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Page 21, line 22, at end insert:
("(ai) the patient and, if practicable and the patient does not object, his nearest relative;").
Page 21, line 43, leave out from first ("and") to ("and") in line 44 and insert ("any other person who has been consulted under subsection (3) (b) (ai) above;").

The noble Earl said: My Lords, I spoke to these amendments when moving Amendment No. 71. I beg to move.

On Question, amendments agreed to.

Lord Carmichael of Kelvingrove moved Amendment No. 94:


Page 21, line 46, after ("of") insert ("(i)").

1 May 1995 : Column 1296

The noble Lord said: My Lords, I shall speak also to Amendment No. 95. Section 110(1) of the Mental Health (Scotland) Act 1984 spells out the information to be given to a person whose section has been renewed. We are advised that some of the authorities in Scotland which are involved believe that it is not tolerable that a lesser amount of information should be given to a patient whose community care order is renewed. An alternative way to achieve the same effect is to extend Section 110 of the Mental Health (Scotland) Act, which is covered by community care orders. That would be a neater way than that suggested in the Bill. I beg to move.

The Earl of Lindsay: My Lords, following an amendment tabled in Committee by the noble Lord, Lord Carmichael, we undertook to consider the issues that he raised. That we have done, and Amendment No. 96 will make it a requirement for the aftercare officer to give the patient an explanation orally and in writing at the time of the renewal of the community care order. That would address the noble Lord's anxieties.

Having indicated that position, and in anticipation of Amendment No. 96, I hope that the noble Lord will feel able to withdraw his amendment.

Lord Carmichael of Kelvingrove: My Lords, I am grateful to the Minister. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendment No. 95 not moved.]

The Earl of Lindsay moved Amendment No. 96:


Page 21, line 47, at end insert:
("( ) Subsection (10) of section 35A of this Act shall apply in relation to a renewal of a community care order under this section as it applies in relation to a community care order made under that section, but with the substitution of a reference to subsection (3) (b) (ai) of this section for the reference to subsection (3) (a) of section 35B.").

The noble Earl said: My Lords, following an amendment tabled in Committee by the noble Lord, Lord Carmichael of Kelvingrove, we undertook to consider whether it should be made clear on the face of the Bill that the patient should receive an explanation of the effect of the renewal. I am grateful to the noble Lord for bringing the matter to our attention.

The effect of this amendment would be that, following renewal of a community care order, the aftercare officer would be required to explain to the patient, both orally and in writing, the purpose and effect of the renewal and the conditions of the order; the patient's right of appeal to the sheriff; and the fact that the patient could make representations to the Mental Welfare Commission at any time. The aftercare officer would also be required to send a copy of the written explanation to the nearest relative, if the nearest relative had been consulted.

We believe that this meets the concerns which were expressed. I beg to move.

Lord Carmichael of Kelvingrove: My Lords, I am grateful to the Minister for having listened and acted on the amendments tabled in Committee.

1 May 1995 : Column 1297

On Question, amendment agreed to.

8.45 p.m.

Lord Carmichael of Kelvingrove moved Amendment No. 97:


Page 22, line 1, after ("where") insert ("either").

The noble Lord said: My Lords, the amendment is designed to provide an opportunity for the doctor or the social worker dealing with the case to consider whether the order requires variation. We believe that in many cases the social worker in the community will be closer to the needs of the patient and will be able to take a view whether his or her aftercare is working. Indeed, a high proportion of social workers are women. If it is not working, the social worker should be able to call for a variation, which I assume will go through the usual channels before a decision is made. The social worker or the doctor will be allowed to trigger the reconsideration of the case. I beg to move.

The Earl of Lindsay: My Lords, it may be for the convenience of the House if I also speak at this stage to Amendments Nos. 98, 100 and 108.

In Committee we discussed and rejected the question of widening the scope of an application for a community care order to allow other persons to make it, because joint applications raise doubts as to who would be ultimately responsible for the application.

The purpose of these amendments would be similarly to widen the scope for varying the conditions of a community care order. I accept that some conditions will relate purely to social care issues and it would seem appropriate to allow the aftercare officer to vary them. However, we believe that the care team needs a single focus for decisions about a patient's care and that that role is best carried out by the special medical officer, who must decide whether the patient's condition justifies a proposed variation.

We have made provision for the care team, and specifically the aftercare officer, to be consulted on all variations. Indeed, guidance could encourage the aftercare officer to propose such variations to the care team. However, we do not favour extending to the aftercare officer the responsibility for proposing a variation of the conditions of the order.

I hope with that explanation the noble Lord will feel able to withdraw his amendment.

Lord Carmichael of Kelvingrove: My Lords, I am not sure whether I understood the Minister's reply. Does it mean that the aftercare officer will not be able to initiate reconsideration of the case even by discussing it with the medical practitioner? If that were the case, I should be reluctant to withdraw the amendment. Will the Minister give an assurance that the aftercare officer acting with the patient will be able to discuss the matter formally with the medical practitioner? If so, I shall be happy to accept the amendment.

The Earl of Lindsay: My Lords, we understand the noble Lord's point. Guidance will encourage the aftercare officer to propose such variations to the care team.

1 May 1995 : Column 1298

Therefore, the aftercare officer can initiate an inquiry with the rest of the medical team. The special medical officer, however, will continue to have ultimate responsibility for the community care order patient and therefore he will initiate and lodge the application on a formal basis. It may be that informally the variation has been initiated by the aftercare officer.

Lord Carmichael of Kelvingrove: My Lords, I thank the Minister for that assurance. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendment No. 98 not moved.]

The Earl of Lindsay moved Amendment No. 99:


Page 22, line 3, at end insert ("and, if practicable and the patient does not object, his nearest relative").

On Question, amendment agreed to.

[Amendments Nos. 100 and 101 not moved.]

The Earl of Lindsay moved Amendment No. 102:


Page 22, line 21, at end insert ("and any other person who has been consulted under subsection (1) (a) above").

On Question, amendment agreed to.

Lord Carmichael of Kelvingrove moved Amendment No. 103:


Page 22, line 21, at end insert ("and, if he does not object, the patient's nearest relative.").

The noble Lord said: My Lords, the nearest relative must always be kept informed, if the patient does not object. This amendment ensures that the nearest relative will be able to speak at any hearing as regards the proposed variation and can act generally to protect the patient's interests. I beg to move.

The Earl of Lindsay: My Lords, we considered this issue when we discussed Amendment No. 102. That proposes that if the nearest relative has been consulted about a proposed variation then he will be sent a copy of both the proposed and approved variation of conditions. Therefore, I hope that the noble Lord will feel able to withdraw the amendment.

Lord Carmichael of Kelvingrove: My Lords, yes. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

The Earl of Lindsay moved Amendment No. 104:


Page 22, line 23, leave out ("who made the community care order") and insert ("of the sheriffdom within which the patient is resident").

The noble Earl said: My Lords, we undertook in Committee to consider this point further. This amendment will provide that the proposed variation of conditions should be sent to the sheriff clerk of the sheriffdom in which the patient is resident, not the sheriff clerk for the sheriff who originally made the order. We believe that this amendment meets the anxieties which were expressed in Committee. I beg to move.

On Question, amendment agreed to.


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