Mental Health Bill [HL]

House of Commons

Session 2006 - 07
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Other Bills before Parliament

Mental Health Bill [HL]

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 1 — Changes to key provisions
1

A
Bill
[AS AMENDED IN PUBLIC BILL COMMITTEE]
To
Amend the Mental Health Act 1983 and the Mental Capacity Act 2005 in
relation to mentally disordered persons; and for connected purposes.
Be it enacted by the Queen’s most Excellent Majesty, by and with the advice and
consent of the Lords Spiritual and Temporal, and Commons, in this present
Parliament assembled, and by the authority of the same, as follows:—
Part 1
Amendments to Mental Health Act 1983
Chapter 1
Changes to key provisions
Mental disorder
5
1
Removal of categories of mental disorder
(1)
Section 1(2) of the 1983 Act (key definitions) is amended as set out in
subsections (2) and (3).
(2)
For the definitions of “mental disorder” and “mentally disordered”
substitute—
10
““mental disorder” means any disorder or disability of the mind;
and
“mentally disordered” shall be construed accordingly;”.
(3)
The following definitions are omitted—
(a)
those of “severe mental impairment” and “severely mentally
15
impaired”,
(b)
those of “mental impairment” and “mentally impaired”, and

Bill 107 54/2

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 1 — Changes to key provisions
2

(c)
that of “psychopathic disorder”.
(4)
Schedule 1 (which contains further amendments to the 1983 Act and
amendments to other Acts) has effect.
2
Learning disability
(1)
Section 1 of the 1983 Act (application of Act) is amended as follows.
5
(2)
After subsection (2) insert—
“(2A)
But a person with learning disability shall not be considered by reason
of that disability to be—
(a)
suffering from mental disorder for the purposes of the
provisions mentioned in subsection (2B) below; or
10
(b)
requiring treatment in hospital for mental disorder for the
purposes of sections 17E and 50 to 53 below,

unless that disability is associated with abnormally aggressive or
seriously irresponsible conduct on his part.
(2B)
The provisions are—
15
(a)
sections 3, 7, 17A, 20 and 20A below;
(b)
sections 35 to 38, 45A, 47, 48 and 51 below; and
(c)
section 72(1)(b) and (c) and (4) below.”
(3)
After subsection (3) insert—
“(4)
In subsection (2A) above, “learning disability” means a state of arrested
20
or incomplete development of the mind which includes significant
impairment of intelligence and social functioning.”
3
Changes to exclusions from operation of 1983 Act
In section 1 of the 1983 Act (application of Act), for subsection (3) substitute—
“(3)
Dependence on alcohol or drugs is not considered to be a disorder or
25
disability of the mind for the purposes of subsection (2) above.”
Tests for detention etc
4
Replacement of “treatability” and “care” tests with appropriate treatment test
(1)
The 1983 Act is amended as follows.
(2)
In section 3 (admission for treatment)—
30
(a)
in subsection (2), omit paragraph (b) (and the word “and” at the end of
that paragraph),
(b)
in that subsection, after paragraph (c) insert “; and
(d)
appropriate medical treatment is available for him.”,
and
35
(c)
in subsection (3)(a), for “(b)” substitute “(d)”.
(3)
In that section, after subsection (3) insert—
“(4)
In this Act, references to appropriate medical treatment, in relation to a
person suffering from mental disorder, are references to medical

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 1 — Changes to key provisions
3

treatment which is appropriate in his case, taking into account the
nature and degree of the mental disorder and all other circumstances of
his case.”
(4)
In section 20 (renewal of authority to detain), in subsection (4)—
(a)
omit paragraph (b) (and the word “and” at the end of that paragraph),
5
(b)
after paragraph (c) insert “and
(d)
appropriate medical treatment is available for him.”,
and
(c)
omit the words from “but, in the case of mental illness” to the end.
(5)
In section 37(2) (conditions for exercise of powers of court to order hospital
10
admission or guardianship), in paragraph (a)(i), for the words from “, in the
case of psychopathic disorder” to the end substitute “appropriate medical
treatment is available for him; or”.
(6)
In section 45A(2) (conditions for exercise of powers of court to direct hospital
admission), for paragraph (c) substitute—
15
“(c)
that appropriate medical treatment is available for him.”
(7)
In section 47(1) (conditions for exercise of Secretary of State’s powers to direct
removal to hospital), in paragraph (b), for the words from “and, in the case of
psychopathic disorder” to the end substitute “; and
(c)
that appropriate medical treatment is available for him;”.
20
(8)
In section 72—
(a)
in subsection (1)(b) (powers of tribunal to direct discharge of patient
not liable to be detained under section 2), after sub-paragraph (ii)
insert—
“(iia)
that appropriate medical treatment is available
25
for him; or”, and
(b)
omit subsection (2).
(9)
In section 73(1) (powers of tribunal to direct discharge of restricted patients), in
paragraph (a), for “or (ii)” substitute “, (ii) or (iia)”.
(10)
In section 145 (interpretation), after subsection (1AA) insert—
30
“(1AB)
References in this Act to appropriate medical treatment shall be
construed in accordance with section 3(4) above.”
5
Further cases in which appropriate treatment test is to apply
(1)
The 1983 Act is amended as follows.
(2)
In section 36(1) (remand to hospital for treatment) after paragraph (a) (inserted
35
by Schedule 1 to this Act) insert “and
(b)
appropriate medical treatment is available for him.”
(3)
In section 48(1) (removal to hospital of immigration detainees etc) after
paragraph (b) (inserted by Schedule 1 to this Act) insert “and
(c)
appropriate medical treatment is available for him;”.
40
(4)
In section 51(6)(a) (further power to make hospital order) after sub-paragraph
(i) (inserted by Schedule 1 to this Act) insert “and
(ii)
appropriate medical treatment is available for him;
and”.

