Report on the Results of the Monitoring Visit to Lviv Multidisciplinary Hospital No. 19

On 17 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 United Nations Standard Minimum Rules for the Treatment of Prisoners and the decisions of the European Court of Human Rights, and pursuant to 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 public organisation “Prisoners’ Rights Protection of Ukraine” conducted a follow-up visit to Lviv Multidisciplinary Hospital No. 19 of the branch of the State Institution “Health Care Centre of the State Criminal-Executive Service of Ukraine in Lviv Oblast” (hereinafter referred to as the hospital, the institution, the facility).

A planned, unannounced visit was conducted. The previous visit took place on 11 July 2023.

In preparation for the visit, the monitors used materials from appeals submitted by prisoners/convicts and their relatives, materials from previous reports, as well as the report of the monitors of the National Preventive Mechanism under the Commissioner for Human Rights of the Verkhovna Rada of Ukraine (NPM).

The visit was conducted within the framework of the project “Reducing Prisoners’ Suffering 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:

• Andriy Didenko — assistant to the People's Deputy of Ukraine Yaroslav Yurchyshyn, programme coordinator of the Kharkiv Human Rights Protection Group, experience in monitoring visits since 2014;
• Serhiy Zuikov — assistant to the People's Deputy of Ukraine Kostyantyn Kasai, member of the public council under the Ministry of Justice of Ukraine, member of the public organisation “Prisoners’ Rights Protection of Ukraine”, possesses many years of experience in monitoring visits;
• Oleh Tsvilyi — member of the public council under the Ministry of Justice of Ukraine, head of the public organisation “Prisoners’ Rights Protection of Ukraine”, has extensive experience in monitoring visits, specialises in issues of torture and cruel, inhuman treatment.

The monitoring visit to the hospital revealed both positive aspects and serious systemic violations in the provision of medical care to convicted persons and prisoners.

Despite the functioning of several departments and the implementation of opioid substitution therapy (OST) programmes, a significant number of violations were identified regarding the observance of human rights, standards of medical care, documentation, the ensuring of privacy during medical procedures, and conditions of detention.

The most critical issues are the lack of a licensed palliative care ward, non-compliance with floor area standards in patient rooms, failure to observe infection control standards, improper documentation of bodily injuries, and the lack of a legal framework for the use of video surveillance in medical premises.

The hospital fails to provide proper isolation for patients with tuberculosis, does not maintain full records of patient consent for medical intervention, and does not ensure accessibility for persons with reduced mobility or the operation of a disinfection chamber.

The absence of a number of specialists, in particular a general practitioner, makes it impossible to conduct a comprehensive preventative medical examination. The identified violations pose a threat to the life and health of convicted persons and do not meet national requirements and international standards, including the recommendations of the European Committee for the Prevention of Torture.

The state of compliance with patients' rights in the medical facility requires an immediate review of policies, increased supervision by the Health Care Centre of the State Criminal-Executive Service of Ukraine, and the involvement of independent medical oversight.

General Information

The Head of Lviv Multidisciplinary Hospital is Taras Mykhailovych Peteychuk.

The facility is designed for 125 beds in accordance with the Order of the Health Care Centre of the State Criminal-Executive Service of Ukraine dated 22 March 2023 No. 47-OD “On changes to the structure of Lviv Multidisciplinary Hospital No. 19 of the branch of the Health Care Centre of the State Criminal-Executive Service of Ukraine in Lviv Oblast”.

The hospital comprises the following departments: a therapeutic ward with 40 beds (20 therapeutic, 10 neurological, 5 female psychiatric, 5 palliative); a surgical ward with 40 beds (30 surgical, 10 oncological); a psychiatric ward with 45 beds based at the State Institution “Drohobych Correctional Colony No. 40” (43 beds for men, 2 for prisoners serving life sentences); and an outpatient clinic (hereinafter — APC), which provides medical care to prisoners and convicts at the state institution “Lviv Pre-trial Detention Centre No. 19” — 1 ward-cell for somatic patients with 5 bed spaces. The tuberculosis unit consists of 4 ward-cells with 15 bed spaces.

Work is underway to fill vacant positions for medical staff in the hospital. The staffing level for doctors is 79.8%, and for nursing staff 81.7%. The overall staffing level in the hospital is 85.1%.

