Report on the results of the monitoring visit to Medical Unit No. 40 and the Psychiatric Department of the Lviv Multidisciplinary Hospital No. 19
On 15 March 2025, in accordance with the Optional Protocol to the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment, taking into account the provisions of the Standard Minimum Rules for the Treatment of Prisoners and the judgments of the European Court of Human Rights, and on the basis of Article 24 of the Criminal Executive Code of Ukraine — Visiting Penal Institutions, a group of monitors from the Kharkiv Human Rights Protection Group and the NGO “Protection of Prisoners of Ukraine” conducted a follow-up visit to Medical Unit No. 40 and the psychiatric department of the Lviv Multidisciplinary Hospital No. 19 of the branch of the State Institution “Public Health Centre of the State Criminal-Executive Service of Ukraine” in the Lviv region.
A planned, unannounced visit was conducted. The previous visit took place on 10 July 2023.
In preparation for the visit, the monitors used materials from complaints filed by prisoners/convicts and their relatives, materials from previous reports, and the report of the monitors of the National Preventive Mechanism under the Ukrainian Parliament Commissioner for Human Rights (NPM).
The visit was carried out within the framework of the project “Reducing the Suffering of Prisoners in the Context of the War in Ukraine”, funded by the government of Denmark in partnership with DIGNITY — Danish Institute Against Torture.
The visit was carried out by the following monitors:
- Andrii Didenko — Assistant to the People's Deputy of Ukraine Yaroslav Yurchyshyn, programme coordinator of the Kharkiv Human Rights Protection Group, with monitoring visit experience since 2014;
- Serhii Zuikov — Assistant to the People's Deputy of Ukraine Kostiantyn Kasai, member of the Public Council under the Ministry of Justice of Ukraine, member of the NGO “Protection of Prisoners of Ukraine”, with many years of experience in monitoring visits;
- Oleh Tsvilyi — member of the Public Council under the Ministry of Justice of Ukraine, head of the NGO “Protection of Prisoners of Ukraine”, with extensive experience in monitoring visits, specializing in issues of torture and cruel, inhuman treatment.
During the monitoring visit to Medical Unit No. 40 and the psychiatric department of the Lviv Multidisciplinary Hospital No. 19, which operate on the premises of the Drohobych Correctional Colony No. 40, systemic violations of national legislation and international standards in the field of healthcare and the treatment of prisoners were uncovered.
In particular, the absence of 24-hour medical supervision, inadequate sanitary and hygienic conditions, low temperatures in the wards, problems with access to drinking water, the lack of telemedicine, and the failure to provide proper care to persons with hepatitis C, drug addiction, and disabilities were recorded.
Cases of restrictions on walks and hygiene procedures for convicts, the absence of informed consent for psychiatric examination, and the practice of disclosing medical information to security personnel were identified.
A number of violations regarding fire safety, accessibility for persons with limited mobility, medical waste disposal, and the provision of hospital property were also established. The conditions of detention for some patients contradict the provisions of Article 3 of the European Convention on Human Rights, which creates risks of repeated complaints to the ECHR.
The facts uncovered indicate the need for urgent intervention to bring the activities of the medical units into compliance with the current legislation of Ukraine and international standards in the field of healthcare and human rights.
General Information
Medical Unit No. 40 and the psychiatric department of the Lviv Multidisciplinary Hospital No. 19 of the branch of the State Institution “Public Health Centre of the State Criminal-Executive Service of Ukraine” in the Lviv region are located on the territory of the state institution “Drohobych Correctional Colony No. 40”.
The head of Medical Unit No. 40 of the branch of the State Institution “Public Health Centre of the State Criminal-Executive Service of Ukraine” in the Lviv region (hereinafter — the medical unit) is Oleksandr Sevastianov.
The inpatient facility of the medical unit has 3 wards for somatic patients with 6 beds, and 2 infectious disease isolation wards for tuberculosis patients with 4 and 2 beds, respectively.
There were 7 patients undergoing inpatient treatment in the medical unit.
According to the staffing table provided by the head of the medical unit, the following positions are filled: head of the medical unit/physician — 1 post, therapist — 1.0 post, psychiatrist — 1.0 post, radiologist — 1.0 post, dentist — 1.0 post, cytomorphologist — 1.0 post, pharmacist — 1.0 post, paramedic — 5.0 posts, junior nurse — 1.0 post, X-ray technician — 0.5 post.
The head of the Lviv Multidisciplinary Hospital No. 19 is Taras Mykhailovych Peteichuk.
The hospital's psychiatric department is designed for 45 beds (43 beds for men, 2 for life-sentenced prisoners). There were 23 patients undergoing inpatient treatment in the hospital.
