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Consideration of Bill: 18th June 2007                  

1300

 

Mental Health Bill[Lords], continued

 
 

Advance decisions and advance statements

 

David Taylor

 

Lynne Jones

 

NC2

 

To move the following Clause:—

 

‘(1)    

The 1983 Act is amended as follows.

 

(2)    

After section 76 (visiting and examinations of patients) insert—

 

“76A  

Advance decisions and advance statements

 

(1)    

In this Act—

 

(a)    

reference to an advance decision is to an advance decision

 

(within the meaning of the Mental Capacity Act 2005 (c. 9))

 

made by the patient, and

 

(b)    

“valid and applicable” in relation to such a decision means valid

 

and applicable to the treatment in question in accordance with

 

section 25 of that Act.

 

(2)    

If an advance decision is found to be valid and applicable to the treatment

 

regulated by Part 4 of the 1983 Act, the person providing the treatment

 

shall have regard to the advance decision.

 

(3)    

Where a decision is made which is inconsistent with a valid and

 

applicable advance decision by the person providing treatment, that

 

person must comply with the requirements set out in subsection (4)

 

below.

 

(4)    

Those requirements are—

 

(a)    

the circumstances in which treatment was provided and the

 

reason for it should be recorded in writing; and

 

(b)    

a copy of that record should be supplied to—

 

(i)    

the patient

 

(ii)    

the patient’s nearest relative and another copy placed in

 

the patient’s medical notes.

 

(5)    

A person performing a function under this Act shall consider, so far as

 

reasonably ascertainable the patient’s past and present wishes and

 

feelings (and in particular any relevant written statement made by him

 

when he had capacity).”.

 

(3)    

In section 63 (treatment not requiring consent), at the end, insert—

 

“(2)    

When deciding what treatment to give, the approved clinician in charge

 

of the treatment shall consider so far as reasonably ascertainable the

 

patient’s past and present wishes and feelings (and in particular any

 

relevant written statement made by him when he had capacity), and shall

 

record any treatments requested by the patient in the patient’s medical

 

record, and if that treatment is not given shall record the reasons for

 

this.”.’.

 



 
 

Consideration of Bill: 18th June 2007                  

1301

 

Mental Health Bill[Lords], continued

 
 

Transfer of prisoners to hospital

 

Dr John Pugh

 

Sandra Gidley

 

NC9

 

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) after “may”, insert “within 14 days beginning with the date

 

he received the reports.”.’.

 


 

Guilding principles: incorporation in the 1983 Act

 

Dr John Pugh

 

Sandra Gidley

 

NC10

 

To move the following Clause:—

 

‘(1)    

Part 1 of the 1983 Act (Application of Act) is amended as follows.

 

(2)    

Before section 1 (Application of Act: “mental disorder”) insert—

 

“A1    

Application of the Act: ‘guiding principles’

 

(1)    

In the discharging of a function by virtue of this Act, a person shall have

 

regard to—

 

(a)    

the importance of the patient participating as fully as is possible

 

in the discharge of the function;

 

(b)    

the present and past wishes and feelings of the patient which are

 

relevant to the discharge of the function; and

 

(c)    

the need to ensure that patients are not subject to unlawful

 

discrimination.

 

(2)    

After having regard to the matters mentioned in subsection (1) above the

 

person shall discharge the function in the manner that involves the

 

minimum restriction on the patient that is necessary in the

 

circumstances.”.’.

 



 
 

Consideration of Bill: 18th June 2007                  

1302

 

Mental Health Bill[Lords], continued

 
 

Treatment requiring consent (period of time since administration of treatment)

 

Tim Loughton

 

Angela Browning

 

Sandra Gidley

 

Mr Tim Boswell

 

Mr Charles Walker

 

James Duddridge

 

Total signatories: 7

 

NC15

 

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”.’.

 


 

Nomination of carer as nearest relative

 

Lynne Jones

 

NC17

 

To move the following Clause:—

 

‘(1)    

The 1983 Act is amended as follows.

