fundamental and human rights �.� national preventive mechanism against torture Supervision of health care for prisoners Health Care Services for Prisoners (VTH) operates in connection with the National Institute for Health and Welfare (THL). The VTH is tasked with providing health care services for all prisoners in Finland. As a rule, VTH produces its own primary health care, oral health care and specialised psychiatric health care services. VTH has outpatient clinics in every prison in Finland, with the exception of Suomenlinna Prison, which arranges health care for its prisoners at the Helsinki Prison outpatient clinic. Eleven prisons have dental clinics in connection with the prison clinic. In Vaasa, the dental clinic operates in a municipal health centre. The units of the Psychiatric Prison Hospital in Turku and Vantaa serve as acute clinics for prisoners everywhere in Finland. The Prison Hospital is a national somatic hospital for prisoners, located in Hämeenlinna. Since the beginning of 2016, the Regional State Administrative Agency of Northern Finland (AVI) has conducted guidance and assessment visits to the outpatient clinics and hospitals of VTH on its own or together with the National Supervisory Authority for Welfare and Health (Valvira). In the reporting year, the AVI conducted five guidance and assessment visits to VTH units. By the end of 2018, the AVI has visited all VTH outpatient clinics and hospitals. A report has been published on the supervision of the national prisoner health care service in 2016–2018: https://www.avi.fi/web/ avi/julkaisut-2019). In the report, the supervisory authorities assess VTH’s operations as part of the national health care system, along with the treatment recommendations and guidelines issued by VTH. The Ombudsman receives AVI Northern Finland’s supervision plans for VTH and guidance and assessment reports following its visits. As part of this collaboration, the Ombudsman sends its own supervision plans and visit reports to Valvira and AVI. The Ombudsman, Valvira and AVI also hold regular meetings on issues in the field of prisoner health care. The NPM visited three VTH outpatient clinics in 2018. Such visits are combined with prison visits and are usually announced in advance. Before visiting the outpatient clinic, the NPM interview the prisoners on matters such as the functioning of health care and medical care in the prison. On these visits, the NPM pays attention to how soon medical screenings are performed on new prisoners and how they are investigated for possible signs of violence. The NPM also determine how the health of prisoners placed in solitary confinement is being monitored. The monitoring is not fully in compliance with the Imprisonment Act, since the majority of outpatient clinics are only open during business hours on weekdays. For example, the mental state of a prisoner placed under observation in the weekend is not examined at the schedule required by the Imprisonment Act, i.e. ”as soon as possible” after the start of observation, but only on the next weekday. Prisoners frequently criticise the fact that they do not receive replies to the inquiry forms they send to the outpatient clinic, or that getting a physician’s or dentist’s appointment is difficult. On these visits, the NPM has frequently drawn the outpatient clinics’ attention to the fact that, according to the Patient Act, the time of their appointment must be communicated to patients if it is known. The Act does not distinguish between prisoners and other patients in this regard. However, it is necessary to take certain security considerations in to account, particularly for appointments outside the prison, and these can have an impact on the level of detail disclosed to specific prisoners about the times of their appointments. 125