According to the staffing table, the following positions are filled: psychiatrist — 1 post, paramedic — 5 posts. The vacant positions are: head of the department/physician — 1 post, psychiatrist — 1 post, clinical psychologist — 1 post, junior nurse — 1 post.
Facts Established During the Visit
During the monitoring visit, violations of national legislation and non-compliance with international recommendations in the field of prisoner treatment were identified, leading to violations of the rights of convicts.
1. In violation of item 4 of Chapter 3 of Section III of the Procedure for organizing medical care for persons sentenced to deprivation of liberty, approved by the Order of the Ministry of Justice of Ukraine and the Ministry of Health of Ukraine dated 15 August 2014 No. 1348/5/572 (hereinafter — the Procedure), the hospital's psychiatric department does not provide 24-hour medical duty.
This violates item 34 of the recommendations of the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (hereinafter — the Committee), which states that detained persons must have access to a doctor at any time, regardless of the regime of their detention (CPT/Inf (93) 12-part).
2. The institution has lacked a constant, centralized water supply for a long time, which leads to problems in maintaining the sanitary and hygienic state of the premises. Water is supplied on a limited basis, only for approximately three hours a day.
At the same time, due to a leaking roof in the hallway, flooding occurs during precipitation. Such conditions contradict Article 115 of the Criminal Executive Code of Ukraine, according to which persons serving sentences in correctional and educational colonies must be provided with necessary living conditions that meet sanitation and hygiene rules.
The monitoring group identified facts that may indicate improper, cruel, or degrading treatment of prisoners and create grounds for filing new applications against Ukraine to the European Court of Human Rights due to violations of Article 3 of the Convention for the Protection of Human Rights and Fundamental Freedoms.
Thus, a convict who was in a ward of the psychiatric department for the treatment of persons sentenced to life imprisonment reported that for three weeks, despite his repeated requests to the administration, he had not been taken out for a walk even once.
This violates item 2 of Section II of the Internal Regulations of Penal Institutions, approved by the Order of the Ministry of Justice of Ukraine dated 28 August 2018 No. 2823/5 (hereinafter — IRPI), Rule 23 of the United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules), and Rule 27.1 of the European Prison Rules.
In addition, the convict was not provided with weekly washing, which contradicts item 3.1 of the Regulation on the organization of laundry services for persons held in penal institutions and pre-trial detention centres, approved by the Order of the Ministry of Justice of Ukraine dated 8 June 2012 No. 849/5, as well as Rule 19.4 of the European Prison Rules and Rule 16 of the United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules).
3. During the inspection of the cell-ward where the convict was held, a violation of Article 8 of the Convention for the Protection of Human Rights and Fundamental Freedoms, which guarantees the right to respect for private life, was established. In particular, the bathroom is not equipped with a door to ensure privacy, which violates the requirement of Rule 19.3 of the European Prison Rules.
Furthermore, the monitoring group found an insufficient level of natural light. In accordance with Appendix Zh “Normative indicators of lighting for premises of residential buildings” of the DBN V.2.5-28:2018 “Natural and artificial lighting”, approved by the Order of the Ministry of Regional Development, Construction and Housing and Communal Services of Ukraine dated 3 October 2018 No. 264, the illumination of work surfaces in bedrooms and living quarters must be 150 LUX. Instead, only 17.4 LUX was recorded in the cell-ward, which is significantly lower than the established standards.
Contrary to the requirements of Rule 22.5 of the European Prison Rules, the cell-ward is not equipped with a tank for drinking water. Bedding, pillows, and mattresses need to be replaced.
4. The medical unit does not organize opioid substitution therapy (hereinafter — OST) for persons with mental and behavioural disorders due to opioid use, in accordance with the Procedure for conducting opioid substitution therapy for persons with mental and behavioural disorders due to opioid use, approved by the Order of the Ministry of Health of Ukraine dated 27 March 2012 No. 200.
Drug-addicted persons are not provided with socio-psychological support, cognitive behavioural therapy (CBT), relapse prevention, motivational interviewing, self-help groups, etc. Thus, these individuals are deprived of the opportunity to receive OST, which violates their right to choose treatment methods in accordance with Article 38 of the Law of Ukraine “Fundamentals of Legislation of Ukraine on Healthcare”.
At the same time, in the report following its visit to Ukraine in 2023, the Committee notes that entry into a penal institution is an opportunity to resolve the drug-related problem, and therefore it is important that appropriate assistance is offered to all interested persons; consequently, appropriate medical care should be available in all institutions.
The assistance offered to such persons must be diverse; substitution therapy programmes for persons with drug addiction should be combined with genuine psychosocial and educational programmes for persons with opioid dependence who are unable to stop using drugs.
