Mental Health Bill [Lords] - continued          House of Commons

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Authority to treat community patients

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

NC14

    To move the following Clause:—

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

      (2) In section 58(3) after first “patient” insert “who is liable to be detained under this Act”.

      (3) After section 58 insert—

    58A Consent to treatment of community patients

      (1) Subject to section 62A below, a community patient who has not been recalled to hospital shall not be given any form of treatment to which this section applies unless—

        (a) he has consented to that treatment and either the approved clinician in charge of that treatment or a registered medical practitioner appointed for the purposes of this Part of this Act has certified in writing that the patient is capable of understanding its nature, purpose and likely effect and has consented to it; or

        (b) a registered medical practitioner appointed as aforesaid (not being the approved clinician in charge of the treatment in question) has certified in writing that—

          (i) the patient is not capable of understanding the nature, purpose or likely effects of that treatment; and

          (ii) he has either no reason to believe that the patient objects to being given the treatment, or he does have reason to believe that patient so objects, but it is not necessary to use force against the patient in order to give the treatment; and

          (iii) he is satisfied that the treatment does not conflict with a valid and applicable advance decision, or a decision made by a donee or deputy or the Court of Protection; and

          (iv) having regard to the likelihood of its alleviating or preventing a deterioration of his condition, the treatment should be given.

      (2) Where a patient who has been liable to detention under this Act has been administered medication for mental disorder to which this section applies for less than three months prior to becoming a community patient, the period mentioned in subsection (1)(b) shall be read to extend for no longer than one month beginning with the day on which the community treatment order is made.

      (3) The Secretary of State may by order vary the length of the period mentioned in subsection (2).

      (4) Certification under subsection (1)(b) may take place whilst a patient remains liable to be detained, but will not come into force until the responsible clinician discharges the patient from detention in hospital under the terms of section 17A(1) above.

      (5) Before giving a certificate under subsection (1)(b) the registered medical practitioner shall consult two other persons, who have been professionally concerned with the patient’s treatment, but of those persons—

        (a) at least one shall be a person who is not a registered medical practitioner; and

        (b) neither shall be the patient’s responsible clinician or the approved clinician in charge of the treatment in question.

      (6) In section 61(1) leave out ‘or 58(3)(b)’ and insert ‘58(3)(b), or 58A(1)(b)’.

      (7) In section 61(1)(a) after ‘20(3)’ insert ‘, 20A(4)’.

      (8) In section 61(3) for ‘responsible medical officer’ substitute ‘approved clinician in charge of the treatment in question’.

      (9) In section 61(3), leave out ‘or 58(3)(b)’ and insert ‘58(3)(b), or 58A(1)(b)’.”.

      (4) After section 62(2) insert—

      “(2A) Section 62A below shall not preclude the continuation of any treatment or of treatment under any plan pending compliance with section 58 where a community patient is recalled to hospital or a community treatment order is revoked and—

        (a) the patient is capable of understanding the nature, purpose and likely effect of that treatment and has consented to it; or

        (b) the patient is not capable of understanding the nature, purpose and likely effect of that treatment, but it is not necessary to use force against the patient in order to give the treatment.”.

      (5) After section 62 (Urgent Treatment) insert—

    62A Treatment on recall of community patient or revocation of order

      (1) This section applies where—

        (a) a community patient is recalled to hospital under section 17E above; or

        (b) a patient is liable to be detained under this Act following the revocation of a community treatment order under section 17F above in respect of him.

      (2) Subject to section 62, a patient to whom this section applies shall not be given any form of treatment to which section 58 applies without its certification under section 58(3) following that recall or revocation.”.

      (6) In section 64 (supplementary provisions for Part IV) after subsection (2) insert—

      “(3) In this Part of this Act, references to ‘not capable of understanding the nature, purpose and likely effects of treatment’ are to be read in accordance with the test established under section 3 of the Mental Capacity Act 2005 (c. 9).

      (4) References to a donee are to a donee of a lasting power of attorney (within the meaning of section 9 of the Mental Capacity Act 2005) created by the patient, where the donee is acting within the scope of his authority and in accordance with that Act.

      (5) References to a deputy are to a deputy appointed for the patient by the Court of Protection under section 16 of the Mental Capacity Act 2005, where the deputy is acting within the scope of his authority and in accordance with that Act.

      (6) Reference to the responsible clinician shall be construed as a reference to the responsible clinician within the meaning of Part 2 of this Act.

      (7) References to a hospital include a registered establishment.”.

      (7) In section 119 (practitioners approved for Part 4 and section 118)—

        (a) in subsection (2)(a) for “registered establishment” substitute “hospital or registered establishment or any community patient in a hospital or establishment of any description or (if access is granted) other place”,

        (b) in subsection (2)(b), leave out “in that home” and insert “there”,

        (c) after subsection (2) insert—

      “(3) In this section, ‘establishment of any description’ shall be construed in accordance with section 4(8) of the Care Standards Act 2000.”.

