Previous Section Back to Table of Contents Lords Hansard Home Page

Baroness Cumberlege moved Amendment No. 2:

Page 13, leave out lines 6 to 15 and insert:

Special provisions as to patients sentenced to imprisonment etc

("25I.—(1) This section applies where a patient who is subject to after-care under supervision is detained in custody in pursuance of any sentence or order passed or made by a court in the United Kingdom (including an order committing or remanding him in custody).
(2) At any time when the patient is so detained he is not required—
(a) to receive any after-care services provided for him under section 117 below; or
(b) to comply with any requirements imposed on him under section 25D above.
(3) If the patient is so detained for a period of, or successive periods amounting in the aggregate to, six months or less and, apart from this subsection, he—
(a) would have ceased to be subject to after-care under supervision during the period for which he is so detained; or
(b) would cease to be so subject during the period of 28 days beginning with the day on which he ceases to be so detained,
he shall be deemed not to have ceased, and shall not cease, to be so subject until the end of that period of 28 days.
(4) Where the period for which the patient is subject to after-care under supervision is extended by subsection (3) above, any examination and report to be made and furnished in respect of the patient under section 25G(3) above may be made and furnished within the period as so extended.
(5) Where, by virtue of subsection (4) above, the patient is made subject to after-care under supervision for a further period after the day on which (apart from subsection (3) above) he would have ceased to be so subject, the further period shall be deemed to have commenced with that day.").

On Question, amendment agreed to.

Baroness Cumberlege moved Amendment No. 3:

Page 13, line 15, at end insert:

Patients moving from Scotland to England and Wales

25J.—(1) A supervision application may be made in respect of a patient who is subject to a community care order under the Mental Health (Scotland) Act 1984 and who intends to leave Scotland in order to reside in England and Wales.
(2) Sections 25A to 25I above, section 117 below and any other provision of this Act relating to supervision applications or patients subject to after-care under supervision shall apply in relation to a patient in respect of whom a supervision application is or is to be made by virtue of this section subject to such modifications as the Secretary of State may by regulations prescribe.").

The noble Baroness said: My Lords, the question of patients who move from England to Scotland, or vice versa, has been raised on a number of occasions during our debates on the Bill. I said on Report that we would be introducing amendments to deal with this, and the present amendment is one of them. It covers the movement of patients from Scotland to England and is complemented by the amendment my noble friend Lord Lindsay will be moving shortly covering movement in the opposite direction.

11 May 1995 : Column 173

The amendment introduces a new provision into Clause 1 under which an application for aftercare under supervision may be made in respect of a patient subject to a community care order. The modifications which need to be made to the procedure to cover the fact that the patient is moving, not from being detained in hospital, but from being subject to a Scottish community care order, will be prescribed in the regulations. In practice we see this working as follows. If the care team in Scotland believes it is in the patient's best interest to move to England or Wales, it will make contact with a Section 12 approved doctor south of the Border. This is likely to be the same person who will eventually be the patient's community RMO after the transfer has taken place. This doctor will then make the application to the health authority, which will have to be supported by two recommendations, one from an approved social worker and the other from a registered medical practitioner who has knowledge of the patient's history.

The significant difference from the general arrangement in Clause 1 of the Bill is that the application is made not by a doctor who has been looking after the patient in hospital, but by one who is likely to be his or her responsible medical officer in the community. So far as the supporting medical recommendation is concerned, it would obviously make sense for this to be given by the special medical officer who is the Scottish equivalent of the community RMO and that is what we expect to happen in the ordinary way. There would have to be full consultation on both sides of the Border and the transfer would take place when all concerned were ready for it to go ahead. The patient would become subject to aftercare under supervision upon taking up residence in England or Wales. He or she would have an immediate right to a mental health review tribunal.

It would only be practicable to apply these provisions to patients who agree to the transfer. The new powers rely on the sanction of the patient's possible return to hospital rather than any more direct form of compulsion, so it is not feasible to legislate for patients who abscond.

