Hospital Criticised over Ex-Patient who killed Father

A psychiatric hospital which discharged a patient who later killed his ailing father was today criticised for failing to ensure enough after-care.

Most of the blame for the tragedy was shared between the management of the South Tees Community and Mental Health NHS Trust and the team caring for Keith Taylor, barrister Richard Barlow, who chaired an independent inquiry into the case, told a news conference.

Taylor stabbed his father William, a victim of Alzheimer's disease, in February last year. He was sentenced to be detained indefinitely in a secure unit at the hospital, St Luke's, at Middlesbrough. Taylor, 48, the second-youngest of a family of four, was initially charged with murder but the prosecution accepted his plea of manslaughter on the grounds of diminished responsibility when the case came before Teesside Crown Court 14 months ago.

The inquiry report tells how Taylor, an epileptic since infancy, whose parents had ensured lived a sheltered life, began caring for his father after his mother, Dorina, herself a former psychiatric patient, died of lung cancer in March, 1994.

This put him under great strain and he was admitted for treatment at the hospital three times over the next six months -- first because he developed "an acute psychotic illness", the second time because he felt suicidal, and the third because he was "behaving irrationally".

The report says that when Taylor was discharged after his second admission, thought should have been given to how a care plan, taking account of his psychological and social needs, could be put into effect.

Because Taylor was a "quiet and undemanding" patient, he was not given as much attention as he should have been and there was "a general failure" to treat him adequately, says the report, adding: "We regard this as a failure of the team as a whole, rather than of an individual." Focusing on the third admission, the report says "some degree of fault" lay with the staff who discharged Taylor "without giving much thought to his aftercare in the community".

It also criticises consultant psychiatrist Dr Khondker Moslehuddin, saying he "should have made inquiries about whether any aftercare in the community was needed" before he decided to discharge Taylor.

"It is entirely inappropriate for a doctor whose patient has had three spells of mental illness in a short period to discharge him in the hope that the social services will become aware of the case and be able to assess the patient's needs."

The NHS trust managers are rapped in the report's conclusions for failing to ensure that a full care programme was carried out after Taylor was discharged. The inquiry panel says that had this happened the chances of avoiding William Taylor's death could have been improved -- but stresses that it could not say that the tragedy would have been averted. A joint statement by the NHS trust, the Tees health authority and Redcar and Cleveland social services said they fully accept the report's recommendations.

"We are totally committed to working together to implement the inquiry panel's recommendations and to further improve arrangements for meeting the needs of mentally ill people," the statement said.

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