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 1 — Changes to key provisions
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Medical treatment
6
Appropriate treatment test in Part 4 of 1983 Act
(1)
Part 4 of the 1983 Act (consent to treatment) is amended as follows.
(2)
In the following provisions, for the words from “, having regard to” to the end
substitute “it is appropriate for the treatment to be given.”—
5
(a)
section 57(2)(b) (certification of second opinion where treatment
requires consent and a second opinion), and
(b)
section 58(3)(b) (certification of second opinion where treatment
requires consent or a second opinion).
(3)
In section 64 (supplementary provisions for Part 4), after subsection (2) insert—
10
“(3)
For the purposes of this Part of this Act, it is appropriate for treatment
to be given to a patient if the treatment is appropriate in his case, taking
into account the nature and degree of the mental disorder from which
he is suffering and all other circumstances of his case.”
7
Change in definition of “medical treatment”
15
In section 145(1) of the 1983 Act (interpretation), in the definition of “medical
treatment”, for the words from “and also” to the end substitute “psychological
intervention and specialist mental health habilitation, rehabilitation and care;”.
Fundamental principles
8
The fundamental principles
20
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.
(2B)
In preparing the statement of principles the Secretary of State shall, in
particular, ensure that each of the following matters is addressed—
25
(a)
respect for patients’ past and present wishes and feelings,
(b)
minimising restrictions on liberty,
(c)
involvement of patients in planning, developing and delivering
care and treatment appropriate to them,
(d)
avoidance of unlawful discrimination,
30
(e)
effectiveness of treatment,
(f)
views of carers and other interested parties,
(g)
patient wellbeing and safety, and
(h)
public safety.
(2C)
The Secretary of State shall also have regard to the desirability of
35
ensuring—
(a)
the efficient use of resources, and
(b)
the equitable distribution of services.
(2D)
In performing functions under this Act persons mentioned in
subsection (1)(a) or (b) shall have regard to the code.”
40

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

Chapter 2
Professional roles
Approved clinicians and responsible clinicians
9
Amendments to Part 2 of 1983 Act
(1)
Part 2 of the 1983 Act (compulsory admission to hospital and guardianship) is
5
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
approved clinician”,
(b)
for subsection (3) substitute—
10
“(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
subsection (2) above in his absence.
(3A)
For the purposes of subsection (3) above—
15
(a)
the registered medical practitioner may nominate
another registered medical practitioner, or an approved
clinician, on the staff of the hospital; and
(b)
the approved clinician may nominate another approved
clinician, or a registered medical practitioner, on the
20
staff of the hospital.”, and
(c)
in subsection (4), after “a practitioner”, in each place, insert “or
clinician”.
(3)
In section 17 (leave of absence)—
(a)
in subsection (1)—
25
(i)
for “responsible medical officer” substitute “responsible
clinician”, and
(ii)
for “that officer” substitute “that clinician”,
(b)
in subsection (3), for “responsible medical officer” substitute
“responsible clinician”, and
30
(c)
in subsection (4)—
(i)
for “responsible medical officer” substitute “responsible
clinician”, and
(ii)
for “that officer” substitute “that clinician”.
(4)
In section 20 (duration of authority)—
35
(a)
in subsections (3) and (5), for “responsible medical officer” substitute
“responsible clinician”,
(b)
in subsection (6), for “appropriate medical officer” substitute
“appropriate practitioner”, and
(c)
omit subsection (10).
40
(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
“appropriate practitioner”, and

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 2 — Professional roles
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(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”.
(7)
In section 24 (visiting and examination of patients), in each place, after
5
“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”.
(9)
In section 34 (interpretation of Part 2 of the 1983 Act), in subsection (1), insert
10
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
services authority, the nominated medical attendant of
15
the patient; and
(b)
in any other case, the responsible clinician;”.
(10)
In that subsection, for the definition of “the responsible medical officer”
substitute—
““the responsible clinician” means—
20
(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;
25
(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;”.
30
10
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”
35
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
40
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
45
approved clinician”.

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 2 — Professional roles
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(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”.
(5)
In section 38 (interim hospital orders)—
5
(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,
substitute “responsible clinician”.
10
(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
to hospital), for “registered medical practitioner who would be in charge of the
15
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
charge of his treatment” substitute “approved clinician who would have
20
overall responsibility for his case”.
(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
25
(b)
section 49(3) (requirement to produce report on person subject to
restriction direction).
11
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.
30
(2)
In section 50(1) (powers of Secretary of State in respect of prisoners under
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)—
35
(a)
in subsection (3)—
(i)
for “responsible medical officer” substitute “responsible
clinician”, and
(ii)
for “registered medical practitioner” substitute “approved
clinician”, and
40
(b)
in subsection (4), for “responsible medical officer” substitute
“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”.
45