House of Commons

Session 2006-07 Publications on the internet Bill Home Page

Notices of Amendments

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given on

Monday 16th April 2007

Public Bill Committee

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Mental Health Bill [Lords]

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Independent mental health advocacy

Sandra Gidley
Tim Loughton
Dr John Pugh
Angela Browning
Mr Tim Boswell
Mr Charles Walker

Andrew Rosindell Dr Richard Taylor

NC1

To move the following Clause:—

‘(1) The appropriate authority must arrange, to such extent as it considers necessary to meet all reasonable requirements, for help from persons to be known as independent mental health advocates, to be available to qualifying patients.

(2) The help available under the arrangements must include—

(a) help in obtaining information about and understanding—

(i) what medical treatment is being provided to the patient,

(ii) why it is being provided,

(iii) under what authority it is being provided,

(iv) the requirements of this Act which apply in connection with the patient’s treatment, and

(v) the rights which can be exercised by or in respect of him under this Act, and

(b) help (by way of representation or otherwise) in exercising those rights.

(3) An independent mental health advocate authorised by a patient or his nearest relative on his behalf may at any reasonable time, for the purpose of providing, in accordance with the arrangements, help requested by the patient or his nearest relative, meet the patient in private.

(4) The appropriate authority may by regulations provide that a person may act as an independent mental health advocate—

(a) only if requirements specified in the regulations are met in respect of him;

(b) only if requirements specified in the regulations are met in respect of any person with whom arrangements are made for him to act as an independent mental health advocate;

(c) only in circumstances otherwise specified in the regulations.

(5) In making arrangements under this section, the appropriate authority must have regard to the principle that the provision of help under the arrangement should, so far as practicable, be independent of any person responsible for the patient’s treatment.

(6) The following are qualifying patients—

(a) a patient who is liable to be detained by virtue of an application for admission for assessment or an application for admission for treatment under Part II of this Act;

(b) a community patient;

(c) a patient who is removed to a place of safety within the meaning of section 135—

(i) in the execution of a warrant under section 135; or

(ii) by a constable under section 136,

(d) an accused person within the meaning of section 35 remanded under that section to hospital for a report on his mental condition;

(e) an accused person within the meaning of section 36 remanded under that section to hospital for treatment;

(f) a patient in respect of whom there is in force—

(i) a hospital order,

(ii) a transfer direction,

(iii) a hospital direction,

(g) a patient, not being liable to be detained under this Act, who is asked to consent to any form of treatment to which section 57 applies.’.

Duty to inform patient of the right of access to an advocate

Sandra Gidley
Tim Loughton
Dr John Pugh
Angela Browning
Mr Tim Boswell
Mr Charles Walker

Andrew Rosindell Dr Richard Taylor

NC2

To move the following Clause:—

‘(1) The appropriate authority shall have a duty to inform a qualifying patient of the right to seek the services of an independent mental health advocate as soon as is reasonably practicable after the patient becomes a qualifying patient and thereafter, at reasonable intervals—

(a) at all points where decisions are made about care and treatment;

(b) on the use of interventions to manage behavour;

(c) in any case where an allegation of abuse, including offences relating to sections 38 to 41 of the Sexual Offences Act 2003, is made by a qualifying patient.

(2) In any case where it is proposed that treatment specified by regulations made by the Secretary of State pursuant to section 58(1)(a) should be given to a patient, the appropriate authority shall have a duty to inform, or as the case may be, remind the patient of the right to seek the services of an independent mental health advocate—

(a) before the patient is asked to consent to the specified treatment; or

(b) before a certificate has been given under section 58(3)(b).

(3) In the case of a patient who is a qualifying patient by virtue of subsection (b)(g) of section [Indpendent mental health advocacy], the appropriate authority shall have a duty to inform, or as the case may be, remind the patient of the right to seek the services of an independent mental health advocate before he is given any form of treatment to which section 57 applies.’.

Tim Loughton
Dr John Pugh
Angela Browning
Sandra Gidley
Mr Tim Boswell
Mr Charles Walker

Andrew Rosindell

1

Clause 31, page 19, line 34, leave out ‘and’ and insert—

‘(aa) in subsection (1)(b), leave out “three months” and insert “two months” and’.

