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Dorrell says care is `under strain'

Social Services Conference: Minister claims killings by the mentally ill have not wrecked public confidence in approach

Stephen Dorrell, the Secretary of State for Health, admitted yesterday that community care for the mentally ill was "under strain" but pledged that it would remain an established feature of care.

He told the 800 delegates at the Annual Social Services Conference in Bournemouth that despite good practice in community care in some areas, there was "still a long way to go".

Services for the mentally ill are crucial to the overall success of community care and to public perceptions of that success," he said. "We cannot hope to develop high-quality comprehensive services for mentally ill people without strong and effective inter-agency collaboration."

There would be no full-scale return to institutional care and Mr Dorrell said that despite some "tragic incidents" there was still a remarkably strong consensus that care in the community was the right policy.

Public fears about care in the community for the mentally ill were raised following high-profile cases such as the killing of Jonathan Zito by Christopher Clunis, a paranoid schizophrenic, on the London Tube.

Last month, two highly critical reports described care in the community as "haphazard" and confused, while next week sees three inquiries all dealing with mentally ill people living in the community who went on to kill.

On Monday, a report will be published into the death of Bryan Bennett, who was killed by Stephen Laudat, 24, at a day centre run by Newham council social services in east London. Laudat thought that Mr Bennett was one of the Kray twins when he killed him.

At the same time, the public hearing into three killings by Jason Mitchell will open in Bury St Edmunds, Suffolk. And finally, on Thursday, the Mental Health Act Commission will report on the case of David Usoro, who killed while at a halfway house in Nottingham.

Mr Dorrell urged close cooperation between health and social service departments, particularly in areas where "less progress has been made," but said that more resources were not the answer. "Of course more resources would always be welcome. But no one can afford to delay tackling some of these very difficult issues in the hope that a white knight will ride over the hill and relieve them of all the resource pressures."

At the end of November health authorities are due to report back on the development of mental health services following a letter from Mr Dorrell's deputy, Gerald Malone.

"If we are to deliver our obligations we must ensure that systems are in place to assess priorities and commission care to meet individual needs on an efficient basis," Mr Dorrell said.

Rita Stringfellow, chairwoman of the Association of Metropolitan Authorities' social services committee, said: "Local authorities have made a remarkable and successful attempt to provide good quality community care but we are on the rack. We are seriously under-funded in community care and children's services."

Jack Bury, chairman of the Association of County Councils, said: "We've proved our side, now the department must prove their's."

t A "fundamental" review of the regulation and inspection of social services was launched by the Department of Health yesterday.

Led by Tom Burgner, a former civil servant, the review will cover care for adults and children, and will consider whether statutory regulations should be extended to small homes for children, home helps and day care for the elderly and disabled. It will also consult on whether regulation and inspection should be run by local authorities.

Although welcoming the review, Mr Bury warned: "There must be adequate fees to pay for quality regulation and inspection services."