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We also agreed with the noble Lord when he said on Second Reading that the care programme approach and its equivalents for older people, children and adolescents should ensure that care planning takes place. We acknowledged then and we do now that CPA is not always consistently applied. Far from it. We drew attention to our current review of CPA, which is examining how patients with the most crucial needs can be targeted, how the process can be streamlined and how patients can be given more control over their care and treatment. The public consultation is due to end today.

I have brought to the attention of the review team the record of this House’s debates on the matter and I promise to bring to its attention our debate this evening. There is still much for the review to do as it begins to consider the representations made. I am more than happy to arrange for the review team to write to interested Peers to offer to meet them to discuss the progress of the review and to outline how it will be taken forward before it reports in the autumn.

Although our debates provide the review with invaluable insights, many Peers may want to take that extra opportunity. We will of course carefully consider the results of the review to see what stakeholders want, and we will see what improvements we can make to CPA and therefore to care planning for all relevant patients, including those under SCTs and those who are detained.

Similarly, in Wales, the Assembly Government have reviewed the operation of CPA and have recently issued a report with recommendations to service commissioners and providers in Wales. It is the implementation of the reviews, not statutory requirements, which we believe will improve care planning for that patient group.

Although acknowledging the importance of care planning, we do not agree with giving statutory force to it, as proposed under the amendment. That is not to say that we think that the amendment is meaningless—far from it. However, there are practical problems in enshrining care planning in legislation, problems that

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we began to appreciate when we got to grips with the detailed practical implications of the proposals that we included in the 2004 draft Mental Health Bill. I fear that there will always be tensions between the need to establish clear legal parameters, whether in primary or secondary legislation, and leaving the flexibility necessary to ensure that care plans are a positively helpful clinical tool. Care planning is such an individual process. The quality of application is the issue, and it must be addressed by improvements in practice. In this Bill, we do not need to make the care plan serve a legal purpose as well as its primary clinical one. That is why we have opted for guidance both in the code of practice for England and, I am told, in the code of practice planned for Wales.

The proof of care planning is measured in patient outcomes and experience. The best way to improve quality is through the current reviews and their effective implementation and through the codes of practice. I therefore invite the noble Lord to work with us on the code of practice and to withdraw his amendment.

10.15 pm

Lord Patel of Bradford: My Lords, I thank the Minister for her response. Obviously I am disappointed that she does not think that we could put this into legislation, but I quite understand the reasons that she has provided. I especially look forward to the review, and the Mental Health Act Commission and I will be very happy to work alongside Ministers and officials to strengthen the code of practice in this area. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 18 [Approved mental health professionals]:

Baroness Royall of Blaisdon moved Amendment No. 21:

The noble Baroness said: My Lords, as we have discussed, the Mental Health Bill replaces the current role of approved social worker with the new role of approved mental health professional. It gives local social services authorities the power to approve a person as an AMHP who is competent in dealing with people suffering from mental disorder, subject to directions from the Secretary of State and Welsh Ministers setting out criteria for approval.

The approval criteria will be binding on local authorities and will apply to the approval of a broader range of professionals than they currently do, to undertake the important functions under the Act undertaken by AMHPs. For this reason, the Delegated Powers and Regulatory Reform Committee said that it would like to see the approval criteria in regulations. We have listened to the advice of the committee and on reflection we think that it would be

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appropriate for Parliament to scrutinise the approval criteria for AMHPs, who will carry out important functions under the Bill in England, and for the National Assembly for Wales to scrutinise the approval criteria in Wales. The criteria in regulations will include the competencies to be demonstrated before a person can be approved. The regulations for England are currently available in draft form in the House Library.

The amendments also address the approval of training courses for AMHPs. The Bill makes local social services authorities responsible for approving AMHPs, but makes it clear that the directions about approval will include courses to be completed both before approval can be given and once an AMHP is approved—the so-called refresher courses. These will be similar to those currently undertaken by approved social workers, or ASWs. The General Social Care Council, or GSCC, and the Care Council for Wales, or CCW, have agreed to approve initial training courses for England and Wales respectively.

We intended to specify in the directions that the GSCC and the CCW should approve these courses. However, as the requirement is to be in regulations, we think that we should take this opportunity to be more specific in the Bill about what is intended. We therefore propose to amend the Bill to provide that regulations may make provision that the courses that a person must complete before he can be approved by a local social services authority, and while he is approved, may be approved by persons set out in the regulations or by the GSCC or the CCW under their new power given by new Section 114A.

It is currently the intention to allow only the GSCC or the CCW to approve initial training courses for AMHPs, but these amendments will ensure that courses may be approved by another body specified in the regulations if, in the future, the GSCC or the CCW no longer wish to approve these courses. At that time, the regulations could be amended to allow an alternative suitable organisation to carry out this function. The regulations will also set out arrangements for refresher courses, which may be approved less formally.

We believe that it is appropriate for the approval arrangements for AMHPs to be in regulations, and I thank the members of the committee for their diligence and advice on this matter. I beg to move.

Baroness Barker: My Lords, I thank the noble Baroness for her helpful introduction to this series of amendments. I want to ask two questions. First, I go back to a point I raised in Committee. Is it envisaged that an AMHP can be contracted by a social services department from a trust and will the question of conflict of interest be dealt with in these regulations or in others? Secondly, given that AMHPs will come from a range of disciplines, including psychology, psychotherapy, occupational therapy and so forth, is it envisaged that the General Social Care Council will not oversee their approval but that other professional bodies will do so? Alternatively, will the approval of all AMHPs come under one body, the General Social Care Council, even though we know that that body

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may not continue to perform that function in the future? I am confused about whether one body or more than one body will do this, or is the noble Baroness outlining a transitional arrangement? That is not the clearest of questions and I am sorry for that.

Baroness Royall of Blaisdon: My Lords, AMHPs will be independent professionals acting on behalf of LSSAs. In their training that independence will be continually stressed. On the responsible bodies, I understand that the GSCC will regulate the training for all the professionals, and in Wales the CCW will do so. There will be just the one body.

Baroness Barker: My Lords, that is very helpful. I thank the noble Baroness.

On Question, amendment agreed to.

Baroness Royall of Blaisdon moved Amendments Nos. 22 to 24:

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(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.”

On Question, amendments agreed to.

Lord Hunt of Kings Heath: My Lords, I beg to move that consideration on Report be now adjourned.

Moved accordingly, and, on Question, Motion agreed to.

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