Health Advisory Service

DEARSIRS I would like to support the call for the abolition of the HAS made by Dr Crow and his colleagues from Northwick Park (Bulletin, June 1986, 10, 150-151). The original Hospital Advisory Service was established in 1969 follow ing several public enquiries which exposed serious short comings in the long-term care provided to the mentally ill and mentally handicapped in some hospitals. It was a sensi tive and tactful political move intended to improve standards and reduce the chance of further scandals and enquiries. By and large, it has been notably successful in this regard. In recent years, however, the service, renamed the Health Advisory Service, appears to have concentrated on pro moting one particular model of psychiatry and psychiatric services, support for which may be widespread, but cer tainly not unanimous. Dr Horrocks denies that there is an HAS'party line' (Bulletin, June 1986,10,145-146) but there certainly is consistency in HAS reports, such as the pro motion of the concept of Mental Health Resource Centres and an associated run-down of hospital services. Whilst there may not be a declared overall HAS policy, it is inevitable that the general approach will reflect the Director's own perception of psychiatric services from the perspective of a former Consultant in Geriatric Medicine; his particular concept would naturally influence his choice of team members, who would be unlikely to be persons taking a radically different view to his own. Moreover, the HAS is funded by the allocation of central department resources and the Service is unlikely, therefore, to feel able to other than foster Government and central department policies on the basis of 'who pays the piper...'. This was certainly my experience in relation to a recent visit, where it seemed that team members were quite unable or unwilling to confront a number of unsatisfactory issues surrounding the implementation of the Griffiths Report. I was also left with the clear impression of the HAS team members pro moting a theoretical model of psychiatric services, possibly appropriate to a district such as Kidderminster, where 90% of the 100,000 population live within four miles of the hos pital but was less relevant in Powys, with a similar popula tion but no District General Hospital and the population scattered over 2000 square miles with two of its population centres over 100miles apart. The perjorative use of the word 'institution' to describe a psychiatric hospital service in such …