Report on the Performance of Activities of the National Preventive Mechanism for 2015 security correctional facility. Apart from that, there are wards for healthcare of prisoners within the state and county prisons, where civil servants with completed medical education and licence to practice their profession independently are employed, by the Prison System Directorate with the Ministry of Justice. If there are no prison physicians employed or if there is not enough of them, heads of the prisons conclude service contracts with external healthcare providers. The Prison Hospital and the so-called “infirmaries”, i.e. prisoners’ healthcare wards, which are established in each penal institution, are not medical institutions and they are not organized in accordance with the Healthcare Act. The Healthcare Act does The Prison hospital and the prescribe the possibility for the Republic of Croatia to establish prisoners’ healthcare a medical institution for providing of healthcare to persons wards, which are present in deprived of their liberty, but this has not been done yet, each penal institution, are although the Ordinance on Minimum Standards of Space, not medical institutions Workers and Medical Equipment for Providing Healthcare to and they are not organized Persons Deprived of Their Liberty was adopted in 2014. Existing in accordance with the wards within penal institutions do not comply with prescribed Healthcare Act. requirements. Supervision of the providing of healthcare to prisoners is carried out by the Ministry of Health, but this is extremely rare. In this context, despite the Decision of the Constitutional Court U-III/64744/2009 of 2010, efficient supervision over the quality of healthcare in the entire prison system has not yet been established. When the state deprives the citizens of their liberty, it accepts the responsibility for their healthcare, which should be the same as the healthcare provided to any person insured under the compulsory health insurance. This is evident from the case law of the ECHR. Taking into consideration the status of the ward where healthcare is provided to prisoners, as well as the current number of healthcare providers and medical equipment available in those wards, it is evident that systematic changes in prisoners’ healthcare are required. A major problem is the fact that prison physicians, who are civil servants and employees of penal institutions, cannot issue prescriptions for medications or referral slips that would be accepted by external medical institutions due to not having a contract concluded with CHIF, which results in the obligation of all prisoners to have their own elected physicians. This is a source of constant dissatisfaction because those physicians generally never get to even see the prisoners. In situations where penal institutions do not have their own “in-house” physician, but rather have service contracts concluded with family practitioners, such difficulties are avoided because prisoners can schedule examinations directly with them, and those practitioners can issue prescriptions and referral slips. All this being considered, it is necessary for the Ministry of Justice and CHIF to conclude a contract that would also enable prison physicians to issue referral slips and prescriptions, and for this to be done as soon as possible. As of 2014, all prisoners with permanent residence and foreign prisoners with approved permanent address have the status of an insured person covered by health insurance, while the costs of healthcare for other prisoners are borne by the penal institutions. 22

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