A London health authority has been accused of planning to 'rebuild an asylum' by proposing to move a psychiatry unit from an acute to a community hospital.

Consultant psychiatrist Christopher McEvedy says the only explanation for the plan is that the HA plans to sell off parts of the acute hospital to fund other developments there.

A consultation paper issued by Kensington & Chelsea and Westminster HA outlines plans to move the Paterson Centre for Mental Health at St Mary's Hospital, Paddington, to St Charles Hospital, North Kensington. St Charles lost its status as an acute hospital with the closure of its accident and emergency and surgical departments some years ago.

Dr McEvedy says the plan is a 'retrograde step' which will have 'profoundly negative consequences for patients'. It would also, he believes, be the first time a psychiatric unit has been moved from a district general hospital site in London.

He says it is widely recognised that such units are best placed on the DGH campus, as confirmed by a forthcoming Royal College of Psychiatrists report on the planning of inpatient units.

Among the reasons are the belief that 'psychiatric disorders and psychiatric patients should not be segregated from other medical conditions. To do so is to step backwards in time and there is certainly an element to the HA's plans that can be construed as the rebuilding of an asylum.'

Dr McEvedy says between 40 and 50 per cent of admissions to the Paterson Centre are via St Mary's A&E department, which would continue to be a major source of emergency psychiatric referrals.

It is unrealistic, he says, to expect the assessment centre at St Charles Hospital to cope with the volume.

He forecasts a marked deterioration in the standard of care offered to patients, and staff recruitment and retention would become much more difficult.

He says he knows of no interested party, apart from managers at St Mary's Hospital, which favours the proposals.

'I believe that they are misconceived, poorly thought through and unworkable. To proceed further with these proposals would be to damage the mental health services in the area.'

KCW HA public health director Sally Hargreaves said the accommodation proposed at St Charles Hospital would be single rooms with en suite facilities.

'It won't look anything like an asylum.'

She added that the preferred option would cost£15m, of which only£3m£5m could be raised by selling the Paterson centre.