Dorrell to shake up care in community

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The Independent Online
Radical plans to reform care in the community were put forward yesterday after the Government admitted that current practice had "failed too often".

"The status quo is not an option," said Stephen Dorrell, the Secretary of State for Health, launching the Green Paper on mental health yesterday. It listed four proposals for dealing with the mental health system aimed at preventing future communication breakdowns between health and social services which have been blamed for a succession of care in the community tragedies.

These include Stephen Laudat who stabbed a fellow patient 82 times, Anthony Smith who killed his mother and brother and Christopher Clunis who stabbed to death Jonathan Zito at a London underground station in 1993.

Last month a report by the research body the King's Fund into London's mental health services found that the capital was failing the mentally ill, with services near to collapse and unable to meet the demands made on them.

The Green Paper's most far-reaching proposal involves setting up a new statutory authority directly accountable to the Health Secretary which would be responsible for both health and social services for the mentally ill. At present the changes will only relate to mentally ill adults. A second option would designate either health or local authorities as the single agency in charge of psychiatric and social care.

Other suggestions are for health and local authorities to establish new joint bodies between them, or to delegate particular functions or responsibilities to each other.

"We either have to demonstrate that we can improve co-ordination by a number of administrative means within the statutory framework, or we have to change the statutory framework. The status quo has failed too often," said Mr Dorrell.

"I think it is clear that any policy based purely on care in the community will not be a sensible policy to pursue," he added.

His proposals met with a mixed reaction from mental health charities. The charity Sane backed the single unitary authority, seeing it as the most effective and economic way of providing beds, 24-hour care and properly trained staff.

But the charity Mind said setting up new unitary mental health authorities would only result in "further upheaval and disruption".

The National Association of Health Authorities and Trusts and the Sainsbury Centre for Mental Health also rejected the idea of new authorities, and called for a mental health agency headed by a single manager while health and social services departments retained their existing responsibilities.

n Developing Partnerships in Mental Health published by The Stationery Office price pounds 6.85

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