Mental Capacity (Amendment) Bill [HL]

Written evidence submitted by Dr R.L. Symonds (MCAB71)

I am a licensed medical practitioner, a consultant psychiatrist working mainly with the Tribunal Service (Mental Health) as a Medical member on Tribunal hearings. I have also been  accredited as a DoLS assessor.

I am concerned that the suggested Liberty Protection Safeguards will be inadequate. A statutory definition of Deprivation of Liberty is extremely difficult as the issue at present is subject to Case Law and is a changing field as new aspects are recognised. The full and balanced assessment of  altered capacity in elderly persons is not easy and requires an experienced psychiatrist as the medical assessor. Any attempt to remove a medical assessor would be disastrous. There is a vast hinterland of possible cases of DoL existing in care homes and in ordinary homes. I have witnessed widespread ignorance of the whole concept of Deprivation of Liberty in care homes and do not trust the proprietors who inevitably have a commercial bias, to detect DoL or to act on it. I also agree that there is concern at the understanding of the interaction between the Mental Health Act and the Mental Capacity Act and that neither are well understood in (non-psychiatric) hospitals by medical staff. The patients concerned are among the most vulnerable in our society, many scandals have occurred in them, and the greatest care needs to be taken in drafting further legislation, when the present situation is at least working and adaptable to be changed.

Dr.R.L.Symonds FRCPsych LL.M.

January 2019


Prepared 22nd January 2019