Mental Health Bill [HL]—
Amendments to be debated in the House of Lordscontinued

House of Lords

back to previous amendments

 

Clause 8

 

BARONESS GARDNER OF PARKES
BARONESS FINLAY OF LLANDAFF

20APage 5, line 2, at end insert—
"(   )  In section 8 of the 1983 Act after subsection (5) insert—
    "(6)  Where a patient who has been received into guardianship is made subject to a requirement made under subsection (1)(a) above that they reside at a place specified by the guardian, and the patient has been served by the guardian with a written notice to that effect, the guardian, or any person authorised by the guardian, shall have the authority to take the patient and convey him to the place specified, at any time within the period of 14 days beginning with the date on which the notice was served.""
 

Clause 12

 

BARONESS MURPHY
EARL HOWE
BARONESS BARKER

21Page 9, line 5, at end insert—
"(   )  Before section 76 insert—
    "75AAdvance decisions and advance statements: making and withdrawing
    (1)  An advance decision is a decision, made by a person ("P") when he has reached the age of 18 and when he has the capacity to do so, that if—
    (a)  at a later time and in such circumstances as he may specify, a specified treatment is proposed to be carried out or continued by a person providing health care for him, and
    (b)  at that time he lacks capacity to consent to the carrying out or continuation of the treatment, the specified treatment is not to be carried out or continued.
    (2)  An advance statement is a written statement made and subscribed by a person when he has capacity to do so setting out the ways he wishes to be treated for mental disorder.
    (3)  An advance decision or an advance statement may be regarded as specifying a treatment or circumstances even though expressed in laymen's terms.
    (4)  P may alter or withdraw an advance decision or an advance statement at any time when he has capacity to do so.
    (5)  An advance decision need not be in writing.
    (6)  A withdrawal, a partial withdrawal, or an alteration of an advance decision need not be in writing.
    75BValidity and applicability of advance decisions and advance statements
    (1)  An advance decision or an advance statement made under section 75A above is not valid if a person ("P")—
    (a)  has withdrawn the advance decision or advance statement at a time when he had capacity to do so,
    (b)  has, under a lasting power of attorney created after the advance decision or advance statement was made, conferred authority on the donee (or, if more than one, any of them) to give or refuse consent to the treatment to which the advance decision or advance statement relates, or
    (c)  has done anything else clearly inconsistent with the advance decision or advance statement remaining his fixed decision.
    (2)  An advance decision or an advance statement is not applicable if—
    (a)  that treatment is not the treatment specified in the advance decision or advance statement,
    (b)  any circumstances specified in the advance decision or advance statement are absent, or
    (c)  there are reasonable grounds for believing that circumstances exist which P did not anticipate at the time of the advance decision or advance statement which would have affected his decision had he anticipated them.
    75CEffect of advance decisions and advance statements
    (1)  If an advance decision or an advance statement made under sections 75A and 75B above is found to be valid and applicable to the treatment, decision or measure at the material time the person making the decision shall have regard to P's wishes as specified in the advance decision or advance statement.
    (2)  Where a decision is made which conflicts with a valid and applicable advance decision or an advance statement the requirements set out in subsection (3) below must be complied with.
    (3)  Those requirements are—
    (a)  recording in writing the circumstances in which those measures were, or treatment or decision was, authorised, given or made, or, as the case may be, not authorised, given or made, and the reasons why;
    (b)  supplying—
    (i)  the peson concerned; and
    (ii)  the person's nearest relative,
      with a copy of that record and placing a copy of that record within that person's medical notes.""
 

Clause 13

 

LORD PATEL OF BRADFORD
EARL HOWE
BARONESS BARKER

22Page 9, line 32, at end insert—
"(   )  In section 45 (general interpretation), in subsection (1), insert the following definition at the appropriate place—
 ""care plan" means a structured plan which sets out timescales, responsibilities and services required to meet a patient's assessed mental health needs;"."
 

Clause 15

 

EARL HOWE
BARONESS VERMA
BARONESS BARKER

23Page 10, line 34, after "recommendations)," insert "is amended as follows.
"(1)"  
24Page 10, line 37, at end insert—
"(2)  For subsections (3) to (7) substitute—
    "(3)  The Secretary of State may make regulations prescribing, in respect of the practitioners giving medical recommendations and the applicant—
    (a)  the circumstances in which any of them may not act, or may not act with another due to conflicts of interest, either generally or in respect of the particular patient;
    (b)  the circumstances in which any one of the medical practitioners and an approved mental health professional who is acting as applicant, should or should not have had recent professional involvement with the patient;
    (c)  any permitted relaxation of the above requirements in circumstances where full compliance with them would result in delay involving serious risk to the health and safety of the patient or serious risk of harm to others.""
 