In addition, access to OST programmes in institutions should be easily accessible, and they should also be managed by prison doctors who have received special training on issues related to drug use (CPT/Inf (2024) 20, item 86).
5. In violation of the requirements of the Instructions for completing the primary accounting form No. 003-7/o “Informed consent of a person to undergo a psychiatric examination”, approved by the Order of the Ministry of Health of Ukraine dated 15 September 2016 No. 970, it was established that the medical documentation (medical record No. 025/o or No. 003/o) lacks the patient's signed informed consent for psychiatric examination.
6. In violation of the requirements of the Standards for medical care for Hepatitis C in adults, approved by the Order of the Ministry of Health of Ukraine dated 15 January 2021 No. 51, not all persons (5 people as of 14 March 2025) with suspected viral hepatitis C are undergoing PCR testing, which means they do not receive the necessary treatment, which could lead to a deterioration in their health and the spread of this infectious disease among convicted and detained persons.
7. In violation of the requirements of the State Building Norms V.2.2-10:2022 “Healthcare institutions. Basic provisions”, the isolation ward for persons with infectious diseases is not equipped with a bathroom and shower cabin, which forces infectious patients to use shared sanitary facilities together with other detained persons undergoing treatment in the medical unit's inpatient facility.
The absence of proper conditions makes effective isolation of patients impossible, facilitates the spread of infectious diseases, and creates a health risk for both the convicts and the institution's staff.
8. Dispensary observation is carried out for 16 persons with disabilities. Of these, 1 person has Group I disability; 6 persons have Group II; 18 persons have Group III.
At the same time, in violation of the requirements of the Law of Ukraine “On the Rehabilitation of Persons with Disabilities in Ukraine”, persons with disabilities do not receive proper diagnostic, treatment, and rehabilitation measures, despite the presence of information confirming persistent impairment of body functions caused by diseases and the consequences of injuries, which cause limitations in normal life activity.
Thus, during a study of the convicts’ medical documentation, it was established that 1 person with a disability lacks an individual rehabilitation programme (hereinafter — IRP).
Furthermore, the recommendations of the IRP are not being fulfilled, due to which the individual does not receive proper diagnostic, treatment, and rehabilitation measures despite the presence of information confirming persistent impairment of body functions caused by diseases and the consequences of injuries, which cause limitations in normal life activity.
9. In violation of the requirements of the State Building Norms of Ukraine V.2.2-17:2006 “Buildings and structures. Accessibility of buildings and structures for persons with limited mobility”, the medical unit has not created conditions for housing people with disabilities.
10. In violation of item 37 of the Resolution of the Cabinet of Ministers of Ukraine No. 285 dated 2 March 2016 “On approval of Licensing conditions for conducting economic activities in medical practice”, the medical unit lacks a conclusion confirming free access to the buildings and premises of the medical institution for persons with limited mobility, the obtaining of which is mandatory.
11. In violation of the Procedure for organizing medical care at the primary, secondary (specialized), and tertiary (highly specialized) levels using telemedicine, approved by the Order of the Ministry of Health of Ukraine dated 19 October 2015 No. 681, the medical unit staff are, due to technical limitations, deprived of the ability to send requests for telemedicine consultations and receive professional assistance for providing medical services to convicts.
12. In the medical unit, particularly in the wards and the dentist's office, the monitoring group recorded a violation of the temperature regime. During the inspection, the air temperature in the premises was plus 10 °C, which does not meet the requirements of Section VI of the State Sanitary Norms and Rules approved by the Order of the Ministry of Health of Ukraine dated 2 April 2013 No. 259 and item 1 of Section XXII of the IRPI: during the cold season, the temperature in living quarters of penal institutions must be maintained at a level no lower than plus 18 °C.
13. In violation of the “State sanitary and anti-epidemic rules and norms regarding the handling of medical waste”, approved by the Order of the Ministry of Health of Ukraine dated 8 June 2015 No. 325, the branch of the State Institution “Public Health Centre of the State Criminal-Executive Service of Ukraine” in the Lviv region has not concluded an agreement with a specialized institution for medical waste disposal, due to which proper collection, sorting, and disposal of medical waste have not been organized in the medical unit since the beginning of 2025.
14. In violation of Part 5 of Article 110 of the Criminal Executive Code of Ukraine, convicts staying in the medical unit's inpatient facility are not provided with the right to use the global Internet network.
The lack of access to the Internet limits their ability to receive information, exercise their right to education, self-education, and maintain social ties, which contradicts item 63 of the Committee's recommendations (CPT/Inf(93) 12-part).
