New rules on mental patients, but no extra cash: Rosie Waterhouse reports on criticism of Bottomley's community care shake-up

A BARRAGE of criticism greeted the Government's announcement yesterday of new powers to improve supervision of mentally ill people under its care in the community policy.

Supervised discharge orders to improve the control of patients formerly detained compulsorily headed a '10-point plan' announced by Virginia Bottomley, Secretary of State for Health. Under the orders a named 'key worker' will be responsible for each patient and failure by the patient to co-operate with treatment will trigger an urgent review of the case and possible readmission to hospital.

Doctors, mental health pressure groups, opposition politicians and relatives of people killed by psychiatric patients complained that no new government money was promised for the changes, which will place an extra burden on health and local authorities, doctors, nurses and social workers.

Jayne Zito, widow of Jonathan Zito, who was killed by Christopher Clunis, a paranoid schizophrenic discharged from hospital, said: 'Let the Government not use the introduction of new legislation as a PR exercise, but actively finance and support it. The Government has yet again failed to recognise the need for increased resources and manpower.'

Susan Sullivan, the mother of a student pyschologist stabbed to death by a schizophrenic woman she was caring for, said the controls were meaningless without measures to punish workers who neglected patients.

The Association of London Authorities said there was mounting concern over the funding of community care this year. They estimated they would need another pounds 1.2bn next year. 'Unless sufficient resources are available people are bound to continue to fall through the net.'

The National Schizophrenia Fellowship estimated the new measures would cost pounds 500m a year. Sane, which runs a helpline for schizophrenics and their families, called for a review of community care funding and implementation, a moratorium on bed closures, the accountability and specialised training of key workers and the guarantee of aftercare for all people discharged from hospital.

The British Medical Association welcomed the proposal for supervised discharge but said: 'We would need to be convinced that sufficient facilities do exist within hospitals for readmissions.'

The Royal College of Psychiatrists said there was a shortage of beds and after care and that delays in discharge would lengthen waiting times for admission of new patients.

Bottomley's plans, page 4

Leading article, page 17