Published: 01/04/2004, Volume II4, No. 5899 Page 4 5

Mental health services in Manchester have become 'gridlocked', the acting chief executive of Manchester Mental Health and Social Care trust has admitted.

'GPs can't get people into services, community mental health trusts are looking after patients who should be in hospital. . .We are going to work with commissioners and the National Institute for Mental Health in England to look quite progressively at service redesign, ' Laura Roberts explained.

'The incremental changes that we are doing at the moment just will not be enough, ' she added.

Ms Roberts - who took control of the trust in December in the wake of the Commission for Health Improvement's damning investigation into abuse of elderly patients on the Rowan ward - outlined the financial and organisational challenges the trust faced.

As part of HSJ's new series On Location examining the issues facing healthcare communities, the chief executive seconded from North Manchester primary care trust described how problems had resulted in a£6m deficit.

The merging of several organisations when the trust was created in April 2002 including inherited overspends and subsequent weak management had not helped, she said. 'We have a recurrent problem of about£2m. We been discussing that with commissioners to get that down.'

Such debt and structural challenges were causing alarm among employees, she said. 'We have a fairly active staff side who, in all likelihood, are on the edge of balloting for industrial action.'

Karen Reissman, chair of staff side at the trust, said talks were continuing, and added: 'We want to alert the government to the situation that we are working in and the appalling services that we are able to provide.With extra funding, we could provide good services.'

Staff have also criticised the private finance initiative project to replace some facilities at Central Manchester and Manchester Childrens University Hospitals trust, because they fear it will mean bed losses. Ms Roberts said she did not believe the scheme would mean fewer beds. But she expressed concern that the focus on the PFI scheme would come at the expense of other issues facing the health economy: 'The problem is the impact on the rest of the economy: it will take most of the development monies for the foreseeable future.'

Contrary to local media reports, Ms Roberts said former chief executive Andrew Butters - who has been seconded to work in St Helens - would not be returning to the trust, nor was he in line for 'any kind of pay-off '.