Clause 17

 

BARONESS BARKER
BARONESS NEUBERGER

25Page 11, line 33, at end insert "; and
    (e)  the making of arrangements for the deployment, supervision and support of persons approved."
 

After Clause 20

 

EARL HOWE
LORD WILLIAMSON OF HORTON
BARONESS WALMSLEY

26Insert the following new Clause—
 "CHAPTER 2A
 Children and young people
  Consent to treatment for 16 and 17 year olds
  After section 131 of the 1983 Act, insert—
    "131AConsent to treatment for 16 and 17 year olds
    (1)  This section applies to a patient who is aged 16 or 17 years.
    (2)  Subsection (3) applies if the patient is—
    (a)  capable of expressing his wishes, and
    (b)  requires treatment for mental disorder.
    (3)  Arrangements may be made by the patient—
    (a)  for him to be admitted to hospital and remain there and be treated for mental disorder, or
    (b)  otherwise for him to be treated for mental disorder,
     and he may be so admitted, so remain and be so treated, or be so treated, in pursuance of the arrangements, even though there are one or more persons who have parental responsibility for him.
    (4)  Subsection (5) applies if the patient refuses to consent to or resists—
    (a)  being admitted to hospital and remaining there and being treated for mental disorder, or
    (b)  otherwise being treated for mental disorder.
    (5)  The patient's refusal to consent or resistance may not be overridden by the giving of consent by a person who has parental responsibility for him.
    (6)  References in this section to the patient being admitted to hospital and remaining there and being treated for mental disorder, or being treated for mental disorder, are references to his being admitted to hospital and remaining there and being so treated, or being so treated, in accordance with any of the provisions of this Act.""
27Insert the following new Clause—
  "Children and young people
  After section 142 of the 1983 Act insert—
    "142AAdmission to age appropriate setting
      In the case of an application for admission for assessment and treatment for a mental disorder, whether voluntary or not, in the case of any child or young person under the age of 18 years, a clinician with specialist training in child or adolescent mental health shall assess the needs of the child or young person and a PCT or equivalent health board shall provide for such services and accommodation as are sufficient for the particular needs of that child or young person.
    142BMedical assessment by a CAMHS specialist prior to imposition of compulsion for a child or young person
      In the case of a minor under the age of 18, who is admitted for assessment under section 2 or admitted for treatment under section 3, one recommendation as specified in these sections shall, except in an emergency where no child or adolescent mental health specialist is available, be made by a qualified child and adolescent registered medical practitioner.
    142CClinical supervisor
      Wherever under any provision of this Act a responsible clinician is to be appointed if the patient is a minor under 18 that clinician shall, except in an emergency where no child and adolescent mental health specialist is available, be a child and adolescent mental health specialist.""
 

LORD CARLILE OF BERRIEW
EARL HOWE

28Insert the following new Clause—
 "CHAPTER 2B
 Criminal justice system amendments
  Court mental health report for those remanded on bail
  Before section 35 (remand to hospital for report on accused's mental condition) of the 1983 Act, insert—
    "34ARemand on bail for a mental health report
    (1)  In relation to the Crown Court, this section applies to a person who—
    (a)  has been sent for trial before the court for an offence punishable with imprisonment and has not yet been sentenced or otherwise dealt with for it (unless he has been convicted of the offence and the sentence is fixed by law),
    (b)  has been committed to the court to be sentenced for such an offence and has not yet been sectioned or otherwise dealt with for it, or
    (c)  has been committed to the court under section 43 and has not yet been dealt with under that section.
    (2)  In relation to a magistrates' court, this section applies to a person who has appeared before the court charged with an offence punishable on summary conviction with imprisonment and has not yet been sentenced or otherwise dealt with for it.
    (3)  Subsections (4) and (5) apply if the court—
    (a)  remands on bail a person to whom this section applies, and
    (b)  is satisfied on the evidence of a registered medical practitioner that there is reason to suspect that the person is suffering from mental disorder.
    (4)  The court may require the appropriate authority to arrange for an approved clinician to prepare a report on—
    (a)  the person's mental condition, or
    (b)  the appropriate medical treatment for that condition,
     (or both) in order to assist the court in dealing with the person for the offence.
    (5)  The court may specify any particular matters which are to be included in the report (including an assessment of the risk posed by the person to members of the public).""
29Insert the following new Clause—
  "Resolving disputes as to receiving hospitals
(1)  The 1983 Act is amended as follows.
(2)  In section 35 (remand to hospital for report on accused's mental condition), after subsection (4), insert—
    "(4A)  Where a court has remanded an accused person under this section and hospital trusts cannot agree to which hospital a person should be sent, the Secretary of State shall resolve the dispute."
(3)  In section 36 (remand of accused person to hospital for treatment), after subsection (3), insert—
    "(3A)  Where a court has remanded an accused person under this section and hospital trusts cannot agree to which hospital a person should be sent, the Secretary of State shall resolve the dispute.""
 