      (8) The Mental Capacity Act 2005 (c. 9) is amended as follows.

      (9) In section 28 (Mental Health Act matters) after subsection (1) insert—

      “(1A) Section 5 does not apply to an act to which section 58A of the Mental Health Act 2007 (c. ) applies.”.’.


Advanced decision (nearest relative)

Mr David Kidney

NC15

    # To move the following Clause:—

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

      (2) After section 26(4) insert—

      “(4A) Where a patient has made an advance decision with regard to the choice of a relative or other person to be his nearest relative, his nearest relative shall, subject to the power of the court under section 29 to appoint an acting nearest relative be determined by giving preference to that choice.

      (4B) ‘Advance decision’ means a decision made by a patient (‘P’), after he has reached 18 and when he has capacity to do so and in contemplation that he shall become subject to any act or decision exercisable under the provisions of this Act that his choice of nearest relative shall take precedence over the provisions of subsection (3).

      (4C) For the purposes of subsection (4A) a decision may be regarded as expressing a choice of nearest relative even though expressed in layman’s terms.

      (4D) P may withdraw or alter an advance decision at any time when he has capacity to do so.

      (4E) A withdrawal (including a partial withdrawal) need not be in writing.

      (4F) An alteration of an advance decision need not be in writing.

      (4G) An advance decision does not affect the liability which a person may incur for carrying out or continuing a treatment in relation to P unless the decision is at the material time valid.

      (4H) An advance decision is not valid if P—

        (a) has withdrawn the decision at a time when he had capacity to do so, or

        (b) has done anything else clearly inconsistent with the advance decision remaining his fixed decision.

      (4I) A decision or statement complies with this subsection only if—

        (a) it is in writing,

        (b) it is signed by P or by another person in P’s presence and by P’s direction,

        (c) the signature is made or acknowledged by P in the presence of a witness, and

        (d) the witness signs it, or acknowledges his signature, in P’s presence.

      (4J) The court may make a declaration as to whether an advance decision—

        (a) exists; and

        (b) is valid;

      (4K) Nothing in an apparent advance decision stops a person—

        (a) providing life-sustaining treatment, or

        (b) doing any act he reasonably believes to be necessary to prevent a serious deterioration in P’s condition, while a decision as respects any relevant issue is sought from the court.”.’.


Treatment requiring consent (administration of medicine)

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

NC16

    # To move the following Clause:—

      ‘(1) Section 58 of the 1983 Act is amended as follows.

      (2) In subsection (1)(b) leave out “three months” and insert “two months”.’.


Removal to hospital of persons serving sentences of imprisonment

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

NC17

    # To move the following Clause:—

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

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

      “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”.’.


ORDER OF THE HOUSE [16TH APRIL 2007]

       The following provisions shall apply to the Mental Health Bill [Lords]:

Committal

        1. The Bill shall be committed to a Public Bill Committee.

Proceedings in Public Bill Committee

        2. Proceedings in the Public Bill Committee shall (so far as not previously concluded) be brought to a conclusion on Tuesday 15th May 2007.

        3. The Public Bill Committee shall have leave to sit twice on the first day on which it meets.

Consideration and Third Reading

        4. Proceedings on consideration shall (so far as not previously concluded) be brought to a conclusion one hour before the moment of interruption on the day on which those proceedings are commenced.

        5. Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at the moment of interruption on that day.

        6. Standing Order No. 83B (Programming committees) shall not apply to proceedings on consideration and Third Reading.

Other proceedings

        7. Any other proceedings on the Bill (including any proceedings on any message from the Lords) may be programmed.

NOTICES WITHDRAWN The following Notices have been withdrawn:

Authority to treat community patients

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

NC8

    To move the following Clause:—

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

      (2) In section 58(3) after “patient”, insert “who is liable to be detained under this Act”.

      (3) After section 58(3) insert—

      “(3A) Subject to section 62A below, a community patient who has not been recalled to hospital shall not be given any form of treatment to which this section applies unless—

        (a) he has consented to that treatment and either the approved clinician in charge of that treatment or a registered medical practitioner appointed for the purposes of this Part of this Act has certified in writing that the patient is capable of understanding its nature, purpose and likely effect and has consented to it; or

        (b) a registered medical practitioner appointed as aforesaid (not being the approved clinician in charge of the treatment in question) has certified in writing that—

          (i) the patient is not capable of understanding the nature, purpose or likely effects of that treatment; and

          (ii) he has either no reason to believe that the patient objects to being given the treatment, or he does have reason to believe that patient so objects, but it is not necessary to use force against the patient in order to give the treatment; and

          (iii) he is satisfied that the treatment does not conflict with a valid and applicable advance decision, or a decision made by a donee or deputy or the Court of Protection; and

          (iv) having regard to the likelihood of its alleviating or preventing a deterioration of his condition, the treatment should be given.

