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 4 — Supervised community treatment
20

“the community treatment order”, in relation to such a patient,
means the community treatment order in force in respect of
him; and
“the responsible hospital”, in relation to such a patient, means the
hospital in which he was liable to be detained immediately
5
before the community treatment order was made, subject to
section 19A below.
17B
Conditions
(1)
A community treatment order shall specify conditions to which the
patient is to be subject while the order remains in force.
10
(2)
But the order may only specify conditions which the approved mental
health professional mentioned in section 17A(4)(b) above agrees should
be specified.
(3)
The conditions which may be specified include—
(a)
a condition that the patient reside at a particular place;
15
(b)
a condition that the patient make himself available at particular
times and places for the purposes of medical treatment;
(c)
a condition that the patient receive medical treatment in
accordance with the responsible clinician’s directions;
(d)
a condition that the patient make himself available for
20
examination (for the purposes, in particular, of section 20A(4)
below or of enabling a Part 4A certificate (within the meaning of
section 64H below) to be given in his case);
(e)
a condition that the patient abstain from particular conduct.
(4)
The responsible clinician may from time to time by order in writing
25
vary the conditions specified in a community treatment order.
(5)
He may also suspend any conditions specified in a community
treatment order.
(6)
If a community patient fails to comply with a condition specified in the
community treatment order, that fact may be taken into account for the
30
purposes of exercising the power of recall under section 17E(1) below.
(7)
But nothing in this section restricts the exercise of that power to cases
where there is such a failure.
17C
Duration of community treatment order
A community treatment order shall remain in force until—
35
(a)
the period mentioned in section 20A(1) below (as extended
under any provision of this Act) expires, but this is subject to
sections 21 and 22 below;
(b)
the patient is discharged in pursuance of an order under section
23 below or a direction under section 72 below;
40
(c)
the application for admission for treatment in respect of the
patient otherwise ceases to have effect; or
(d)
the order is revoked under section 17F below,
whichever occurs first.

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment
21

17D
Effect of community treatment order
(1)
The application for admission for treatment in respect of a patient shall
not cease to have effect by virtue of his becoming a community patient.
(2)
But while he remains a community patient—
(a)
the authority of the managers to detain him under section 6(2)
5
above in pursuance of that application shall be suspended; and
(b)
reference (however expressed) in this or any other Act, or in any
subordinate legislation (within the meaning of the
Interpretation Act 1978 (c. 30)), to patients liable to be detained,
or detained, under this Act shall not include him.
10
(3)
And section 20 below shall not apply to him while he remains a
community patient.
(4)
Accordingly, authority for his detention shall not expire during any
period in which that authority is suspended by virtue of subsection
(2)(a) above.
15
17E
Power to recall to hospital
(1)
The responsible clinician may recall a community patient to hospital if
in his opinion—
(a)
the patient requires medical treatment in hospital for his mental
disorder; and
20
(b)
there would be a risk of harm to the health or safety of the
patient or to other persons if the patient were not recalled to
hospital for that purpose.
(2)
The responsible clinician may also recall a community patient to
hospital if the patient fails to comply with a condition imposed under
25
section 17B(3)(d) above.
(3)
The hospital to which a patient is recalled need not be the responsible
hospital.
(4)
Nothing in this section prevents a patient from being recalled to a
hospital even though he is already in the hospital at the time when the
30
power of recall is exercised; references to recalling him shall be
construed accordingly.
(5)
The power of recall under subsections (1) and (2) above shall be
exercisable by notice in writing to the patient.
(6)
A notice under this section recalling a patient to hospital shall be
35
sufficient authority for the managers of that hospital to detain the
patient there in accordance with the provisions of this Act.
17F
Powers in respect of recalled patients
(1)
This section applies to a community patient who is detained in a
hospital by virtue of a notice recalling him there under section 17E
40
above.
(2)
The patient may be transferred to another hospital in such
circumstances and subject to such conditions as may be prescribed in
regulations made by the Secretary of State (if the hospital in which the

