The government and opponents of the
Mental Health Bill are refusing to budge on
remaining areas of contention, including the use of compulsory
community treatment, as the legislation enters its final
stretch.
Opposition peers, who command a majority in the House of Lords,
are vowing to push for amendments on four key areas of the bill
(see
Remaining points of contention), as passed by the House of Commons last week, when the
bill re-enters the upper house next week.
However, health minister Rosie Winterton has said that
government concessions made in the Commons - on ensuring
patients under 18 receive age-appropriate treatment and that
treatment of people under section be for a therapeutic purpose -
meant the bill required no further change. Any changes in the Lords
would have to be agreed by the Commons, meaning there could be
parliamentary "ping-pong" until one side backs down, or the bill
may fall.
The main area of discord is the use of compulsory treatment
orders (CTOs) in the community. As the bill stands, CTOs could be
applied to anyone who had been sectioned just once. The
government's opponents in parliament and the Mental Health Alliance
want it reserved only for patients who would otherwise be in and
out of hospital.
Referring to a
government-commissioned report, which showed that international
evidence on community treatment orders was inconclusive,
Conservative health spokesperson Earl Howe said: "We feel even more
strongly about this than we did before because the international
evidence on the efficacy of CTOs is so iffy."
However, he and alliance chair Andy Bell both urged the
government to sit down and discuss the remaining areas of
contention to forge a consensus.
Bell said: "We'd very much like to work with the government to
get something out of this that we can all support."
Remaining points of contention
(
back)
● Community Treatment Orders: opposition peers want these limited
to patients who would otherwise be regularly in and out of
hospital.
● Impaired decision-making: the opposition wants to bar detention
for people who possess capacity and refuse treatment.
● Definition: opponents want more exclusions from the definition of
a mental disorder, such as sexual orientation.
● Responsible clinicians: opponents want a renewal of detention to
be agreed by a medical practitioner and a responsible clinician,
such as a nurse, not just a responsible clinician.
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Contact the author
Mithran Samuel