Mental Health Bill [HL]
THIRD
MARSHALLED
LIST OF AMENDMENTS
TO BE MOVED
IN COMMITTEE
The amendments have been marshalled in accordance with the Instruction of 29th November 2006, as follows—
Clauses 4 to 20
Schedule 2
Clauses 21 to 25
Schedules 3 and 4
Clauses 26 to 32
Schedule 5
Clauses 33 to 38 | Schedules 6 to 8
Clauses 39 to 41
Schedule 9
Clauses 42 and 43
Schedule 10
Clauses 44 to 47 |
[Amendments marked * are new or have been altered]
Amendment
No.
| | LORD CARLILE OF BERRIEW
EARL HOWE
BARONESS MEACHER |
| 8 | Insert the following new Clause— |
| (1) | Section 20 (duration of authority) of the 1983 Act is amended as follows. |
| (a) | for paragraph (a), substitute— |
| "(a) | if he is a medical practitioner, to examine the patient and to arrange for another registered medical practitioner to examine the patient, or |
| (b) | if he is not a medical practitioner to arrange for two registered medical practitioners to examine the patient"; |
| (i) | for "him" substitute "them", |
| (ii) | for "if it appears to him that the conditions set out in subsection (4) below are satisfied, to" substitute "if the requirements of subsection (4) are satisfied the responsible clinician shall". |
| (3) | After subsection (3) insert— |
| "(3A) | The report to be furnished under subsection (3) shall be founded on the written recommendations in the prescribed form of the two registered medical practitioners including in each case a statement that in the opinion of the practitioner the conditions set out in subsection (2) are complied with and each such recommendation shall include— |
| (a) | such particulars as may be prescribed of the grounds for that opinion so far as it relates to the conditions set out in paragraphs (a) to (c) of subsection (5), specifying whether other methods of dealing with the patient are available, and |
| (b) | a statement of the reasons for that opinion so far as it relates to the conditions set out in paragraph (c) of that subsection, specifying whether other methods of dealing with the patient are available and if so why they are not appropriate."" |
| | LORD CARLILE OF BERRIEW
EARL HOWE
BARONESS MURPHY |
| | The above-named Lords give notice of their intention to oppose the Question that Clause 5 stand part of the Bill. |
| | BARONESS MURPHY
EARL HOWE
BARONESS NEUBERGER
BARONESS MEACHER |
| 9 | Insert the following new Clause— |
| | "Single gateway for treatment |
| | Section 3 of the 1983 Act (admission for treatment) is amended as follows— |
| (a) | in subsection (1) after the words "to a hospital"; and |
| (b) | in subsection (2) after "a patient", |
| | insert "who has been admitted to hospital for assessment under section 2"." |
| | LORD CARLILE OF BERRIEW
EARL HOWE
BARONESS MURPHY |
| | The above-named Lords give notice of their intention to oppose the Question that Clause 6 stand part of the Bill. |
| | BARONESS KNIGHT OF COLLINGTREE |
| 10 | Insert the following new Clause— |
| | "Provision of appropriate food and drink |
| (1) | Section 58 of the 1983 Act is amended as follows. |
| (2) | In subsection (1)(b) after "medicine" in the first line insert the words ", but excluding the provision of food and drink,". |
| (3) | After subsection (1)(b) insert— |
| "(c) | the provision of adequate food and drink to a patient." |
| (4) | After subsection (3) insert— |
| "(3A) | Subject to section 62 below, a patient shall be provided with adequate food and drink at all times unless— |
| (a) | he has consented not to receive adequate food and drink and either the responsible medical officer or a registered medical practitioner appointed for the purposes of this Part of this Act by the Secretary of State has certified in writing that the patient is capable of understanding the nature, purpose and likely effects of this decision and has consented to it; or |
| (b) | a registered medical practitioner appointed as aforesaid (not being the responsible medical officer) has certified in writing that the patient is not capable of understanding the nature, purpose and likely effects of the decision not to receive adequate food and drink or has not consented but that, having regard to the likelihood of its alleviating or preventing a deterioration of his condition adequate food and drink should not be given." |
| (5) | In subsection (4) after "(3)(b)" insert the words "or (3A)(b)"." |
| | BARONESS KNIGHT OF COLLINGTREE |
| 11 | Page 4, line 18, at end insert "but does not include provision of adequate food and drink" |
| 12 | Page 4, line 18, at end insert— |
| "( ) | In section 64(1) of the Mental Capacity Act 2005 in the definition of "treatment", after "procedure" insert "but does not include provision of adequate food and drink"." |
| | LORD CARLILE OF BERRIEW
EARL HOWE
BARONESS MURPHY |
| 13 | Insert the following new Clause— |
| (1) | The 1983 Act is amended as follows. |
| (2) | In section 3(2)(b) (admission for treatment), omit the words "in the case of psychopathic disorder or mental impairment,". |
| (3) | In section 37(2)(a)(i) (power of courts), omit the words ", in the case of psychopathic disorder of mental impairment,". |
| (4) | In section 47(1)(b) (removal to hospital), omit the words ", in the case of psychopathic disorder or mental impairment,". |
| (5) | In section 72(2)(b) (discharge of patients), omit the words " in the case of a patient suffering from mental illness or severe mental impairment"." |
| | EARL HOWE
BARONESS BARKER
BARONESS MURPHY |
| 14 | Insert the following new Clause— |
| | Electroconvulsive therapy |
| (1) | Section 58 (treatment requiring consent or a second opinion) of the 1983 Act is amended as follows— |
| (a) | at the beginning of subsection (3)(b) insert "except where the trreatment is electroconvulsive therapy"; |
| (b) | after subsection (3)(b) insert "; or |
