No beds, so patient is sent home to kill: Camden mental health trust presided over ‘scandal’

Peter Holboll

Peter Holboll - Credit: Archant

Camden’s mental health service has come under intense scrutiny this week after it emerged a paranoid schizophrenic killed his mother after being denied a hospital bed.

Police and fire service in Lawford Road, Kentish Town. Picture: Polly Hancock

Police and fire service in Lawford Road, Kentish Town. Picture: Polly Hancock - Credit: Archant

Camden and Islington NHS Foundation Trust (C&I) was said to have presided over a “scandal” after the Old Bailey heard Peter Holboll, 44, was allowed to remain at his mother’s home on May 7, when no beds were available.

Two days later he stabbed his mother Tamara, 76, to death before setting fire to her flat in Lawford Road, Kentish Town, endangering five people in flats above.

Two inquiries are now underway – an independent “serious incident investigation” commissioned by the trust and a “domestic homicide review” led by Camden Council.

Holboll and his mother had repeatedly pleaded with C&I professionals for him to be taken into hospital in the two days before he killed her. At one point, Mrs Holboll wept as she begged staff to admit him, fearing he would turn violent as his mental state deteriorated.

The court was also told that a staff member dismissed her fears as being “overly dramatic” in their notes – though the trust has since denied this.

The case has put C&I under severe pressure over the missed warning signs and its decision to axe more than 100 beds in the past four years.

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Marjorie Wallace, chief executive of the mental health charity Sane, who lives in Highgate, said: “It is nothing short of a scandal that Tamara Holboll lost her life and other lives were put at risk.

“Peter Holboll was one of the relatively few people with a history of severe mental illness and threat of violence who should have been taken into hospital when he and his mother told psychiatric services he was no longer safe.

“Camden and Islington Foundation Trust has shut down more than 100 beds in the last three years, relying instead on community teams.

“What is most unforgivable is the way these teams belittled and ignored the seriousness of the threat he posed.

“While mental health services are in meltdown, we will see more heart-rending tragedies like this.”

The probes will examine whether Holboll would have been admitted, and not deemed safe to remain with Mrs Holboll, were any beds available.

Referring to the conclusions of a psychiatrist who examined Holboll after the killing, prosecutor Edward Brown QC said: “It is likely he would have been admitted to a psychiatric hospital if a bed was available.”

Between 2011 and 2014, C&I lost the second-biggest proportion of beds of any mental health service in the country, with 19.1 per cent being scrapped.

It also had the largest reduction in nursing staff, losing 18 per cent.

The closures have meant nearly 200 patients have had to be sent elsewhere for treatment since 2011.

The Holboll case comes after a recent Care Quality Commission report highlighted a number of failures at C&I.

Though inspectors said patients were treated with “dignity and respect”, they found the service to be in breach of six regulations, including leaving dangerous ligature points in wards.

A spokesman for C&I said: “We would like to take this opportunity to offer our deepest sympathies to Mrs Holboll’s family for their loss.

“We would agree with The Recorder of London, Judge Brian Barker QC, who said in court that this case ‘highlights how difficult it is to assess the severity of relapses and allocate resources that are available’.

“The judge’s summing up puts into context that at the time of the incident we did not have a spare bed.

“However, we don’t turn people away if they need one, and if we can’t find a bed within the trust then we will always find one in another organisation, and we were actively doing this for other patients at the time.

“The findings of [the two inquiries] will ensure our trust and our teams learn from this tragic incident.”

Holboll admitted manslaughter and arson at the Old Bailey hearing on Monday.