Annual Report 2015 • • the equivalence of the care provided to detained persons and the care provided to persons in the regular healthcare system (principle of equivalence) cannot as yet be assessed; more options will be available for treating forensic patients in mental healthcare institutions and the placement of patients from the mental healthcare system in forensic psychiatric centres are laid down by law. Due to the important role played by the Minister when a judicial ground for placement is lacking, the balance between serving justice and providing care is a point requiring attention. The RSJ believes the proposed legislation is insufficiently well-conceived, coherent, transparent and unambiguously applicable in practice. Even though the process of passing the proposals into law has been going on for a couple of years, it is necessary that the provision of care is properly laid down by law and that no lack of clarity or unnecessary complexity enters the law due to time pressure. The RSJ attaches great importance to making it sufficiently clear which party is responsible for what action and emphasises that sufficient time and capacity will need to be provided to implement the proposed changes. Haste makes waste in this connection. At the time this annual report was drawn up, the parliamentary debate of the Bill was still ongoing. Risks and obstacles related to a longstay order As a result of the DJI Masterplan for the period 2013-2018, there will only be one longstay clinic (divided over two locations) for those under a hospital order ("TBS"). The RSJ identified the following obstacles in this connection: • A "monopoly position" for the clinic and, thus, a risk of the development of a one-sided view of the treatment and punitive approach to TBS longstay patients. This could impede the outflow from the longstay facility. • It is not (always) possible to transfer TBS longstay patients, for example, in connection with a deadlock or an incident. This is because the two longstay locations of the institutions, in the current situation, are not comparable with respect to the punitive approach and the level of guidance and counselling. • The level of awareness of and familiarity with the time-out provision, i.e., the possibility of transferring a TBS longstay patient temporarily (for a period of seven weeks), pursuant to Section 13 of the Hospital Orders (Care) Act, with the purpose of observing the involved person, is insufficient. Concerns were also voiced during the advisory phase, in connection with the Vught longstay location. A penitentiary environment is not the ideal environment in which to provide TBS longstay patients with the required high-quality climate for their stay and care needs. The small size of the Vught longstay location (a total of 24 spaces) reinforces the existing dependence of Pompestichting on the DJI staff and the facilities at PI Vught. At the Specialised Intensive Care Unit of the Vught longstay location, incidents occur almost daily in the small unit (six spaces), despite the efforts of the staff. The two seclusion cells are used quite regularly and the staff turnover rate is high. The RSJ in its advice outlines two scenarios with recommendations with which to obviate the risks and obstacles related to a longstay order. An important element in both scenarios is the closure of (at least the majority of) the Vught longstay location. The RSJ recommends that this longstay location be closed in view of the fact that a longstay facility which is embedded in a penitentiary setting, although 27 Table of Cont