Vacant positions: Head of Surgical Department — 1 post, Head of Pharmacy — 1 post, Anaesthesiologist — 1 post, Cardiologist — 0.75 post, Anaesthetic Nurse/Brother — 1 post, Surgical Nurse/Brother — 1.5 posts, Therapeutic Ward Nurse/Brother — 1 post, Therapeutic Ward Inpatient Nurse/Brother — 0.5 post, X-ray Technician — 1 post, Healthcare Facility Maintenance Worker — 1 post, Junior Medical Nurse for patient care — 1.5 posts.

Vacant positions in the APC: General Practitioner (General Practice/Family Medicine) — 1 post, Narcologist — 1 post, Paramedic — 1.25 posts.

The hospital conducts opioid substitution therapy for patients dependent on narcotic substances. As of 17 March 2025, 64 persons are on the opioid substitution therapy programme (hereinafter — OST) in the APC of Lviv Multidisciplinary Hospital No. 19 (57 are taking methadone, 7 are taking buprenorphine). In 2024, 87 persons were included in the OST programme. In 2025, 31 persons have been included in the OST programme.

The hospital hosts a medical consultative commission for referring patients to the Medical-Social Expert Commission (MSEC) to determine the degree of temporary and permanent disability of convicts.

Work of the medical consultative commission (MCC) regarding the application of Article 84 of the Criminal Code of Ukraine to convicted patients over the first two months of 2025: number of persons released under Article 84 of the Criminal Code of Ukraine — 3; number of cases reviewed by the MCC — 4; number of materials sent to court — 4; refused by the court — 0; number of deaths during court proceedings — 0. Since the beginning of the year, 3 convicts have died.

Facts Identified During the Visit

During the monitoring visit, violations of national legislation and failure to observe international recommendations in the field of the treatment of prisoners were identified, leading to violations of the rights of convicted persons:

1. According to the order on the distribution of convicts and persons in custody requiring inpatient medical care to healthcare facilities, men and women requiring palliative care from penal institutions and pre-trial detention centres in the Volyn, Lviv, Rivne, Ivano-Frankivsk, Zakarpattia, Ternopil, and Chernivtsi regions are sent to Lviv Multidisciplinary Hospital No. 19.

At the same time, the hospital lacks a palliative care ward for providing palliative care in inpatient conditions, in accordance with Clause 4 of Section IV of the “Procedure for Providing Palliative Care”, approved by Order of the Ministry of Health of Ukraine dated 4 June 2020 No. 1308.

According to the “Procedure for Providing Palliative Care”, the main components of palliative care are medical, social, spiritual, and psychological support for the patient. At the same time, the hospital does not have a licence to conduct business in medical practice for the necessary medical specialities, which means it fails to provide the proper organisational, personnel, and technological requirements for the hospital’s material and technical base to carry out psychological support for a palliative patient.

2. In violation of Part 1 of Article 115 of the Criminal-Executive Code of Ukraine, the departments of the hospital violate the requirements regarding the living space standard per convict in conditions of inpatient treatment (not less than 5 m²).

For instance, in ward No. 185, where 6 beds are located and 6 convicted persons were residing, the area of the premises according to the living space measurement certificate is 23.08 m². Thus, the actual area per convicted person was 3.84 m². A similar violation was established in wards No. 194, 197, 198, 202, 203. Furthermore, it was established that in wards No. 193 and 201, the actual number of bed spaces exceeds the permissible limit to ensure the legally prescribed living space standard per person.

The aforementioned violation creates conditions for possible abuse by the hospital’s management and staff regarding compliance with the living space standard per convicted person in conditions of inpatient treatment and does not ensure proper personal space for persons in the inpatient wards.

3. In ward-cell No. 183 for the treatment of persons sentenced to life imprisonment, the bathroom is not equipped with doors to ensure privacy, which violates Rule 19.3 of the European Prison Rules. Contrary to the requirements of Rule 22.5 of the European Prison Rules, the ward-cell is not equipped with drinking water containers. In addition, the monitoring group found an insufficient level of natural lighting.

According to Appendix Zh “Normative indicators of lighting for premises of residential buildings” of the State Building Norms DBN V.2.5-28:2018 “Natural and artificial lighting”, approved by Order of the Ministry of Regional Development, Construction and Housing and Communal Services of Ukraine dated 3 October 2018 No. 264, the illumination of working surfaces in sleeping and residential premises must be 150 LUX. However, only 9.8 LUX was recorded in the ward-cell, which is significantly lower than the established standards.

The room has an unpleasant odour, there is no ventilation, and the bed linen and mattresses require replacement. The aforementioned does not comply with Part 1 and Part 2 of Article 115 of the Criminal-Executive Code of Ukraine, as well as Clause 53 of the recommendations of the European Committee for the Prevention of Torture or Inhuman or Degrading Treatment or Punishment (hereinafter — the Committee) (CPT/Inf (93) 12-part).

