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[AS AMENDED IN PUBLIC BILL COMMITTEE] |
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Amend the Mental Health Act 1983 and the Mental Capacity Act 2005 in |
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relation to mentally disordered persons; and for connected purposes. |
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Be it enacted by the Queen’s most Excellent Majesty, by and with the advice and |
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consent of the Lords Spiritual and Temporal, and Commons, in this present |
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Parliament assembled, and by the authority of the same, as follows:— |
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Amendments to Mental Health Act 1983 |
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Changes to key provisions |
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1 | Removal of categories of mental disorder |
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(1) | Section 1(2) of the 1983 Act (key definitions) is amended as set out in |
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(2) | For the definitions of “mental disorder” and “mentally disordered” |
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““mental disorder” means any disorder or disability of the mind; |
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“mentally disordered” shall be construed accordingly;”. |
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(3) | The following definitions are omitted— |
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(a) | those of “severe mental impairment” and “severely mentally |
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(b) | those of “mental impairment” and “mentally impaired”, and |
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(c) | that of “psychopathic disorder”. |
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(4) | Schedule 1 (which contains further amendments to the 1983 Act and |
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amendments to other Acts) has effect. |
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(1) | Section 1 of the 1983 Act (application of Act) is amended as follows. |
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(2) | After subsection (2) insert— |
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“(2A) | But a person with learning disability shall not be considered by reason |
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of that disability to be— |
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(a) | suffering from mental disorder for the purposes of the |
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provisions mentioned in subsection (2B) below; or |
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(b) | requiring treatment in hospital for mental disorder for the |
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purposes of sections 17E and 50 to 53 below, |
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| unless that disability is associated with abnormally aggressive or |
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seriously irresponsible conduct on his part. |
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(a) | sections 3, 7, 17A, 20 and 20A below; |
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(b) | sections 35 to 38, 45A, 47, 48 and 51 below; and |
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(c) | section 72(1)(b) and (c) and (4) below.” |
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(3) | After subsection (3) insert— |
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“(4) | In subsection (2A) above, “learning disability” means a state of arrested |
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or incomplete development of the mind which includes significant |
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impairment of intelligence and social functioning.” |
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3 | Changes to exclusions from operation of 1983 Act |
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In section 1 of the 1983 Act (application of Act), for subsection (3) substitute— |
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“(3) | Dependence on alcohol or drugs is not considered to be a disorder or |
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disability of the mind for the purposes of subsection (2) above.” |
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4 | Replacement of “treatability” and “care” tests with appropriate treatment test |
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(1) | The 1983 Act is amended as follows. |
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(2) | In section 3 (admission for treatment)— |
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(a) | in subsection (2), omit paragraph (b) (and the word “and” at the end of |
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(b) | in that subsection, after paragraph (c) insert “; and |
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(d) | appropriate medical treatment is available for him.”, |
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(c) | in subsection (3)(a), for “(b)” substitute “(d)”. |
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(3) | In that section, after subsection (3) insert— |
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“(4) | In this Act, references to appropriate medical treatment, in relation to a |
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person suffering from mental disorder, are references to medical |
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treatment which is appropriate in his case, taking into account the |
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nature and degree of the mental disorder and all other circumstances of |
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(4) | In section 20 (renewal of authority to detain), in subsection (4)— |
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(a) | omit paragraph (b) (and the word “and” at the end of that paragraph), |
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(b) | after paragraph (c) insert “and |
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(d) | appropriate medical treatment is available for him.”, |
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(c) | omit the words from “but, in the case of mental illness” to the end. |
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(5) | In section 37(2) (conditions for exercise of powers of court to order hospital |
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admission or guardianship), in paragraph (a)(i), for the words from “, in the |
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case of psychopathic disorder” to the end substitute “appropriate medical |
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treatment is available for him; or”. |
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(6) | In section 45A(2) (conditions for exercise of powers of court to direct hospital |
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admission), for paragraph (c) substitute— |
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“(c) | that appropriate medical treatment is available for him.” |
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(7) | In section 47(1) (conditions for exercise of Secretary of State’s powers to direct |
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removal to hospital), in paragraph (b), for the words from “and, in the case of |
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psychopathic disorder” to the end substitute “; and |
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(c) | that appropriate medical treatment is available for him;”. |
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(a) | in subsection (1)(b) (powers of tribunal to direct discharge of patient |
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not liable to be detained under section 2), after sub-paragraph (ii) |
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“(iia) | that appropriate medical treatment is available |
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(9) | In section 73(1) (powers of tribunal to direct discharge of restricted patients), in |
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paragraph (a), for “or (ii)” substitute “, (ii) or (iia)”. |
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(10) | In section 145 (interpretation), after subsection (1AA) insert— |
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“(1AB) | References in this Act to appropriate medical treatment shall be |
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construed in accordance with section 3(4) above.” |
