Mental Health Bill [HL]
REVISED
MARSHALLED
LIST OF AMENDMENTS
TO BE MOVED
ON REPORT
The amendments have been marshalled in accordance with the Order of 5th February 2007, as follows—
Clause 1
Schedule 1
Clauses 2 to 21
Schedule 2
Clauses 22 to 26
Schedules 3 and 4
Clauses 27 to 33
Schedule 5 | Clauses 34 to 39
Schedules 6 to 8
Clauses 40 to 42
Schedule 9
Clauses 43 and 44
Schedule 10
Clauses 45 to 48 |
[Amendments marked * are new or have been altered]
Amendment
No.
| | EARL HOWE
BARONESS BARKER
BARONESS MURPHY
BARONESS MEACHER |
| 1* | Insert the following new Clause— |
| | "Guiding principles: incorporation in the 1983 Act |
| (1) | Part 1 of the 1983 Act (application of Act) is amended as follows. |
| (2) | Before section 1 (application of Act: "mental disorder") insert— |
| | A1 Application of Act: guiding principles |
| (1) | In the discharging of a function by virtue of this Act, a person shall have regard to— |
| (a) | the importance of the patient participating as fully as is possible in the discharge of the function; |
| (b) | the present and past wishes and feelings of the patient which are relevant to the discharge of the function; |
| (c) | the principles of non-discrimination contained in— |
| (i) | the Sex Discrimination Act 1975; |
| (ii) | the Race Relations Act 1976; |
| (iii) | the Disability Discrimination Act 1995; and |
| (iv) | the Equality Act 2006. |
| (2) | After having regard to the matters mentioned in subsection (1) above, the person shall discharge the function in the manner that involves the minimum restriction on the patient that is necessary in the circumstances."" |
| 2* | Page 2, leave out lines 13 and 14 |
| | EARL HOWE
BARONESS BARKER
BARONESS MURPHY |
| 3 | Page 2, leave out lines 25 and 26 and insert— |
| ""(3) | For the purposes of subsection (2) above, a person shall not be considered to have a mental disorder as defined in this section solely on the grounds of— |
| (a) | his substance misuse (including dependence upon, or use of, alcohol or drugs); |
| (b) | his sexual identity or orientation; |
| (c) | his commission, or likely commission, of illegal or disorderly acts; |
| (d) | his cultural, religious or political beliefs."" |
| | LORD CARLILE OF BERRIEW
EARL HOWE
BARONESS MURPHY
BARONESS MEACHER |
| 4 | Page 3, line 13, leave out from "is" to end of line 15 and insert "likely to alleviate or prevent a deterioration in his condition." |
| | LORD CARLILE OF BERRIEW
EARL HOWE
BARONESS MEACHER |
| 5* | Insert the following new Clause— |
| (1) | Section 20 of the 1983 Act (duration of authority) is amended as follows. |
| (2) | In subsection (3), after paragraph (a), insert— |
| (aa) | to arrange for the patient to be examined by— |
| (i) | the registered medical practitioner who has been professionally concerned with the medical treatment of the patient; or |
| (ii) | if no such practitioner is available, a registered medical practitioner who is an approved clinician, and" |
| (3) | In subsection (3)(b) for "if it appears to him that the conditions set out in subsection (4) below are satisfied, to" substitute "if the responsible clinician and the medical practitioner agree that the requirements of subsection (4) are satisfied the responsible clinician shall"" |
| | LORD CARLILE OF BERRIEW
EARL HOWE
BARONESS MURPHY
BARONESS MEACHER |
| 6 | Page 4, line 16, leave out subsection (2) |
| 7* | Page 4, line 24, leave out from "is" to end of line 26 and insert "likely to alleviate or prevent a deterioration in his condition."" |
| 8 | Page 4, line 28, leave out from beginning to ", in" and insert— |
| "(1) | Section 145 of the 1983 Act (interpretation) is amended as follows. |
| | LORD CARLILE OF BERRIEW
BARONESS BARKER |
| 9 | Page 4, line 29, leave out from "substitute" to end of line 30 and insert ""drug therapy, nursing and also psychological intervention and specialist mental health habilitation, rehabilitation and care, for mental disorder and its consequences, under the supervision of the responsible clinician;"." |
| 10 | Page 4, line 30, at end insert— |
| "( ) | In section 64(1) of the Mental Capacity Act 2005 (interpretation), in the definition of "treatment", for "includes a diagnostic or other procedure" substitute "is a diagnostic or therapeutic intervention performed by a registered medical practitioner in the management of disease or illness". |
| 11 | Page 4, line 30, after "care" insert "(but see also subsection (4) below)" |
| 12 | Page 4, line 30, at end insert— |
| "(3) | After subsection (3) insert— |
| "(4) | Any reference in this Act to medical treatment, in relation to mental disorder, shall be construed as a reference to medical treatment the purpose of which is to alleviate, or prevent a worsening of, the disorder or one or more of its symptoms or effects."" |
| | EARL HOWE
BARONESS BARKER
BARONESS MURPHY |
| 13 | Insert the following new Clause— |
| | "Three month rule for second medical opinions |
| | In section 58(1)(b) of the 1983 Act (treatment requiring consent or a second opinion) for "three months" substitute "28 days"." |
