New arrangements 'part of evolutionary process': Virginia Bottomley talks to Rosie Waterhouse about the task ahead

THE PREVENTION of further incidents like the killing of Jonathan Zito by Christopher Clunis - a paranoid schizophrenic who had been discharged from hospital under the Government's care in the community policy - is a central aim of the measures announced by Virginia Bottomley yesterday.

Asked whether she believed the killing, and other deaths involving former psychiatric patients, would have been prevented if the legal powers had been in force, Mrs Bottomley said: 'Obviously we are awaiting the report from the independent inquiry (into Clunis's case) which will identify, I am sure, a number of issues. But it does seem he was a patient who had a history of deteriorating when he was discharged from hospital and there are a number of important questions about the way in which the agencies worked together.

'So the combination of the supervised discharge order, the new code of practice on the existing mental health legislation, which is not always properly understood, the firmer guidance on inter-agency working, together with the use of special supervision registrars, so that there is a register of people who are likely to be particularly at risk, should, I believe, lead to improvements in places. I think if those four elements (had been in place) some of the most worrying cases could or should have been picked up. '

Mrs Bottomley rejected an appeal from Mr Zito's widow Jayne for a public inquiry into his death last December when Clunis stabbed him in the eye at a London railway station, three months after being released from Guy's Hospital. Instead, she opted for an inquiry administered by the two London health authorities which had dealings with Clunis in the six months before the killing.

An investigation by the Independent showed Clunis had a history of violence and had drifted in and out of hospital for six years. Eight days before the killing, he ran amok with a screwdriver and a knife, but the police failed to pick him up despite repeated requests from members of the public.

Asked if she thought the inquiry she ordered was sufficient to examine the role of other hospitals, doctors, social services and the police, Mrs Bottomley said: 'Certainly if the chairwoman, Jean Ritchie QC, wishes to extend it further or to make further comments, she is free to do so. The issue must be to get to the bottom of the case . . .

'Should the chairwoman wish to discuss other matters or extend the inquiry then she is free to discuss it with the regional health authorities concerned.'

Mrs Bottomley said the Government was already spending pounds 2bn on mental health services. 'The task is to ensure that the extra resources are targeted on those who are most at risk.'

Rejecting charges that care in the community had failed, Mrs Bottomley said: 'I believe this is part of the evolution of community care. Far from being a reverse, I believe we are simply refining the instruments we need to make community care the success that I am determined it should be.'

(Photograph omitted)