Leading Article: Special hospitals in need of urgent surgery

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BRITAIN'S SPECIAL hospitals are in trouble - and they have been for years, dragging Britain's shameful legacy of benighted lunatic asylums with them across the 20th century and, it now appears, to the brink of the 21st. The publication of Sir Peter Fallon's report into the Ashworth Special Hospital on Merseyside shows a dreadful example of this lack of progress.

The revelations contained in the report seem too shocking even to merit the word "disgrace". Many allegations made by a former inmate, which prompted the setting up of the inquiry in 1997 by the then Conservative Health Secretary, Stephen Dorrell, have been confirmed. Management seems to have let the system spin out of control, with drink and drug abuse rife. Pornography seeped into an institution meant to house those convicted of abusing children - incompetence of an unimaginably high order.

These problems have existed for many years. Sir Louis Blom-Cooper conducted a government inquiry into them as long ago as 1991, reaching the conclusion that such institutions could not be saved. Only radical reform, he concluded, could salvage anything from the wreck. Why has it taken so many years for another report just to record similarly that the staff were unhappy and divided, the facilities were inadequate and the care was dismal?

Ashworth's problems were bad enough to come to the attention of any decent monitoring system. The staff's behaviour since the whistle was blown speaks for itself. The last two years have seen the sacking or resignation of two of Ashworth's chief executives and the resignation of a number of less senior staff.

Frank Dobson, the Secretary of State for Health, announced his response to the Fallon report yesterday: procedures in the Personality Disorder Unit are to be tightened and a number of management staff dismissed. Vital measures, doubtless, but they do not go nearly far enough. Mr Dobson argues that abolishing special hospitals altogether would change only"bricks and mortar"; but the buildings reflect the ethos of an outdated system.

The mental health charity Mind has long advocated the only sensible resolution: special hospitals - including Rampton and Broadmoor, Ashworth's sister institutions - should be closed down and replaced with a network of smaller, modern units. That would allow a range of different treatments to be adopted, rather than just dumping disturbed individuals - many of whom have committed no crime but are being confined on the basis of their theoretical danger - in virtual prisons.

No one is arguing that security around some of the most dangerous people in Britain should be loosened, but medical and psychiatric care require a higher priority. By refusing to countenance a new approach, the Government demonstrates an unwelcome and dangerous conservatism.