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Public Bill Committee Proceedings: 15th May 2007          

31

 

Mental Health Bill[ [], continued

 
 

(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 the patient shall specify.”.’.

 


 

Authority to treat community patients

 

Angela Browning

 

Tim Loughton

 

Dr John Pugh

 

Mr Tim Boswell

 

Sandra Gidley

 

Mr Charles Walker

 

Not called  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


 
 

Public Bill Committee Proceedings: 15th May 2007          

32

 

Mental Health Bill[ [], continued

 
 

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—


 
 

Public Bill Committee Proceedings: 15th May 2007          

33

 

Mental Health Bill[ [], continued

 
 

“(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

 

Not called  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


 
 

Public Bill Committee Proceedings: 15th May 2007          

34

 

Mental Health Bill[ [], continued

 
 

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

 

Not called  nc16

 

To move the following Clause:—


 
 

Public Bill Committee Proceedings: 15th May 2007          

35

 

Mental Health Bill[ [], continued

 
 

‘(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

 

Not called  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”.’.

 


 

Local arrangements for assessment, conveyance and admission of urgent cases

 

Ann Coffey

 

Withdrawn  nc18

 

To move the following Clause:—

 

‘In the 1983 Act, for Section 140 (Notification of hospitals) substitute—

 

“140  

Local arrangements for assessment, conveyance and admission of

 

urgent cases

 

(1)    

It shall be the duty of every Primary Care Trust, in conjunction with—

 

(a)    

the NHS Trusts contracted to provide in-patient mental health

 

services and ambulance services within its area,

 

(b)    

the police authority or authorities within its area, and

 

(c)    

the local social services authority or authorities within its area,

 

    

to prepare, publish and maintain a comprehensive, up-to-date scheme for

 

the safe, timely and effective management of the cases of patients within

 

its area who may require urgent admission to hospital for treatment for

 

mental disorder, whether under this Act or otherwise.

 

(2)    

This scheme shall include details of—

 

(a)    

the arrangements for the assessment of urgent cases and for

 

ensuring the safety of the patient, carers, those carrying out the

 

assessment and any other persons present during the assessment,


 
 

Public Bill Committee Proceedings: 15th May 2007          

36

 

Mental Health Bill[ [], continued

 
 

(b)    

the arrangements for obtaining a bed, if required, and the criteria

 

for determining the relative priority of urgent cases awaiting

 

admission,

 

(c)    

the arrangements for ensuring safe custody and conveyance of

 

patients who need to be admitted to hospital under Section 6(1)

 

of this Act,

 

(d)    

agreed time-limits for response by the bodies listed in 1 (a-c)

 

above in cases of urgency where there is a serious risk to the

 

safety of the patient or others.’”.

 


 

Responsibility for conveyance to hospital

 

Ann Coffey

 

Not called  nc19

 

To move the following Clause:—

 

‘(1)    

The 1983 Act is amended as follows.

 

(2)    

In Section 11(2) after “sought”, insert “or in the case of a National Health Service

 

patient, to the NHS Trust responsible for hospital provision”.

 

(3)    

In Section 6(1) for “applicant, or any person authorised by the applicant”

 

substitute “the body to which the application is addressed, or any person

 

authorised by that body” and for “convey him to the hospital” substitute “convey

 

him to the hospital identified by that body as being able to receive him.”’.

 


 

Nearest relative (named persons)

 

Sandra Gidley

 

Dr John Pugh

 

Not called  nc20

 

To move the following Clause:—

 

‘(1)    

Section 26 of the 1983 Act (“definitions of relative” and “nearest relative”) is

 

amended as follows.

 

(2)    

In the cross-heading preceding Section 26 after “functions of relatives” insert “,

 

persons acting as relatives”.

 

(3)    

Before subsection (1) insert—

 

“(A1)    

In this Part of the Act “named person” means any person—

 

(a)    

described in subsection (1) below; or

 

(b)    

not described in subsection (1) below who is the patient’s carer;

 

    

who has been nominated by the patient in accordance with subsection

 

(1A) below.

 

(B1)    

In this Part of the Act “carer” has the same meaning as in Section 1(1)(a)

 

of the Carers and Disabled Children Act 2000.”.

 

(4)    

After subsection (1) insert—


 
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