Tim Loughton
Dr John Pugh
Angela Browning
Sandra Gidley
Mr Tim Boswell
Mr Charles Walker

Andrew Rosindell Dr Richard Taylor

2

Clause 32, page 24, line 34, at end insert ‘for a maximum of three years in total’.

Tim Loughton
Angela Browning
Sandra Gidley
Mr Tim Boswell
Mr Charles Walker
Andrew Rosindell

3

Clause 32, page 21, leave out line 46.

Tim Loughton
Angela Browning
Dr John Pugh
Mr Tim Boswell
Sandra Gidley
Mr Charles Walker

Andrew Rosindell Dr Richard Taylor

4

Clause 32, page 22, line 7, at end insert—

‘(8) A community patient or his nearest relative may make an application to the Mental Health Review Tribunal to vary or suspend any or all of the conditions imposed under section (3)(a), (b), (d) and (e) of the Mental Health Bill [Lords] 2007 (c. ) within the relevant period or if substantial variations have been made by the responsible clinician under subsection (4) above.

(9) In subsection (8) above “the relevant period” means—

(a) six months beginning with the day on which the community treatment order is made; and

(b) the period or periods for which the community treatment period is extended by virtue of the report.

(10) Where application is made to a Mental Health Review Tribunal by or in respect of a community patient under subsection (8) above the tribunal—

(a) may recommend that the responsible clinician consider whether to vary or suspend any or all of the conditions imposed under sections (3)(a), (b), (d) and (e) of the Mental Health Bill [Lords] 2007 (c. ); and

(b) may further consider the patient’s case if the responsible clinician does not make all or some of the changes recommended.

(11) Nothing in this section restricts the power to make applications to tribunals under section 66.’.

Tim Loughton
Angela Browning
Dr John Pugh
Mr Tim Boswell
Sandra Gidley
Mr Charles Walker

Andrew Rosindell Dr Richard Taylor

5

Schedule 3, page 63, line 27, at end insert—

‘(d) Where application is made to the tribunal by or in respect of a community patient and the tribunal does not direct that the patient be discharged, the tribunal—

(i) may recommend that the responsible clinician consider whether to vary or suspend any or all of the conditions imposed under section (3)(a), (b), (d) and (e) of the Mental Health Bill [Lords] 2007 (c. ); and (ii) may further consider the patient’s case if the responsible clinician does not make all or some of the changes recommended.’.

Tim Loughton
Angela Browning
Dr John Pugh
Mr Tim Boswell
Sandra Gidley
Mr Charles Walker

Andrew Rosindell Dr Richard Taylor

6

Clause 32, page 22, line 7, at end insert—

‘17BA Making of community treatment order

(1) The responsible clinician shall not make a community treatment order unless—

(a) the following persons have been consulted about the making of the order under section 17A and the conditions to which the patient is subject specified under 17B—

(i) the patient;

(ii) the nearest relative;

(iii) any person with the authority to act on the patient’s behalf;

(iv) one or more persons who have been professionally concerned with the patient’s medical treatment in hospital;

(v) one or more persons who will be professionally concerned with the treatment to be provided for the patient after he leaves hospital; and

(vi) any person who the responsible clinician believes will play a substantial part in the care of the patient after he leaves hospital but will not be professionally concerned with the medical treatment to be so provided, and

(b) the responsible medical officer has taken into account any views expressed by the persons consulted under paragraph (a).

(2) On making a community treatment order in respect of a patient the responsible clinician shall—

(a) inform the patient both orally and in writing; and

(b) inform any person who has been consulted under paragraph (a)(ii) and (iv) of subsection (1) above;

of the matters specified in subsection (3) below.

(3) The matters referred to in subsection (2) above are—

(a) that the order is being made;

(b) the after-care services to be provided under section 117 below; and

(c) any requirements to be imposed upon him under section 17B above.’.

