`Community care is good but it is under-funded'

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Dr Anthony Inwald, a north London GP, was stabbed twice by a patient, Maria Caseiro, who had been released from mental hospital three weeks earlier in December 1995. Now 63, he had gone to the aid of a colleague, Dr Judith Scharpey-Schafer, who had refused Caseiro's request for sleeping pills whereupon the patient had produced a 12 inch kitchen knife.

"When Judith hit the panic alarm several of us ran to her aid. I tried to restrain Caseiro in a bear hug, but before I could disarm her she stabbed me under the arm and in the back. I was in hospital for a couple of days and although I was not seriously hurt I suffered from anxiety and flashbacks at first. I was a bit apprehensive when I returned to work but everyone was very supportive and I am fine now.

I was able to get over it because I was so angry with the whole thing. Community care is good but it is under-funded. I became heavily involved in changing the Mental Health Act, particularly in relation to tribunals, and that was very therapeutic.

Unfortunately, it was worse for Judith [the GP who was the target of the attack]. She was badly affected and has given up general practice to go into another branch of medicine. It is very sad because she was a very good, caring doctor.

After the attack, the staff at the practice were so distressed the health authority allowed us to have a security guard in the evenings for about a year. There are panic buttons in all the consulting rooms and we all carry personal alarms.

We have had the odd mild incident since - nothing too awful. It usually involves someone who has had too much drink. I support the Government's move for patients who are dangerously violent, but just because someone comes in a bit drunk and obstreperous doesn't mean they should be banned.

The difficulty is that someone who acts violently in Dr A's surgery and is struck off their list can go to Dr B's surgery and they have no way of finding out about his history. GPs can strike patients off their lists without giving a reason.

I tried to persuade the health authority that they should inform all doctors in the area when they get reports of violent patients so that GPs have a chance to choose whether they will take them on their list. It is important for other patients, too. Violent incidents in the surgery can be very distressing for them."