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment
22

patient is detained is in England) or the Welsh Ministers (if that hospital
is in Wales).
(3)
If he is so transferred to another hospital, he shall be treated for the
purposes of this section (and section 17E above) as if the notice under
that section were a notice recalling him to that other hospital and as if
5
he had been detained there from the time when his detention in
hospital by virtue of the notice first began.
(4)
The responsible clinician may by order in writing revoke the
community treatment order if—
(a)
in his opinion, the conditions mentioned in section 3(2) above
10
are satisfied in respect of the patient; and
(b)
an approved mental health professional states in writing—
(i)
that he agrees with that opinion; and
(ii)
that it is appropriate to revoke the order.
(5)
The responsible clinician may at any time release the patient under this
15
section, but not after the community treatment order has been revoked.
(6)
If the patient has not been released, nor the community treatment order
revoked, by the end of the period of 72 hours, he shall then be released.
(7)
But a patient who is released under this section remains subject to the
community treatment order.
20
(8)
In this section—
(a)
“the period of 72 hours” means the period of 72 hours beginning
with the time when the patient’s detention in hospital by virtue
of the notice under section 17E above begins; and
(b)
references to being released shall be construed as references to
25
being released from that detention (and accordingly from being
recalled to hospital).
17G
Effect of revoking community treatment order
(1)
This section applies if a community treatment order is revoked under
section 17F above in respect of a patient.
30
(2)
Section 6(2) above shall have effect as if the patient had never been
discharged from hospital by virtue of the community treatment order.
(3)
The provisions of this or any other Act relating to patients liable to be
detained (or detained) in pursuance of an application for admission for
treatment shall apply to the patient as they did before the community
35
treatment order was made, unless otherwise provided.
(4)
If, when the order is revoked, the patient is being detained in a hospital
other than the responsible hospital, the provisions of this Part of this
Act shall have effect as if—
(a)
the application for admission for treatment in respect of him
40
were an application for admission to that other hospital; and
(b)
he had been admitted to that other hospital at the time when he
was originally admitted in pursuance of the application.
(5)
But, in any case, section 20 below shall have effect as if the patient had
been admitted to hospital in pursuance of the application for admission
45
for treatment on the day on which the order is revoked.”

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment
23

(3)
After section 20 (the cross-heading immediately above which becomes
“Duration of authority and discharge”) insert—
“20A
Community treatment period
(1)
Subject to the provisions of this Part of this Act, a community treatment
order shall cease to be in force on expiry of the period of six months
5
beginning with the day on which it was made.
(2)
That period is referred to in this Act as “the community treatment
period”.
(3)
The community treatment period may, unless the order has previously
ceased to be in force, be extended—
10
(a)
from its expiration for a period of six months;
(b)
from the expiration of any period of extension under paragraph
(a) above for a further period of one year,

and so on for periods of one year at a time.
(4)
Within the period of two months ending on the day on which the order
15
would cease to be in force in default of an extension under this section,
it shall be the duty of the responsible clinician—
(a)
to examine the patient; and
(b)
if it appears to him that the conditions set out in subsection (6)
below are satisfied and if a statement under subsection (7)
20
below is made, to furnish to the managers of the responsible
hospital a report to that effect in the prescribed form.
(5)
Where such a report is furnished in respect of the patient, the managers
shall, unless they discharge him under section 23 below, cause him to
be informed.
25
(6)
The conditions referred to in subsection (4) above are that—
(a)
the patient is suffering from mental disorder of a nature or
degree which makes it appropriate for him to receive medical
treatment;
(b)
it is necessary for his health or safety or for the protection of
30
other persons that he should receive such treatment;
(c)
subject to his continuing to be liable to be recalled as mentioned
in paragraph (d) below, such treatment can be provided
without his being detained in a hospital;
(d)
it is necessary for his health or safety or for the protection of
35
other persons that he should continue to be liable to be recalled
to hospital for medical treatment; and
(e)
appropriate medical treatment is available for him.
(7)
The statement referred to in subsection (4) above is a statement in
writing by an approved mental health professional—
40
(a)
that it appears to him that the conditions set out in subsection
(6) above are satisfied; and
(b)
that it is appropriate to extend the community treatment period.
(8)
Before furnishing a report under subsection (4) above the responsible
clinician shall consult one or more other persons who have been
45
professionally concerned with the patient’s medical treatment.

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment
24

(9)
Where a report is duly furnished under subsection (4) above, the
community treatment period shall be thereby extended for the period
prescribed in that case by subsection (3) above.
20B
Effect of expiry of community treatment order
(1)
A community patient shall be deemed to be discharged absolutely from
5
liability to recall under this Part of this Act, and the application for
admission for treatment cease to have effect, on expiry of the
community treatment order, if the order has not previously ceased to
be in force.
(2)
For the purposes of subsection (1) above, a community treatment order
10
expires on expiry of the community treatment period as extended
under this Part of this Act, but this is subject to sections 21 and 22
below.”
(4)
Schedules 3 and 4 (which contain further amendments) have effect.
30
Relationship with leave of absence
15
(1)
The 1983 Act is amended as follows.
(2)
In section 17 (leave of absence from hospital), after subsection (2) insert—
“(2A)
But longer-term leave may not be granted to a patient unless the
responsible clinician first considers whether the patient should be dealt
with under section 17A instead.
20
(2B)
For these purposes, longer-term leave is granted to a patient if—
(a)
leave of absence is granted to him under this section either
indefinitely or for a specified period of more than seven
consecutive days; or
(b)
a specified period is extended under this section such that the
25
total period for which leave of absence will have been granted
to him under this section exceeds seven consecutive days.”
(3)
In Part 2 of Schedule 1 (patients subject to special restrictions), in paragraph 3
after paragraph (a) insert—
“(aa)
subsections (2A) and (2B) shall be omitted;”.
30
31
Consent to treatment
(1)
Part 4 of the 1983 Act (consent to treatment) is amended as follows.
(2)
For section 56 substitute—
“56
Patients to whom Part 4 applies
(1)
Section 57 and, so far as relevant to that section, sections 59 to 62 below
35
apply to any patient.
(2)
Subject to that, this Part of this Act applies to a patient only if he falls
within subsection (3) or (4) below.
(3)
A patient falls within this subsection if he is liable to be detained under
this Act but not if—
40

