DMH 03 Memorandum from Stewart Ingram,
Primary Care Facilitator - Mental Health
I recently attended a seminar in Newcastle on the
above Bill run by NIMHE. I have some concerns which I understand
I can make known via this address.
The limitations of the current legislation are well
known to those who use it and those who are subject of it, however
I believe many of the limitations result as much from the poor
implementation of the legislation as from it's inherent weaknesses.
I fear the new legislation will merely mask a suspicion of and
reluctance to work to legislation by some mental health professionals
and will face similar difficulties as the operation of the present
Act.
Whilst it is clear that the philosophy and principals
of the new legislation should be established first, I am concerned
that the practical difficulties, such as training, recruitment,
resourcing and monitoring the new system of tribunals, expert
panels and specialist advocacy will not be addressed before implementation
or they will be passed to SHA or PCT level as "operational
matters". These issues are crucial to the effectiveness of
the new legislation and need to be acknowledged and resolved.
Finally whilst the introduction of judicial or semi-judicial
scrutiny of all compulsory treatments and detentions after 28
days provides independent scrutiny of the processes involved,
it potentially leaves the initial detention of the person to doctors
and professionals traditionally subject to the authority of doctors.
It is suggested that Regulations made under the Bill will specify
the qualifications and experience of at least one of the doctors
and seek to ensure there will be no conflict of interests between
any of the examiners. These issues are dealt with in the current
legislation and in my opinion, are sufficiently important to be
included in the new legislation rather than relegated to regulations.
The Bill also suggests that the local authority will approve
the mental health professional but I am unclear as to how their
competence, independence and performance will be monitored by
the local authority. I trust the issues I have outlined will be
addressed before the new legislation is enacted.
Stewart Ingram
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