A unit offering a haven for rape victims is bringing together forensic, psychiatric and medical services - and changing the way the police handle this crime. Lyn Whitfield reports

Imagine you have been raped. You go to the police. They need to find a doctor to examine you. Finding a doctor is difficult. It takes 24 hours.

While you wait, you cannot shower or change your clothes.

A horror story, admits Nick Hulme, general manager, medicine, at King's Healthcare trust in South London. But it's the sort of thing that happens when rape victims are examined in police station rape suites.

Mr Hulme says that under this system there was 'little incentive' for doctors - especially female doctors - to sign up for the rota when they could be called out, alone, to see victims of sexual assault 'at 3am'.

'They were working with no support - and this is a fairly harrowing thing to do. It was not conducive to providing a good service, 'he says.

The victims of serious sexual assault - 97 per cent of whom are women - generally had to wait in police stations.

Anne Coughlan, chief executive of Victim Support London, says drily that 'these are not the most inviting of places'.

And the police were not happy either. Detective chief superintendent Andy Baker says the rape suites were set up in the wake of 'fly on the wall' documentaries in the 1980s, criticising police for the way they dealt with victims of sexual assault.

The suites were recognised as a great advance at the time. But DCS Baker says: 'Old police stations and places like that were used and they were pretty musty.'

King's, which has provided a service to the Metropolitan Police for eight years, has won a 'groundbreaking'contract to provide a 24-hour forensic medical service at King's College Hospita l.

The Haven - Camberwell is a two year pilot, funded with£400,000 from the Met, that covers eight London boroughs. It is based on a similar centre at St Mary's Hospital in Manchester.

Unlike the Manchester centre, the Haven is integrated into the hospital's department of sexual health. Dr Jan Welch, consultant in genito-urinary medicine, says this has a number of advantages.

Women can be offered immediate forensic, psychiatric and medical care that can then be followed up in existing clinics.

Staff operate in a supportive environment and do a variety of work, providing a break from what Dr Welch also describes as 'harrowing' examinations.

And the unit can call on the services of a major teaching hospital - including its crash teams and accident and emergency facilities - if it needs them.

The Haven is working on the basis that it will see 850 women a year, but it could well see more. Dr Welch predicts that as word spreads, the centre will get a lot of self-referrals. It may also encourage more men to seek help.

Ms Coughlan says the Manchester unit's experience suggests that 35 per cent of women never report what has happened to the police, but the figure could be much higher.

Women, she says, may be unwilling to go to the police if they were abused within a relationship or by a previous partner. Some are too traumatised.

Some have little confidence that a complaint will lead to a conviction.

'That is probably the biggest problem, ' says Ms Coughlan. 'People do not feel they can subject themselves to having their lives turned inside out in court, when conviction rates are so low.'

The Haven will encourage women to report crimes to the police. It will also conduct forensic examinations and store evidence so victims can think the matter over.

DCS Baker says even the anonymised information the centre will be able to provide will allow officers to spot trends - a new attacker or dangerous areas that could be improved with better lighting or security measures.

Ms Coughlan believes the Haven's existence, and the possibility of selfreferral, are both major advances. 'I would not want to be seen blaming the police, ' she says. 'Some of the worst experiences women have had have been at the hands of the forensic medical examiners.

'The fact that FMEs are going to be chosen and trained for this work is a big step forward. Now the police and the FMEs are getting their act together, the really big issue remains of trying to get the courts to do the same.'

The centre has its own, secure entrance for police vehicles, a waiting room for police escorts, office space and an examination room, which is probably as pleasant as it can be.

All the chairs, surfaces and floors are designed for easy cleaning with special fluid that prevents the contamination of DNA samples.

The Haven's all-female staff wear surgical 'blues' for examinations. DCS Baker says 'more and more' rapists wear condoms, but skin from under victims' fingernails, fibres and even sweat can provide vital forensic evidence.

Clinical research fellow Dr Evelyn Kerr says the position and size of any marks and bruises have to be recorded, nails checked and an internal examination conducted. 'We are always thinking of the Old Bailey, ' she says.

Women have to be seen by different members of staff at follow-up clinics, to avoid conflicts of interest. The centre has already trained 23 full and part-time staff, and expects to train more.

DCS Baker that is convinced that it should provide the best possible conditions for collecting evidence. If evaluation is positive, he expects to see three or four 'havens' across London, and possibly more across the country.

Indeed, just one major gripe seems to have surfaced so far. The police would like a television in the waiting room. Not that big a problem, really.