On 9th March 1961 Enoch Powell, the Minister of Health, addressed the annual conference of the National Association of Mental Health.

His audience expected an anodyne speech. Instead, they were astonished at a major announcement of changed policy that altered mental health policy ever after. Speaking in almost messianic terms about future policy on mental hospitals, he said of the old hospitals: 

“There they stand, isolated, majestic, imperious, brooded over by the giant water tower and chimney combined, rising unmistakable and daunting out of the countryside…”

Not more than half the present number of places was likely to be needed, a redundancy of 75,000 beds. The beds should be in general hospitals. The change would imply the elimination of the greater part of the existing hospitals, a colossal undertaking. He would resist attempts to foist another purpose on them.

One of the audience said: “We all sat up, looked at each other and wondered what had happened, because we’d been struggling for years to get the idea of community care and the eventual closure of mental hospitals on the map and here it was offered to us on a plate”.

This was the beginning of care in the community. Progress was slow for it was hard to build new community facilities while cash still had to be spent on the old asylums. Community care was never going to be a cheap service. Still, here was the beginning, and a contribution of Enoch Powell to the NHS that should never be forgotten.

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