Tim Loughton
Angela Browning
Dr John Pugh
Mr Tim Boswell
Sandra Gidley
Mr Charles Walker

Andrew Rosindell Dr Richard Taylor

7

Clause 43, page 41, line 6, at end add—

‘(5) In Section 135 (Warrant to search for and remove patients) of the 1983 Act subsection (6) for the words from “means” to the end of that subsection substitute—

“(a) residential accommodation provided by a local social services authority under Part III of the National Assistance Act 1948, a hospital as defined by this Act, an independent hospital or care home for mentally disordered persons or any other suitable place the occupier of which is willing temporarily to receive the patient; or, if, in the circumstances of the case it is impracticable to use any of these places,

(b) a police station.”.

(6) In Section 136 (Mentally disordered persons found in public places) of the 1983 Act after subsection (2) insert—

“(3) Where a police station is used as the place of safety the person may not be detained at the police station for a period longer than 24 hours.”.’.

Duty to assess needs

Sandra Gidley
Tim Loughton
Dr John Pugh
Angela Browning
Mr Tim Boswell
Mr Charles Walker

Andrew Rosindell Dr Richard Taylor

NC3

To move the following Clause:—

‘(1) The 1983 Act is amended as follows—

(2) After section 1 insert—

“1A Assessment of needs for health and social care services

(1) Where it appears to a local authority or a health authority that—

(a) any person with a mental disorder for whom they may provide or arrange for the provision of community care services may be in need of any such services, or

(b) that any person with a mental disorder may be in need of services which are commissioned by the health authority in respect of mentally disordered persons—

the authority and the health authority shall carry out a joint assessment of his needs for those services; and having regard to the results of that assessment, shall then decide whether his needs call for the provision by them of any such services.

(2) Where a local authority or health authority receives a request for an assessment under subsection (1) in writing by—

(a) the person with mental disorder,

(b) the carer, (as defined under section 1 of the Carers and Disabled Children Act 2000),

(c) the person who is or who would be the Nearest Relative, or

(d) an Approved Mental Health Professional

the authorities must comply with subsection (3) below.

(3) The requirement referred to in subsection (2) above is to give notice, before the expiry of the period of 14 days beginning with the day on which the request is received, to the person who made the request of whether the health authority and local authority intends to undertake the assessment; and if the intention is not to undertake the assessment, of the reason why that is the case.”.’.

Advance decisions and advance statements

Sandra Gidley
Tim Loughton
Dr John Pugh
Angela Browning
Mr Tim Boswell
Mr Charles Walker

Andrew Rosindell Dr Richard Taylor

NC4

To move the following Clause:—

‘(1) The 1983 Act is amended as follows.

(2) After section 76 (visiting and examination of patients) insert—

“76A Advance decisions and advance statements

(1) In this Act—

(a) reference to an advance decision is to an advance decision (within the meaning of the Mental Capacity Act 2005) made by the patient, and

(b) “valid and applicable” in relation to such a decision means valid and applicable to the treatment in question in accordance with section 25 of that Act.

(2) If an advance decision is found to be valid and applicable to the treatment regulated by Part 4 of the 1983 Act, at the material time, the person making the decision shall have regard to the advance decision.

(3) Where a decision is made which is inconsistent with a valid and applicable advance decision then the requirements set out in subsection (4) below must be complied with.

(4) Those requirements are—

(a) recording in writing the circumstances in which treatment and the reasons why;

(b) supplying—

(i) the patient concerned, and

(ii) the patient’s nearest relative

with a copy of that record and placing a copy of that record in that patient’s medical notes.

(5) A person performing a function under this Act shall consider, so far as reasonably ascertainable the patient’s past and present wishes and feelings (and in particular any relevant written statement made by him when he had capacity.”.

(3) In section 63 (treatment not requiring consent), at the end, insert—

“(2) When deciding what treatment to give, the approved clinician in charge of the treatment shall consider so far as reasonably ascertainable the patient’s past and p-resent wishes and feelings (and in particular any relevant written statement made by him when he had capacity), and shall record any treatments requested by the patient in the patient’s medical record, and if that treatment is not given shall record the reasons for this.”.’.

Dr John Pugh
Tim Loughton
Sandra Gidley
Angela Browning
Mr Tim Boswell
Mr Charles Walker

Andrew Rosindell Dr Richard Taylor

8

Clause 14, page 9, line 9, at end insert—

‘(1A) In section 47 (Removal to hospital of persons serving sentences of imprisonment, etc) in subsection (1) leave out from “condition” to the end of the subsection and insert—

“the Secretary of State must by warrant direct that that person be removed and detained in such hospital as may be specified in the direction: and a direction under this section shall be known as “a transfer direction”.’.