| | BARONESS MURPHY
EARL HOWE
BARONESS BARKER |
| 14 | Insert the following new Clause— |
"CHAPTER 1A
| | Capacitous patient's right to refuse electroconvulsive therapy |
| ( ) | In section 58(3) of the 1983 Act (treatment requiring consent or a second opinion) after paragraph (b) insert "; or |
| (c) | subject to section 58A (as inserted by section (Electro-convulsive therapy: children)), in the case of electroconvulsive therapy 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 that treatment but that, having regard in particular to the likelihood of its alleviating or preventing a deterioration of his condition it is necessary for the treatment to be given."" |
| | BARONESS MURPHY
EARL HOWE
BARONESS BARKER
BARONESS MEACHER |
| 15 | Insert the following new Clause— |
| | "Electro-convulsive therapy: children |
| | After section 58 of the 1983 Act (treatment requiring consent or a second opinion) insert— |
| "58A | Treatment for patients under 18 requiring consent and a second opinion |
| (1) | Subject to section 62 below, a patient under eighteen years (whether or not he is liable to detention) shall not be given electro-convulsive 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 in particular to the likelihood of its alleviating or preventing a deterioration of his condition it is necessary for the treatment to be given 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."" |
| | BARONESS MURPHY
EARL HOWE
BARONESS BARKER |
| 16 | Insert the following new Clause— |
| | "ECT emergency criteria: patients lacking capacity |
| | In section 62 of 1983 Act (urgent treatment), after subsection (4) insert— |
| "(5) | Subsection (1)(b), (c) and (d) above shall not apply if the treatment is electroconvulsive therapy."" |
| | EARL HOWE
BARONESS BARKER
BARONESS MURPHY |
| 17 | Insert the following new Clause— |
| | "Patients' wishes and requests for treatment |
| (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 approved clinician in charge of the treatment 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." |
| (3) | In section 63 (treatment not requiring consent), at the end, insert— |
| "(2) | When deciding what treatment to give, the approved clinician in charge of the treatment 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."" |
| 18 | Page 5, line 29, leave out "subsections (3) and (5)" and insert "subsection (3)" |
| 19 | Page 5, line 30, at end insert— |
| "( ) | in subsection (5), for the words from "responsible medical officer" to the end substitute "responsible clinician shall carry out a consultation in accordance with subsection (5A) below.", |
| ( ) | after subsection (5) insert— |
| "(5A) | The responsible clinician shall— |
| (a) | if he is a registered medical practitioner, consult one or more other qualifying persons; |
| (b) | if he is not such a practitioner, consult one or more other qualifying persons, at least one of whom is such a practitioner; |
| (c) | if he is not such a practitioner but no other qualifying person is such a practitioner, consult— |
| (i) | one or more other qualifying persons; and |
| (ii) | a registered medical practitioner who is an approved clinician and has examined the patient. |
| (5B) | A person is a qualifying person for the purposes of subsection (5A) above if he has been professionally concerned with the patient's medical treatment."," |
| 20 | Page 9, line 44, at end insert— |
| | ""care plan" means a structured plan which sets out timescales, responsibilities and services required to meet a patient's assessed mental health needs;"." |
| 21 | Page 11, leave out lines 28 to 33 and insert— |
| "(4) | The appropriate national authority may by regulations make provision in connection with the giving of approvals under subsection (1) above. |
| (5) | The provision which may be made by regulations under subsection (4) above includes, in particular, provision as to—" |
| 22 | Page 12, line 3, at end insert— |
| "(5A) | Provision made by virtue of subsection (5)(b) above may relate to courses approved or provided by such person as may be specified in the regulations (as well as to courses approved under section 114A below). |
| (5B) | An approval by virtue of subsection (5A) above may be in respect of a course in general or in respect of a course in relation to a particular person." |
| 23 | Page 12, line 4, leave out from "to" to end of line 5 and insert "make regulations under subsection (4) above includes power to make different provision for different cases or areas" |
| 24 | Page 12, line 5, at end insert— |
| "( ) | In this section "the appropriate national authority" means— |
| (a) | in relation to persons who are or wish to become approved to act as approved mental health professionals by a local social services authority whose area is in England, the Secretary of State; |
| (b) | in relation to persons who are or wish to become approved to act as approved mental health professionals by a local social services authority whose area is in Wales, the Welsh Ministers." |
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