Amid a wave of revulsion over the death of the two women at Pau general psychiatric hospital, one of whom was decapitated, Philippe Douste-Blazy pledged urgent measures to reinforce security for all medical personnel.

He also promised increased funding for mental health institutions to meet criticism that they are understaffed and that dangerous patients are being discharged into the community without being treated.

Police believe that a former patient may have been responsible for killing the two employees, whose bodies were discovered early on Saturday.

“We might have to make a lot of arrests, but we think that it is among the discharged patients that we’ll find the assassin,” an officer said.

French authorities gave few details of the victims, except to say that one was born in 1956, the other in 1964. Both were married. One had two children, aged 11 and 2, the second had a three-year-old son. Police said that they had died during the night shift in an attack of extraordinary violence, probably carried out with a sabre or a machete.

One of the women had her throat slit and was found lying in a pool of blood in a corridor in a unit for patients with Alzheimer’s disease. The head of the second victim had been severed and placed on a television in the day-room in the ward.

Detectives said that the killer had broken a window to get out of the hospital, but they admitted that they did not know how he had entered it.

Paul Bonnan, head of the psychiatric unit at Cadillac hospital, near Bordeaux, said: “This is certainly the work of someone who is profoundly psychotic, who is hallucinating or completely delirious, or of someone who is in a state of total destruction after taking alcohol or drugs.” The killer was “extremely dangerous” and likely to strike again, Dr Bonnan said .

He added that physical and verbal violence had become a greater risk in French hospitals: “Practically every day, carers are attacked or insulted by patients, in psychiatric hospitals or accident and emergency departments.”

He said that the rise in violence was linked to “poverty, suffering and despair. There are also problems created by the breakdown of social and family ties.”

Last night M Douste-Blazy called leading French doctors and hospital managers to an emergency meeting on hospital safety. He said: “We are determined to reinforce the system of security in accident and emergency departments and in psychiatric hospitals.”

Unions said that public hospitals were underfunded, with mental health institutions facing the most acute difficulties. Nadine Prigent, general secretary of the nursing section of the Confédération Générale du Travail union, said that psychiatric care was “in crisis”. “Jobs are being cut,” she said, “beds are being shut and patients are being discharged without being treated in the community.”

Cathy Sanders, head of the Force Ouvrière union branch at Pau psychiatric hospital, said: “In the 1970s, people were interned on an arbitrary basis. Now, they are discharged into the community on an arbitrary basis. The average stay is being reduced all the time. It is 20 days in our establishment. How can you expect us to treat serious psychiatric cases in 20 days?”

M Douste-Blazy said that he agreed with much of the criticism: “There is an enormous deficiency in public and private psychiatry, notably in the networks that enable us to follow patients in the community. I have been working on a mental health plan for several months and the Prime Minister has agreed to release funds for it.”

Five men, including a former patient, were arrested after the attack. They were released without charge last night.

Explore World News

• Iraq News

• US & Americas News

• Europe News

• Middle East News

• Asia News

• Africa News

Times Recommends

• Valley of death may be $88bn key to life
• Hope fades for the missing as earthquake toll leaps
• Invasion of the computer-eating alien ants