 

(2)    

After section 26(4) insert—

 

“(4A)    

Where a person has made an advance nomination 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 nomination” means a nomination made by a person (“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 (4B) P’s nomination must be his carer as

 

defined by section 1(1)(a) of the Carer’s and Disabled Children Act 2000.

 

(4D)    

For the purposes of section (4B) nomination cannot be made or

 

withdrawn if P is subject to an order under this Act.

 

(4E)    

An advance nomination 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

 

nomination remaining his fixed decision.

 

(4F)    

An advance nomination is valid 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,


 
 

Consideration of Bill: 18th June 2007                  

1303

 

Mental Health Bill[Lords], continued

 
 

(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.

 

(4G)    

The court may make a declaration as to whether an advance

 

nomination—

 

(a)    

exists; and

 

(b)    

is valid.”.’.

 


 

Tim Loughton

 

Angela Browning

 

Mr Tim Boswell

 

Mr Charles Walker

 

James Duddridge

 

Andrew Rosindell

 

102

 

Page  4,  line  34  [Clause  8],  at end insert—

 

‘(i)    

physical health of the patient’.

 


 

Mr Andrew Dismore

 

Dr Evan Harris

 

71

 

Page  8,  line  39  [Clause  12],  at end insert—

 

‘( )    

in subsection (1)—

 

(i)    

in paragraph (a) for “such forms of” substitute “naso-gastric

 

feeding and such other”.’.

 

Mr Andrew Dismore

 

Dr Evan Harris

 

72

 

Page  8,  line  39  [Clause  12],  at end insert—

 

‘( )    

in subsection (1)—

 

(ii)    

in paragraph (b) for “one month” substitute “three months”.’.

 


 

Lynne Jones

 

104

 

Page  15,  line  27  [Clause  23],  leave out ‘or’.

 

Lynne Jones

 

105

 

Page  15,  line  29  [Clause  23],  at end insert ‘because his appointment poses a risk to

 

the health or well-being of the patient; or


 
 

Consideration of Bill: 18th June 2007                  

1304

 

Mental Health Bill[Lords], continued

 
 

(f)    

that in the reasonable opinion of the patient the person is not

 

appropriate.’.

 


 

Ms Secretary Hewitt

 

10

 

Page  17,  line  23  [Clause  27],  after ‘(3)’, insert ‘, (3A)’.

 

Ms Secretary Hewitt

 

11

 

Page  17,  line  24  [Clause  27],  at end insert—

 

‘( )    

he has attained the age of 18 years;’.

 

Ms Secretary Hewitt

 

12

 

Page  17,  line  30  [Clause  27],  at end insert—

 

‘(3A)    

A patient falls within this subsection if—

 

(a)    

he has not attained the age of 18 years; but

 

(b)    

he has consented to the treatment in question; and

 

(c)    

a registered medical practitioner appointed as aforesaid (not

 

being the approved clinician in charge of the treatment) has

 

certified in writing—

 

(i)    

that the patient is capable of understanding the nature,

 

purpose and likely effects of the treatment and has

 

consented to it; and

 

(ii)    

that it is appropriate for the treatment to be given.’.

 

Ms Secretary Hewitt

 

14

 

Page  17,  line  43  [Clause  27],  leave out sub-paragraph (iii).

 


 

Ms Secretary Hewitt

 

16

 

Page  18,  line  7  [Clause  27],  at end insert—

 

‘(5A)    

This section shall not by itself confer sufficient authority for a patient

 

who falls within section 56(5) above to be given a form of treatment to

 

which this section applies if he is not capable of understanding the nature,

 

purpose and likely effects of the treatment (and cannot therefore consent

 

to it).’.

 

Ms Secretary Hewitt

 

17

 

Page  18,  line  41  [Clause  28],  leave out ‘58A(4)’ and insert ‘58A(3A) or (4)’.


 
 

Consideration of Bill: 18th June 2007                  

1305

 

Mental Health Bill[Lords], continued

 
 

Ms Secretary Hewitt

 

18

 

Page  18,  line  43  [Clause  28],  leave out ‘58A(4)’ and insert ‘58A(3A) or (4)’.

