Clause 1 - The Principles
Mental Capacity Bill
10:45 am
Mr David Lammy (Parliamentary Under-Secretary, Department for Constitutional Affairs; Tottenham, Labour)
That came across to me in vivid detail when I was a Minister at the Department of Health. I was reminded of it when I first qualified as a lawyer and was lucky enough to practise in medical ethics and medical negligence. One thing will hit anyone who spends any time walking through the wards of our hospitals—that the vast majority of patients are elderly. The air ambulance picks people up all over London and, unfortunately, will pick people up today. The assumption is that young people who have had motor bike and car accidents will be in a neurological ward. However, I went into the neurological ward in the Royal London hospital and the vast majority of people there were elderly and had had strokes.
I saw the doctors and nurses caring for those people. I met a patient who had had an accident six months ago. On seeing the scans and listening to the consultant explaining the context, I could understand why the doctor's judgment had been that the individual had a very poor prognosis and that he might well be a PVS-type case. Six weeks later that young man, Jim, was chewing and sitting up in bed. That is why the issue about time raised by my hon. Friend the Member for Crosby is so important. The doctor said that he had not thought that that would happen, but that it had. He then explained the time issues to me. In the same way, there are serious issues around strokes and clots on the brain—how big they are, where they are positioned—for the many elderly patients there, as people are assisted to some degree of recovery, along with medication.
However, ultimately, as my hon. Friend the Member for Knowsley, North and Sefton, East said, judgments have to be made case by case. Doctors and nurses have to make those judgments. We ought to remember that in this Bill such judgments are subject to a duty of care and to charges of gross negligence and manslaughter, and that this Bill rules out euthanasia, as does English common law. All doctors and nurses make those judgments, notwithstanding the guidance of the British Medical Association and the Royal College of Nursing. I see that my hon. Friend the Member for Crosby, who has nursing experience, is nodding. They all make those judgments every day.