Conservatives set out to challenge Mental Health Bill on several fronts

The Conservative Party has tabled a series of amendments to the Mental Health Bill and vowed that it will not pass through the House of Lords unamended.

Shadow health minister Tim Loughton said the party had already tabled amendments limiting the use of community treatment orders, which would extend compulsory treatment in the community, introducing a right to advocacy and challenging the abolition of the treatability test. Under the test, patients can only be detained for treatment likely to have a therapeutic benefit.

Loughton said the bill had no chance of getting through the Lords unamended and the government had privately accepted this.

The amendments will be discussed at the bill’s committee stage, expected in the new year. 

In the bill’s second reading in the Lords last week, peers from all parties criticised “deeply flawed” proposals that would need “substantial amendment”.

The bill was introduced by health minister Lord Warner as “a balanced and focused group of measures” to improve patient safeguards, modernise terminology and produce “proportionate changes” in the area of supervised community treatment.

Warner said the government was in “listening and negotiating mode”, but many peers demanded amendment to core parts of the bill.

Crossbench peer and Mencap president Lord Rix described the bill as “deeply flawed”, while the Bishop of Manchester said much of it was a “disappointment”. He suggested introducing several conditions to raise the eligibility  threshold for compulsory treatment in the community.

The House of Commons can reverse amendments made in the Lords but the changes would then go back to peers for further discussion.

The bill’s key battlegrounds

The treatability test
The bill proposes scrapping the requirement that people can only be detained if the treatment is likely to have a therapeutic benefit. It will be replaced with a requirement that “appropriate treatment” is available.
Chance of consensus: 1/10. It seems inconceivable the government will back down from what is a fundamental part of its bill. Campaigners are equally vehement in their opposition.

Principles on the face of the bill
Campaigners want to see principles such as nondiscrimination and using the least restrictive treatment in the bill. The government wants to restrict such principles to the code of practice.
Chance of consensus: 7/10. It would not cost anything to put the principles in the bill and may be a tactical compromise for the government.

Advance statements
Campaigners would like patients to have the choice of making an advance statement, where they indicate what treatment they would like should they become ill. There are no such provisions in the bill.
Chance of consensus: 6/10. It may be possible to compromise on “advance refusals” where patients can specify what type of treatments they do not want to receive.

Community treatment orders
The bill allows compulsory treatment in the community for those who have already been compulsorily treated in hospital. Opponents believe compulsion should only apply to people whose condition is so bad they have to be detained.
Chance of consensus: 6/10. Surprisingly high. Mental Health Act Commission chair Lord Kamlesh Patel has suggested amendments which would raise the threshold of eligibility and apply a time limit to the orders.

Right to advocacy
Campaigners would like those detained to have a statutory right to independent advocacy. The government intends to give patients access to advocacy on a non-statutory basis.
Chance of consensus: 5/10. Both sides agree on the importance of advocacy so surely a deal can be struck? The issue, as ever, will be how much money is required to guarantee advocacy as a statutory right.

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  Simeon Brody