Vote Bundle Text (941026-07)

Amendments proposed to the Mental Capacity Bill - continued	House of Commons

back to previous text

Medical Advisers

Mrs Angela Browning

NC12

To move the following Clause:—

'The Medical Adviser for the purposes of this Act is a registered medical practitioner who is a member of the Expert Panel appointed by the Secretary of State.'.

Representation

Mrs Angela Browning

NC13

To move the following Clause:—

'(1) As soon as practicable after appointing a responsible clinician for P, under section C, the Secretary of State must notify the local social services authority of the appointment.

(2) The authority must then, as soon as practicable—

(a) notify P of the help available from appropriate advocates under any arrangements existing within the hospital or the relevant local authority area, notwithstanding that P might not be deemed to be "ordinarily resident" within the relevant local authority area,

(b) notify P of what rights to apply to the court existing under section 48, the help available to obtain representation and the powers of the court,

(c) notify any carer, representative, the Independent Consultee, a donee of a lasting power of attorney granted by P, or a deputy appointed for P by the court of the help so available.'.

Role of representative

Mrs Angela Browning

NC14

To move the following Clause:—

'(1) The responsible clinician for a qualifying patient, P, must ensure that one representative adopted or appointed by P—

(a) is consulted before medical treatment of any description is commenced, and

(b) is kept informed while medical treatment of any description continues, and

(2) If it appears to the representative consulted that P, if he had been capable of doing so, would not have consented to medical treatment of a particular description being used (or being continued)—

(a) he must inform the responsible clinician, and

(b) the responsible clinician must then ensure that, except in a case of urgency, medical treatment of that description is not used (or continued).'.

Preparation of care plan

Mrs Angela Browning

NC15

To move the following Clause—

'(1) the managers of a hospital at which medical treatment is provided to a qualifying patient, P, must secure that—

(a) a care plan is prepared for P by the responsible clinician, and

(b) the care plan is included in P's records.

(2) the managers must secure that the plan is prepared not later than the end of 28 days beginning with the day on which a responsible clinician is appointed for P.

(3) In preparing a plan for P, the responsible clinician must consult P and P's representative.

(4) A plan must—

(a) include the required information, and

(b) be prepared in the form prescribed by the Secretary of State in regulations.

(5) In this section, the "required information" means—

(a) a description of the medical treatment which is to be provided to P during the period for which the plan applies, and

(b) such other information relating to the care of the patient during that period as may be prescribed by the Secretary of State in regulations.'.

Approval of care plan

Mrs Angela Browning

NC16

To move the following Clause:—

'(1) The responsible clinician must, as soon as practicable after preparing a care plan, send a copy of it for approval to a person (the "medical adviser") appointed by the Secretary of State for that purpose.

(2) The medical adviser must be a member of the Expert Panel who is a registered medical practitioner.

(3) The medical adviser must first—

(a) examine P,

(b) satisfy himself that section J(3) has been complied with, and

(4) If the medical adviser is satisfied that the treatment specified in the plan can lawfully be provided to P without P being subject to the provisions of Part II Mental Health Act 1983, he must approve the plan.

(5) If the medical adviser does not approve the plan within the time prescribed by the Secretary of State in regulations, the responsible clinician must apply to the court for approval of the plan.

(6) The responsible clinician must send a copy of the plan to P and to P's representative as soon as practicable after it is approved.

(7) A medical adviser may, for the purposes of discharging functions under this section, at any reasonable time—

(a) visit, interview and examine P in private, and

(b) require the production of and inspect any records relating to him which are kept by the responsible clinician.'.

Amendment of care plan

Mrs Angela Browning

NC17

To move the following Clause:—

'(1) The responsible clinician may amend P's care plan at any time.

(2) Sections H to K apply to an amended care plan as they apply to a care plan.

(3) If the responsible clinician amends P's care plan, the managers of the hospital at which P is resident must secure that the amended plan is included in P's records as soon as practicable after it is prepared.'.

Review

Mrs Angela Browning

NC18

To move the following Clause:—

'(1) A care plan for P must specify the date on or before which P's responsible clinician must carry out a review (the "review date").

(2) The first review date must be not more than six months after the day on which the plan is approved under section K.

(3) Each subsequent review date must be not more than six months after the previous one.

(4) P's representative may request a review at any time, but may not make more than one request in any 6 months.

