The inducements resulted in unnecessary admissions to the psychiatric hospitals, or treatments that went far longer than necessary, according to Government and court documents.

But many psychiatrists say the number of unnecessary admissions is small and warn of the danger of trivializing the problems of many very sick people.

The inspector general's study found that 78 percent of the unnecessary admissions involved cases that "would have been treated more appropriately in outpatient settings."

Indeed, the whole Griffiths White paper is centred upon reducing the amount of 'unnecessary' admission to institutional care.

This, of course, raises the question of who defines an unnecessary admission.

The redevelopment is needed to expand capacity, deliver treatment in a more comfortable and modern way, and to reduce unnecessary inpatient admissions.

Clinicians in these groups will spend the money directly on local care services that best meet their patients' clinical needs and prevent unnecessary admissions to hospital.

Intensive reviews of eight hospitals showed that unnecessary admissions, not simply a lack of documentation, was the major concern, Mr. Baine said.

The intensive reviews showed that unnecessary admissions ranged by hospital from 26 to 91 percent of the cases.

But even if utilization review can eliminate all unnecessary admissions and days, it won't have much impact on hospital costs over the long term.