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Mental Health Bill [HL]


Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 1 — Changes to key provisions

1

 

A

Bill

To

Amend the Mental Health Act 1983 and the Mental Capacity Act 2005 in

relation to mentally disordered persons; and for connected purposes. 

Be it enacted by the Queen’s most Excellent Majesty, by and with the advice and

consent of the Lords Spiritual and Temporal, and Commons, in this present

Parliament assembled, and by the authority of the same, as follows:—

Part 1

Amendments to Mental Health Act 1983

Chapter 1

Changes to key provisions

Mental disorder

5

1       

Removal of categories of mental disorder

(1)   

Section 1(2) of the 1983 Act (key definitions) is amended as set out in

subsections (2) and (3).

(2)   

For the definitions of “mental disorder” and “mentally disordered”

substitute—

10

““mental disorder” means any disorder or disability of the mind;

and

“mentally disordered” shall be construed accordingly;”.

(3)   

The following definitions are omitted—

(a)   

those of “severe mental impairment” and “severely mentally

15

impaired”,

(b)   

those of “mental impairment” and “mentally impaired”, and

(c)   

that of “psychopathic disorder”.

(4)   

Schedule 1 (which contains further amendments to the 1983 Act and

amendments to other Acts) has effect.

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HL Bill 154/2
 
 

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 1 — Changes to key provisions

2

 

2       

Learning disability

(1)   

Section 1 of the 1983 Act (application of Act) is amended as follows.

(2)   

After subsection (2) insert—

“(2A)   

But a person with learning disability shall not be considered by reason

of that disability to be—

5

(a)   

suffering from mental disorder for the purposes of the

provisions mentioned in subsection (2B) below; or

(b)   

requiring treatment in hospital for mental disorder for the

purposes of sections 17E and 50 to 53 below,

   

unless that disability is associated with abnormally aggressive or

10

seriously irresponsible conduct on his part.

(2B)   

The provisions are—

(a)   

sections 3, 7, 17A, 20 and 20A below;

(b)   

sections 35 to 38, 45A, 47, 48 and 51 below; and

(c)   

section 72(1)(b) and (c) and (4) below.”

15

(3)   

After subsection (3) insert—

“(4)   

In subsection (2A) above, “learning disability” means a state of arrested

or incomplete development of the mind which includes significant

impairment of intelligence and social functioning.”

3       

Changes to exclusions from operation of 1983 Act

20

In section 1 of the 1983 Act (application of Act), for subsection (3) substitute—

“(3)   

Dependence on alcohol or drugs is not considered to be a disorder or

disability of the mind for the purposes of subsection (2) above.”

Tests for detention etc

4       

Replacement of “treatability” and “care” tests with appropriate treatment test

25

(1)   

The 1983 Act is amended as follows.

(2)   

In section 3 (admission for treatment)—

(a)   

in subsection (2), omit paragraph (b) (and the word “and” at the end of

that paragraph),

(b)   

in that subsection, after paragraph (c) insert “; and

30

(d)   

appropriate medical treatment is available for him.”,

and

(c)   

in subsection (3)(a), for “(b)” substitute “(d)”.

(3)   

In that section, after subsection (3) insert—

“(4)   

In this Act, references to appropriate medical treatment, in relation to a

35

person suffering from mental disorder, are references to medical

treatment which is appropriate in his case, taking into account the

nature and degree of the mental disorder and all other circumstances of

his case.”

(4)   

In section 20 (renewal of authority to detain), in subsection (4)—

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Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 1 — Changes to key provisions

3

 

(a)   

omit paragraph (b) (and the word “and” at the end of that paragraph),

(b)   

after paragraph (c) insert “and

(d)   

appropriate medical treatment is available for him.”,

and

(c)   

omit the words from “but, in the case of mental illness” to the end.

5

(5)   

In section 37(2) (conditions for exercise of powers of court to order hospital

admission or guardianship), in paragraph (a)(i), for the words from “, in the

case of psychopathic disorder” to the end substitute “appropriate medical

treatment is available for him; or”.

(6)   

In section 45A(2) (conditions for exercise of powers of court to direct hospital

10

admission), for paragraph (c) substitute—

“(c)   

that appropriate medical treatment is available for him.”

(7)   

In section 47(1) (conditions for exercise of Secretary of State’s powers to direct

removal to hospital), in paragraph (b), for the words from “and, in the case of

psychopathic disorder” to the end substitute “; and

15

(c)   

that appropriate medical treatment is available for him;”.

(8)   

In section 72—

(a)   

in subsection (1)(b) (powers of tribunal to direct discharge of patient

not liable to be detained under section 2), after sub-paragraph (ii)

insert—

20

“(iia)   

that appropriate medical treatment is available

for him; or”, and

(b)   

omit subsection (2).

(9)   

In section 73(1) (powers of tribunal to direct discharge of restricted patients), in

paragraph (a), for “or (ii)” substitute “, (ii) or (iia)”.

