29. The CPT considers that, as a general principle, all categories of psychiatric patient, i.e. voluntary or involuntary, civil or forensic, with legal capacity or legally incapacitated, should be placed in a position to give their free and informed consent to treatment.9 Consent to treatment can only be qualified as free and informed if it is based on full, accurate and comprehensible information about the patient’s condition, the treatment which is proposed and its possible side effects, as well as about the possibility to withdraw consent, and if the patient concerned has the capacity to give valid consent at the moment when it is sought. Further, it is essential that all patients who have given their consent to treatment are continuously informed about their condition and the treatment applied to them and that they are placed in a position to withdraw their consent at any time. Any derogation from this fundamental principle should be based upon law and only relate to clearly and strictly defined exceptional circumstances and should be accompanied by appropriate safeguards. In particular, the relevant legislation should require a second psychiatric opinion (i.e. from a psychiatrist not involved in the treatment of the patient concerned) in any case where a patient does not agree with the treatment proposed by the establishment's doctors; further, patients should be able to challenge a compulsory treatment decision before an independent outside authority and must be informed in writing of this right. The CPT wishes to be informed of the measures taken at Korydallos Psychiatric Hospital for prisoners to ensure compliance with the above precepts. d. staffing 30. The CPT has in the past been critical of the lack of all categories of staff at the Hospital. Regrettably, the situation remains dire. At the time of the November 2022 visit, there was still no resident psychiatrist for the 170 psychiatric patients in the hospital. Psychiatric input amounted to some 20 hours provided by five psychiatrists who visited the establishment once or twice a week. This is clearly insufficient. The nursing cover was even more dire with only one fully trained nurse working in the hospital at the time of the visit. She was supported by three custodial officers performing nursing tasks with one being present in the evenings and at weekends. There were also two psychologists and four social workers.10 However, there was no occupational therapist or other staff working with the patients. Nor was there a pharmacist, which is necessary given the high demand for both psychopharmacological medication and medication for the treatment of somatic diseases. A general practitioner was present between 17:00 and 07:00 seven days a week for the whole Korydallos Complex. Following the 2018 visit to the Hospital, the Greek authorities had informed the CPT that 40 new healthcare staff positions, including seven psychiatrists and 20 nurses, would be established at the Hospital by January 2019. Clearly this did not happen. The CPT reiterates its recommendation that urgent action be taken to engage resident psychiatrists and to significantly reinforce the number of qualified nurses. A pharmacist and an occupational therapist should also be recruited. It also wishes to receive a revised staffing table for what the Ministry of Health and Ministry of Citizen Protection deem are the minimum requirements for psychiatric and nursing input for a hospital of 160 beds. 31. The remaining staff consisted of eight administrative workers, a technician and the director as well as 32 custodial officers, including the chief officer. A further 12 custodial officers were deployed to other duties within the hospital (including three as nurses). 9. I.e., the admission of a person to a psychiatric establishment on an involuntary basis, be it in the context of civil or criminal proceedings, should not preclude seeking informed consent to treatment. 10. i.e. 1 psychologist for 85 patients and 1 social worker for 43 patients. 11