Tim Loughton
Dr John Pugh
Angela Browning
Sandra Gidley
Mr Tim Boswell
Mr Charles Walker

Andrew Rosindell Dr Richard Taylor

9

Clause 30, page 19, line 29, at end add—

‘58B Treatment for patients under 18 requiring consent and a second opinion

(1) Subject to section 62 below, a patient under eighteen years shall not be given electroconvulsive therapy (whether or not he is liable to detention), unless a registered medical practitioner appointed as aforesaid (not being the responsible clinician) has certified in writing that—

(a) the patient is capable of understanding the nature, purpose and likely effects of that treatment, and has consented, and that having regard in particular to the likelihood of its alleviating or preventing a deterioration of his condition, the treatment should be given; or

(b) the patient is incapable of understanding the nature, purpose and likely effects of that treatment, and either—

(i) a person who has parental authority for the patient understands the nature, purpose and likely effects of that treatment and has consented to the treatment and that having regard to the likelihood of its alleviating or preventing a deterioration of his condition, the treatment should be given; or

(ii) the High Court has determined that having regard to the likelihood of its alleviating or preventing a deterioration of his condition, the treatment should be given;

(2) For the purposes of treatment given under this section either the registered medical practitioner responsible for the patient’s treatment or the registered medical practitioner providing the second opinion shall be a clinician with specialist training in child and adolescent mental health.’.

Tim Loughton
Dr John Pugh
Angela Browning
Sandra Gidley
Mr Tim Boswell
Mr Charles Walker

Andrew Rosindell Dr Richard Taylor

10

Clause 31, page 20, line 2, at end insert—

‘(c) after subsection (4) insert—

“(5) Subsection (1)(b), (c) and (d) above shall not apply if the treatment is electro-convulsive therapy.’.

Seclusion

Dr John Pugh
Tim Loughton
Sandra Gidley
Angela Browning
Mr Tim Boswell
Mr Charles Walker

Andrew Rosindell Dr Richard Taylor

NC5

To move the following Clause:—

‘(1) The 1983 Act is amended as follows.

(2) After section 142 insert—

“142A Use of seclusion and other forms of behaviour management

(1) This section applies to the use of seclusion, mechanical restraint or other interventions to manage disturbed behaviour as may be specified for the purposes of this section by regulations made by the Secretary of State.

(2) For the purposes of this Act, seclusion means the removal of a patient without consent from normal levels of association or freedom of movement for the protection of others from significant harm.

(3) A patient shall not be so removed except for the purpose stated in subsection (2) above.

(4) A patient shall not be subject to any form of intervention to which this section applies, except in accordance with regulations.

(5) The Secretary of State shall make regulations prescribing—

(a) circumstances under which any form of intervention to which this section applies may be used;

(b) reporting requirements on the use of any such intervention;

(c) review of such interventions with a view to bringing the intervention to an end;

(d) scrutiny of the use of such interventions; and

(e) circumstances under which patients subject to such interventions must be visited by persons authorised by the Commission.

(6) Before making any regulations for the purposes of this section the Secretary of State shall consult such bodies as appear to him to be concerned”.’.

Right to move hospital

Tim Loughton
Sandra Gidley
Angela Browning
Dr John Pugh
Mr Tim Boswell
Mr Charles Walker

Andrew Rosindell Dr Richard Taylor

NC6

To move the following Clause:—

‘(1) The 1983 Act is amended as follows—

(2) After section 19 (Regulations as to transfer of patients) of the 1983 Act insert—

“19A The right to move hospital

(1) All patients and their families must be informed that a patient can apply to move from one hospital to another if there is a good reason to do so, taking into account their family, culture or medical needs and wishes.

(2) All applications by patients shall be recorded.

(3) If an application is refused written reasons shall be provided to the applicant, and subject to the wishes of the patient, to the nearest relative and any relatives (as defined in section 26) as he shall specify.”.’.

Prepared: 17 April 2007