Mental Health Bill [HL]

House of Commons

Session 2006 - 07
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Mental Health Bill [HL]

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 2 — Professional roles
5

Fundamental principles
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The fundamental principles
After section 118(2) of the 1983 Act (code of practice) insert—
“(2A)
The code shall include a statement of the principles which the Secretary
of State thinks should inform decisions under this Act.
5
(2B)
In preparing the statement of principles the Secretary of State shall, in
particular, ensure that each of the following matters is addressed—
(a)
respect for patients’ past and present wishes and feelings,
(b)
minimising restrictions on liberty,
(c)
involvement of patients in planning, developing and delivering
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care and treatment appropriate to them,
(d)
avoidance of unlawful discrimination,
(e)
effectiveness of treatment,
(f)
views of carers and other interested parties,
(g)
patient wellbeing and safety, and
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(h)
public safety.
(2C)
The Secretary of State shall also have regard to the desirability of
ensuring—
(a)
the efficient use of resources, and
(b)
the equitable distribution of services.
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(2D)
In performing functions under this Act persons mentioned in
subsection (1)(a) or (b) shall have regard to the code.”
Chapter 2
Professional roles
Approved clinicians and responsible clinicians
25
11
Amendments to Part 2 of 1983 Act
(1)
Part 2 of the 1983 Act (compulsory admission to hospital and guardianship) is
amended as follows.
(2)
In section 5 (application in respect of patient already in hospital)—
(a)
in subsection (2), after “registered medical practitioner” insert “or
30
approved clinician”,
(b)
for subsection (3) substitute—
“(3)
The registered medical practitioner or approved clinician in
charge of the treatment of a patient in a hospital may nominate
one (but not more than one) person to act for him under
35
subsection (2) above in his absence.
(3A)
For the purposes of subsection (3) above—
(a)
the registered medical practitioner may nominate
another registered medical practitioner, or an approved
clinician, on the staff of the hospital; and
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Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 2 — Professional roles
6

(b)
the approved clinician may nominate another approved
clinician, or a registered medical practitioner, on the
staff of the hospital.”, and
(c)
in subsection (4), after “a practitioner”, in each place, insert “or
clinician”.
5
(3)
In section 17 (leave of absence)—
(a)
in subsection (1)—
(i)
for “responsible medical officer” substitute “responsible
clinician”, and
(ii)
for “that officer” substitute “that clinician”,
10
(b)
in subsection (3), for “responsible medical officer” substitute
“responsible clinician”, and
(c)
in subsection (4)—
(i)
for “responsible medical officer” substitute “responsible
clinician”, and
15
(ii)
for “that officer” substitute “that clinician”.
(4)
In section 20 (duration of authority)—
(a)
in subsections (3) and (5), for “responsible medical officer” substitute
“responsible clinician”,
(b)
in subsection (6), for “appropriate medical officer” substitute
20
“appropriate practitioner”, and
(c)
omit subsection (10).
(5)
In section 21B (patients who are taken into custody or return after more than
28 days)—
(a)
in subsections (2) and (3), for “appropriate medical officer” substitute
25
“appropriate practitioner”, and
(b)
in subsection (10), omit the definition of “appropriate medical officer”.
(6)
In section 23(2) (persons who may apply for discharge of patient), in
paragraphs (a) and (b), for “responsible medical officer” substitute
“responsible clinician”.
30
(7)
In section 24 (visiting and examination of patients), in each place, after
“registered medical practitioner” insert “or approved clinician”.
(8)
In section 25(1) (restrictions on discharge by nearest relative)—
(a)
for “responsible medical officer” substitute “responsible clinician”, and
(b)
for “that officer” substitute “that clinician”.
35
(9)
In section 34 (interpretation of Part 2 of the 1983 Act), in subsection (1), insert
the following definition at the appropriate place—
““the appropriate practitioner” means—
(a)
in the case of a patient who is subject to the
guardianship of a person other than a local social
40
services authority, the nominated medical attendant of
the patient; and
(b)
in any other case, the responsible clinician;”.
(10)
In that subsection, for the definition of “the responsible medical officer”
substitute—
45
““the responsible clinician” means—

