The Commons health select committee has launched a fierce attack on key strands of government policy on mental health.
Its report on the provision of NHS mental health services rejects government proposals for dealing with dangerous people with severe personality disorder and calls for the closure of the three special hospitals.
It also says primary care trusts should be forced to demonstrate benefits to patients ahead of being allowed to provide mental health services, and urges the government to reinstate the original 'philosophy' of reciprocity underpinning proposals to reform the 1983 Mental Health Act.
The committee's rejection of both of the government's proposals on DSPD individuals as 'unnecessary' comes two months after criticism from the Commons home affairs select committee.
The health select committee's report expresses concern 'at the use of what could be described as a quasi-medical definition' and calls for more research around the treatability of DSPD individuals.
It also backs proposals put forward by Peter Fallon QC in his inquiry into the personality disorder unit at Ashworth Special Hospital, which called for the closure of all three special hospitals and their replacement with eight regional units.
Defending the decision to reject that recommendation, health secretary Alan Milburn told the select committee that existing organisations had 'built up a level of expertise dealing with in some cases very difficult, very disordered and sometimes very dangerous people indeed'. But the report says visits to Ashworth and Broadmoor had 'made us sceptical as to the 'special expertise' alleged as one of the benefits of the special hospitals.'
'Although we had no doubt at all as to the commitment of senior management to change, we felt the difference between management aspiration and the actual atmosphere on the wards was considerable.'
The report also flags up concerns about new models of service delivery for mental health services, highlighting the fears of the Sainsbury Centre for Mental Health that 'the complexity of mental health services means that the commissioning of them is likely to be beyond the ability of most primary care groups and PCTs'.
The report urges caution for PCTs looking to take on provision of specialist mental health services: 'We strongly believe that that this should only take place if the PCT has been able to demonstrate clearly that the new system will provide significantly better services to local users.'
Examining the government's green paper on reforming the 1983 Mental Health Act, the committee urged ministers to reinstate principles of non-discrimination and rights to assessment that were part of a preceding report by Professor Genevra Richardson.
User groups welcome report
Charities and user groups involved in mental health welcomed the report. On Tuesday, an alliance of 50 groups joined together calling for the legal right to an assessment to be enshrined in future mental health legislation. National Schizophrenia Fellowship chief executive Cliff Prior said: 'Where is the benefit in compelling more people to use inadequate services? What would really make a difference would be a legal right to quality care and treatment.'
Provision of NHS Mental Health Services. The Stationery Office.£12.50.