25

(10)   

In section 145 (interpretation), after subsection (1AA) insert—

“(1AB)   

References in this Act to appropriate medical treatment shall be

construed in accordance with section 3(4) above.”

5       

Further cases in which appropriate treatment test is to apply

(1)   

The 1983 Act is amended as follows.

30

(2)   

In section 36(1) (remand to hospital for treatment) after paragraph (a) (inserted

by Schedule 1 to this Act) insert “and

(b)   

appropriate medical treatment is available for him.”

(3)   

In section 48(1) (removal to hospital of immigration detainees etc) after

paragraph (b) (inserted by Schedule 1 to this Act) insert “and

35

(c)   

appropriate medical treatment is available for him;”.

(4)   

In section 51(6)(a) (further power to make hospital order) after sub-paragraph

(i) (inserted by Schedule 1 to this Act) insert “and

(ii)   

appropriate medical treatment is available for him;

and”.

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Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 2 — Professional roles

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Medical treatment

6       

Appropriate treatment test in Part 4 of 1983 Act

(1)   

Part 4 of the 1983 Act (consent to treatment) is amended as follows.

(2)   

In the following provisions, for the words from “, having regard to” to the end

substitute “it is appropriate for the treatment to be given.”—

5

(a)   

section 57(2)(b) (certification of second opinion where treatment

requires consent and a second opinion), and

(b)   

section 58(3)(b) (certification of second opinion where treatment

requires consent or a second opinion).

(3)   

In section 64 (supplementary provisions for Part 4), after subsection (2) insert—

10

“(3)   

For the purposes of this Part of this Act, it is appropriate for treatment

to be given to a patient if the treatment is appropriate in his case, taking

into account the nature and degree of the mental disorder from which

he is suffering and all other circumstances of his case.”

7       

Change in definition of “medical treatment”

15

In section 145(1) of the 1983 Act (interpretation), in the definition of “medical

treatment”, for the words from “and also” to the end substitute “psychological

intervention and specialist mental health habilitation, rehabilitation and care;”.

Chapter 2

Professional roles

20

Approved clinicians and responsible clinicians

8       

Amendments to Part 2 of 1983 Act

(1)   

Part 2 of the 1983 Act (compulsory admission to hospital and guardianship) is

amended as follows.

(2)   

In section 5 (application in respect of patient already in hospital)—

25

(a)   

in subsection (2), after “registered medical practitioner” insert “or

approved clinician”,

(b)   

for subsection (3) substitute—

“(3)   

The registered medical practitioner or approved clinician in

charge of the treatment of a patient in a hospital may nominate

30

one (but not more than one) person to act for him under

subsection (2) above in his absence.

(3A)   

For the purposes of subsection (3) above—

(a)   

the registered medical practitioner may nominate

another registered medical practitioner, or an approved

35

clinician, on the staff of the hospital; and

(b)   

the approved clinician may nominate another approved

clinician, or a registered medical practitioner, on the

staff of the hospital.”, and

 
 

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 2 — Professional roles

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(c)   

in subsection (4), after “a practitioner”, in each place, insert “or

clinician”.

(3)   

In section 17 (leave of absence)—

(a)   

in subsection (1)—

(i)   

for “responsible medical officer” substitute “responsible

5

clinician”, and

(ii)   

for “that officer” substitute “that clinician”,

(b)   

in subsection (3), for “responsible medical officer” substitute

“responsible clinician”, and

(c)   

in subsection (4)—

10

(i)   

for “responsible medical officer” substitute “responsible

clinician”, and

(ii)   

for “that officer” substitute “that clinician”.

(4)   

In section 20 (duration of authority)—

(a)   

in subsections (3) and (5), for “responsible medical officer” substitute

15

“responsible clinician”,

(b)   

in subsection (6), for “appropriate medical officer” substitute

“appropriate practitioner”, and

(c)   

omit subsection (10).

(5)   

In section 21B (patients who are taken into custody or return after more than

20

28 days)—

(a)   

in subsections (2) and (3), for “appropriate medical officer” substitute

“appropriate practitioner”, and

(b)   

in subsection (10), omit the definition of “appropriate medical officer”.

(6)   

In section 23(2) (persons who may apply for discharge of patient), in

25

paragraphs (a) and (b), for “responsible medical officer” substitute

“responsible clinician”.

(7)   

In section 24 (visiting and examination of patients), in each place, after

“registered medical practitioner” insert “or approved clinician”.

(8)   

In section 25(1) (restrictions on discharge by nearest relative)—

30

(a)   

for “responsible  medical officer” substitute “responsible clinician”, and

(b)   

for “that officer” substitute “that clinician”.

(9)   

In section 34 (interpretation of Part 2 of the 1983 Act), in subsection (1), insert

the following definition at the appropriate place—

““the appropriate practitioner” means—

35

(a)   

in the case of a patient who is subject to the

guardianship of a person other than a local social

services authority, the nominated medical attendant of

the patient; and

(b)   

in any other case, the responsible clinician;”.

