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Mental Health Bill [HL]


Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment

22

 

(5)   

Subsection (4)(a) above shall not preclude the continuation of any

treatment, or of treatment under any plan, pending compliance with

section 58 above if the approved clinician in charge of the treatment

considers that the discontinuance of the treatment, or of the treatment

under the plan, would cause serious suffering to the patient.

5

(6)   

In a case where subsection (1)(b) above applies, subsection (3) above

only applies pending compliance with section 58 above.

(7)   

In subsection (4) above—

“Part 4A certificate” has the meaning given in section 64H below;

and

10

“specified”, in relation to a Part 4A certificate, means specified in

the certificate.”

29      

Authority to treat

(1)   

After Part 4 of the 1983 Act, insert the following Part—

“Part 4A

15

Treatment of community patients not recalled to hospital

64A     

Meaning of “relevant treatment”

In this Part of this Act “relevant treatment”, in relation to a patient,

means medical treatment which—

(a)   

is for the mental disorder from which the patient is suffering;

20

and

(b)   

is not treatment falling within section 57 above.

64B     

Adult community patients

(1)   

This section applies to the giving of relevant treatment to a community

patient who—

25

(a)   

is not recalled to hospital under section 17E above; and

(b)   

has attained the age of 16 years.

(2)   

The treatment may not be given to the patient unless—

(a)   

there is authority to give it to him; and

(b)   

if it is section 58 type treatment, the certificate requirement is

30

met.

(3)   

But the certificate requirement does not apply if—

(a)   

giving the treatment to the patient is authorised in accordance

with section 64G below; or

(b)   

the treatment is immediately necessary and—

35

(i)   

the patient has capacity to consent to it and does consent

to it; or

(ii)   

a donee or deputy or the Court of Protection consents to

the treatment on the patient’s behalf.

(4)   

Nor does the certificate requirement apply in so far as the

40

administration of medicine to the patient at any time during the period

of one month beginning with the day on which the community

treatment order is made is section 58 type treatment.

 
 

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment

23

 

(5)   

The reference in subsection (4) above to the administration of medicine

does not include any form of treatment specified under section 58(1)(a)

above.

64C     

Section 64B: supplemental

(1)   

This section has effect for the purposes of section 64B above.

5

(2)   

There is authority to give treatment to a patient if—

(a)   

he has capacity to consent to it and does consent to it;

(b)   

a donee or deputy or the Court of Protection consents to it on his

behalf; or

(c)   

giving it to him is authorised in accordance with section 64D or

10

64G below.

(3)   

Relevant treatment is section 58 type treatment if, at the time when it is

given to the patient, section 58 above would have applied to it, had the

patient remained liable to be detained at that time (rather than being a

community patient).

15

(4)   

The certificate requirement is met in respect of treatment to be given to

a patient if—

(a)   

a registered medical practitioner appointed for the purposes of

Part 4 of this Act (not being the approved clinician in charge of

the treatment) has certified in writing that it is appropriate for

20

the treatment to be given or for the treatment to be given subject

to such conditions as may be specified in the certificate; and

(b)   

if conditions are so specified, the conditions are satisfied.

(5)   

Treatment is immediately necessary if—

(a)   

it is immediately necessary to save the patient’s life; or

25

(b)   

it is immediately necessary to prevent a serious deterioration of

the patient’s condition and is not irreversible; or

(c)   

it is immediately necessary to alleviate serious suffering by the

patient and is not irreversible or hazardous; or

(d)   

it is immediately necessary, represents the minimum

30

interference necessary to prevent the patient from behaving

violently or being a danger to himself or others and is not

irreversible or hazardous.

(6)   

Subsection (3) of section 62 above applies for the purposes of this

section as it applies for the purposes of that section.

35

64D     

Adult community patients lacking capacity

(1)   

A person is authorised to give relevant treatment to a patient as

mentioned in section 64C(2)(c) above if the conditions in subsections (2)

to (6) below are met.

(2)   

The first condition is that, before giving the treatment, the person takes

40

reasonable steps to establish whether the patient lacks capacity to

consent to the treatment.

(3)   

The second condition is that, when giving the treatment, he reasonably

believes that the patient lacks capacity to consent to it.

(4)   

The third condition is that—

45

 
 

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment

24

 

(a)   

he has no reason to believe that the patient objects to being

given the treatment; or

(b)   

he does have reason to believe that the patient so objects, but it

is not necessary to use force against the patient in order to give

the treatment.

5

(5)   

The fourth condition is that—

(a)   

he is the approved clinician in charge of the treatment; or

(b)   

the treatment is given under the direction of that clinician.

(6)   

The fifth condition is that giving the treatment does not conflict with—

(a)   

an advance decision which he is satisfied is valid and

10

applicable; or

(b)   

a decision made by a donee or deputy or the Court of

Protection.

(7)   

In this section—

(a)   

reference to an advance decision is to an advance decision

15

(within the meaning of the Mental Capacity Act 2005) made by

the patient; and

(b)   

“valid and applicable”, in relation to such a decision, means

valid and applicable to the treatment in question in accordance

with section 25 of that Act.

20

64E     

Child community patients

(1)   

This section applies to the giving of relevant treatment to a community

patient who—

(a)   

is not recalled to hospital under section 17E above; and

(b)   

has not attained the age of 16 years.

