Tim Loughton (Shadow Minister (Children), Health; East Worthing & Shoreham, Conservative)

I beg to move amendment No. 10, page 20, line 1, at end insert—

‘(c) after subsection (3) insert—

“(4) Subsection (1)(b), (c) and (d) above shall not apply if the treatment is electro-convulsive therapy.’.

The amendment is another probing one in relation to ECT. Its purpose is to amend the 1983 Act to restrict the right to give emergency ECT without the normal safeguards to patients lacking capacity, and instead to limit treatment to situations in which it is given to save the patient’s life. We agreed earlier that, although we might not like the use of ECT—some hon. Members have questioned whether it ever has any efficacy, and I share that concern—in emergency life or death cases, we must rely on the opinions of clinicians at the coal face.

Section 62 of the 1983 Act covers urgent treatment. It severely limits the emergency provision of treatments that are hazardous or irreversible. It is generally accepted, and I think that there is general agreement in the Committee, that ECT is hazardous, although the risk to individuals will vary depending on general health and other factors. Indeed, as the hon. Member for Norwich, North has said, there is a question mark over the issue of its effect, and its possible side effects. It is therefore possible, under section 62, that it should not be available except under section 62(1)(a), as immediately necessary to save the patient’s life.

It is not clear, however, that section 62 can be interpreted in that way. The form of wording implies a relevant treatment not being irreversible or hazardous  of itself, although it might be either irreversible or hazardous in an individual case. I know that the Mental Health Alliance believes that a treatment that is potentially hazardous and irreversible should not be given without a second opinion, except in the most compelling circumstances, such as when it is immediately necessary to save life. I agree with that view. It is, also, extremely unlikely that ECT would ever be the only alternative for a patient. We have heard in an earlier debate the Minister’s reassurance about how little ECT is used for children. There have been a couple of handfuls of cases in the past few years, so the practice is not widespread, but it is important that safeguards should exist for the relevant people; they should be protected.

In the debate on this subject in the House of Lords, Baroness Murphy said:

“The only circumstance where one is justified in giving emergency ECT—in other words, to give it without a second opinion in a life-threatening illness—is where someone has stopped eating and drinking. Under those circumstances they have nearly always stopped speaking as well.—[Official Report, House of Lords, 15 January 2007; Vol. 688, col. 483-4.]

The amendment is a probing one, to attempt to instil some safeguards into the arrangements. There appears to be some doubt in the wording of the 1983 Act about the potentially hazardous nature of ECT. We want more safeguards on ECT, alongside those for other potentially hazardous treatments covered by the Bill.

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