emergency measures taken and the additional measures promised as positive development. However, the current improvements are still inadequate. It would be desirable to implement additional measures as quickly as possible in order to bring the special medical facility at the Stein correctional institution up to standard and guarantee adequate medical care. Demands remain in force Moreover, the NPM emphasises that placebo medication can only be tolerated if the patient is informed. 101