Following discussions with representatives of medical and nursing staff in September 1974, it was decided that each of the four mental hospitals of the Merseyside Region should make interim arrangements pending the construction of a purpose-built Regional Secure Unit. Three hospitals decided to open an Interim Secure Unit, the other to accept the monies offered to increase staffing levels on admission wards.

By the 1970s three groups of psychiatric patients were receiving a particularly poor deal from the National Health Service: (a) The psychopathic patients who had never received the special facilities recommended by the DHSS; (b) A new group of patients, i.e. the difficult or dangerous psychotic patients who are now being refused admission to local hospitals, but whose behaviour is not such as to require the care of a Special Hospital; (c) The difficult or dangerous subnormal patients who could not be managed in new style or overcrowded, understaffed subnormality hospitals.

There has been increasing concern about Governmental collection of information for statistical analysis (World Medicine, 13 June 1973; British Medicine, 7 April 1978; the Sunday Times, 2 July 1978). Recently the Central Ethical Committee of the BMA refused to agree that General Practitioners should record information about pre-school children containing details about the mother's obstetric history. Again, the Regional Community Physicians refused to allow Police access to hospital diagnostic information about patients who had been involved in road traffic accidents. Yet, since 1964, psychiatrists have apparently been happy to send to the DHSS on HMR1(Psych) forms identifiable information containing such highly-sensitive details as whether an in-patient is manic-depressive, homosexual, epileptic, has used alcohol or other drugs, has venereal disease, is living with someone other than his wife, or has been in prison.

Most psychiatrists have been willing, for some 30 years, to supply information to a central register held in a Government department. This confidence has not been abused. It may not be generally known that even medical research workers do not have access to names or other identifying information. They must submit lists of names which they have already acquired, with appropriate permission, in some other way. If their bona fides, which is strictly examined, is considered by the medical officer responsible for confidentiality to be beyond reproach, they are issued with the name of the hospital where the patient was admitted. They must then apply to that hospital for any further information they require. The decision as to whether to release the information lies in the hands of the local medical committee or individual consultant, according to local practice. The DHSS has frequently reaffirmed that this procedure has always been followed and that it will always be adhered to.