25

(2)   

The treatment may not be given to the patient unless—

(a)   

there is authority to give it to him; and

(b)   

if it is section 58 type treatment, the certificate requirement is

met.

(3)   

But the certificate requirement does not apply if—

30

(a)   

giving the treatment to the patient is authorised in accordance

with section 64G below; or

(b)   

in a case where the patient is competent to consent to the

treatment and does consent to it, the treatment is immediately

necessary.

35

(4)   

Nor does the certificate requirement apply in so far as the

administration of medicine to the patient at any time during the period

of one month beginning with the day on which the community

treatment order is made is section 58 type treatment.

(5)   

The reference in subsection (4) above to the administration of medicine

40

does not include any form of treatment specified under section 58(1)(a)

above.

(6)   

For the purposes of subsection (2)(a) above, there is authority to give

treatment to a patient if—

(a)   

he is competent to consent to it and he does consent to it; or

45

 
 

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment

25

 

(b)   

giving it to him is authorised in accordance with section 64F or

64G below.

(7)   

Subsections (3) to (6) of section 64C above have effect for the purposes

of this section as they have effect for the purposes of section 64B above.

(8)   

Regulations made by virtue of section 32(2)(d) above apply for the

5

purposes of this section as they apply for the purposes of Part 2 of this

Act.

64F     

Child community patients lacking competence

(1)   

A person is authorised to give relevant treatment to a patient as

mentioned in section 64E(6)(b) above if the conditions in subsections (2)

10

to (5) below are met.

(2)   

The first condition is that, before giving the treatment, the person takes

reasonable steps to establish whether the patient is competent to

consent to the treatment.

(3)   

The second condition is that, when giving the treatment, he reasonably

15

believes that the patient is not competent to consent to it.

(4)   

The third condition is that—

(a)   

he has no reason to believe that the patient objects to being

given the treatment; or

(b)   

he does have reason to believe that the patient so objects, but it

20

is not necessary to use force against the patient in order to give

the treatment.

(5)   

The fourth condition is that—

(a)   

he is the approved clinician in charge of the treatment; or

(b)   

the treatment is given under the direction of that clinician.

25

64G     

Emergency treatment for patients lacking capacity or competence

(1)   

A person is also authorised to give relevant treatment to a patient as

mentioned in section 64C(2)(c) or 64E(6)(b) above if the conditions in

subsections (2) to (4) below are met.

(2)   

The first condition is that, when giving the treatment, the person

30

reasonably believes that the patient lacks capacity to consent to it or, as

the case may be, is not competent to consent to it.

(3)   

The second condition is that the treatment—

(a)   

is immediately necessary to save the patient’s life; or

(b)   

is immediately necessary to prevent a serious deterioration of

35

the patient’s condition and is not irreversible; or

(c)   

is immediately necessary to alleviate serious suffering by the

patient and is not irreversible or hazardous; or

(d)   

is immediately necessary, represents the minimum interference

necessary to prevent the patient from behaving violently or

40

being a danger to himself or others and is not irreversible or

hazardous.

(4)   

The third condition is that if it is necessary to use force against the

patient in order to give the treatment—

 
 

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment

26

 

(a)   

the treatment needs to be given in order to prevent harm to the

patient; and

(b)   

the use of such force is a proportionate response to the

likelihood of the patient’s suffering harm, and to the

seriousness of that harm.

5

(5)   

Subsection (3) of section 62 above applies for the purposes of this

section as it applies for the purposes of that section.

64H     

Certificates: supplementary provisions

(1)   

A certificate under section 64B(2)(b) or 64E(2)(b) above (a “Part 4A

certificate”) may relate to a plan of treatment under which the patient

10

is to be given (whether within a specified period or otherwise) one or

more forms of section 58 type treatment.

(2)   

A Part 4A certificate shall be in such form as may be prescribed by

regulations made by the appropriate national authority.

(3)   

Before giving a Part 4A certificate, the registered medical practitioner

15

concerned shall consult two other persons who have been

professionally concerned with the patient’s medical treatment but, of

those persons—

(a)   

at least one shall be a person who is not a registered medical

practitioner; and

20

(b)   

neither shall be the patient’s responsible clinician.

(4)   

The appropriate national authority may at any time give notice

directing that a Part 4A certificate shall not apply to treatment given to

a patient after a date specified in the notice, and the relevant section

shall then apply to any such treatment as if that certificate had not been

25

given.

(5)   

The relevant section is—

(a)   

if the patient is not recalled to hospital in accordance with

section 17E above, section 64B or 64E above;

(b)   

if the patient is so recalled or is liable to be detained under this

30

Act following revocation of the community treatment order

under section 17F above, section 58 above (subject to section

62A(2) above).

(6)   

The notice under subsection (4) above shall be given to the approved

clinician in charge of the treatment in question.

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(7)   

Subsection (4) above shall not preclude the continuation of any

treatment or of treatment under any plan pending compliance with the

relevant section if the approved clinician in charge of the treatment

considers that the discontinuance of the treatment or of treatment

under the plan would cause serious suffering to the patient.

40

(8)   

In this section, “the appropriate national authority” means—

(a)   

in relation to community patients in respect of whom the

responsible hospital is in England, the Secretary of State;

(b)   

in relation to community patients in respect of whom the

responsible hospital is in Wales, the Welsh Ministers.

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