Cock-up or conspiracy? Mental health organisations spent two days at an official DoH policy summit, and they still were not told of ministers' plans. Mark Crail reports

Members of the Independent Reference Group, set up to advise ministers on mental health issues, met for their first summit with most still in the dark over the government's plans for mental health services.

'Officially, there is no policy document, not even a draft, ' one participant told the Journal . 'People asked about it, but officially it doesn't even exist.'

As a result, many participants were left wondering after two days of discussion what last week's event was for. It was not, unlike the IRG's routine meetings, to advise on particular hospital closure; nor did it cover new ground.

But it was certainly considered important: Department of Health permanent secretary Chris Kelly opened the event, and it was widened beyond normal IRG membership to include more NHS input and other voluntary groups.

And when IRG members asked about policy development, they were told officially that there was 'a blank piece of paper'.

In fact, the policy's existence is Whitehall's worst kept secret. Journal sources suggest that the document is 'now in its 27th draft' because health minister Paul Boateng and the Downing Street policy unit cannot agree its content.

The DoH set up a leak inquiry after BBC social affairs editor Niall Dickson reported on an early version in February. A later version was reported at length in last week's Journal (see box).

And a number of those involved in mental health issues also admit privately to having seen it.

But the issue is clearly a sensitive one at the DoH, where a spokesman initially insisted: 'This was not a summit. That is not a word we have been using because it obviously raises expectations that there is going to be something more happening - that there is going to be a change of policy. There is not.'

Twenty-four hours later, he confirmed that the DoH itself had been calling the event a summit.

'It was an historical look back and also an opportunity for them to express their hopes for the future, ' he said.

But mental health user groups are bewildered by the secrecy surrounding the policy documents.

Mind director Judi Clements says: 'We don't know whether the document is a consultation paper, a green paper or a white paper.

'We are sitting there, supposedly representing the major stakeholders and players in mental health, and we are not allowed to know it exists.

'There has been rumour and speculation about it for months, and to be changing it piecemeal over that time while claiming it does not exist does not seem to me to be very helpful.'

She says IRG members were led to believe when the group was set up that it would play a part in policy development, and had expected to see the new policy unveiled in some form last week.

'But it became increasingly clear that they were backing rapidly away from that, ' she says.

Her frustration is shared by SANE chief executive Marjorie Wallace, by Mental Health Foundation chief executive June McKerrow and by others the Journal spoke to this week.

All say they have been assured that there is no such document.

Ms McKerrow says she came out of the summit no wiser than when she went in. 'There was nothing which made me any more certain that ministers would listen to us, ' she says.

And Ms Wallace adds: 'I think the IRG has been quite good on the detail, but when you have 31 hospitals due to close in two or three years', it is clear that it has come far too late to influence anything fundamental.'

Ms McKerrow fears that Mr Boateng, who is responsible for mental health policy, is unsympathetic. 'He has taken a very NIMBY attitude to things in his own constituency, ' she says.

But others believe that he has so far not produced anything tough enough to satisfy Downing Street, whose main concern is to prevent further 'high-profile' failures of community care.

But the real story of the summit that never was may be more one of cock-up than conspiracy. One Journal source says: 'The real issue was that they got the timing all wrong.

'I think they wanted to produce a final draft of the policy in time for the summit, but they did not manage that, and since cancelling or postponing it would have looked bad, they went ahead anyway with nothing to talk about.'

Others believe that if the DoH does not come up with 'something to talk about' soon, there may be a mass exodus of groups from the IRG.

Key points from the draft policy document

'Community care has failed'.

Public confidence needs to be rebuilt.

The first priority of mental health services is to 'protect the public'.

£50m a year for 10 years for NHS mental health services.

£40m a year for personal social services.

Money to fund 1,000 places in 24-hour staffed housing.

Money for more assertive outreach and emergency response teams.

A review of the Mental Health Act.

Legislation in autumn 2000.