Reassessing community care... HAs warn over planned crown indemnity scheme... New proposals to raise profile of CHCs...

Prime minister Margaret Thatcher is being advised to re-assess - and possibly throw into reverse - the whole philosophy of

community care for people with mental illnesses. The view that it has 'gone too far', which is being promoted by one of Mrs Thatcher's closest advisers, is expected to be reflected in a new mood of caution over closing psychiatric hospitals. 'There is a widespread belief that there are probably too many people with mental illnesses in the community and some should go back into institutions,' HSJ has been told.

Doctors at the British Medical Association's annual

representative meeting gave their president, Dr John Marks, a standing ovation for a 'fight, fight and fight again' speech attacking the internal market reform proposals. He reiterated demands that the government introduce pilot schemes.

Health authorities could face medical negligence payouts of up to 5 per cent of their annual budget if the crown indemnity scheme planned by the

government goes ahead, HAs have warned the Department of Health. The Medical Defence Union has predicted that managers could be forced to close wards to fund some of the largest compensation bills.

Three retired consultants have urged West Midlands regional chair Sir James Ackers to reconsider controversial plans to overhaul Birmingham's health services, which include closing 18 hospitals, merging two HAs and creating four acute 'supersites'.

Wide-ranging proposals to turn community health councils into high-profile, powerful and more independent consumer watchdogs may be presented to the government by the CHCs' national body. One of the more radical proposals is to divorce CHCs from their employing regional HAs and make them accountable to a new national agency independent of the government.