Ministers to 'slow down' mental health changes after Valdo Calocane report

The government has told the families of the Nottingham attack victims it will slow down mental health care reforms in the wake of a highly critical report on the treatment that Valdo Calocane received in the years before the killings.

Dr Sanjoy Kumar, whose daughter, Grace O’Malley-Kumar was one of three people murdered in the attacks, said the health secretary had told the family that mental health reforms would be slowed down.

Dr Kumar told Sky news: “Wes Streeting, secretary of state for health, has promised us that he’s going to slow down the modifications to the Mental Health Act.

“He has promised that we will be able to work with people who are working with the law. A change is needed. We need to step back a little bit and really see what is safe for the public.”

In the King’s Speech in July, the government revealed plans to “modernise” the Mental Health Act, which applies to England and Wales, and give patients “greater choice, autonomy, rights and support.”

They included plans to revise detention criteria so people could be detained under the act only if they posed a risk of serious harm, as well as shortening the length of time for which they could be detained.

The government also said it would “strengthen the voice of patients” by adding statutory weight to their right to be involved with planning their care and making choices and refusals.

Kumar said he wanted to “get the Mental Health Act right” and it was “not about depriving people of their liberty.”

He said: “It’s about holding clinicians responsible who put people like that out on our streets. Any psychiatrist who puts out a dangerous person on our streets must be held responsible if he has not done a comprehensive risk assessment. We really hope to be working collaboratively with Wes Streeting, who certainly has the will and the intention to get this right.”

Streeting said he wanted to reform the act in a way that would get the “balance right between recognising there are people whose liberties are being deprived today who could live safely in the community, but also recognising for others there needs to be much better and closer supervision so that people like Calocane are not able to be on the street causing risk or fatalities to others.”

Calocane, who was diagnosed with paranoid schizophrenia, killed O’Malley-Kumar, Barnaby Webber and Ian Coates in Nottingham in the early hours of 13 June last year. He also seriously injured three other people when he drove a van into pedestrians.

A Care Quality Commission (CQC) review of the mental health care that Calocane received in the years before the killings found “a series of errors, omissions and misjudgements” in his treatment.

These included risk assessments that “minimised or omitted” key details such as the seriousness of his risk to others, and not opting to medicate him via depot injection, a slow-releasing form of medication, since he was not taking it himself.

Calocane frequently refused to take medication when at home and showed “little understanding or acceptance of his condition”, the CQC said.

The report criticised clinicians for not assessing whether Calocane was able to make decisions about his care, saying his psychosis symptoms would have “impaired his ability to weigh up the information regarding the need for antipsychotic treatment and the risks of discontinuing it.”

Calocane declined depot injection and therapies, and frequently missed appointments.

In response to the CQC report, Wes Streeting said: “I want to assure myself and the country that the failures identified in Nottinghamshire are not being repeated elsewhere. I expect the findings and recommendations in this report to be considered and applied throughout the country so that other families do not experience the unimaginable pain that Barnaby, Grace and Ian’s family are living with.”

A partner in the Clinic Negligence and Catastrophic Injury team at Harrowells Solicitors, Kim Daniells, said: “There does seem to be a specific issue in relation to patients who have no insight and do not accept that they have any illness and therefore do not comply with treatment plans.

“Although, in the vast majority of cases, these patients pose a risk only to themselves, there are clearly cases where they pose a risk to others and the challenge will be in finding guidelines that preserve individual patient rights whilst also safeguarding the public.”