15. In violation of the requirements of the Standards for bedding, special clothing, and special footwear (inventory property) for convicts undergoing treatment in medical and preventive institutions, institutions with the rights of medical facilities, and medical units at penal institutions and pre-trial detention centres, approved by the Order of the Ministry of Justice of Ukraine dated 20 February 2012 No. 280/5, convicted persons do not receive hospital property (hospital suit, robe, and slippers).
Convicts are staying in the inpatient facility in their everyday clothes, sometimes with their own bedding.
16. During the inspection of the disciplinary isolation unit (DIU), monitors established that when a convict is placed in the disciplinary isolation unit, it is standard practice to attach to the case file a medical certificate containing the state of health, according to the conclusion of which the convict is fit to be held in the DIU or cell-type quarters.
The identified facts confirm that the institution's staff possess confidential information regarding the health status of convicts who are in the DIU. This violates the requirements of Article 39-1 of the Law of Ukraine “Fundamentals of Legislation of Ukraine on Healthcare” regarding the right of persons to confidentiality about their state of health.
At the same time, the Committee has repeatedly emphasized that the obligation of prison doctors to certify the fitness of convicts to serve disciplinary punishment is unlikely to contribute to the development of positive relationships between doctor and patient.
In principle, medical personnel should never participate in any part of the decision-making process regarding the application of any form of solitary confinement, unless this measure is applied for medical reasons.
On the other hand, medical personnel must be very attentive to the condition of convicts held in solitary confinement. Medical personnel must be informed immediately about every such placement and must visit the convict immediately after placement, and then regularly, at least once a day, and provide them with prompt medical assistance and treatment if necessary.
Medical personnel must notify the institution's administration if a convict's health is under serious threat due to solitary confinement (CPT/Inf (2024) 20, item 104). In addition, this contradicts points 43.2 and 43.3 of the European Prison Rules.
17. In violation of item 7 of Chapter III of Section II of the Procedure, the monitoring group recorded that two canteen workers lacked personal medical books and that results of examinations conducted by medical specialists (including laboratory, clinical, and other tests) required for admission to work at food facilities were absent from their medical records.
18. In violation of the Fire Safety Rules in Ukraine, approved by the Ministry of Internal Affairs of Ukraine dated 30 December 2014 No. 1417 (hereinafter — the Rules), the premises of the medical unit and the psychiatric department are not equipped with fire extinguishing and fire alarm systems.
19. The doctors’ office and X-ray room are not provided with fire extinguishers, which is a violation of the requirements of item 3.6 of Chapter 3 of Section V of the Rules and a violation of item 10.18 of Chapter 10 of the State Sanitary Rules and Norms “Hygienic requirements for the design and operation of X-ray rooms and conducting X-ray procedures” approved by the Order of the Ministry of Health of Ukraine dated 4 June 2007 No. 294, registered with the Ministry of Justice of Ukraine on 7 November 2007 under No. 1256/14523.
Recommendations:
- Take measures aimed at eliminating the identified human rights violations and preventing torture, and other cruel, inhuman, or degrading treatment or punishment in the psychiatric department of the Lviv Multidisciplinary Hospital No. 19 and Medical Unit No. 40 of the branch of the State Institution “Public Health Centre of the State Criminal-Executive Service of Ukraine” in the Lviv region;
- Ensure control over the proper maintenance of medical records in accordance with the Procedure for organizing medical care for persons sentenced to deprivation of liberty, approved by the joint order of the Ministry of Justice of Ukraine and the Ministry of Health of Ukraine dated 15 August 2014 No. 1348/5/572, and other regulatory legal acts;
- Staff the hospital with medical specialists according to needs;
- Ensure the possibility of receiving opioid substitution therapy based on a diagnosis of mental and behavioural disorders due to opioid use;
- Ensure informed consent is obtained from patients for examinations and treatment in the established form;
- Ensure proper medical care for persons with viral hepatitis C;
- Fulfil the requirements of item 37 of the Resolution of the Cabinet of Ministers of Ukraine No. 285 dated 2 March 2016 “On approval of Licensing conditions for conducting economic activities in medical practice”;
- Ensure the provision of individual rehabilitation for persons in need of it;
- Ensure the accessibility of the institution's buildings in accordance with the State Building Norms of Ukraine V.2.2-17:2006 “Buildings and structures. Accessibility of buildings and structures for persons with limited mobility”;
- Ensure the proper operation of the telemedicine complex for doctors to submit requests for telemedicine consultation;
- Ensure the proper disposal of medicinal products and medical devices;
- Stop the practice of doctors certifying the health status of convicts and detainees upon their placement in the DIU/cell-type quarters;
- Provide the medical unit with hospital property (hospital suit, robe, and slippers);
- Eliminate violations of the Fire Safety Rules.