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5 | Further cases in which appropriate treatment test is to apply |
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(1) | The 1983 Act is amended as follows. |
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(2) | In section 36(1) (remand to hospital for treatment) after paragraph (a) (inserted |
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by Schedule 1 to this Act) insert “and |
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(b) | appropriate medical treatment is available for him.” |
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(3) | In section 48(1) (removal to hospital of immigration detainees etc) after |
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paragraph (b) (inserted by Schedule 1 to this Act) insert “and |
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(c) | appropriate medical treatment is available for him;”. |
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(4) | In section 51(6)(a) (further power to make hospital order) after sub-paragraph |
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(i) (inserted by Schedule 1 to this Act) insert “and |
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(ii) | appropriate medical treatment is available for him; |
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6 | Appropriate treatment test in Part 4 of 1983 Act |
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(1) | Part 4 of the 1983 Act (consent to treatment) is amended as follows. |
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(2) | In the following provisions, for the words from “, having regard to” to the end |
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substitute “it is appropriate for the treatment to be given.”— |
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(a) | section 57(2)(b) (certification of second opinion where treatment |
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requires consent and a second opinion), and |
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(b) | section 58(3)(b) (certification of second opinion where treatment |
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requires consent or a second opinion). |
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(3) | In section 64 (supplementary provisions for Part 4), after subsection (2) insert— |
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“(3) | For the purposes of this Part of this Act, it is appropriate for treatment |
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to be given to a patient if the treatment is appropriate in his case, taking |
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into account the nature and degree of the mental disorder from which |
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he is suffering and all other circumstances of his case.” |
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7 | Change in definition of “medical treatment” |
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In section 145(1) of the 1983 Act (interpretation), in the definition of “medical |
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treatment”, for the words from “and also” to the end substitute “psychological |
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intervention and specialist mental health habilitation, rehabilitation and care;”. |
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8 | The fundamental principles |
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After section 118(2) of the 1983 Act (code of practice) insert— |
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“(2A) | The code shall include a statement of the principles which the Secretary |
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of State thinks should inform decisions under this Act. |
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(2B) | In preparing the statement of principles the Secretary of State shall, in |
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particular, ensure that each of the following matters is addressed— |
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(a) | respect for patients’ past and present wishes and feelings, |
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(b) | minimising restrictions on liberty, |
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(c) | involvement of patients in planning, developing and delivering |
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care and treatment appropriate to them, |
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(d) | avoidance of unlawful discrimination, |
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(e) | effectiveness of treatment, |
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(f) | views of carers and other interested parties, |
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(g) | patient wellbeing and safety, and |
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(2C) | The Secretary of State shall also have regard to the desirability of |
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(a) | the efficient use of resources, and |
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(b) | the equitable distribution of services. |
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(2D) | In performing functions under this Act persons mentioned in |
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subsection (1)(a) or (b) shall have regard to the code.” |
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Approved clinicians and responsible clinicians |
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9 | Amendments to Part 2 of 1983 Act |
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(1) | Part 2 of the 1983 Act (compulsory admission to hospital and guardianship) is |
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(2) | In section 5 (application in respect of patient already in hospital)— |
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(a) | in subsection (2), after “registered medical practitioner” insert “or |
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(b) | for subsection (3) substitute— |
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“(3) | The registered medical practitioner or approved clinician in |
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charge of the treatment of a patient in a hospital may nominate |
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one (but not more than one) person to act for him under |
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subsection (2) above in his absence. |
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(3A) | For the purposes of subsection (3) above— |
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(a) | the registered medical practitioner may nominate |
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another registered medical practitioner, or an approved |
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clinician, on the staff of the hospital; and |
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(b) | the approved clinician may nominate another approved |
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clinician, or a registered medical practitioner, on the |
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staff of the hospital.”, and |
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(c) | in subsection (4), after “a practitioner”, in each place, insert “or |
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(3) | In section 17 (leave of absence)— |
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(i) | for “responsible medical officer” substitute “responsible |
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(ii) | for “that officer” substitute “that clinician”, |
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(b) | in subsection (3), for “responsible medical officer” substitute |
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“responsible clinician”, and |
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(i) | for “responsible medical officer” substitute “responsible |
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(ii) | for “that officer” substitute “that clinician”. |
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(4) | In section 20 (duration of authority)— |
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(a) | in subsections (3) and (5), for “responsible medical officer” substitute |
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(b) | in subsection (6), for “appropriate medical officer” substitute |
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“appropriate practitioner”, and |
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(c) | omit subsection (10). |
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(5) | In section 21B (patients who are taken into custody or return after more than |
