Government rejects MPs' proposals on mentally ill: Reforms backed by Tory-dominated committee ruled out

THE Government has rejected almost every recommendation by a Tory-dominated committee of MPs to change its controversial care in the community policy to improve services for the seriously mentally ill.

No new commitments are promised and many reforms are ruled out in the response to the Health Select Committee's damning report, given by John Bowis, parliamentary secretary at the Department of Health, yesterday.

The response to the report, Better Off in the Community? The Care of People who are Seriously Mentally Ill, argues that many of the proposed changes are unworkable or already carried out in some places, although not as part of a co- ordinated policy as urged by the committee.

The report was particularly critical of lack of services and resources for homeless mentally ill people and of the shortage of acute beds in inner cities. Rejected recommendations include: the Department of Health should require health providers to implement within a year the 'care programme approach' providing adequate hospital discharge procedures and clear local policies on acute beds; the department should issue instructions on minimum acceptable levels of provision for 24-hour staffed community houses; the Department of the Environment should give priority in its policy review to housing people with serious mental health problems; local authority housing departments should be required to state the number of residential places available for the seriously mentally ill; within one year the Department of Health should begin collection and analysis of information about the function of local mental health services.

Recommendations which the Government said it may take into account in future planning include an urgent review of inner-city mental health services; a social deprivation score should be included in any weighting factor in resource allocation; the review should examine the funding priorities of health authorities and fundholding GPs for the seriously mentally ill and the requirements of the homeless mentally ill; no further reductions in mental health services budgets should be made until the review is complete.

Mr Bowis welcomed the parts of the select committee's report which supported government policy in such areas as hospital discharge and continuing care for mentally disordered people.

He listed steps that the department had already announced, including supervision registers for the seriously mentally ill who are a danger to themselves or others and the increase in the mental illness specific grant to pounds 36m for the coming year.

Mind, the mental health charity, said: 'Government cannot stand back and hope purchasers and providers will come up with the solution. We need minimum standards to ensure effective care.' David Hinchliffe, Labour's community care spokesman, said policy was 'too often made on the hoof in response to tragedies'.