Reid refuses to accept all recommendations of Blofeld report

BMJ 2004; 328 doi: (Published 19 February 2004) Cite this as: BMJ 2004;328:423

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  1. Mark Gould
  1. London

    Health secretary John Reid has agreed, in his response to the report into the death of a black mental health patient while in hospital, that there is no place for discrimination in the NHS.

    But he gave no commitment to accepting the 22 recommendations of the report from Sir John Blofeld into the death of David “Rocky” Bennett (14 February, p 367). He insisted that the government was acting to tackle concerns and pointed out that Professor Kamlesh Patel, one of the Blofeld team andthe chairman of the Mental Health Act Commission, was chairing a national programme to ensure the black and ethnic minority groups secured equitable representation in the NHS.

    Sir John's report said it would take at least 10 years to introduce training on the management of violence and aggression that ensures that black and ethnic minority patients are not mistreated.

    Kevin Gournay, professor of psychiatric nursing at the Institute of Psychiatry, London, and the chairman of a National Institute for Clinical Excellence committee designing new guidelines on the management of violence and aggression, said that current training had no reference to race, culture, or ethnicity and was “a mess.”

    Professor Gournay gave evidence to the Blofeld inquiry. David “Rocky” Bennett died in an NHS clinic in Norwich in 1998 after he was pinioned face down for 28 minutes by up to five members of staff.

    The inquiry made 22 recommendations to eliminate what it described as the “abscess” of “institutional racism” in the NHS.

    It was welcomed by organisations such as the King's Fund, the Sainsbury Centre, and the Mental Health Act Commission. These groups previously revealed a system in which minority groups were four times more likely to be detained than white people and in which staff were inadequately trained and did not reflect the racial mix of the communities they served.

    Sir John found unacceptably high levels of detention, medication, and restraint and called for wholesale changes, including the creation of a black and ethnic minority mental health tsar, three-minute limits on prone restraint, and better training in managing violence and aggression.

    Professor Gournay's guidelines, which should be issued by the Department of Health following consultation in the spring, will create a national “kite marked” accreditation system. But he said implementation would be an “enormous 10 year task” owing to the difficulty in releasing teams to take part in courses lasting seven days.

    Gill Morgan, the chief executive of the NHS Confederation, said that as the largest employer ofethnic minority groups in Europe, the NHS had a duty to equality. Nearly 8% of the United Kingdom's population were black or from an ethnic minority, and they make up 8.4% of the NHS's 1.3 millionstaff. At senior levels, 10% of non-executive directors and 5.5% of chairs were black or from an ethnic minority, but only 1% of NHS chief executives came from these groups, the confederation said.

    Results of a survey (response rate 89%) last December by the Royal College of Psychiatrists ofits UK and Ireland members showed that nearly 67% of members are white, that the largest ethnic minority group is Asian (15%), and that only 2.46% of its members are black.

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