40

(10)   

In that subsection, for the definition of “the responsible medical officer”

substitute—

““the responsible clinician” means—

(a)   

in relation to a patient liable to be detained by virtue of

an application for admission for assessment or an

45

application for admission for treatment, or a community

 
 

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 2 — Professional roles

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patient, the approved clinician with overall

responsibility for the patient’s case;

(b)   

in relation to a patient subject to guardianship, the

approved clinician authorised by the responsible local

social services authority to act (either generally or in any

5

particular case or for any particular purpose) as the

responsible clinician;”.

9       

Amendments to Part 3 of 1983 Act

(1)   

Part 3 of the 1983 Act (patients concerned in criminal proceedings) is amended

as follows.

10

(2)   

In section 35 (remand to hospital for report)—

(a)   

in subsections (4) and (5), for “registered medical practitioner”

substitute “approved clinician”, and

(b)   

in subsection (8), after “registered medical practitioner” insert “or

approved clinician”.

15

(3)   

In section 36 (remand to hospital for treatment)—

(a)   

in subsection (3), for “registered medical practitioner who would be in

charge of his treatment” substitute “approved clinician who would

have overall responsibility for his case”,

(b)   

in subsection (4), for “responsible medical officer” substitute

20

“responsible clinician”, and

(c)   

in subsection (7), after “registered medical practitioner” insert “or

approved clinician”.

(4)   

In section 37 (hospital and guardianship orders), in subsection (4), for

“registered medical practitioner who would be in charge of his treatment”

25

substitute “approved clinician who would have overall responsibility for his

case”.

(5)   

In section 38 (interim hospital orders)—

(a)   

in subsection (4), for “registered medical practitioner who would be in

charge of his treatment” substitute “approved clinician who would

30

have overall responsibility for his case”, and

(b)   

in subsection (5), for “responsible medical officer”, in each place,

substitute “responsible clinician”.

(6)   

In section 41 (power of courts to restrict discharge from hospital), in

subsections (3)(c) and (6), for “responsible medical officer” substitute

35

“responsible clinician”.

(7)   

In section 44(2) (person who is to give evidence in connection with committal

to hospital), for “registered medical practitioner who would be in charge of the

offender’s treatment” substitute “approved clinician who would have overall

responsibility for the offender’s case”.

40

(8)   

In section 45A(5) (person who is to give evidence in connection with hospital

or limitation direction), for “registered medical practitioner who would be in

charge of his treatment” substitute “approved clinician who would have

overall responsibility for his case”.

(9)   

In the following provisions, for “responsible medical officer” substitute

45

“responsible clinician”—

 
 

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 2 — Professional roles

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(a)   

section 45B(3) (requirement to produce report on person subject to

hospital and limitation directions), and

(b)   

section 49(3) (requirement to produce report on person subject to

restriction direction).

10      

Further amendments to Part 3 of 1983 Act

5

(1)   

Part 3 of the 1983 Act (patients concerned in criminal proceedings) is further

amended as follows.

(2)   

In section 50(1) (powers of Secretary of State in respect of prisoners under

sentence)—

(a)   

for “responsible medical officer” substitute “responsible clinician”, and

10

(b)   

for “registered medical practitioner” substitute “approved clinician”.

(3)   

In section 51 (further provisions as to detained persons)—

(a)   

in subsection (3)—

(i)   

for “responsible medical officer” substitute “responsible

clinician”, and

15

(ii)   

for “registered medical practitioner” substitute “approved

clinician”, and

(b)   

in subsection (4), for “responsible medical officer” substitute

“responsible clinician”.

(4)   

In section 52 (further provisions as to persons remanded by magistrates’

20

courts), in subsections (5) and (7), for “responsible medical officer” substitute

“responsible clinician”.

(5)   

In section 53(2) (powers of Secretary of State in respect of civil prisoners and

persons detained under the Immigration Acts)—

(a)   

for “responsible medical officer” substitute “responsible clinician”, and

25

(b)   

for “registered medical practitioner” substitute “approved clinician”.

(6)   

In section 54 (requirements as to medical evidence), for subsection (2)

substitute—

“(2)   

For the purposes of any provision of this Part of this Act under which a

court may act on the written evidence of any person, a report in writing

30

purporting to be signed by that person may, subject to the provisions of

this section, be received in evidence without proof of the following—

(a)   

the signature of the person; or

(b)   

his having the requisite qualifications or approval or authority

or being of the requisite description to give the report.

35

(2A)   

But the court may require the signatory of any such report to be called

to give oral evidence.”

(7)   

In section 55 (interpretation of Part 3), for the definition of “responsible medical

officer” in subsection (1) substitute—

““responsible clinician”, in relation to a person liable to be

40

detained in a hospital within the meaning of Part 2 of this Act,

means the approved clinician with overall responsibility for the

patient’s case.”

(8)   

In Part 2 of Schedule 1 (modifications in relation to patients subject to special

restrictions), in paragraph 3—

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