(5) On each review the responsible clinician must consider—

(a) whether the conditions specified in section E are met,

(b) the date to be substituted in the care plan at the next review date, and

(6) If the responsible clinician determines that any of the conditions under E are not met in P's case, P ceases to be a qualifying patient.

(7) The responsible clinician must inform P's representative in writing of the determinations made on any review and the reasons for them.'.

Refusal of a request for review

Mrs Angela Browning

NC19

To move the following Clause:—

'(1) If the responsible clinician refuses a request under section M(4 for a review, he must, if required to do so by P or his advocate or representative, refer his decision to a member of the Expert Panel who is a registered medical practitioner (the "medical adviser").

(2) If, on a reference under subsection (1), the medical adviser decides that the review ought to be carried out, the responsible clinician may either—

(a) carry out the review, or

(b) apply to the court.

(3) If—

(a) the responsible clinician fails to make a reference under subsection (1),

(b) the medical adviser agrees, on a reference under that subsection, with the decision not to carry out the review, or

P may apply to the court.

(4) On an application under subsection (2)(b) or (3), the court must determine either—

(a) that the responsible clinician must carry out the review, or

(b) that he is not required to carry out the review.'.

Disputes about outcome of review

Mrs Angela Browning

NC20

To move the following Clause:—

'(1) The responsible clinician must, if requested to do so by P's representative refer to the medical adviser appointed by the Secretary of State for that purpose any complaint made by P's representative as to the outcome of a review.

(2) If, on a reference under subsection (1) the complaint is not resolved within the prescribed time and the medical adviser upholds the complaint, the responsible clinician must apply to the court.

(3) If—

(a) the responsible clinician fails to make a reference under subsection (1),

(b) the complaint is not resolved within the prescribed time, and the medical adviser dismisses the complaint, or

P's representative may apply to the court.

(4) On an application under subsection (2) or (3), the court must, so far as relevant to the application, make a declaration either—

(a) that the determination of the responsible clinician in respect of that matter is approved, or

(b) that the determination of the responsible clinician in respect of that matter is not approved.'.

Application to the court for discharge

Mrs Angela Browning

NC21

To move the following Clause:—

'(1) An application may be made to the court by P or by his or her representative for an order requiring the managers of the hospital to discharge P.

(2) If the court is satisfied that P is being unlawfully detained at the hospital, it must make the order.'.

Right to an advocate in connection with the provision of accommodation

Mr Tom Clarke

NC22

To move the following Clause:—

'(1) The specified circumstances in which independent advocacy must be made available shall include consideration of a major change in a person's accommodation and or support where the accommodation on support is to be paid for in whole or in part from public funds, or would be but for the fact the person's resources exceeds those set in regulations under section 22 National Assistance Act 1948 and where it appears to the relevant authority that P may lack capacity in relation to that major change in P's accommodation and/or support arrangements.

(2) A major change for the purposes of this section means any change

(a) to accommodation for a continuous period intended to or likely to exceed 28 days, or

(b) any new contractual arrangements for providing support, for a person who lacks capacity to agree to the changes, where the accommodation or support is to be paid for in whole or in part from public funds or

(3) Any NHS body or local authority must seek and take into account representations from in independent advocate if it is liable to provide an assessment or assessments under any of the following for the person P where it appears to the relevant authority that P may lack capacity in relation to specific matters connected to that assessment or assessments:

(a) section 47 NHS and Community Care Act 1990 (and for the avoidance of doubt this includes those assessments under section 3 of the Community Care (Delayed Discharges etc) Act 2003,

(b) section 117 Mental Health Act 1983,

(d) assessment under the Continuing Care (National Health Service Responsibilities) Directions 2004 or Delayed Discharge (Continuing Care) Directions 2004

(e) any assessment for services which fall within the functions of a local housing authority (within the meaning of the Housing Act 1985) or any assessment for support under the Supporting People (England) Directions 2003, the Supporting People Grant (England) Guidance 2003 or assessment for charges under the Local Authorities (charges for Specified Welfare Services) (England) Regulations 2003 or

(f) any care planning for in-patient care, care following discharge or continuing care under the Care Programme Approach.

(4) Where emergency accommodation and support arrangements have to be made, these arrangements shall be reviewed as soon as possible, taking account of representations made by the independent advocate.

(5) "NHS body" has such meaning as may be prescribed by regulations made for the purposes of this section by

(a) the Secretary of State, in relation to bodies in England, or

(b) the National Assembly for Wales, in relation to bodies in Wales.'.