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 2 — Professional roles
7

(a)
in relation to a patient liable to be detained by virtue of
an application for admission for assessment or an
application for admission for treatment, or a community
patient, the approved clinician with overall
responsibility for the patient’s case;
5
(b)
in relation to a patient subject to guardianship, the
approved clinician authorised by the responsible local
social services authority to act (either generally or in any
particular case or for any particular purpose) as the
responsible clinician;”.
10
12
Amendments to Part 3 of 1983 Act
(1)
Part 3 of the 1983 Act (patients concerned in criminal proceedings) is amended
as follows.
(2)
In section 35 (remand to hospital for report)—
(a)
in subsections (4) and (5), for “registered medical practitioner”
15
substitute “approved clinician”, and
(b)
in subsection (8), after “registered medical practitioner” insert “or
approved clinician”.
(3)
In section 36 (remand to hospital for treatment)—
(a)
in subsection (3), for “registered medical practitioner who would be in
20
charge of his treatment” substitute “approved clinician who would
have overall responsibility for his case”,
(b)
in subsection (4), for “responsible medical officer” substitute
“responsible clinician”, and
(c)
in subsection (7), after “registered medical practitioner” insert “or
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approved clinician”.
(4)
In section 37 (hospital and guardianship orders), in subsection (4), for
“registered medical practitioner who would be in charge of his treatment”
substitute “approved clinician who would have overall responsibility for his
case”.
30
(5)
In section 38 (interim hospital orders)—
(a)
in subsection (4), for “registered medical practitioner who would be in
charge of his treatment” substitute “approved clinician who would
have overall responsibility for his case”, and
(b)
in subsection (5), for “responsible medical officer”, in each place,
35
substitute “responsible clinician”.
(6)
In section 41 (power of courts to restrict discharge from hospital), in
subsections (3)(c) and (6), for “responsible medical officer” substitute
“responsible clinician”.
(7)
In section 44(2) (person who is to give evidence in connection with committal
40
to hospital), for “registered medical practitioner who would be in charge of the
offender’s treatment” substitute “approved clinician who would have overall
responsibility for the offender’s case”.
(8)
In section 45A(5) (person who is to give evidence in connection with hospital
or limitation direction), for “registered medical practitioner who would be in
45
charge of his treatment” substitute “approved clinician who would have
overall responsibility for his case”.

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 2 — Professional roles
8

(9)
In the following provisions, for “responsible medical officer” substitute
“responsible clinician”—
(a)
section 45B(3) (requirement to produce report on person subject to
hospital and limitation directions), and
(b)
section 49(3) (requirement to produce report on person subject to
5
restriction direction).
13
Further amendments to Part 3 of 1983 Act
(1)
Part 3 of the 1983 Act (patients concerned in criminal proceedings) is further
amended as follows.
(2)
In section 50(1) (powers of Secretary of State in respect of prisoners under
10
sentence)—
(a)
for “responsible medical officer” substitute “responsible clinician”, and
(b)
for “registered medical practitioner” substitute “approved clinician”.
(3)
In section 51 (further provisions as to detained persons)—
(a)
in subsection (3)—
15
(i)
for “responsible medical officer” substitute “responsible
clinician”, and
(ii)
for “registered medical practitioner” substitute “approved
clinician”, and
(b)
in subsection (4), for “responsible medical officer” substitute
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“responsible clinician”.
(4)
In section 52 (further provisions as to persons remanded by magistrates’
courts), in subsections (5) and (7), for “responsible medical officer” substitute
“responsible clinician”.
(5)
In section 53(2) (powers of Secretary of State in respect of civil prisoners and
25
persons detained under the Immigration Acts)—
(a)
for “responsible medical officer” substitute “responsible clinician”, and
(b)
for “registered medical practitioner” substitute “approved clinician”.
(6)
In section 54 (requirements as to medical evidence), for subsection (2)
substitute—
30
“(2)
For the purposes of any provision of this Part of this Act under which a
court may act on the written evidence of any person, a report in writing
purporting to be signed by that person may, subject to the provisions of
this section, be received in evidence without proof of the following—
(a)
the signature of the person; or
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(b)
his having the requisite qualifications or approval or authority
or being of the requisite description to give the report.
(2A)
But the court may require the signatory of any such report to be called
to give oral evidence.”
(7)
In section 55 (interpretation of Part 3), for the definition of “responsible medical
40
officer” in subsection (1) substitute—
““responsible clinician”, in relation to a person liable to be
detained in a hospital within the meaning of Part 2 of this Act,
means the approved clinician with overall responsibility for the
patient’s case.”
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Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 2 — Professional roles
9

