Psychiatrists quit over risks to patients

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Public Policy Editor

Consultants are quitting acute psychiatry in the National Health Service because of the increasing risks that patients are facing from overloaded NHS services.

Dr Massimo Riccio, 43, a consultant at Chelsea and Westminster Hospital, in London, who left the NHS for the private sector two weeks ago, said he had resigned after having to "deal with more patients, who are more severely ill, with less beds and facilities".

He will be followed soon by Dr Cosmo Hallstrom, 49, a consultant at the Gordon Hospital in London, who said the stress of deciding whether to discharge patients before they are ready, in order to admit others who are more acutely ill, was producing staff "burn out". Each time there was a suicide or killing, he said, "I think, there but for the grace of God, go I."

As if to illustrate the point, a new inquiry is under way after a man believed to be suffering from a mental disorder discharged himself from a psychiatric hospital, stabbed his mother to death and killed himself on Sunday night.

Labour yesterday called for a moratorium on further bed closures in the wake of the Royal College of Psychiatrists' report on homicides and suicides. John Bowis, a junior health minister, conceded that "we must make sure we have the range of beds to back up the community services".

It is the lack of such beds which Dr Riccio says has left hospitals dealing with an increasingly disturbed mix of patients. "A lot of funding has gone into very worthwhile causes," Dr Riccio said. These included the court diversion scheme to place mentally ill offenders in hospital rather than prison, and homelessness projects, which he says have "worked well but unearthed a lot of otherwise undetected mental illness".

The result was mounting pressure on acute beds, while secure units meant to take the potentially most violent patients had silted up. "I recently had an acutely psychotic patient in a very disturbed state on an open ward who was caught with two daggers under the bed. We spent three or four days phoning every secure unit in England, Scotland and Wales trying to find him a place."

Hunting for beds, page 8