DMH 159 Leicestershire Partnership NHS
Trust
Memorandum from the Mental Health Act
Steering Group on behalf of Leicestershire Partnership NHS Trust
to the Joint Parliamentary Committee
The Mental Health Act Steering Group is a multi-disciplinary
group which is responsible for the operation of the current Mental
Health Act within the Trust. As such it has considerable experience
and expertise in the working of mental health legislation.
Considered Evidence on the Committee's Scope
1. Is the Draft Mental Health Bill rooted
in a set of unambiguous basic principles?
The Mental Health Act Steering Group (the Group)
is concerned that the Act's guiding principles are to be incorporated
into the Code of Practice and not in the body of the Act itself.
The Group would recommend that the guiding principles drive the
Act and that the Code of Practice be written based on those guiding
principles in the same way as the Scottish Act of 2003.
1.1 Are these principles appropriate and
desirable?
The Group considers the guiding principles to be
both appropriate and desirable in essence, however concerns remain
that the overall ethos of the Bill remains rooted in compulsion
and public order.
2. Is the definition of Mental Disorder
appropriate and unambiguous?
The Group recognises
the ambiguity of the definition under current legislation, however
there remains a number of reservations relating to appropriate
inclusion under the definition proposed in the draft Bill in that
it is too broad.
2.1 Are the conditions for treatment
and care under compulsion sufficiently stringent?
The Group welcome
the higher threshold i.e. 'serious neglect' and 'suicide/self
harm', however the reservations outlined for 'definition' remain.
2.2 Are the provisions for assessment
and treatment in the Community adequate and sufficient?
The Group agree
the provisions given are adequate, however would recommend further
consideration be made to the continued development of support
services in the community that would negate compulsion in the
community.
3. Does the draft Bill achieve the right
balance between protecting the personal and human rights of the
mentally ill on one hand, and concerns for public and personal
safety on the other?
The Group retains
its concerns outlined above in relation to the guiding principles
of the Bill. The Group considers that those principles, based
foremost in compulsion and public order may render the Bill vulnerable
to challenge - see point 9 below.
4. Are the proposals in the draft Bill
necessary, workable, efficient and clear?
The Group recognises
that current legislation is now out of date and considers there
is a definite need for the Bill, however the complexities of the
proposed Tribunal system, in the main, could not be considered
workable with the investment in terms of workforce and training
which is proposed. The draft Bill, in comparison to current legislation,
is long and complex in its interpretation and language.
4.1 Are there any important omissions
in the Bill?
The Group would
like, in particular, to see the following inclusions:
- Duty placed on the police/ambulance service to
assist
- Duty to provide sufficient numbers of approved
doctors and approved mental health practitioners
5. Is the proposed institutional framework
appropriate and sufficient for the enforcement of measures contained
in the draft Bill?
The proposed
institutional framework should fully support the guiding principles
of the proposed Bill, the Groups concerns are outlined at point
1 above.
Future legislation should provide a framework
that provides continued monitoring of the use of the legislation
and it's enforcement.
6. Are the safeguards against abuse adequate?
Are the safeguards in respect of particularly vulnerable groups,
for example children, sufficient? Are there enough safeguards
against misuse of aggressive procedures such as ECT and Psychosurgery?
The Group recognise
and acknowledge the safeguards within the draft Bill, however
they await assurance that adequate resources will be made available
to enable a timely response.
7. Is the balance struck between what
has been included on the face of the draft Bill and what goes
into Regulations and the Code of Practice?
The concerns of the Group are outlined
in point 1 in relation to the inclusion of the principles within
the Bill itself and the danger of reliance on the Code of Practice.
8. Is the draft Bill adequately integrated
with the Mental Capacity Bill (as introduced in the House of Commons
on 17 July 2004)?
The Mental Capacity
Bill was welcomed by the Group, however they feel there are insufficient
links and are disappointed that the interests of informal patients
who lack capacity are not fully represented.
9. Is the draft Bill in full compliance
with the Human Rights Act?
The broad definition of mental illness,
together with previous comments relating to the emphasis on compulsion,
particularly through the legal process, could, in the opinion
of the Group, render the Bill vulnerable to challenge under the
HRA.
10. What are likely to be the human and
financial resource implications of the draft Bill? What will be
the effect on the roles of professionals? Has the Government analysed
the effects of the Bill adequately, and will sufficient resources
be available to cover any costs arising from implementation of
the Bill?
The Group considers
that the resource and financial implications of the draft Bill
have been underestimated, particularly in terms of:
- Administrative support
- The Tribunal resources - inadequate under current
legislation
- The provision of AMHPs
- The proposed ratio of advocates
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