4. The procedure for admitting prisoners and convicts to the institution does not fully comply with the requirements of Chapter 2, Section II of the Internal Regulations of Pre-trial Detention Centres of the State Criminal-Executive Service of Ukraine, approved by Order of the Ministry of Justice of Ukraine dated 14 June 2019 No. 1769/5 (hereinafter — IR SIZO). Thus, during the visit to the premises of the intake ward, it was established that medical examinations for new arrivals were conducted in conditions that do not ensure privacy and confidentiality, in particular in the presence of the institution’s staff and/or representatives of other law enforcement agencies.

This indicates that the institution’s employees and other persons obtain confidential information regarding the health status of these persons during medical examinations. This violates the requirements of Clause 7, Chapter 2, Section X of the IR SIZO, Article 39-1 of the Law of Ukraine “Fundamentals of Legislation of Ukraine on Health Care” regarding the right of persons to confidentiality of health status, and Clause 9, Section I of the “Procedure for Organising the Provision of Medical Care to Convicts Sentenced to Imprisonment”, 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.

5. The monitoring group identified the presence of a metal partition in the procedure room of the outpatient clinic, through which medical examinations and procedures for convicts and prisoners are carried out. In its report on the results of the visit to Ukraine in 2020, the Committee expressed concern about the use of cages or metal partitions in medical offices, where prisoners are usually placed during medical consultations or procedures (for example, injections).

As the Committee has repeatedly emphasised in previous reports, it acknowledges that specific security measures may be justified in individual cases; however, the systematic placement of prisoners in cages during medical procedures or consultations violates their dignity, hinders the establishment of a proper patient-doctor relationship, and may complicate an accurate medical diagnosis.

The Committee calls on the Ukrainian authorities to immediately dismantle cages and barred areas in medical premises and to stop this practice in all penitentiary institutions (CPT/Inf (2020) 40, paragraph 60).

6. In violation of the requirements of the Instruction on completing primary accounting documentation form No. 003/o “Medical Card of an Inpatient”, approved by Order of the Ministry of Health of Ukraine dated 14 February 2012 No. 110, the absence of a created form for patient S., who was undergoing inpatient treatment in ward-cell No. 93 of the hospital's outpatient clinic, was established.

All data regarding treatment and diagnostics in the inpatient unit, including information obtained during the patient's examination, together with the prescription sheet, must be entered into this form.

7. In violation of the requirements of the Instruction on completing primary accounting documentation form No. 003-6/o “Informed voluntary consent of the patient to the provision of diagnostics, treatment and to the performance of an operation and anaesthesia and to the presence or participation of participants in the educational process”, approved by Order of the Ministry of Health of Ukraine dated 14 February 2012 No. 110, the absence of informed voluntary consent signed by patients who were in the inpatient unit of the hospital's outpatient clinic for diagnostics and treatment was established.

The aforementioned may indicate the lack of voluntary consent of patients for the application of methods of diagnostics, prevention, and treatment to them, which is a violation of Article 43 of the Law of Ukraine “Fundamentals of Legislation of Ukraine on Health Care” and Clause 47 of the Committee’s recommendations (CPT/Inf (93) 12-part).

8. In violation of the requirements of the Instruction on completing primary accounting documentation form No. 003-7/o “Informed consent of a person to undergo a psychiatric examination”, approved by Order of the Ministry of Health of Ukraine dated 15 September 2016 No. 970, the absence of informed consent of the person signed by the patient to undergo a psychiatric examination in the medical documentation (medical card No. 025/o or No. 003/o) was established.

9. In ward-cell No. 93, the monitoring group recorded an installed video surveillance camera. At the same time, according to Clause 8, Section VII of the Procedure for the Use of Technical Means of Supervision and Control in Correctional and Educational Colonies of the State Criminal-Executive Service of Ukraine, approved by Order of the Ministry of Justice of Ukraine dated 26 June 2018 No. 2025/5 (registered with the Ministry of Justice of Ukraine on 02 July 2018 under No. 766/32218), the use of video cameras and portable video recorders is prohibited in premises (cells) where medical examinations (checks) of convicts and strip searches are conducted.

This fact indicates the obtaining by the institution’s employees of confidential information regarding the health status of convicted persons during medical examinations, manipulations, or procedures. The aforementioned violates the requirements of Article 39-1 of the Law of Ukraine “Fundamentals of Legislation of Ukraine on Health Care” regarding the right of persons to confidentiality of health status and Clause 9, Section I of the Procedure for Organising the Provision of Medical Care to Convicts Sentenced to Imprisonment.