(8)
In Part 2 of Schedule 1 (modifications in relation to patients subject to special
restrictions), in paragraph 3—
(a)
in paragraph (b), for ““the responsible medical officer” and after the
words “that officer”” substitute ““the responsible clinician” and after
the words “that clinician””, and
5
(b)
in paragraph (c), for ““by the responsible medical officer”” substitute
““by the responsible clinician””.
14
Amendments to Part 4 of 1983 Act
(1)
Part 4 of the 1983 Act (consent to treatment) is amended as follows.
(2)
In section 57 (requirements as to certification for treatment requiring consent
10
and a second opinion)—
(a)
in subsection (2)(a), for “responsible medical officer” substitute
“approved clinician in charge of the treatment in question”, and
(b)
in subsection (3), at the end insert “nor the responsible clinician”.
(3)
In section 58 (requirements as to certification for treatment requiring consent
15
or a second opinion)—
(a)
in subsection (3)—
(i)
in paragraph (a), for “responsible medical officer” substitute
“approved clinician in charge of it”, and
(ii)
in paragraph (b), for “responsible medical officer” substitute
20
“approved clinician in charge of the treatment in question”, and
(b)
in subsection (4), at the end insert “nor the responsible clinician”.
(4)
In section 61 (review of treatment)—
(a)
in subsection (1)—
(i)
for “by the responsible medical officer” substitute “by the
25
approved clinician in charge of the treatment”, and
(ii)
in paragraph (a), for “responsible medical officer” substitute
“responsible clinician”,
(b)
in subsection (2)(b), for “responsible medical officer” substitute
“responsible clinician”,
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(c)
in subsection (3), omit the words “to the responsible medical officer”,
and
(d)
after that subsection insert—
“(3A)
The notice under subsection (3) above shall be given to the
approved clinician in charge of the treatment.”
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(5)
In section 62(2) (exception to discontinuance of treatment), for “responsible
medical officer” substitute “approved clinician in charge of the treatment”.
(6)
In section 63 (treatment requiring consent), for “responsible medical officer”
substitute “approved clinician in charge of the treatment”.
(7)
In section 64 (supplementary provisions for Part 4)—
40
(a)
in subsection (1), for the words from ““the responsible” to “treatment”
substitute ““the responsible clinician” means the approved clinician
with overall responsibility for the case”, and

