CONTENTS
Terms of Reference
Summary
Conclusions and Recommendations
Chapter 1: Introduction
The role of post-legislative scrutiny
Overall finding
Keeping the Act under review
Chapter 2: Background to the Mental Capacity
Act
What did the Act intend to achieve?
How did the Government set out to achieve
it?
How did the Government intend to measure
success?
Measuring public attitudes
Chapter 3: The five core principles: Is the
Act working as intended?
Context of the health and social care
sector
Changes in the human rights framework
Implementation of the Core Principles
Box 1: The principles of Mental Capacity
Act
The first principle: presumption of capacity
Capacity assessments
Box 2: Assessing Capacity Section 3 of the
Act
Quality of capacity assessments
Box 3: The case of Steven Neary
Assessing capacity in adults with specific
conditions
What triggers an assessment?
The second principle: supported decision-making
Box 4: Jim Blair, learning disability nurse
consultant & hospital passports
The third principle: unwise decisions
The fourth principle: best interests
Box5: Best Interests, section 4
The fifth principle: the least restrictive
option
Conclusions and recommendations
Chapter 4: Addressing poor implementation
of the Act
Oversight of organisations
Training and oversight of professionals:
the role of professional regulators and medical Royal Colleges
Commissioning
Access to advice and information on the MCA
The Codes of Practice
Box 6: A case study of what works
Chapter 5: Advocacy and Advance Planning
Independent Mental Capacity Advocates
Lasting Powers of Attorney
Advance decisions to refuse treatment (ADRTs)
Chapter 6: The Court of Protection
Is the Court of Protection appropriate?
Delays
Transparency
A Mental Capacity Tribunal?
Mediation
Access to the Court
Legal Aid
Chapter 7: Deprivation of Liberty Safeguards
Box 7: The Bournewood gap
Overview of findings
Use of the Deprivation of Liberty Safeguards
Criticisms of the legislation
Why are the safeguards not working in practice?
Failure to apply the principles
Complexity
A definition?
Unhelpful nomenclature
The effectiveness of the Relevant Person's
Representative role
The effectiveness of the supervisory body
role
Potential new gaps
The eligibility criteria and a 'new Bournewood
gap'?
Chapter 8: Criminal Law Provisions
Box 8: Ill-treatment or neglect
Appendix 1: List of Members and Declarations
of Interest
Appendix 2: List of Witnesses
Appendix 3: Call for Evidence
Appendix 4: Letter from Norman Lamb MP-6
November 2013
Appendix 5: Letter from Norman Lamb MP-28
November 2013
Appendix 6: Letter from Norman Lamb MP-9
December 2013
Appendix 7: Letter from Lord McNally-10 December
2013
Appendix 8: Memorandum from Ministry of Justice
12 February 2014
Appendix 9: Report of a special meeting of
the Forget-Me-Nots
Appendix 10: Note of the Committee visit
to the Court of Protection-20 November 2013
Appendix 11: Note of the Committee visit
to meet adults with learning disabilities-28 November 2013
Appendix 12: Glossary of Acronyms
NOTE: Evidence is published online at http://www.parliament.uk/mental-capacity-act-2005/
and available for inspection at the Parliamentary Archives (020
7219 5314)
References in footnotes to the Report are as follows:
Q refers to a question in oral evidence;
Witness names without a question reference refer
to written evidence.
In order to protect individuals, some witnesses are
referred to by their initials only.
| 