10. During the study of medical documentation, it was established that in the outpatient medical cards 025/o, photographs of existing bodily injuries are not attached to primary accounting documentation form No. 511/o “Certificate of fixation of bodily injuries”, approved by Order of the Ministry of Health of Ukraine dated 02 February 2024 No. 186, as provided for by Clause 2.11, Section II of the Procedure for Interaction between Healthcare Institutions of the State Criminal-Executive Service of Ukraine and Healthcare Institutions regarding the provision of medical care to persons in custody, approved by the joint Order of the Ministry of Justice of Ukraine and the Ministry of Health of Ukraine dated 10 February 2012 No. 239/5/104 (hereinafter — the Procedure).

At the same time, the Committee, in its report on the results of the visit to Ukraine in 2023, notes that any traumatic injuries detected during a medical examination should be photographed in detail, and the photographs, together with body diagrams, should be kept in the individual medical file of the person. (CPT/Inf (2024) 20) paragraph 82).

11. According to Clause 2 and Clause 3 of Chapter III, Section II of the “Procedure for Organising the Provision of Medical Care to Convicts Sentenced to Imprisonment”, 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 (hereinafter — the Procedure for Organising the Provision of Medical Care to Convicts Sentenced to Imprisonment), a general practitioner (or a family doctor), a psychiatrist, and a dentist must participate in the preventative medical examination.

At the same time, in the hospital's outpatient clinic, the positions of general practitioner are vacant, which indicates the incompleteness of the primary and preventative medical examination, in connection with which convicts and prisoners do not receive proper medical care.

The aforementioned violates Clause 38 of the Committee's recommendations (CPT/Inf(93)12-part), which states that medical services in places of deprivation of liberty must be able to provide medical care and treatment, as well as an appropriate diet, physiotherapy, rehabilitation, or any other special care at the same level as that offered to patients in civilian medical facilities. The provision of medical, auxiliary medical, and technical personnel must be provided, and appropriate premises, equipment, and apparatus must be made available.

12. In violation of the requirements of the Standards of medical care for HCV in adults, approved by Order of the Ministry of Health of Ukraine dated 15 January 2021 No. 51, not all persons (91 persons as of 16 March 2025) with suspected viral hepatitis C are undergoing PCR testing, in connection with which they do not receive the necessary treatment, which may lead to the deterioration of their health and the spread of the aforementioned infectious disease among convicts and prisoners.

13. In violation of the requirements of Clause 1, Section II of the Infection Control Standard for healthcare institutions providing care to patients with tuberculosis, approved by Order of the Ministry of Health of Ukraine dated 01 February 2019 No. 287, the requirements regarding the isolation of patients with tuberculosis are not observed in the hospital's outpatient clinic.

In particular, wards are used to accommodate more than one or two persons (one ward-cell is designed for four bed spaces), doors are not equipped with a sealed threshold and seals along the edges, and air recirculation is not ensured due to the lack of mechanical ventilation.

14. In violation of Clause 4, Chapter 1, Section X of the Internal Regulations of Pre-trial Detention Centres of the State Criminal-Executive Service of Ukraine, approved by Order of the Ministry of Justice of Ukraine dated 14 June 2019 No. 1769/5 (hereinafter — IR SIZO), the inpatient unit lacks a properly equipped isolation ward for persons with mental disorders for prisoners who pose a danger to others.

15. In violation of the Procedure for organising the provision of medical care at primary, secondary (specialised), and tertiary (highly specialised) levels using telemedicine, approved by Order of the Ministry of Health of Ukraine dated 19 October 2015 No. 681, medical personnel are deprived of the ability to send requests for telemedicine consultations and receive professional assistance for providing medical services to convicts due to technical limitations.

16. 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 reduced mobility”, no conditions have been created in the hospital facility for the maintenance of persons with disabilities.

17. In violation of Clause 37 of the Resolution of the Cabinet of Ministers of Ukraine No. 285 dated 2 March 2016 “On approval of Licensing conditions for carrying out business activities in medical practice”, the hospital facility lacks the conclusion confirming free access to buildings and premises of the medical facility for persons with reduced mobility, the receipt of which is mandatory.

18. In violation of the requirements of the Equipment Supply List for one workplace of a dentist and dental technician, approved by Order of the Ministry of Health of Ukraine dated 11 April 2005 No. 158, the hospital lacks a dental X-ray machine, which makes it impossible to conduct a thorough dental examination of convicts and does not ensure the timely provision of proper dental care.

