Our secure 'hospitals' are prisons by any other name

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The House of Commons Select Committee on Health published a stinging report yesterday, arguing that secure hospitals such as Broadmoor, Rampton and Ashworth should be closed down. The arguments are unassailable. The word "hospital" is used. These are, however, prisons by any other name. They are of benefit neither to the inmates nor to society.

The House of Commons Select Committee on Health published a stinging report yesterday, arguing that secure hospitals such as Broadmoor, Rampton and Ashworth should be closed down. The arguments are unassailable. The word "hospital" is used. These are, however, prisons by any other name. They are of benefit neither to the inmates nor to society.

The report rightly suggests that the main reason for keeping existing institutions open is "political expedience". Millions of pounds are spent every year - and for what? Each of the 1,300 patients held in Ashworth on Merseyside, in Rampton, Nottinghamshire, and in Broadmoor, Berkshire costs the taxpayer around £100,000 a year. This makes no sense at all. Nor, as yesterday's report makes clear, is this the way to ensure "the most appropriate and secure provision".

This report is just the latest in recent years to make the same point - though the language has become increasingly testy in recent years as it became clear that neither Conservative nor Labour governments were eager to take any notice of such sober counsel. In 1988, the Health Advisory Service noted that time was "running out" for Broadmoor; four years later, an inquiry into Ashworth spoke of the "brutalising regime" there. In 1999, the Fallon inquiry into Ashworth - after it was discovered that a young girl and large quantities of pornography had been smuggled into the hospital - argued that the managers were "totally unable" to control it, and recommended that Ashworth should close.

All of these recommendations were ignored. There comes a moment when reform is not enough, and when it is necessary to tear things up and start again. That point has been reached. The Government must acknowledge what so many people have argued for so long. Severe psychological disorders are extraordinarily difficult to deal with. In the overwhelming majority of cases, however, people with these difficulties are as much a danger to themselves as they are to others.

We should return to the old use of the word "asylum", where patients find themselves in a place of refuge. We must distinguish clearly between the Peter Sutcliffes of this world, who are an obvious threat to society, and those who, though disturbed, do not need to be kept in such high-security conditions. The Select Committee is right to argue that a smaller number of secure units would be of benefit to all. After so many years, the Government no longer has any reason to delay.

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