Health districts `failing in duty to mentally ill'

COLIN BROWN

Chief Political Correspondent

Disturbing evidence has emerged that the Government's policy of care in the community for the mentally ill is failing in some areas, despite ministerial warnings to health authorities to tighten up their procedures.

A new survey of authorities shows that in some areas too few resources are being targeted at the severely mentally ill, and that the response to the Government's programme for treating patients has been uneven.

Details have been revealed in answers to a letter sent in August by Gerry Malone, the health minister, to all chairmen of National Health Service trust hospitals and health authorities, expressing concern that the response to the Government's care-programme approach remained "patchy" four years after its introduction.

The Department of Health is still studying the response, but a senior ministerial source said: "We have given a commitment to publish the response. The picture is that a majority are doing quite well but there are a small number who are not living up to their duties."

Stephen Dorrell, the Secretary of State for Health, is expected to announce an initiative to answer growing public unease, but ministers are still under pressure to call a halt to care in the community. Mr Dorrell is hoping that below-standard health authorities will be improved by clarifying the rights of mentally ill patients and the duties of the authorities.

The Government's record on mental illness has been put in the spotlight by several high-profile cases, such as the recent stabbing of a GP in his surgery when he went to the aid of a fellow doctor threatened by a patient. Earlier attempts to allay the public's fears about mentally ill patients in the community led to the introduction of statutory supervision orders by the former Secretary of State for Health, Virginia Bottomley, which was launched in the wake of a number of tragedies including the fatal stabbing of Jonathan Zito by a schizophrenic, Christopher Clunis, and the mauling of another schizophrenic who climbed into a lion's cage.

Mr Malone said the Government was determined to see the programme fully implemented in all districts as a matter of urgency. "Although individual examples of good practice were highlighted, it is clear that much remains to be done by health and local authorities working together," he said.

His warning was prompted by a report by the Clinical Standards Advisory Group on Schizophrenia which showed that "a significant number" of health districts "still have some way to go".

Mr Malone said: "There are now a series of reports, including both national reports from bodies such as the Audit Commission and the CSAG, and local reports into tragic incidents involving mentally ill patients, which show quite clearly that further urgent work is needed to deliver good mental health services across the country."

He said the areas which required particular attention included targeting resources, providing a full range of care, including in-patient care; setting up supervision registers; and managing, training and supervising staff effectively.

Ministers are adamant that there can be no turning back to institutionalised treatment in this area. But the appearance of mentally disturbed patients on the streets, particularly at Christmas in the capital, may reinforce public pressure for action.