In May 1994, faced with increasing public concern about homicides involving mental patients, the NHS Executive instructed health authorities to initiate independent inquiries into every case. The publication of these painstaking inquiries has been the major source of evidence of what has gone wrong with psychiatric care both in the community and in hospital, and they are widely used in attempts to improve the service nationally.
When Paul Medley walked out of the Royal Oldham Hospital's psychiatric unit in September 1994 and killed Harry Johnstone, the West Pennine Health Authority set up an independent inquiry, as it was required to do so. However, it also asked that the inquiry should consider the cases of four other "clients" of the hospital.
Unlike any previous homicide inquiry, the report of the inquiry into "the treatment and care of five individual patients by Oldham NHS Trust" was not published, on grounds of patient confidentiality. The recommendations and some conclusions of the report did not mention the homicide, nor that the other four individuals were dead, having committed suicide. Thus patient confidentiality was, sadly, no longer an issue. All four cases were the subject of a coroner's inquest and were therefore in the public domain.
Keith Jones, commissioning director for the West Pennine Health Authority, said he could not compromise confidentiality, and that he had personally approached the families, who had unanimously asked that the report should not be published. Within hours, Mary Smith, mother of one of the suicides, broadcast on radio and television asking for publication of the full report. Another of the families has called the report a "cover-up".
It is hard to escape the conclusion that the health authority used the cloak of confidentiality to obscure the truth about the specific failures in mental health care provided in Oldham.
Sane, The Mental Health Charity