Although the number of patients who are likely to be affected by such transfers is probably very small, we feel that we need this new provision to ensure that a patient does not lose the support and supervision he or she may need simply as a result of moving to the other side of the Border. I beg to move.

On Question, amendment agreed to.

Clause 2 [Absence without leave]:

Baroness Cumberlege moved Amendment No. 4:

Page 16, line 21, at end insert:
("(2A) In section 22 of that Act (special provisions as to patients sentenced to imprisonment etc.)—
(a) in subsection (2) (detained patient in whose case application for admission for treatment or guardianship application does not cease to have effect), for the words "and 21" there shall be substituted ", 21 and 21A"; and
(b) after that subsection there shall be inserted the following subsection—
"(3) In its application by virtue of subsection (2) above section 18(4) above shall have effect with the substitution of the words "end of the period of 28 days beginning with the first day of his absence without leave." for the words from "later of" onwards."").

11 May 1995 : Column 174

The noble Baroness said: My Lords, this amendment serves to correct an oversight in the current provisions relating to detained patients who are sentenced to imprisonment. It was brought to our attention as a result of our consideration of the earlier government amendments on this issue.

At present, Section 22 of the Mental Health Act 1983 states that when a patient who has been subject to imprisonment is released, he should be treated as though he were absent without leave under Section 18 of the 1983 Act. This is a legal device to provide a period of 28 days in which such patients could be returned to detention in hospital. However, as your Lordships know, Clause 2 of this Bill extends the period of time in which an absconding patient can be returned to hospital from 28 days to at least six months. An unintentional consequence of this is to extend the period of time within which a released prisoner could be returned to detention under the 1983 Act. I am sure your Lordships will agree that this is undesirable, both in its own right, and because it would be inconsistent with the provisions laid out in the earlier amendments relating to prisoners subject to supervision applications. The effect of the amendment, therefore, is to retain for the purposes of Section 22 the period of 28 days within which a person who has been released from prison may be returned to hospital. This is followed by a period of seven days during which the responsible medical officer must examine the patient and determine whether his liability to detention should be renewed. I beg to move.

On Question, amendment agreed to.

3.30 p.m.

Clause 4 [Community care orders]:

Lord Carmichael of Kelvingrove moved Amendment No. 5:

Page 18, line 12, after ("appropriate") insert ("to ensure that the patient receives such medical treatment and after-care services").

The noble Lord said: My Lords, in moving this amendment, it may be for the convenience of the House if I speak also to Amendment No. 9. The purpose of Amendment No. 5 is to ensure that any order that the sheriff gives under these provisions should not impose conditions in the community care order which are not relevant to the main aims of the order. We believe that if this wording is not inserted, the sheriff's powers could be too wide and that would defeat the purpose of treatment of the patient. I beg to move.

The Earl of Lindsay: My Lords, as the noble Lord, Lord Carmichael, explained, these amendments seek to clarify the position when a sheriff amends or adds to the conditions proposed in an application, or if the sheriff varies the conditions following the refusal of an appeal against the order. The amendment seeks to specify that the conditions must be:

    "to ensure that the patient receives such medical treatment and after-care services".

The general objective of making a community care order is so that a patient can receive the medical treatment and aftercare services that he needs to support him in the community. We believe that it is unnecessary to add qualifications to the sheriff's power to impose conditions or vary conditions following the refusal of an appeal

11 May 1995 : Column 175

against an order. Any condition of an order or variation thereof would have to continue to relate to the need for conditions; that is, that they be with a view to ensuring that the patient receives medical treatment and aftercare services.

The sheriff will decide whether a condition which he is imposing or varying relates to those aims. We believe that the example that I gave in Committee was a valid one. However, we accept that it is likely that conditions of this nature would more usually be the exception than the rule. More usual conditions might include attendance at various places for the purposes of education or training, and a required place of residence. In addition, we believe that the discretion of the sheriff to vary the conditions, which must be exercised reasonably, must be preserved to allow him to take account of relevant points put forward on appeal.

After that explanation, I hope that the noble Lord will be prepared to withdraw this amendment.

Next Section Back to Table of Contents Lords Hansard Home Page