EARL HOWE
LORD CARLILE OF BERRIEW

30Insert the following new Clause—
  "Duty of Secretary of State: transfer directions
  In section 47(1) (removal to hospital of persons serving sentences of imprisonment, etc) of the 1983 Act omit the words from "condition" to the end and insert "the Secretary of State must by warrant direct that that person be removed and detained in such hospital as may be specified in the direction; and a direction under this section shall be known as "a transfer direction"."
 

EARL HOWE
BARONESS VERMA
BARONESS MEACHER

31Insert the following new Clause—
  "Warrant to search for and remove patients
  In section 135 of the 1983 Act for subsection (1)(a) and (b) substitute—
"(a)  may be in need of care or treatment for his mental disorder and is living in any place within the jurisdiction of the justice,
(b)  access to that place is necessary for the purpose of establishing whether or not he is in need of such care or treatment; and
(c)  it has not been possible to gain such access without a warrant"."
 

LORD WILLIAMSON OF HORTON

32Insert the following new Clause—
  "Duty to inform nearest relatives of rights
(1)  Section 13 of the 1983 Act (duty of approved social workers to make applications for admission or guardianship) is amended as follows.
(2)  After subsection (5) insert—
    "(5A)  After making an application for admission or guardianship, the approved mental health professional shall have a duty to take all practicable steps to inform the person (if any) appearing to be the nearest relative of the following rights within 7 days—
    (a)  to apply for admission for assessment under section 11(1) above;
    (b)  to apply for admission for treatment under section 11(1) above;
    (c)  to apply for guardianship under section 11(1) above;
    (d)  to be informed of an admission for assessment under section 11(3) above;
    (e)  to object to an application for admission for treatment or a guardianship application under section 11(4)(a) above;
    (f)  to be consulted before an admission for treatment or guardianship under section 11(4)(b) above;
    (g)  to require a local authority to make arrangements for an approved social worker to consider the patient's case and to be given written reasons if an application is not made under section 13(4) above;
    (h)  to discharge the patient from detention or guardianship under section 23(2) below;
    (i)  to apply to the Mental Health Review Tribunal under section 66(1) below;
    (j)  to be informed of the intended discharge of a patient under section 133(1) below;
    (k)  to be involved in aftercare planning under section 117 below; and
    (l)  to be furnished with a copy of information relating to community patients under section 25 of the Mental Health Act 2007.""
 

EARL HOWE
BARONESS VERMA
BARONESS MEACHER
BARONESS BARKER

33Insert the following new Clause—
  "Effect of application for admission
  In section 6(1) of the 1983 Act—
(a)  for all references to "applicant" substitute "NHS trust responsible for hospital provision"; and
(b)  for "convey him to the hospital" substitute "convey him to the hospital identified by the trust as being able to receive him"."
 

BARONESS GARDNER OF PARKES
BARONESS FINLAY OF LLANDAFF

33AInsert the following new Clause—
  "Notification of hospitals having arrangements for reception of urgent cases
  In the 1983 Act, for section 140 substitute—
    "140Notification of hospitals having arrangements for reception of urgent cases
    (1)  It shall be the duty of every Primary Care Trust, in conjunction with—
    (a)  the NHS trusts contracted to provide in-patient mental health services and ambulance services within its area,
    (b)  the police authority or authorities within its area, and
    (c)  the local social services authority or authorities within its area,
      to prepare, publish and maintain up-to-date a comprehensive scheme for the safe, timely and effective management of the cases of patients within its area who may require urgent admission to hospital for treatment for mental disorder, whether under this Act or otherwise.
    (2)  This scheme shall include details of—
    (a)  the arrangements for the assessment of urgent cases and for ensuring the safety of the patient, carers, those carrying out the assessment and any other persons present during the assessment,
    (b)  the arrangements for obtaining a bed, if required, and the criteria for determining the relative priority of urgent cases awaiting admission,
    (c)  the arrangements for ensuring safe custody and conveyance of patients who need to be admitted to hospital under section 6(1) of this Act, and
    (d)  agreed time-limits for response by the bodies listed in subsection (1)(a) to (c) above in caes of urgency where there is a serious risk to the safety of the patient or others.""

 
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12 January 2007