| (c) | subject to section 58A, in the case of electroconvulsive therapy a registered medical practitioner appointed as aforesaid (not being the responsible clinician) has certified in writing that the patient is not capable of understanding the nature, purpose and likely effects of that treatment but that, having regard to the likelihood of its alleviating or preventing a deterioration of his condition the treatment should be given."; |
| (c) | in subsection (4) after "(3)(b)" insert "or (c) or section 58A or section 63A". |
| (2) | After section 58 insert— |
| "58A | Treatment for patients under 18 requiring consent and a second opinion |
| (1) | Subject to section 62 below, a patient under eighteen years shall not be given electroconvulsive therapy, unless a registered medical practitioner appointed as aforesaid (not being the responsible clinician) has certified in writing that— |
| (a) | the patient is capable of understanding the nature, purpose and likely effects of that treatment, and has consented, and that having regard to the likelihood of its alleviating or preventing a deterioration of his condition, the treatment should be given; or |
| (b) | the patient is incapable of understanding the nature, purpose and likely effects of that treatment, and either— |
| (i) | a person who has parental authority for the patient understands the nature, purpose and likely effects of that treatment and has consented to the treatment and that having regard to the likelihood of its alleviating or preventing a deterioration of his condition, the treatment should be given; or |
| (ii) | the High Court has determined that having regard to the likelihood of its alleviating or preventing a deterioration of his condition, the treatment should be given. |
| (2) | For the purposes of treatment given under this section, either the registered medical practitioner responsible for the patient's treatment or the registered medical practitioner providing the second opinion shall be a clinician with special training in child and adolescent mental health."" |
| 15 | Insert the following new Clause— |
| | "Informal patients under 18: ECT safeguards |
| | Subsection (2) of section 56 (patients to whom Part IV applies) is amended as follows— |
| (a) | after "Section 57" insert "and section 58A". |
| (b) | for "that section" substitute "these sections"." |
| 16 | Insert the following new Clause— |
| (1) | Section 62 (urgent treatment) of the 1983 Act is amended as follows. |
| (2) | In subsection (2) at the beginning insert "Subject to subsection (4) below,". |
| (3) | After subsection (3) insert— |
| "(4) | This section shall not apply to electroconvulsive therapy if the patient is capable of understanding the nature, purpose and likely effect of the treatment and does not consent to it. |
| (5) | Subsection (1)(b), (c) and (d) above shall not apply if the treatment is electroconvulsive therapy."" |
| 17 | Insert the following new Clause— |
| | "ECT compliance with standards |
| | After section 63 of the 1983 Act insert— |
| "63A | ECT compliance with standards |
| | Electroconvulsive therapy (ECT) shall not be administered except in a service that has been accredited for that purpose by the Royal College of Psychiatrists."" |
| | EARL HOWE
BARONESS VERMA
BARONESS BARKER |
| 18 | Insert the following new Clause— |
| | "Administration of medicine |
| | In section 58(1)(b) of the 1983 Act (treatment requiring consent or a second opinion) for "three months" substitute "28 days"." |
| 19 | Insert the following new Clause— |
| | "Other treatment safeguards |
| (1) | The 1983 Act is amended as follows. |
| (2) | After subsection (4) of section 58 (treatment requiring consent or a second opinion) insert— |
| "(4B) | When deciding what treatment to give, the responsible clinician shall have regard to the wishes of the patient, whether expressed directly or in an advance statement, and shall record any treatments requested by the patient in the patient's medical record, and if that treatment is not given shall record the reasons for this. |
| (4C) | In certifying that a treatment should be given under section 58(3)(b), 58(3)(c) or 63A, the registered medical practitioner concerned shall give reasons in writing for his opinion explaining how the treatment represents, for the patient in question, a favourable balance of therapeutic benefit over harm. |
| (4D) | The reasons given under subsection (4C) shall be communicated to the patient, except where this is likely to cause serious harm to the physical or mental health of the patient or of any other person." |
| (3) | In section 63 (treatment not requiring consent), at the end, insert— |
| "(2) | When deciding what treatment to give, the responsible clinician shall have regard to the wishes of the patient, whether expressed directly or in an advance statement, and shall record any treatments requested by the patient in the patient's medical record, and if that treatment is not given shall record the reasons for this."" |
| | EARL HOWE
BARONESS BARKER
BARONESS MURPHY |
| 20 | Insert the following new Clause— |
| | After section 63 of the 1983 Act (treatment not requiring consent) insert— |
| | No medicine or medicines shall be administered to a patient at doses that singly or in combination exceed limits set out in the British National Formulary, unless— |
| (a) | he has consented to that treatment up to that dose and either the responsible clinician or a registered medical practitioner appointed for the purposes of this Part of the Act by the Secretary of State has certified in writing that the patient is capable of understanding its nature, purpose and likely effect and has consented to it; or |
| (b) | a registered medical practitioner appointed under paragraph (a) (not being the responsible clinician) has certified in writing that the patient is not capable of understanding the nature, purpose and likely effects of that treatment at that dose but that, having regard to the likelihood of its preventing serious risk to the life of the patient, the treatment should be given up to that dose."" |
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