A REPLACEMENT for York's Bootham Park Hospital is unlikely to be built before 2019 at the earliest.

That means psychiatric inpatients in York will continue to be sent to mental hospitals elsewhere, or treated in the community, for at least the next three years.

This is totally unsatisfactory. But at least there are now welcome signs that the new health trust responsible for managing mental health services in York - the Tees, Esk and Wear Valley NHS Trust - is determined to get to grips with the shocking state of mental health care in the city. It is just a shame this did not happen much sooner.

Possible options being considered for the future of psychiatric impatient care in York include building a new hospital in the shell of Bootham Park; or building one at either Clifton Park in Rawcliffe or at The Retreat.

The fragmented and bureaucratic nature of the NHS means that there are still many hurdles to be overcome yet before we reach anything like a satisfactory solution to York's mental health crisis, however.

No fewer than four separate organisations are involved. NHS Property Services owns Bootham Park; The Tees, Esk and Wear Valley Trust now runs mental heath services in York; the Vale of York Clinical Commissioning Group of GPs commissions those services; and the Care Quality Commission monitors them.

Who ever believed that such a tangled mess of competing health quangos was ever going to be the best way of running our NHS?