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 2 — Professional roles
10

(b)
after that subsection insert—
“(1A)
Insofar as this Part of this Act applies to a patient who is neither
liable to be detained under this Act nor a community patient,
references in this Part to the responsible clinician or the
approved clinician in charge of the treatment of the patient shall
5
be construed as references to the person in charge of the
patient’s treatment.”
15
Amendments to Part 5 of 1983 Act
(1)
Part 5 of the 1983 Act (Mental Health Review Tribunals) is amended as follows.
(2)
In the following provisions, after “registered medical practitioner” insert “or
10
approved clinician”—
(a)
section 67(2) (power to visit and examine patient for the purposes of a
tribunal reference), and
(b)
section 76(1) (power to visit and examine patient for the purposes of a
tribunal application).
15
(3)
In section 79 (interpretation of Part 5), in subsection (6), for “, and “the
responsible medical officer” means the responsible medical officer,” substitute
“, and “the responsible clinician” means the responsible clinician,”.
16
Amendments to other provisions of 1983 Act
(1)
The 1983 Act is amended as follows.
20
(2)
In section 118 (code of practice), in subsection (1)(a), after “registered medical
practitioners” insert “, approved clinicians”.
(3)
In the following provisions, after “registered medical practitioner” insert “or
approved clinician”—
(a)
section 120(4)(a) (right of person authorised by Secretary of State etc to
25
visit patients), and
(b)
section 121(5)(a) (right of person authorised by Mental Health Act
Commission to visit patients).
(4)
In section 134 (correspondence of patients), in subsection (1), for “registered
medical practitioner in charge of the treatment of the patient” substitute
30
“approved clinician with overall responsibility for the patient’s case”.
(5)
In section 145 (general interpretation), in subsection (1), insert the following
definition at the appropriate place—
““approved clinician” means a person approved by the Secretary of State
(in relation to England) or by the Welsh Ministers (in relation to Wales)
35
to act as an approved clinician for the purposes of this Act;”.
17
Amendments to other Acts
(1)
In section 116B(5) of the Army Act 1955 (3 & 4 Eliz. 2 c. 18) (provision for
person subject to hospital order and restriction order to be remitted for trial,
etc)—
40
(a)
for “the responsible medical officer” substitute “the responsible
clinician”, and

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 2 — Professional roles
11

(b)
for the words from “In this subsection” to the end substitute—

“In this subsection “responsible clinician” means the
responsible clinician within the meaning of Part 3 of the 1983
Act.”
(2)
In section 116B(5) of the Air Force Act 1955 (3 & 4 Eliz. 2 c. 19) (provision for
5
person subject to hospital order and restriction order to be remitted for trial,
etc)—
(a)
for “the responsible medical officer” substitute “the responsible
clinician”, and
(b)
for the words from “In this subsection” to the end substitute—
10

“In this subsection “responsible clinician” means the
responsible clinician within the meaning of Part 3 of the 1983
Act.”
(3)
In section 63B(5) of the Naval Discipline Act 1957 (c. 53) (provision for person
subject to hospital order and restriction order to be remitted for trial, etc)—
15
(a)
for “the responsible medical officer” substitute “the responsible
clinician”, and
(b)
for the words from “In this subsection” to the end substitute—

“In this subsection “responsible clinician” means the
responsible clinician within the meaning of Part 3 of the 1983
20
Act.”
(4)
In section 5A(4) of the Criminal Procedure (Insanity) Act 1964 (c. 84) (provision
for person subject to hospital order and restriction order to be remitted for trial,
etc), for “the responsible medical officer” substitute “the responsible clinician”.
(5)
In section 171 of the Armed Forces Act 2006 (c. 52) (remission for trial)—
25
(a)
in subsection (1), for “the responsible medical officer” substitute “the
responsible clinician”, and
(b)
in subsection (4) for the definition of “the responsible medical officer”
substitute—
““the responsible clinician” means the responsible clinician within
30
the meaning of Part 3 of the Mental Health Act 1983.”
(6)
On the commencement of the repeal of an enactment mentioned in subsection
(1), (2) or (3) by the Armed Forces Act 2006, that subsection shall also cease to
have effect.
18
Certain registered medical practitioners to be treated as approved under
35
section 12 of 1983 Act
In section 12 of the 1983 Act (general provisions as to medical
recommendations), after subsection (2) insert—
“(2A)
A registered medical practitioner who is an approved clinician shall be
treated as also approved for the purposes of this section under
40
subsection (2) above as having special experience as mentioned there.”