NHS criticised over soldier’s care
Thursday 19th September 2013, 5:40PM BST.
The NHS has admitted it needs to learn lessons after a former soldier who thought he was being followed by the Taliban stabbed his wife to death.
Gary Walker, 42, fatally knifed his wife Natalie, 34, while their three children were at home in Broadstairs, Kent, on March 5, 2011.
Violent Walker was jailed indefinitely at Canterbury Crown Court later that year after admitting manslaughter on the grounds of diminished responsibility.
An independent report into the care and treatment Walker received has been released revealing that health professionals could have predicted he would go on to harm – but not that he would kill.
Mental health campaigners have criticised psychiatric services for their “lack of response” in assessing and treating Walker, who had a history of violence and substance abuse.
Walker, who had previous convictions for criminal damage and assault, was first referred to mental health services in October 2005 by a GP who thought he needed anger management.
The investigation into the care and treatment Walker had in the run-up to the killing said the service was not offered by his local community mental health team, and the referral was rejected.
Two years later, Walker received a suspended prison sentence for assaulting a man.
And in 2008 and 2009 he spent 84 weeks in prison for assaulting his wife, the report by management consultancy Verita for NHS South of England said.
Following his release from jail in August 2009, Walker returned to the family home but began to use drugs and alcohol, leading later to him showing psychotic symptoms.
He went to the police complaining he was being harassed by the Taliban and that his phone was being bugged, the report added.
Three months before he killed his wife, Walker went to his GP surgery “in crisis”, suffering from paranoia, depression and hallucinations.
He was prescribed medication and a GP sent an urgent referral to the community mental health team asking for him to be assessed within 24 hours.
But when he was seen some 10 days later, his “crisis” was said to have passed, his psychosis appeared under control, and he had cut his drug and alcohol use.
The report said: “The assessment concluded that (Walker) did not have mental health problems that required support from the (community mental health team), but that he needed counselling and psychological intervention to help him address his ‘unresolved issues with his past’.”
Arrangements were made for Walker to see a psychological therapies service, but this did not happen before he went on to kill his wife.
A month before the killing, an “agitated, anxious” Walker visited his GP surgery asking to see his doctor urgently after slitting his wrists.
A GP contacted the community mental health team demanding he be assessed urgently within four hours – but was told Walker could not be reviewed until the following day.
The doctor paid for a taxi to take Walker to a local hospital’s accident and emergency department for a mental health assessment, and he was referred to the psychiatric liaison service.
But the report said Walker was not viewed to be a risk to himself or others and it was recommended he “go home and tidy the family home”.
Walker was advised to contact the community mental health team’s access team for further assessment of his paranoia and consider self-referring to a project to help with his drug use. He was not admitted.
Walker returned home before spending the next three night sleeping in woods.
On March 2, three days before the killing, he contacted the community mental health team asking for an appointment, which was arranged for March 18, by which time he had already fatally stabbed his wife.
The report concluded that Walker’s two GPs generally delivered a “good level of care” but criticism was levelled at the community health team which “did not function well”.
It said: “It had experienced a number of problems historically and was undergoing significant managerial and structural change during the period when (Walker’s) mental health was deteriorating.”
With Walker’s history of domestic violence, there should have been “shared intelligence” between the police, children’s services and mental health service about him.
Although it might have been predicted that Walker would be violent again, it could not be foreseen that he would have gone on to kill his wife, the report went on.
Marjorie Wallace, chief executive of the mental health charity SANE, said all services should have been put on “red alert” following Walker’s release from jail.
She said: “This is a gross failure of psychiatric services to provide treatment for a care in the community psychiatric patient with a known history of violence, drug and alcohol abuse and psychotic behaviour.
“In their lack of response over years to provide Gary Walker with proper assessment and treatment, they failed in their duty of care to protect the life of his former wife, Natalie Walker, and protect three young children from trauma.
“If community mental health teams cannot manage to keep people like Gary Walker safely in the community we should not be relying on them.
“Upon his release after spending nearly 18 months in prison for assaulting his wife, all services should have been put on red alert and his children on an ‘at risk’ register.
“As it was all the team was able to do was offer appointments too far ahead to deal with his current crisis, fail to offer any suitable medication or therapy, ignore his and his GP’s requests for help and fail to take account of the risk he posed.”
A number of changes have been implemented but staff at the community mental health team report continued problems within their service.
The report said: “They reported that their caseloads remained too high given their complexity and that there continued to be a lack of resources within the service.”
Dr James Thallon, medical director for NHS England in Kent and Medway, said: “We acknowledge that the NHS has lessons to learn from this case and we have been and continue to work with NHS colleagues to ensure that the recommendations are followed up on.”