Chief Political Correspondent
Doctors' leaders who are due to meet ministers tomorrow to demand better security in surgeries are also pressing police chiefs to agree that they should be allowed to examine violent patients in police stations instead of on practice premises.
Doctors are worried about the threat of attacks both from mentally ill patients who have been released into the community and from drug addicts.
The British Medical Association will put pressure on Stephen Dorrell, Secretary of State for Health, at a meeting tomorrow, arguing that family doctors are in the front line in dealing with potentially dangerous patients.
The BMA is not pressing for guards to be appointed to all GP surgeries but it has asked the Government to consider creating high-security surgeries with protection for doctors where selected patients could be treated.
Officials at the Department of Health are considering the BMA's proposals as ministers prepare to face renewed criticism over the release of mentally ill patients into the community.
Mr Dorrell, who is meeting the BMA to discuss the renegotiation of their contract, will announce details shortly of a new patients' charter for the mentally ill. It will give patients specific rights to treatment in the community, and lay duties on health authorities to provide the services.
Mr Dorrell underlined his concern in a review of the National Health Service in a speech last week at Manchester Business School. "A modern mental health service needs to provide a spectrum of care, including acute hospital space, as well as sheltered support, community mental health teams and facilities to deal with crisis care.
"When those services are all properly provided, and the links with social services all work properly, we deliver a high-quality service. But there are too many examples of breakdown and too many areas where some part of the jigsaw is missing," he said.
In highlighting "variations" in national care for the mentally ill, Mr Dorrell said the public had been led to believe that it was the Government's policy to close all acute mentally health facilities and treat all patients in the community, but "that is not and never has been an accurate description of our policy".
A comprehensive care plan for dealing with psychiatric patients in the community should have been in place by the end of last month. But reports suggested that in some cases cover for such patients was missing. Mr Dorrell has admitted that there are now a series of reports, including national accounts from bodies such as the Audit Commission and local ones, of tragic incidents involving mentally ill patients "which show quite clearly that further urgent work is needed to deliver good mental health services across the country as a whole".
He said there needed to be a continuing focus on providing the full range of care, including in-patient care and longer-term professional staff provision for those with the most pressing needs.Reuse content