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment
25

(a)
he is so liable by virtue of an emergency application and the
second medical recommendation referred to in section 4(4)(a)
above has not been given and received;
(b)
he is so liable by virtue of section 5(2) or (4) or 35 above or
section 135 or 136 below or by virtue of a direction under section
5
37(4) above; or
(c)
he has been conditionally discharged under section 42(2) above
or section 73 or 74 below and he is not recalled to hospital.
(4)
A patient falls within this subsection if—
(a)
he is a community patient; and
10
(b)
he is recalled to hospital under section 17E above.”
(3)
In section 61 (review of treatment), in subsection (1)—
(a)
before “a report on” insert “, or by virtue of section 62A below in
accordance with a Part 4A certificate (within the meaning of that
section),”, and
15
(b)
in paragraph (a) for “or 21B(2) above renewing the authority for the
detention” substitute “, 20A(4) or 21B(2) above in respect”.
(4)
After section 62 insert—
“62A
Treatment on recall of community patient or revocation of order
(1)
This section applies where—
20
(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.
25
(2)
For the purposes of section 58(1)(b) above, the patient is to be treated as
if he had remained liable to be detained since the making of the
community treatment order.
(3)
But section 58 above does not apply to treatment given to the patient
if—
30
(a)
the certificate requirement is met (within the meaning of section
64C below); or
(b)
as a result of section 64B(4) or 64E(4) below, the certificate
requirement would not apply (were the patient a community
patient not recalled to hospital under section 17E above).
35
(4)
In a case where this section applies, the certificate requirement is met
only in so far as—
(a)
the Part 4A certificate expressly provides that it is appropriate
for one or more specified forms of treatment to be given to the
patient in that case (subject to such conditions as may be
40
specified); or
(b)
a notice having been given under subsection (4) of section 64H
below, treatment is authorised by virtue of subsection (7) of that
section.
(5)
Subsection (4)(a) above shall not preclude the continuation of any
45
treatment, or of treatment under any plan, pending compliance with
section 58 above if the approved clinician in charge of the treatment

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment
26

considers that the discontinuance of the treatment, or of the treatment
under the plan, would cause serious suffering to the patient.
(6)
In a case where subsection (1)(b) above applies, subsection (3) above
only applies pending compliance with section 58 above.
(7)
In subsection (4) above—
5
“Part 4A certificate” has the meaning given in section 64H below;
and
“specified”, in relation to a Part 4A certificate, means specified in
the certificate.”
32
Authority to treat
10
(1)
After Part 4 of the 1983 Act, insert the following Part—
“Part 4A
Treatment of community patients not recalled to hospital
64A
Meaning of “relevant treatment”
In this Part of this Act “relevant treatment”, in relation to a patient,
15
means medical treatment which—
(a)
is for the mental disorder from which the patient is suffering;
and
(b)
is not a form of treatment to which section 57 or 58A above
applies.
20
64B
Adult community patients
(1)
This section applies to the giving of relevant treatment to a community
patient who—
(a)
is not recalled to hospital under section 17E above; and
(b)
has attained the age of 16 years.
25
(2)
The treatment may not be given to the patient unless—
(a)
there is authority to give it to him; and
(b)
if it is section 58 type treatment, the certificate requirement is
met.
(3)
But the certificate requirement does not apply if—
30
(a)
giving the treatment to the patient is authorised in accordance
with section 64G below; or
(b)
the treatment is immediately necessary and—
(i)
the patient has capacity to consent to it and does consent
to it; or
35
(ii)
a donee or deputy or the Court of Protection consents to
the treatment on the patient’s behalf.
(4)
Nor does the certificate requirement apply in so far as the
administration of medicine to the patient at any time during the period
of one month beginning with the day on which the community
40
treatment order is made is section 58 type treatment.