19. In violation of the requirements of the Standards of Ownership of Bedding, Special Clothing, and Special Footwear (inventory property) for convicts undergoing treatment in medical and preventative institutions, institutions with the status of medical facilities, and medical units at penal institutions and pre-trial detention centres, approved by 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 remain in the inpatient unit in their everyday clothes, sometimes with their own bed linen.

20. In violation of Part 5 of Article 110 of the Criminal-Executive Code of Ukraine, convicts during their stay in the hospital's inpatient unit are not provided with the right to use the global internet. The lack of access to the internet limits their ability to receive information, exercise the right to education and self-education, and maintain social ties, which contradicts Clause 63 of the Committee's recommendations (CPT/Inf(93) 12-part).

21. According to Clause 3.19.1, Section III of the Regulation on the organisation of bath and laundry services for persons held in penal institutions and pre-trial detention centres, approved by Order of the Ministry of Justice of Ukraine No. 849/5 dated 08 June 2021 (hereinafter — the Regulation), sanitary processing involves the washing of convicts (persons in custody) in a bathhouse using soap and a washcloth, mandatory replacement of bed linen and underwear, as well as disinfection (destruction of pathogenic microorganisms) and disinsection (destruction of insects and ticks that are vectors of infectious diseases) of personal clothing and bedding (pillows, mattresses, blankets) in a disinfection chamber.

However, as established by the monitoring group, the disinfection chamber at the institution is not operational, which makes proper sanitary processing of bedding and clothing impossible, increases the risk of the spread of infectious diseases among convicts and staff, and contradicts established sanitary and hygienic standards.

22. The premises of the doctors' office and the X-ray room are not provided with fire extinguishers, which is a violation of the requirements of Clause 3.6, Chapter 3, Section V of the Rules and a violation of Clause 10.18, Chapter 10 of the State Sanitary Rules and Norms “Hygienic requirements for the arrangement and operation of X-ray rooms and the conduct of X-ray procedures” approved by Order of the Ministry of Health of Ukraine dated 04 June 2007 No. 294, registered with the Ministry of Justice of Ukraine on 07 November 2007 under No. 1256/14523.

Furthermore, in violation of Clause 2.23, Chapter 2, the placement of extraneous items (boxes) is permitted in the procedure room.

Recommendations:

1. Take measures aimed at eliminating the identified violations of human rights and preventing torture, other cruel, inhuman, or degrading treatment and punishment at Lviv Multidisciplinary Hospital No. 19 of the branch of the State Institution “Health Care Centre of the State Criminal-Executive Service of Ukraine in Lviv Oblast”;
2. Ensure the further referral of palliative patients to municipal healthcare institutions that have the appropriate organisational, personnel, and technological conditions for the proper support of such patients;
3. Ensure control over the proper maintenance of medical documentation in accordance with the Procedure for Organising the Provision of Medical Care to Convicts Sentenced to Imprisonment, 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, the Procedure for Interaction between Healthcare Institutions of the State Criminal-Executive Service of Ukraine and Healthcare Institutions regarding the provision of medical care to persons in custody, approved by the joint Order of the Ministry of Justice of Ukraine and the Ministry of Health of Ukraine dated 10 February 2012 No. 239/5/104, and other regulatory legal acts;
4. Staff the hospital facility with medical specialists according to needs;
5. Ensure proper conditions for patients in wards with compliance with the floor area standards per person;
6. Ensure the timely and proper fixation of bodily injuries in convicts;
7. Ensure proper medical care for persons suffering from viral hepatitis C;
8. Terminate the practice of conducting medical examinations and medical manipulations on convicts and prisoners through bars and dismantle the metal partition in the procedure room;
9. Ensure the proper accounting of preventative examinations;
10. Ensure compliance with the requirements for the isolation of persons with tuberculosis, in accordance with the Standard;
11. 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 reduced mobility”;
12. Fulfil the requirements of Clause 37 of the Resolution of the Cabinet of Ministers of Ukraine No. 285 dated 2 March 2016 “On approval of Licensing conditions for carrying out business activities in medical practice”;
13. Ensure the equipment of an isolation ward for persons with mental and behavioural disorders in accordance with the requirements;
14. Ensure the proper operation of the telemedicine complex for doctors to send requests for telemedicine consultation;
15. Provide the hospital with hospital property (hospital suit, robe, and slippers);
16. Ensure the operation of the disinfection chamber;
17. Dismantle video surveillance cameras from ward premises;
18. Provide the X-ray room with a fire extinguisher.