      (3B) Where a patient who has been liable to detention under this Act has been administered medication for mental disorder to which this section applies for less than three months prior to becoming a community patient, the period mentioned in Section 58(1)(b) above shall be read to extend for no longer than one month beginning with the day on which the community treatment order is made.

      (3C) The Secretary of State may by order vary the length of the period mentioned in subsection (3B) above.

      (3D) Certification under subsection (3A) above may take place whilst a patient remains liable to be detained, but will not come into force until the responsible clinician discharges the patient from detention in hospital under the terms of section 17A(1) above.”.

      (4) After section 58(4) insert—

      “(4A) Before giving a certificate under section 58(3A)(b) above the registered medical practitioner shall consult two other persons, who have been professionally concerned with the patient’s treatment, but of those persons—

        (a) at least one shall be a person who is not a registered medical practitioner; and

        (b) neither shall be the patient’s responsible clinician or the approved clinician in charge of the treatment in question.”.’.

Authority to treat community patients (No. 2)

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

NC9

    To move the following Clause:—

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

      (2) In section 61(1) leave out “or” before “58(3)(b)” and after “58(3)(b)” insert “or 58(3A)(b)”.

      (3) In section 61(1)(a) after “20(3)” insert “20A(4)”.

      (4) In section 61(3) after “give notice to the”, for “responsible medical officer” substitute “approved clinician in charge of the treatment in question”.

      (5) In section 61(3), leave out “or” before “58(3)(b)” and after “58(3)(b)” insert “or 58(3A)(b)”.’.

Authority to treat community patients (No. 3)

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

NC10

    To move the following Clause:—

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

      (2) In section 64 (supplementary provisions for Part IV) after subsection (2) insert—

      “(3) In this Part of this Act, references to “not capable of understanding the nature, purpose and likely effects of treatment” are to be read in accordance with the test established under section 3 of the Mental Capacity Act 2005 (c. 9).

      (4) References to a donee are to a donee of a lasting power of attorney (within the meaning of section 9 of the Mental Capacity Act 2005) created by the patient, where the donee is acting within the scope of his authority and in accordance with that Act.

      (5) References to a deputy are to a deputy appointed for the patient by the Court of Protection under section 16 of the Mental Capacity Act 2005, where the deputy is acting within the scope of his authority and in accordance with that Act.

      (6) Reference to the responsible clinician shall be construed as a reference to the responsible clinician within the meaning of Part 2 of this Act.

      (7) References to a hospital include a registered establishment.”.

      (3) In section 119 (practitioners approved for Part 4 and section 118)—

        (a) in subsection (2)(a) leave out “in a registered establishment” and insert “in a hospital or registered establishment or any community patient in a hospital or establishment of any description or (if access is granted) other place”,

        (b) in subsection (2)(b), leave out “in that home” and insert “there”,

        (c) after subsection (2) insert—

      “(3) In this section, “establishment of any description” shall be construed in accordance with section 4(8) of the Care Standards Act 2000.”.

      (4) In section 28 (Mental Health Act matters) of the Mental Capacity Act 2005 (c. 9), after subsection (1) insert—

      “(1A) Section 5 does not apply to an act to which section 58(3A) of the Mental Health Act applies.”.’.

Authority to treat community patients (No. 4)

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

NC11

    To move the following Clause:—

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

      (2) After section 62(2) insert—

      “(2A) Section 62A below shall not preclude the continuation of any treatment or of treatment under any plan pending compliance with section 58 where a community patient is recalled to hospital or a community treatment order is revoked and—

        (a) the patient is capable of understanding its nature, purpose and likely effect of that treatment and has consented to it; or

        (b) the patient is not capable of understanding the nature, purpose and likely effect of that treatment, but it is not necessary to use force against the patient in order to give the treatment.”.

      (3) After section 62 (Urgent Treatment) insert—

    62A Treatment on recall of community patient or revocation of order

      (1) This section applies where—

        (a) a community patient is recalled to hospital under section 17E above; or

        (b) a patient is liable to be detained under this Act following the revocation of a community treatment order under section 17F above in respect of him.

      (2) Subject to section 62, a patient to whom this section applies shall not be given any form of treatment to which section 58 applies without its certification under section 58(3) following that recall or revocation.”.’.

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

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’.

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

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 “Secretary of State” to the end of the subsection and insert—

      “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”.’.

Young people: tribunals

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

NC7

    To move the following Clause:—

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

      (2) After section 78 insert—

    78A Young people: tribunals

      Where a patient is under the age of 18 the Mental Health Review Tribunal shall include a professional with such expertise in child and adolescent mental health services as the Secretary of State shall by regulation define.’.


 
 
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Prepared: 23 April 2007