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(a) | in subsections (2) and (3), for “appropriate medical officer” substitute |
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“appropriate practitioner”, and |
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(b) | in subsection (10), omit the definition of “appropriate medical officer”. |
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(6) | In section 23(2) (persons who may apply for discharge of patient), in |
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paragraphs (a) and (b), for “responsible medical officer” substitute |
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(7) | In section 24 (visiting and examination of patients), in each place, after |
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“registered medical practitioner” insert “or approved clinician”. |
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(8) | In section 25(1) (restrictions on discharge by nearest relative)— |
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(a) | for “responsible medical officer” substitute “responsible clinician”, and |
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(b) | for “that officer” substitute “that clinician”. |
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(9) | In section 34 (interpretation of Part 2 of the 1983 Act), in subsection (1), insert |
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the following definition at the appropriate place— |
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““the appropriate practitioner” means— |
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(a) | in the case of a patient who is subject to the |
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guardianship of a person other than a local social |
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services authority, the nominated medical attendant of |
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(b) | in any other case, the responsible clinician;”. |
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(10) | In that subsection, for the definition of “the responsible medical officer” |
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““the responsible clinician” means— |
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(a) | in relation to a patient liable to be detained by virtue of |
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an application for admission for assessment or an |
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application for admission for treatment, or a community |
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patient, the approved clinician with overall |
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responsibility for the patient’s case; |
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(b) | in relation to a patient subject to guardianship, the |
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approved clinician authorised by the responsible local |
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social services authority to act (either generally or in any |
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particular case or for any particular purpose) as the |
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10 | Amendments to Part 3 of 1983 Act |
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(1) | Part 3 of the 1983 Act (patients concerned in criminal proceedings) is amended |
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(2) | In section 35 (remand to hospital for report)— |
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(a) | in subsections (4) and (5), for “registered medical practitioner” |
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substitute “approved clinician”, and |
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(b) | in subsection (8), after “registered medical practitioner” insert “or |
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(3) | In section 36 (remand to hospital for treatment)— |
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(a) | in subsection (3), for “registered medical practitioner who would be in |
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charge of his treatment” substitute “approved clinician who would |
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have overall responsibility for his case”, |
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(b) | in subsection (4), for “responsible medical officer” substitute |
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“responsible clinician”, and |
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(c) | in subsection (7), after “registered medical practitioner” insert “or |
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(4) | In section 37 (hospital and guardianship orders), in subsection (4), for |
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“registered medical practitioner who would be in charge of his treatment” |
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substitute “approved clinician who would have overall responsibility for his |
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(5) | In section 38 (interim hospital orders)— |
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(a) | in subsection (4), for “registered medical practitioner who would be in |
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charge of his treatment” substitute “approved clinician who would |
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have overall responsibility for his case”, and |
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(b) | in subsection (5), for “responsible medical officer”, in each place, |
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substitute “responsible clinician”. |
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(6) | In section 41 (power of courts to restrict discharge from hospital), in |
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subsections (3)(c) and (6), for “responsible medical officer” substitute |
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(7) | In section 44(2) (person who is to give evidence in connection with committal |
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to hospital), for “registered medical practitioner who would be in charge of the |
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offender’s treatment” substitute “approved clinician who would have overall |
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responsibility for the offender’s case”. |
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(8) | In section 45A(5) (person who is to give evidence in connection with hospital |
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or limitation direction), for “registered medical practitioner who would be in |
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charge of his treatment” substitute “approved clinician who would have |
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overall responsibility for his case”. |
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(9) | In the following provisions, for “responsible medical officer” substitute |
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(a) | section 45B(3) (requirement to produce report on person subject to |
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hospital and limitation directions), and |
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(b) | section 49(3) (requirement to produce report on person subject to |
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11 | Further amendments to Part 3 of 1983 Act |
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(1) | Part 3 of the 1983 Act (patients concerned in criminal proceedings) is further |
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(2) | In section 50(1) (powers of Secretary of State in respect of prisoners under |
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(a) | for “responsible medical officer” substitute “responsible clinician”, and |
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(b) | for “registered medical practitioner” substitute “approved clinician”. |
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(3) | In section 51 (further provisions as to detained persons)— |
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(i) | for “responsible medical officer” substitute “responsible |
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(ii) | for “registered medical practitioner” substitute “approved |
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(b) | in subsection (4), for “responsible medical officer” substitute |
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(4) | In section 52 (further provisions as to persons remanded by magistrates’ |
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courts), in subsections (5) and (7), for “responsible medical officer” substitute |
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