 

Ms Secretary Hewitt

 

19

 

Page  18,  line  45  [Clause  28],  leave out from ‘treatment)’ to ‘in’ in line 2 on page 19

 

and insert ‘, after subsection (1) insert—

 

“(1A)    

Section 58A above, in so far as it relates to electro-convulsive therapy by

 

virtue of subsection (1)(a) of that section, shall not apply to any treatment

 

which falls within paragraph (a) or (b) of subsection (1) above.

 

(1B)    

Section 58A above, in so far as it relates to a form of treatment specified

 

by virtue of subsection (1)(b) of that section, shall not apply to any

 

treatment which falls within such of paragraphs (a) to (d) of subsection

 

(1) above as may be specified in regulations under that section.

 

(1C)    

For the purposes of subsection (1B) above, the regulations—

 

(a)    

may make different provision for different cases (and may, in

 

particular, make different provision for different forms of

 

treatment);

 

(b)    

may make provision which applies subject to specified

 

exceptions; and

 

(c)    

may include transitional, consequential, incidental or

 

supplemental provision.”

 

( )    

In that section,’.

 


 

Ms Secretary Hewitt

 

20

 

Page  19,  line  5  [Clause  28],  at end insert—

 

‘( )    

In section 64 (supplementary provisions), after subsection (1A) (inserted by

 

section 12 of this Act) insert—

 

“(1B)    

References in this Part of this Act to the approved clinician in charge of

 

a patient’s treatment shall, where the treatment in question is a form of

 

treatment to which section 58A above applies and the patient falls within

 

section 56(5) above, be construed as references to the person in charge of

 

the treatment.

 

(1C)    

Regulations made by virtue of section 32(2)(d) above apply for the

 

purposes of this Part as they apply for the purposes of Part 2 of this

 

Act.”’.

 

Ms Secretary Hewitt

 

21

 

Page  19,  line  5  [Clause  28],  at end insert—

 

‘( )    

In section 28 of the Mental Capacity Act 2005 (c. 9) (Mental Health Act matters),

 

after subsection (1) insert—

 

“(1A)    

Subsection (1) does not apply in relation to any form of treatment to

 

which section 58A of that Act (electro-convulsive therapy, etc.) applies


 
 

Consideration of Bill: 18th June 2007                  

1306

 

Mental Health Bill[Lords], continued

 
 

if the patient comes within subsection (5A) of that section (informal

 

patient under 18 who cannot give consent).”.’.

 


 

Ms Secretary Hewitt

 

25

 

Page  24,  line  37  [Clause  31],  after ‘that’, insert ‘and to subsection (5) below’.

 


 

Ms Secretary Hewitt

 

26

 

Page  25,  line  5  [Clause  31],  leave out ‘under section 37(4)’ and insert ‘for his

 

detention in a place of safety under section 37(4) or 45A(5)’.

 

Ms Secretary Hewitt

 

27

 

Page  25,  line  11  [Clause  31],  after ‘above.’, insert—

 

‘(5)    

Section 58A and, so far as relevant to that section, sections 59 to 62

 

below also apply to any patient who—

 

(a)    

does not fall within subsection (3) above;

 

(b)    

is not a community patient; and

 

(c)    

has not attained the age of 18 years.’.

 

Ms Secretary Hewitt

 

28

 

Page  25,  line  31  [Clause  31],  leave out ‘(within the meaning of section 64C

 

below)’ and insert ‘for the purposes of section 64C or 64E below’.

 

Ms Secretary Hewitt

 

29

 

Page  25,  line  35  [Clause  31],  at end insert—

 

‘( )    

Section 58A above does not apply to treatment given to the patient if

 

there is authority to give the treatment, and the certificate requirement is

 

met, for the purposes of section 64C or 64E below.’.

 

Ms Secretary Hewitt

 

30

 

Page  25,  line  47  [Clause  31],  after ‘58’, insert ‘or 58A’.

 


 

Ms Secretary Hewitt

 

31

 

Page  26,  line  19  [Clause  32],  leave out ‘or 58A’.


 
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