guarantee of professional practices that respect patients' rights and harmonised health and medical protocols between the two health facilities. These measures are certainly commendable, but they will resolve neither the difficulty in principle where patients suffering from chronic disorders are grouped together in a penal institution, nor the tangible difficulties caused by these patients' inability to complete their basic everyday tasks on their own. The publication of this report and the answers from the Ministries of Justice and Health sparked a debate over the summer, picked up by the social networks and the press. Beyond the differences in opinion, it seems necessary to give a reminder that prison is an institution organised for the purposes of serving sentences - it is not designed for delivering medical care or providing for people whose disorders make them dependent. Illness and dependency throw into sharp focus the question of the purpose of sentences, and must therefore lead to the arrangements, and even the principle, being revised in this regard. On this point, the persisting lack of knowledge about the mental health of the prison population - which has not been addressed by any epidemiological study since 2004 - is regrettable. Finally, the need to maintain a clear separation between the care-based approach, which must guide hospitals, and the punishment-based approach which underpins prisons, must be stressed. 2.3 Overcrowding has got worse According to the statistics published by the Prison Administration Department, between 1 January 2016 and 1 November 2017, prison occupancy rates have increased faster than new places have been created: the number of operational places in penal institutions has risen from 58,561 to 59,151, whereas the number of prisoners has climbed from 66,678 to 69,307. Under these conditions, overall incarceration density has increased from 114 to 117%, the density in remand prisons from 136 to 141%. The number of prisoners with only a mattress on the ground has gone up from 1,200 to 1,473 (+ 22.7%). The number of institutions with a density exceeding 200% has dropped, meanwhile, from 4 to 3, and the number of institutions with a density of between 150 and 200% has remained stable at 37, which corresponds to nearly half (46.5%) of the 86 remand prisons in France. The phenomenon is therefore far from marginal. The repercussions of prison overcrowding are manifold, both in terms of detention conditions (lack of space and privacy, violence, etc.) and the provision of services for prisoners. Indeed, during its visits to institutions, the CGLPL finds that services are stretched to capacity, access to work is restricted, visiting room times are curtailed to enable access for everyone, there is a lack of activities on offer, access to education is limited and waiting times for medical care are longer, etc. In the remand prisons, it found four people being detained in a 9 sq.m. cell, and even five people in an 11 sq.m. cell. Individual cell allocation has obviously become impossible, and this will also, evidently, be the case in 2019, the end of the last moratorium voted on in 20148. On this point it is significant that the year "2019" has all but disappeared from documents on the draft budget for 2018, where it has been replaced with the term "eventually". Current prison overcrowding is hampering the success of genuine efforts on reintegration and preventing reoffending. 8 Amending finance act of 29 December 2014 for 2014, Art. 106. 22

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