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Column Number: 231
Standing Committee A
Thursday 28 October 2004
(Afternoon)
[Mr. James Cran in the Chair]
Clause 28
Mental Health Act matters
2.30 pm
Question proposed, That the clause stand part of the Bill.
The Chairman: With this it will be convenient to consider the following: New clause 6
Duties of the responsible clinician
'(1) The responsible clinician may be any registered doctor responsible for P's assessment and medical treatment at the relevant time.
(2) If P's responsible clinician considers that the conditions specified in section E (2) to (7) are met in relation to a medical treatment to which section D applies, he must notify—
(a) the Secretary of State, and
(b) any other person of a description specified in regulations made by the Secretary of State.'.
New clause 7
Cases where informal treatment for mental disorder not available
'(1) This section applies where it appears to the responsible clinician that the conditions specified in subsection (3) are met in P's case.
(2) The responsible clinician must ensure that, for so long as those conditions appear to him to be met, treatment for mental disorder is not given to P, except in a case of urgency, unless it is authorised by or under Part II of the Mental Health Act 1983.
(3) The conditions are that—
(a) P is not capable of consenting to the treatment by virtue of a lack of capacity within the meaning of section 2 and there is no reasonable prospect that he will become capable of doing so, and
(l) he either—
(i) would resist the treatment if given, or
(ii) is at substantial risk of committing suicide or causing serious harm to other persons.
(4) For the purposes of this section, it is to be assumed that if P has at any time indicated that he does not want to receive treatment for mental disorder or particular treatment, he would resist such treatment.'.
New clause 8
Duty to determine whether P is to be assessed
for safeguards
(1) The Secretary of State must, if requested to do so by any person, determine whether the conditions specified in section E (2) to (7) appear to be met in P's case.
(2) If the Secretary of State determines that those conditions appear to be so met, he must, as soon as practicable after making the determination—
(a) appoint a responsible clinician to act in respect of P for the purposes of this Part, and
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New clause 9
Duty of hospital managers to request assessment of existing patient
'(1) Where—
(a) treatment for mental disorder is being provided to P at a hospital otherwise than in accordance with Part II of the Mental Health Act 1983, and
(b) it appears to the responsible clinician that the conditions specified in section E (2) to (7) appear to be met in P's case,
the managers of the hospital must request the Secretary of State to determine under section C(1) whether those conditions appear to be met.
(2) Where P is liable to assessment for admission or treatment under Part II of the Mental Health Act 1983 and it appears to the responsible clinician that the conditions specified in section E(2) to (7) appear to be met in P's case, the managers of the hospital to which P has been admitted must request the Secretary of State to determine under section C(1) whether those conditions appear to be met.'.
New clause 10
Assessment for safeguards
'(1) The assessment of P under this section is for the purpose of determining whether the conditions specified in subsection (2) to (7) are met in P's case.
(2) The first condition is that P is aged 16 or over.
(3) The second condition is that P is suffering from a mental disorder within the meaning of section 1(1) of the Mental Health Act 1983.
(4) The third condition is that that mental disorder is of such a nature of degree as to warrant the provision of medical treatment to P.
(5) The fourth condition is that P is a resident patient at a hospital for the provision of treatment to him.
(6) The fifth condition is P is not capable of consenting to the treatment.
(7) the sixth condition is that the treatment can lawfully be provided to P without P being subject to the provisions of Part II of the Mental Health Act 1983.
(8) If the responsible clinician determines that any of those conditions is not met in P's case, P ceases to be a qualifying patient.'.
New clause 11
Assessment: supplementary
'(1) The Secretary of State must secure that the assessment is made not later than the end of 28 days beginning with the day on which a responsible clinician is appointed for P.
(2) If because of exceptional circumstances it is impracticable to make the assessment within the 28 days, the Secretary of State must secure that it is made as soon as is practicable.
(3) The responsible clinician must make a record of—
(a) his determination under section E and reasons for it, and
(b) any exceptional circumstances to which subsection (2) applies.'.
New clause 12
Medical Advisers
'The Medical Adviser for the purposes of this Act is a registered medical practitioner who is a member of the Expert Panel appointed by the Secretary of State.'.—
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New clause 13
Representation
'(1) As soon as practicable after appointing a responsible clinician for P, under section C, the Secretary of State must notify the local social services authority of the appointment.
(2) The authority must then, as soon as practicable—
(a) notify P of the help available from appropriate advocates under any arrangements existing within the hospital or the relevant local authority area, notwithstanding that P might not be deemed to be ''ordinarily resident'' within the relevant local authority area,
(b) notify P of what rights to apply to the court existing under section 48, the help available to obtain representation and the powers of the court,
(c) notify any carer, representative, the Independent Consultee, a donee of a lasting power of attorney granted by P, or a deputy appointed for P by the court of the help so available.'.—
New clause 14
Role of representative
'(1) The responsible clinician for a qualifying patient, P, must ensure that one representative adopted or appointed by P—
(a) is consulted before medical treatment of any description is commenced, and
(b) is kept informed while medical treatment of any description continues, and
(c) is consulted before P is discharged or becomes a non-resident patient of the hospital.
(2) If it appears to the representative consulted that P, if he had been capable of doing so, would not have consented to medical treatment of a particular description being used (or being continued)—
(a) he must inform the responsible clinician, and
(b) the responsible clinician must then ensure that, except in a case of urgency, medical treatment of that description is not used (or continued).'.
New clause 15
Preparation of care plan
'(1) the managers of a hospital at which medical treatment is provided to a qualifying patient, P, must secure that—
(a) a care plan is prepared for P by the responsible clinician, and
(b) the care plan is included in P's records.
(2) the managers must secure that the plan is prepared not later than the end of 28 days beginning with the day on which a responsible clinician is appointed for P.
(3) In preparing a plan for P, the responsible clinician must consult P and P's representative.
(4) A plan must—
(a) include the required information, and
(b) be prepared in the form prescribed by the Secretary of State in regulations.
(5) In this section, the ''required information'' means—
(a) a description of the medical treatment which is to be provided to P during the period for which the plan applies, and
(b) such other information relating to the care of the patient during that period as may be prescribed by the Secretary of State in regulations.'.
New clause 16
Approval of care plan
'(1) The responsible clinician must, as soon as practicable after preparing a care plan, send a copy of it for approval to a person (the
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''medical adviser'') appointed by the Secretary of State for that purpose.
(2) The medical adviser must be a member of the Expert Panel who is a registered medical practitioner.
(3) The medical adviser must first—
(a) examine P,
(b) satisfy himself that section J(3) has been complied with, and
(c) discuss the treatment specified in the plan with the responsible clinician.
(4) If the medical adviser is satisfied that the treatment specified in the plan can lawfully be provided to P without P being subject to the provisions of Part II Mental Health Act 1983, he must approve the plan.
(5) If the medical adviser does not approve the plan within the time prescribed by the Secretary of State in regulations, the responsible clinician must apply to the court for approval of the plan.
(6) The responsible clinician must send a copy of the plan to P and to P's representative as soon as practicable after it is approved.
(7) A medical adviser may, for the purposes of discharging functions under this section, at any reasonable time—
(a) visit, interview and examine P in private, and
(b) require the production of and inspect any records relating to him which are kept by the responsible clinician.'.
New clause 17
Amendment of care plan
'(1) The responsible clinician may amend P's care plan at any time.
(2) Sections H to K apply to an amended care plan as they apply to a care plan.
(3) If the responsible clinician amends P's care plan, the managers of the hospital at which P is resident must secure that the amended plan is included in P's records as soon as practicable after it is prepared.'.
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